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2.
J Surg Oncol ; 2024 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-38973141

RESUMEN

BACKGROUND: Cancer immunotherapy has had an important role in oncologic therapeutics for patients with non-small cell lung cancer (NSCLC) using checkpoint inhibitors. We will explore the possible prognosis biomarker candidates such as: soluble OX40 (sOX40), OX40L (sOX40L), Glucocorticoid-induced tumor necrosis factor receptor family-related receptor (GITR), and their ligand (GITRL), 4-1BB or tumor necrosis factor receptor superfamily 9 (TNFRS9) and inducible T cell co-stimulator (ICOS) in peripheral blood of NSCLC patients. METHODS: Fifty-eight patients were diagnosed with advanced NSCLC between January 2019 and March 2020. RESULTS: High sOX40 and low s4-1BB levels in smokers compared non-smoker NSCLC patients. Lower sOX40L levels were found in the male than female (p < 0.05). High sOX40 and sGITRL in stage III compared to the stage IV (p < 0.05). With follow-up at 21.4 months, 44.1% and 91.1% were alive in the sGITRhigh and sGITRlow groups, respectively (p = 0.02), and 73.3% and 27.7% were alive in the sGITRLhigh and sGITRLlow groups, respectively (p = 0.02). At 22 months, 38.7% and 92.3% were alive in the sOX40Lhigh and sOX40Llow groups, respectively (p = 0.01). CONCLUSION: sGITR, sGITRL, and sOX40L levels were potential prognostic biomarkers and could have an important role as new targets of immunotherapy in NSCLC patients. sGITR, sGITRL, sOX40L, and sOX40 levels were associated with smoking, sex, stage, and age in NSCLC.

3.
Trop Med Infect Dis ; 9(6)2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38922044

RESUMEN

Neurological complications are frequent during the active course of infective endocarditis (IE), and they are associated with high in-hospital mortality rates. However, limited data exist on the prognostic value of these complications for late outcomes. This study aimed to assess the long-term impact of neurological complications in patients surviving an IE episode. A total of 263 consecutive IE patients admitted to a tertiary care center between 2007 and 2022 were prospectively included. Neurological complications at admission included transient ischemic attack (TIA), ischemic stroke, hemorrhagic stroke, intracerebral abscess, and meningitis. The primary outcome was a composite of overall mortality or heart valve surgery. Of the patients, 34.2% died in the hospital, leaving 173 survivors for long-term follow-up. Over a median of 3.5 years, 29 patients died, and 13 (9%) underwent cardiac surgery, resulting in an overall adverse event rate of 30%. Neurological complications independently predicted long-term adverse outcomes (hazard ratio (HR) 2.237; 95% CI 1.006-4.976), after adjusting for age, chronic kidney disease (CKD), and heart failure (HF) development. In an IE patient cohort, neurological complications at admission, which is a complication directly related to the IE process, were independent predictors of long-term outcomes.

4.
Reprod Toxicol ; 128: 108647, 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38909693

RESUMEN

The prostate gland is one of the main sites of hyperplasia and cancer in elderly men. Numerous factors have been demonstrated to disrupt prostate homeostasis, including exposure to environmental pollutants. Arsenic is a metalloid found ubiquitously in soil, air, and water, which favors human poisoning through the involuntary intake of contaminated drinking water and food and has harmful effects by increasing the oxidative stress response. This study aimed to investigate the effects of prolonged exposure to arsenic at environmentally relevant concentrations on the prostate biology of adult Wistar rats. Thirty 80-day-old male rats were divided into three experimental groups. Rats from the control group received filtered water, whereas animals from the arsenic groups ingested 1 mg L-1 and 10 mg L-1 of arsenic, in the form of sodium arsenite, daily. The arsenic solutions were provided ad libitum in the drinking water for eight weeks. Our results showed that 1 mg L-1 and 10 mg L-1 of arsenic made the prostate susceptible to evolving benign and premalignant histopathological changes. While the ingestion of 1 mg L-1 of arsenic reduced SOD activity only, 10 mg L-1 diminished SOD and CAT activity in the prostate tissue, culminating in high MDA production. These doses, however, did not affect the intraprostatic levels of DHT and estradiol. In conclusion, exposure to arsenic at environmentally relevant concentrations through drinking water induces histological and oxidative stress-related changes in the prostate of adult rats, strengthening the between arsenic exposure and prostate disorders.

