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1.
Radiol Bras ; 55(5): 299-304, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36320369

RESUMEN

Objective: To evaluate the role of magnetic resonance imaging (MRI) in the assessment of femoral and acetabular version in developmental dysplasia of the hip (DDH). Materials and Methods: This was a cross-sectional study of 20 consecutive patients with DDH (27 dysplastic hips) who were examined with MRI. In dysplastic and normal hips (DDH and comparison groups, respectively), we evaluated the following parameters: osseous acetabular anteversion (OAA); cartilaginous acetabular anteversion (CAA); femoral anteversion; osseous Mckibbin index (OMI); cartilaginous Mckibbin index (CMI); and the thickness of the anterior and posterior acetabular cartilage. Results: The OAA was significantly greater in the dysplastic hips. The CAA, femoral anteversion, OMI, and CMI did not differ significantly between the normal and dysplastic hips. In the DDH and comparison groups, the OAA was significantly lower than the CAA, the OMI was significantly lower than the CMI, and the posterior acetabular cartilage was significantly thicker than the anterior cartilage. Conclusion: Our findings confirm that MRI is a valuable tool for the assessment of femoral and acetabular version in DDH. Preoperative MRI evaluation has great potential to improve the planning of pelvic and femoral osteotomies.


Objetivo: Avaliar o papel da ressonância magnética (RM) na avaliação da versão femoral e acetabular na displasia do desenvolvimento do quadril (DDQ). Materiais e Métodos: Estudo transversal de 20 pacientes consecutivos com DDQ (27 quadris displásicos) que foram examinados com RM. Nos quadris displásicos e normais (grupos DDQ e comparação, respectivamente), avaliamos os seguintes parâmetros: anteversão acetabular óssea (AAO), anteversão acetabular cartilaginosa (AAC), anteversão femoral, índice de Mckibbin ósseo (IMO), índice de Mckibbin cartilaginoso (IMC) e espessura da cartilagem acetabular anterior e posterior. Resultados: A AAO foi significativamente maior nos quadris displásicos. A AAC, anteversão femoral, IMO e IMC não diferiram significativamente entre os quadris normais e displásicos. Nos grupos DDQ e comparação, a AAO foi significativamente menor que a AAC, o IMO foi significativamente menor que o IMC, e a cartilagem acetabular posterior foi significativamente mais espessa que a anterior. Conclusão: Nossos achados confirmam que a RM é uma ferramenta valiosa para a avaliação da versão femoral e acetabular na DDQ. A avaliação pré-operatória por RM tem grande potencial para melhorar o planejamento das osteotomias pélvicas e femorais.

2.
Radiol. bras ; Radiol. bras;55(5): 299-304, Sept.-Oct. 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1406522

RESUMEN

Abstract Objective: To evaluate the role of magnetic resonance imaging (MRI) in the assessment of femoral and acetabular version in developmental dysplasia of the hip (DDH). Materials and Methods: This was a cross-sectional study of 20 consecutive patients with DDH (27 dysplastic hips) who were examined with MRI. In dysplastic and normal hips (DDH and comparison groups, respectively), we evaluated the following parameters: osseous acetabular anteversion (OAA); cartilaginous acetabular anteversion (CAA); femoral anteversion; osseous Mckibbin index (OMI); cartilaginous Mckibbin index (CMI); and the thickness of the anterior and posterior acetabular cartilage. Results: The OAA was significantly greater in the dysplastic hips. The CAA, femoral anteversion, OMI, and CMI did not differ significantly between the normal and dysplastic hips. In the DDH and comparison groups, the OAA was significantly lower than the CAA, the OMI was significantly lower than the CMI, and the posterior acetabular cartilage was significantly thicker than the anterior cartilage. Conclusion: Our findings confirm that MRI is a valuable tool for the assessment of femoral and acetabular version in DDH. Preoperative MRI evaluation has great potential to improve the planning of pelvic and femoral osteotomies.