5.
NanoImpact ; 35: 100517, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38848992

RESUMEN

Superparamagnetic iron oxide nanoparticles (SPIONs) have gained significant attention in biomedical research due to their potential applications. However, little is known about their impact and toxicity on testicular cells. To address this issue, we conducted an in vitro study using primary mouse testicular cells, testis fragments, and sperm to investigate the cytotoxic effects of sodium citrate-coated SPIONs (Cit_SPIONs). Herein, we synthesized and physiochemically characterized the Cit_SPIONs and observed that the sodium citrate diminished the size and improved the stability of nanoparticles in solution during the experimental time. The sodium citrate (measured by thermogravimetry) was biocompatible with testicular cells at the used concentration (3%). Despite these favorable physicochemical properties, the in vitro experiments demonstrated the cytotoxicity of Cit_SPIONs, particularly towards testicular somatic cells and sperm cells. Transmission electron microscopy analysis confirmed that Leydig cells preferentially internalized Cit_SPIONs in the organotypic culture system, which resulted in alterations in their cytoplasmic size. Additionally, we found that Cit_SPIONs exposure had detrimental effects on various parameters of sperm cells, including motility, viability, DNA integrity, mitochondrial activity, lipid peroxidation (LPO), and ROS production. Our findings suggest that testicular somatic cells and sperm cells are highly sensitive and vulnerable to Cit_SPIONs and induced oxidative stress. This study emphasizes the potential toxicity of SPIONs, indicating significant threats to the male reproductive system. Our findings highlight the need for detailed development of iron oxide nanoparticles to enhance reproductive nanosafety.

6.
Menopause ; 31(6): 556-562, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38688468

RESUMEN

IMPORTANCE: Menopausal hormone therapy (HT) includes a wide variety of hormonal compounds, and its effect on blood pressure is still uncertain. OBJECTIVE: The aim of this study was to assess evidence regarding the effect of HT on blood pressure in postmenopausal women and its association with arterial hypertension. EVIDENCE REVIEW: This systematic review and meta-analysis included randomized clinical trials and prospective observational studies. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of hypertension were assessed. All stages were independently performed by two reviewers. For blood pressure outcome, standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated as effect measures. Heterogeneity was assessed using the I2 statistic. The results are presented based on the HT type. The incidence of hypertension was compared using descriptive analyses. FINDINGS: Eleven studies were included with 81,041 women evaluated, of which 29,812 used HT. The meta-analysis, conducted with 8 studies and 1,718 women, showed an increase in SBP with the use of oral conjugated equine estrogens plus progestogen (SMD = 0.60 mm Hg, 95% CI = 0.19 to 1.01). However, oral or transdermal use of estradiol plus progestogen (SMD = -2.00 mm Hg, 95% CI = -7.26 to 3.27), estradiol alone, and tibolone did not show any significant effect. No significant effect on DBP was observed for any formulation. Women who used oral estrogen plus progestogen had a higher risk of incident hypertension than those who never used it. CONCLUSIONS AND RELEVANCE: The effect of HT on blood pressure is influenced by the formulation used, especially the type of estrogen. The combined formulations of conjugated equine estrogens plus progestogen increased SBP and the risk of hypertension, which was not observed among estradiol plus progestogen, estradiol alone, and tibolone users.


Asunto(s)
Presión Sanguínea , Terapia de Reemplazo de Estrógeno , Hipertensión , Posmenopausia , Humanos , Femenino , Hipertensión/tratamiento farmacológico , Presión Sanguínea/efectos de los fármacos , Terapia de Reemplazo de Estrógeno/métodos , Progestinas/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como Asunto , Estrógenos Conjugados (USP)/administración & dosificación , Persona de Mediana Edad , Estradiol/administración & dosificación , Norpregnenos/efectos adversos , Norpregnenos/administración & dosificación , Estrógenos/administración & dosificación
7.
Sci Rep ; 14(1): 9667, 2024 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-38671078