Resumo Objetivo: Avaliar o papel da ressonância magnética (RM) na avaliação da versão femoral e acetabular na displasia do desenvolvimento do quadril (DDQ). Materiais e Métodos: Estudo transversal de 20 pacientes consecutivos com DDQ (27 quadris displásicos) que foram examinados com RM. Nos quadris displásicos e normais (grupos DDQ e comparação, respectivamente), avaliamos os seguintes parâmetros: anteversão acetabular óssea (AAO), anteversão acetabular cartilaginosa (AAC), anteversão femoral, índice de Mckibbin ósseo (IMO), índice de Mckibbin cartilaginoso (IMC) e espessura da cartilagem acetabular anterior e posterior. Resultados: A AAO foi significativamente maior nos quadris displásicos. A AAC, anteversão femoral, IMO e IMC não diferiram significativamente entre os quadris normais e displásicos. Nos grupos DDQ e comparação, a AAO foi significativamente menor que a AAC, o IMO foi significativamente menor que o IMC, e a cartilagem acetabular posterior foi significativamente mais espessa que a anterior. Conclusão: Nossos achados confirmam que a RM é uma ferramenta valiosa para a avaliação da versão femoral e acetabular na DDQ. A avaliação pré-operatória por RM tem grande potencial para melhorar o planejamento das osteotomias pélvicas e femorais.

4.
Surg Endosc ; 36(7): 4956-4959, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-34750704

RESUMEN

BACKGROUND: Transoral incisionless fundoplication (TIF) has been used for treating chronic gastroesophageal reflux disease (GERD) refractory to medical therapy. We aim to investigate the complications associated with TIF using a national database. METHODS: We analyzed post-marketing surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database from Jan 2011 through Jan 2021. RESULTS: During the study period, approximately 95 event cases reported to the FDA. Approximately 131 patient complications were identified. The number of adverse events declined from 2011 to 2016 (R2 = 0.96) but increased from 2016 to 2020 (R2 = 0.99). The most common adverse event was perforation (19.8%), followed by laceration 17.6%, bleeding (9.2%), and pleural effusion (9.2%). The most common patient complications were treated using endoscopic clips (12.3%), chest tube or drain insertion (12.3%), use of endoscopic retriever device (11.1%), esophageal stent (8.6%), and emergent or open surgery (11.1%). CONCLUSIONS: Adverse events from TIF range from mild to severe. Further research is needed to develop approaches aimed at reducing patient risks.


Asunto(s)
Esofagoplastia , Reflujo Gastroesofágico , Fundoplicación/efectos adversos , Reflujo Gastroesofágico/etiología , Reflujo Gastroesofágico/cirugía , Humanos , Resultado del Tratamiento
5.
ISME J ; 16(3): 705-716, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34556817

RESUMEN

Uranium is a naturally occurring radionuclide. Its redistribution, primarily due to human activities, can have adverse effects on human and non-human biota, which poses environmental concerns. The molecular mechanisms of uranium tolerance and the cellular response induced by uranium exposure in bacteria are not yet fully understood. Here, we carried out a comparative analysis of four actinobacterial strains isolated from metal and radionuclide-rich soils that display contrasted uranium tolerance phenotypes. Comparative proteogenomics showed that uranyl exposure affects 39-47% of the total proteins, with an impact on phosphate and iron metabolisms and membrane proteins. This approach highlighted a protein of unknown function, named UipA, that is specific to the uranium-tolerant strains and that had the highest positive fold-change upon uranium exposure. UipA is a single-pass transmembrane protein and its large C-terminal soluble domain displayed a specific, nanomolar binding affinity for UO22+ and Fe3+. ATR-FTIR and XAS-spectroscopy showed that mono and bidentate carboxylate groups of the protein coordinated both metals. The crystal structure of UipA, solved in its apo state and bound to uranium, revealed a tandem of PepSY domains in a swapped dimer, with a negatively charged face where uranium is bound through a set of conserved residues. This work reveals the importance of UipA and its PepSY domains in metal binding and radionuclide tolerance.


Asunto(s)
Uranio , Bacterias/genética , Bacterias/metabolismo , Hierro/metabolismo , Proteínas de Unión a Hierro , Suelo
6.
Dig Dis Sci ; 67(7): 3220-3227, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-34251561

RESUMEN

BACKGROUND: Endoscopic papillectomy is a viable therapy in ampullary lesions. Prior studies have reported on outcomes of sporadic ampullary lesions, and only small cohort studies have reported outcomes associated with familial adenomatous polyposis (FAP) syndrome. AIMS: We performed a systematic review with pooled analysis to assess the safety and efficacy of EP for treating ampullary adenomas in FAP. METHODS: We performed a comprehensive literature search of major databases from inception to May 2020. Studies that included patients with endoscopically resected ampullary lesions and FAP were eligible. The rate of technical success, en bloc resection, piecemeal resection, recurrence, and adverse events was pooled by means of a random-effects model to obtain a proportion with a 95% confidence interval (CI). RESULTS: Six studies, including a total of 99 patients, were included in our final analysis. Patient age ranged from 28 to 91 years. Pooled technical success was 90.3% (CI 76.9-96.3%, I2 = 31%). Rate of en bloc resection was 60.6% (CI 47.9-72.0%, I2 = 0%). Recurrence rate was 25.4% (5.7-65.9%, I2 = 82%). The post-procedural pancreatitis rate was 14.7% of which 68% (51 of 75) utilized prophylactic pancreatic stenting. Other adverse events included bleeding (9.2%) and perforation (4%). CONCLUSION: Endoscopic papillectomy offers high technical success but remains challenging in patients with FAP, particularly due to high recurrence rates.


Asunto(s)
Adenoma , Poliposis Adenomatosa del Colon , Ampolla Hepatopancreática , Neoplasias del Conducto Colédoco , Neoplasias Duodenales , Neoplasias Hepáticas , Neoplasias Pancreáticas , Adenoma/patología , Adenoma/cirugía , Poliposis Adenomatosa del Colon/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Ampolla Hepatopancreática/patología , Ampolla Hepatopancreática/cirugía , Neoplasias del Conducto Colédoco/patología , Neoplasias del Conducto Colédoco/cirugía , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Humanos , Neoplasias Hepáticas/patología , Persona de Mediana Edad , Neoplasias Pancreáticas/patología , Estudios Retrospectivos , Esfinterotomía Endoscópica/efectos adversos , Resultado del Tratamiento
7.
BMC Vet Res ; 17(1): 350, 2021 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-34784920

RESUMEN

BACKGROUND: Gentamicin (GM) is a low-cost, low-resistance antibiotic commonly used to treat gram-negative bacterial diseases. Cisplatin (Csp) is a platinum-derived anti-neoplastic agent. This experiment aimed to identify the early signs of gentamicin and cisplatin-induced nephrotoxicity in rats. Thirty Wistar rats were divided into three groups of 10: a control group, which received no treatment; a gentamicin group administered by a dose of (100 mg/kg, IP) for 7 consecutive days, and a cisplatin group was administered intraperitoneal in a dose of (1.5 mg/kg body weight) repeated twice a week for 3 weeks. RESULTS: Both experimental groups exhibited increased levels of creatinine, urea, and uric acid, with the cisplatin-treated group showing higher levels than the gentamicin group. Experimental groups also exhibited significantly increased Malondialdehyde (MDA), reduced glutathione (GSH), and glutathione peroxidase (GSH-Px) with more pronounced effects in the cisplatin-treated group. Further, both experimental groups exhibited significant up-regulation of Tumor Necrosis Factor α (TNF-α), caspase-3, and Bax and down regulation of Bcl-2. CONCLUSION: These findings confirm the use of necrotic, apoptotic genes as early biomarkers in the detection of tubular kidney damage. Further, cisplatin was shown to have a greater nephrotoxic effect than gentamicin; therefore, its use should be constrained accordingly when co-administered with gentamicin.