RESUMEN

The advanced stage at diagnosis of colorectal cancer (CRC) may be related to individual factors, socioeconomic conditions, and healthcare service availability. The objective of the study was to analyze the prevalence of advanced stage CRC at the time of diagnosis and its association with individual, contextual, socioeconomic, and healthcare service indicators. An observational, cross-sectional study was conducted, analyzing cases of malignant neoplasms of the colon and rectum in individuals of both sexes, aged between 18 and 99 years, diagnosed between 2010 and 2019 in Brazil (n = 69,047). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A Multilevel Poisson Regression model with random intercept was used. The prevalence of advanced stage CRC at diagnosis was 65.6%. Advanced stage was associated with older age groups prevalence ratio (PR) 4.40 and younger age groups (PR 1.84), low Human Development Index (HDI) (PR 1.22), and low density of family health strategy teams (PR 1.10). The study highlights the unequal distribution of social determinants of health in the diagnosis CRC in Brazil, revealing the need to evaluate and redirect public policies aimed at improving early detection and prevention of CRC in the country.


Asunto(s)
Neoplasias Colorrectales , Análisis Multinivel , Estadificación de Neoplasias , Determinantes Sociales de la Salud , Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/patología , Anciano , Adulto , Brasil/epidemiología , Anciano de 80 o más Años , Estudios Transversales , Adolescente , Adulto Joven , Factores Socioeconómicos , Prevalencia , Sistema de Registros
8.
Reprod Toxicol ; 126: 108584, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38561096

RESUMEN

In the domain of medical advancement, nanotechnology plays a pivotal role, especially in the synthesis of biocompatible materials for therapeutic use. Superparamagnetic Iron Oxide Nanoparticles (SPIONs), known for their magnetic properties and low toxicity, stand at the forefront of this innovation. This study explored the reproductive toxicological effects of Sodium Citrate-functionalized SPIONs (Cit_SPIONs) in adult male mice, an area of research that holds significant potential yet remains largely unknown. Our findings reveal that Cit_SPIONs induce notable morphological changes in interstitial cells and the seminiferous epithelium when introduced via intratesticular injection. This observation is critical in understanding the interactions of nanomaterials within reproductive biological systems. A striking feature of this study is the rapid localization of Cit_SPIONs in Leydig cells post-injection, a factor that appears to be closely linked with the observed decrease in steroidogenic activity and testosterone levels. This data suggests a possible application in developing nanostructured therapies targeting androgen-related processes. Over 56 days, these nanoparticles exhibited remarkable biological distribution in testis parenchyma, infiltrating various cells within the tubular and intertubular compartments. While the duration of spermatogenesis remained unchanged, there were many Tunel-positive germ cells, a notable reduction in daily sperm production, and reduced progressive sperm motility in the treated group. These insights not only shed light on the intricate mechanisms of Cit_SPIONs interaction with the male reproductive system but also highlight the potential of nanotechnology in developing advanced biomedical applications.


Asunto(s)
Células Intersticiales del Testículo , Nanopartículas Magnéticas de Óxido de Hierro , Espermatogénesis , Espermatozoides , Testículo , Testosterona , Animales , Masculino , Células Intersticiales del Testículo/efectos de los fármacos , Células Intersticiales del Testículo/metabolismo , Nanopartículas Magnéticas de Óxido de Hierro/toxicidad , Testículo/efectos de los fármacos , Testículo/metabolismo , Espermatogénesis/efectos de los fármacos , Espermatozoides/efectos de los fármacos , Ratones , Citrato de Sodio/toxicidad
9.
Respir Physiol Neurobiol ; 323: 104240, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38417564

RESUMEN

In this study, we hypothesized that long-term administration of hesperidin can modulate the inflammatory response and oxidative stress in animals submitted to mechanical ventilation (MV). Twenty-five C57BL/6 male mice were divided into 5 groups: control, MV, animals receiving hesperidin in three doses 10, 25 and 50 mg/kg. The animals received the doses of hesperidin for 30 days via orogastric gavage, and at the end of the period the animals were submitted to MV. In animals submitted to MV, increased lymphocyte, neutrophil and monocyte/macrophage cell counts were observed in the blood and airways. Associated to this, MV promoted an increase in inflammatory cytokine levels such as CCL2, IL-12 and TNFα. The daily administration of hesperidin in the three doses prevented the effects caused by MV, which was observed by a lower influx of inflammatory cells into the airways, a reduction in inflammatory markers and less oxidative damage.