Asunto(s)
Cisplatino/toxicidad , Gentamicinas/toxicidad , Enfermedades Renales/inducido químicamente , Animales , Antibacterianos/toxicidad , Antineoplásicos/toxicidad , Apoptosis/genética , Biomarcadores , Caspasa 3/genética , Genes bcl-2/genética , Enfermedades Renales/patología , Masculino , Necrosis/genética , Ratas Wistar , Factor de Necrosis Tumoral alfa/genética , Proteína X Asociada a bcl-2/genética
8.
Ann Gastroenterol ; 34(5): 699-704, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34475741

RESUMEN

BACKGROUND: Modifying patient position during colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distention and improve navigation through the large bowel. The left lateral (LL) decubitus starting position is commonly used during colonoscopy. However, reports indicate that other starting positions may offer additional benefit. We aimed to determine if the right lateral (RL) starting position compared to the standard LL starting position could improve outcomes in colonoscopy. METHODS: We searched PubMed, Medline, and EMBASE through June 2020 to identify studies comparing RL and LL starting positions during colonoscopy. The primary outcomes included mean cecal insertion time and cecal intubation rate, and adverse events were assessed by pooling data using a random-effects model expressed in terms of odds ratio (OR), mean difference, and 95% confidence interval (CI). RESULTS: We identified 5 randomized controlled trials, including 809 participants, that compared LL vs. RL colonoscopy. The pooled OR for cecal intubation rate was 1.3 (95%CI 0.8-2.3; P=0.3). The mean difference in mean cecal insertion time was 0.08 (95%CI -0.09 to 0.26; P=0.4). Heterogeneity between studies was low (I 2=0%). No complications were reported in either arm of the study. Pain scores assessed using a visual analog scale were comparable among both arms of the study. CONCLUSION: The RL starting position for colonoscopy was comparable to the LL and offered no additional benefit in terms of cecal intubation time, intubation rate, or patient discomfort.

9.
Endosc Int Open ; 9(7): E989-E993, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34222618

RESUMEN

Background and study aims The goal of this study was to assess surgical resection (SR) of early gastric cancer (EGC) fitting Japanese Gastric Cancer Association (JGCA) endoscopic resection (ER) criteria. Patients and methods We analyzed EGC data from the national Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Results A total of 2219 EGC cases were identified (1074 T1a and 1145 T1b). Of them, 409 met absolute criteria, 219 met expanded 1, 529 expanded 2, and 229 expanded 3. 259 lesions were treated endoscopically while 1007 were surgically resected (20.5 % vs 79.5 %, P  = 0.0001). Temporal analysis showed that the frequency of ER steadily increased while SR proportionally decreased during the study period. Cox proportion regression analysis adjusting for confound variables (including age, gender, and race) showed no significant difference in the risk of mortality following either surgery or endoscopy. Conclusions EGC can be safely treated with ER. However, EGC meeting JGCA ER criteria is largely treated with SR in the United States.

10.
JAMA Netw Open ; 4(6): e2112049, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34137831

RESUMEN

Importance: Patients with major gastrointestinal (GI) cancers are at long-term risk for cardiac disease and mortality. Objective: To investigate the cardiac-specific mortality rate among individuals with major GI cancers and the association of radiation and chemotherapy with survival outcomes in the United States. Design, Setting, and Participants: This US cohort study included individual patient-level data of men and women older than 18 years with 5 major gastrointestinal cancers, including colorectal, esophageal, gastric, pancreatic, and hepatocellular cancer from 1990 to 2016. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) national cancer database. Data cleaning and analyses were conducted between November 2020 and March 2021. Exposures: Patients received chemotherapy, radiotherapy, or a combination of adjuvant therapy for major GI cancers. Main Outcomes and Measures: The primary outcome was cardiac-specific mortality. Examined factors associated with cardiac mortality included age, sex, race, tumor location, tumor grade, SEER stage, TNM (seventh edition) staging criteria, cancer treatment (ie, the use of radiation, chemotherapy, or surgery), survival months, and cause of death. Results: A total of 359 032 patients (mean [SD] age at baseline, 65.1 [12.9] years; 186 921 [52.1%] men) with GI cancers were analyzed, including 313 940 patients (87.4%) with colorectal cancer, 7613 patients (2.1%) with esophageal cancer, 21 048 patients (5.9%) with gastric cancer, 7227 patients (2.0%) with pancreatic cancer, and 9204 patients (2.6%) with hepatocellular cancer. Most cancers were localized except pancreatic cancer, which presented with regional and distant involvement (3680 cancers [50.9%]). Overall, all major gastrointestinal tumors were associated with increased risk of cardiac mortality compared with noncardiac mortality (median survival time: 121 [95% CI, 120-122] months vs 287 [95% CI, 284.44-290] months). Patients with hepatocellular cancer had the lowest cardiac-specific median survival time (98 [95% CI, 90-106] months), followed by pancreatic cancer (105 [95% CI, 98-112] months), esophageal cancer (113 [95% CI, 107-119] months), gastric cancer (113 [95% CI, 110-116] months), and colorectal cancer (122 [95% CI, 121-123] months). At 15 years of follow up, the use of only chemotherapy, only radiation, or radiation and chemotherapy combined was associated with poor survival rates from cardiac causes of death (eg, colorectal: chemotherapy, 0 patients; radiation, 1 patient [1.9%]; radiation and chemotherapy, 3 patients [2.7%]). Conclusions and Relevance: These findings suggest that among patients with major gastrointestinal cancers, cardiac disease is a significant cause of mortality. The use of only chemotherapy, only radiation, or both was associated with higher cardiac mortality.


Asunto(s)
Enfermedad Coronaria/mortalidad , Neoplasias Gastrointestinales/mortalidad , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estados Unidos , Adulto Joven
11.
Curr HIV Res ; 19(5): 411-419, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34053428

RESUMEN

BACKGROUND: The "remission theory" is an emerging concept that suggests the presence of human immunodeficiency virus (HIV) results in decreased disease severity in patients with inflammatory bowel disease. This theory is based upon evidence that implicates CD4 T-lymphocytes in the pathogenesis of both Crohn's disease and ulcerative colitis. This study sought to elucidate the legitimacy of this theory. METHODS: A retrospective cohort analysis of all adult inpatient hospitalizations for inflammatory bowel disease (IBD) using the 2016 National Inpatient Sample (NIS) was conducted. Our study population included patients admitted with IBD who were infected with HIV. We compared our study group to patients who also had IBD but were not infected with HIV. Baseline demographic characteristics, resource utilization, and in-hospital mortality rates were extracted for both groups. RESULTS: A total of 58,979 patients were admitted for IBD in 2016. Of those patients, we identified 145 who also had the presence of HIV. We found that patients with ulcerative colitis and HIV had a shorter length of hospital stay (4.1 vs. 5.9 days, p-value < 0.01), lower hospital charge ($35,716 vs $52,893, p-value < 0.01), and lower hospital cost ($7,814 vs. $13,395, p-value < 0.01) than those who did not have HIV. In patients with Crohn's disease, the presence of HIV resulted in decreased colonoscopy rates (0% vs. 17.4%, p-value < 0.01); however, the rate of esophagogastroduodenoscopies was not statistically significant (7.1% vs. 14.7%, p-value 0.106). CONCLUSION: In this retrospective population-based study, we found that patients with ulcerative colitis and concurrent HIV had a milder course of the disease when compared to ulcerative colitis patients that were not infected with HIV. These findings support the remission theory in that HIV may play a role in inflammatory bowel disease.


Asunto(s)
Colitis Ulcerosa , Enfermedad de Crohn , Infecciones por VIH , Enfermedades Inflamatorias del Intestino , Adulto , Colitis Ulcerosa/epidemiología , Enfermedad de Crohn/epidemiología , VIH , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/epidemiología , Estudios Retrospectivos
12.
Sci Rep ; 11(1): 8118, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33854097

RESUMEN

A radiological or nuclear attack could involve such a large number of subjects as to overwhelm the emergency facilities in charge. Resources should therefore be focused on those subjects needing immediate medical attention and care. In such a scenario, for the triage management by first responders, it is necessary to count on efficient biological dosimetry tools capable of early detection of the absorbed dose. At present the validated assays for measuring the absorbed dose are dicentric chromosomes and micronuclei counts, which require more than 2-3 days to obtain results. To overcome this limitation the NATO SPS Programme funded an Italian-Egyptian collaborative project aimed at validating a fast, accurate and feasible tool for assessing the absorbed dose early after radiation exposure. Biomarkers as complete blood cell counts, DNA breaks and radio-inducible proteins were investigated on blood samples collected before and 3 h after the first fraction of radiotherapy in patients treated in specific target areas with doses/fraction of about: 2, 3.5 or > 5 Gy and compared with the reference micronuclei count. Based on univariate and multivariate multiple linear regression correlation, our results identify five early biomarkers potentially useful for detecting the extent of the absorbed dose 3 h after the exposure.


Asunto(s)
Biomarcadores/metabolismo , Radiación Ionizante , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Biomarcadores/sangre , Recuento de Células Sanguíneas , Roturas del ADN de Doble Cadena/efectos de la radiación , Relación Dosis-Respuesta en la Radiación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Exposición a la Radiación , Radiometría
13.
Obes Surg ; 31(7): 3360-3364, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33687626

RESUMEN

Intragastric balloons have been used to bridge the obesity treatment gap. We aim to investigate the number and type of complications associated with intragastric balloons using public-access governmental databanks. We analyzed post-marketing surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database from Jan 2017 through Nov 2020. During the study period, approximately 773 cases with 830 device issues and 1134 patient complications were identified. Most balloon complications were due to leaks (33.4%). The most reported adverse events were vomiting (26.6%), abdominal pain (25.3%), and nausea (15.8%). Findings from the MAUDE database highlight patient and device adverse outcomes that should be addressed to improve clinical success.


Asunto(s)
Balón Gástrico , Obesidad Mórbida , Bases de Datos Factuales , Balón Gástrico/efectos adversos , Humanos , Obesidad Mórbida/cirugía
14.
Int J Colorectal Dis ; 36(8): 1801-1804, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33616738

RESUMEN

INTRODUCTION: The incidence of CRC is higher in minority racial and ethnic groups. However, studies assessing trends among sex and racial groups on the incidence and mortality of CRC are lacking. We aim to investigate disparities in CRC by reviewing a large national cancer registry. METHODS: This is a retrospective cross-sectional study of the Surveillance, Epidemiology, and End Results Registry (SEER) of individuals aged 45-79 years from 2000-2017. RESULTS: During the study period, the incidence of CRC decreased for both males and females, respectively (APC -2.14 vs -1.81). Among all racial groups, African American showed the least decline in incidence of CRC. African American females showed the highest risk for CRC (IRR 1.34; 95% CI 1.32-1.36, p< 0.001) compared to other females or males from different racial groups. Subgroup analysis using Kaplan-Meier estimations showed that African American females had the poorest 5-year survival rate (56%) compared to other female racial groups. Among males, American Indian/Alaska Natives had the poorest 5-year survival (54%) compared to male of other racial groups. CONCLUSION: Overall, the incidence of colorectal cancer is declining. However, the incidence of CRC remains highest in African Americans females who are also burden with poor survival rates.


Asunto(s)
Neoplasias Colorrectales , Neoplasias Colorrectales/epidemiología , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Sistema de Registros , Estudios Retrospectivos , Programa de VERF , Estados Unidos/epidemiología
15.
J Clin Gastroenterol ; 55(6): 534-541, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33464029

RESUMEN

BACKGROUND: The incidence of colorectal cancer is increasing among young adults in the United States. We aim to investigate the incidence rate, the effect of multimodal therapy, and survival outcomes of rectal cancer in patients under 45 years of age. PATIENTS AND METHODS: Data on young-onset (under 45 y) rectal cancer between 2000 and 2016 was extracted from the Surveillance, Epidemiology, and End Results Registry (SEER). RESULTS: A total of 10,375 patients with young-onset rectal cancer were identified where 54.7% were male. The median age at diagnosis was 40±5.7 years. The overall age-adjusted incidence of rectal cancer between 2000 and 2016 was 1.24 per 100,000 per year. Incidence increased with age, with the highest incidence occurring in the 40- to 44-year age group. Over the 16-year study period, rectal cancer increased by ∼2.29%. Most tumors on presentation were moderately differentiated (30.8%) while the most common stage at presentation was stage 4 (48.3%). One- and 5-year cause-specific survival for rectal cancer was 93% and 72%, respectively. According to Cox proportional hazard models, chemotherapy was associated with increased mortality in patients with localized cancer [hazard ratio (HR)=2.88, 95% confidence interval (CI): 2.04-4.08, P<0.001], did not significantly improve mortality outcomes in patients with regional cancer (HR=0.89, 95% CI: 0.70-1.04, P=0.116), but reduced mortality in patients with distant cancer (HR=0.62, 95% CI: 0.56-0.70, P<0.001), though this effect was largely seen in patients 35 years and older. Surgery was associated with improved survival across all cancer stages. CONCLUSIONS: The incidence of regional and distant rectal cancer is increasing in young patients. While patient age is an important prognostic indicator of survival, chemotherapy does not appear to improve survival in younger patients with localized and regional disease.


Asunto(s)
Neoplasias del Recto , Estudios de Cohortes , Humanos , Incidencia , Masculino , Estadificación de Neoplasias , Neoplasias del Recto/epidemiología , Neoplasias del Recto/terapia , Programa de VERF , Tasa de Supervivencia , Estados Unidos/epidemiología , Adulto Joven
17.
Pancreatology ; 21(1): 124-129, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33334692

RESUMEN

BACKGROUND: Pancreatic cancer is projected to become the second leading cause of cancer related death in the US. We aim to investigate the demographics, clinical outcomes and survival outcomes of patients diagnosed with early-onset (<40 years) and late-onset (>40 years) pancreatic adenocarcinoma (PAC). METHODS: Data on PAC between 1975 and 2016 were extracted from the Surveillance, Epidemiology, and End Results Registry. RESULTS: Within the study period, 136,100 patients were identified which included 1181 patients with early-onset PAC and 134,919 patients with late-onset PAC. Both cohorts tend to present with distant metastasis (70.3% vs 57.9%). Both groups also showed an exponential rise in incidence (early-onset 3.69% annual change vs late-onset 6.25% annual change). When stratified by anatomical location, there was a trend of increasing cancer in the head of the pancreas for patients <40 years (3.63% annual change). While late PAC showed increasing cancer in all anatomical locations, the largest increase was observed in the tail of the pancreas (8.62% annual change). Overall, there was a mild difference in survival for early- and late-onset PAC (7 months vs 6 months, respectively, log rank p = 0.004). Both age groups showed the worse prognosis when cancer occurred in the tail of the pancreas (6 months vs 4 months, respectively). On cox proportion analysis, patients with late-onset PAC had twice the risk of mortality compared to early-onset PAC (HR 2.06, CI: 1.788-2.370, P = 0.001). CONCLUSIONS: Our study showed that both early- and late-onset PAC are increasing and while prognosis remains poor. Tumor anatomy showed a growing incidence of early-onset PAC in the head of the pancreas while late-onset PAC showed a rising incidence in the body and tail of the pancreas.


Asunto(s)
Adenocarcinoma/patología , Envejecimiento , Neoplasias Pancreáticas/patología , Adenocarcinoma/epidemiología , Adulto , Estudios de Cohortes , Humanos , Incidencia , Neoplasias Pancreáticas/epidemiología , Estudios Retrospectivos , Factores de Tiempo
19.
Nanomaterials (Basel) ; 10(8)2020 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-32722342

RESUMEN

Surfactant-modified exfoliated Fayum clay (CTAB-EC) obtained after chemical treatment with a CTAB/H2O2 solution was further decorated with magnetic Fe3O4 nanoparticles (MNP). The final nanocomposite (MNP/CTAB-EC) was characterized by XRD, SEM, FTIR, TEM and its adsorptive capability against a model cationic dye, crystal violet (CV), was evaluated. A comparison of the adsorption performance of the raw clay and its modified counterparts using H2O2, CTAB, CTAB/H2O2 or MNP indicated that the adsorption capacity of MNP/CTAB-EC was the highest for CV removal at pH 8.0. The pseudo‒second order for the kinetics and Freundlich model for adsorption equilibrium fitted well the CV removal experimental data at all tested temperatures (25, 40 and 55 °C). The enhancement of the Langmuir adsorption capacity from 447.1 to 499.4 mg g-1 with increasing the temperature from 25 to 55 °C revealed an endothermic nature of the removal process. The interactions between CV and MNP/CTAB-EC were interpreted using advanced statistical physics models (ASPM) in order to elucidate the adsorption mechanism. Multilayer model fitted the adsorption process and therefore, the steric and energetic factors that impacted the CV adsorption were also interpreted using this model. The aggregated number of CV molecules per MNP/CTAB-EC active site ( n ) was more than unity at all temperatures, representing thus a vertical adsorption orientation and a multi‒interactions mechanism. It was determined that the increase of CV uptake with temperature was mainly controlled by the increase of the number of active sites (NM). Calculated adsorption energies (ΔE) revealed that CV removal was an endothermic and a physisorption process (ΔE < 40 kJ mol -1). MNP/CTAB-EC was magnetically separated, regenerated by NaOH, and reused without significant decrease in its adsorption efficiency, supporting a prosperity of its utilization as an effective adsorbent against hazardous dyes from wastewaters.

20.
Nat Microbiol ; 5(4): 570-583, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32094587

RESUMEN

Toxoplasma gondii has a complex life cycle that is typified by asexual development that takes place in vertebrates, and sexual reproduction, which occurs exclusively in felids and is therefore less studied. The developmental transitions rely on changes in the patterns of gene expression, and recent studies have assigned roles for chromatin shapers, including histone modifications, in establishing specific epigenetic programs for each given stage. Here, we identified the T. gondii microrchidia (MORC) protein as an upstream transcriptional repressor of sexual commitment. MORC, in a complex with Apetala 2 (AP2) transcription factors, was shown to recruit the histone deacetylase HDAC3, thereby impeding the accessibility of chromatin at the genes that are exclusively expressed during sexual stages. We found that MORC-depleted cells underwent marked transcriptional changes, resulting in the expression of a specific repertoire of genes, and revealing a shift from asexual proliferation to sexual differentiation. MORC acts as a master regulator that directs the hierarchical expression of secondary AP2 transcription factors, and these transcription factors potentially contribute to the unidirectionality of the life cycle. Thus, MORC plays a cardinal role in the T. gondii life cycle, and its conditional depletion offers a method to study the sexual development of the parasite in vitro, and is proposed as an alternative to the requirement of T. gondii infections in cats.


Asunto(s)
Adenosina Trifosfatasas/genética , Histona Desacetilasas/genética , Histonas/metabolismo , Proteínas Protozoarias/genética , Toxoplasma/genética , Factores de Transcripción/genética , Transcripción Genética , Adenosina Trifosfatasas/química , Adenosina Trifosfatasas/metabolismo , Animales , Gatos , Cromatina , Fibroblastos/parasitología , Código de Histonas , Histona Desacetilasas/química , Histona Desacetilasas/metabolismo , Histonas/genética , Humanos , Estadios del Ciclo de Vida/genética , Modelos Moleculares , Cultivo Primario de Células , Unión Proteica , Procesamiento Proteico-Postraduccional , Estructura Secundaria de Proteína , Proteínas Protozoarias/química , Proteínas Protozoarias/metabolismo , Toxoplasma/crecimiento & desarrollo , Toxoplasma/metabolismo , Factores de Transcripción/química , Factores de Transcripción/metabolismo
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