Asunto(s)
Hesperidina , Neumonía , Ratones , Animales , Masculino , Hesperidina/farmacología , Hesperidina/uso terapéutico , Ratones Endogámicos C57BL , Citocinas/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Estrés Oxidativo , Neumonía/prevención & control , Inflamación/prevención & control
10.
Int Immunopharmacol ; 128: 111523, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38219440

RESUMEN

Since the Orthoflavivirus zikaense (ZIKV) has been considered a risk for Zika congenital syndrome development, developing a safe and effective vaccine has become a high priority. Numerous research groups have developed strategies to prevent ZIKV infection and have identified the domain III of the ZIKV envelope protein (zEDIII) as a promising target. Subunit antigens are often poorly immunogenic, necessitating the use of adjuvants and/or delivery systems to induce optimal immune responses. The subject of nanotechnology has substantial expansion in recent years in terms of research and applications. Nanoparticles could be used as drug delivery systems and to increase the immunogenicity and stability of a given antigen. This work aims to characterize and validate the potential of a vaccine formulation composed of domain zEDIII and bovine serum albumin nanoparticles containing polyinosinic-polycytidylic acid (NPPI). NPPI were uptake in vitro by immature bone marrow dendritic cells and histological analysis of the skin of mice treated with NPPI showed an increase in cellularity. Immunization assay showed that mice immunized with zEDIII in the presence of NPPI produced neutralizing antibodies. Through the passive transfer of sera from immunized mice to ZIKV-infected neonatal mice, it was demonstrated that these antibodies provide protection, mitigating weight loss, clinical or neurological signs induced by infection, and significantly increased survival rates. Protection was further substantiated by the reduction in the number of viable infectious ZIKV, as well as a decrease in inflammatory cytokines and tissue alterations in the brains of infected mice. Taken together, data presented in this study shows that NPPI + zEDIII is a promising vaccine candidate for ZIKV.


Asunto(s)
Vacunas Virales , Infección por el Virus Zika , Virus Zika , Animales , Ratones , Anticuerpos Neutralizantes , Infección por el Virus Zika/prevención & control , Poli I-C , Albúmina Sérica Bovina , Anticuerpos Antivirales , Proteínas del Envoltorio Viral
11.
Urol Oncol ; 42(1): 22.e13-22.e21, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38030469

RESUMEN

INTRODUCTION: Bladder microbiota dysbiosis has been associated with several urological disorders. However, dysbiosis markers in bladder cancer have not been identified and little is known about the effect of Bacillus Calmette-Guérin (BCG) intravesical therapy on the bladder microbiota. In this study, we compared the bladder microbiota of patients with non-muscle-invasive bladder cancer (NMIBC) undergoing BCG therapy to nononcological controls. We also longitudinally analyzed the impact of BCG therapy on the bladder microbiota of NMIBC patients and addressed whether bladder microbiota is associated with BCG efficacy. METHODS: We collected catheterized urine samples from males with intermediate/high-risk NMIBC (cancer group, n = 32) or benign prostatic hyperplasia (control group, n = 41). The cancer group also provided urine samples during and after BCG induction. We used 16S rRNA gene sequencing to characterize the bladder microbiota. Bladder microbiota parameters, such as diversity and taxonomic composition, were compared between groups and associated with clinicopathological data and BCG efficacy. RESULTS: We observed no significant differences between the bladder microbiota of NMIBC patients and controls. BCG intravesical instillations did not significantly alter the bladder microbiota of NMIBC patients, and BCG was rarely detected in the bladder during and after BCG therapy. Microbiota diversity and overall composition before BCG induction did not influence disease persistence at 3 months. However, higher abundance of Lactobacillus, Streptococcus, and Cutibacterium in the pre-BCG bladder microbiota was associated with BCG effectiveness. CONCLUSION: We were unable to identify markers of bladder microbiota dysbiosis among male NMIBC patients. Moreover, we demonstrated for the first time using longitudinally collected samples that BCG cannot persist in the bladder microbiota nor significantly alter its diversity and composition. The associations found between bladder microbes and BCG efficacy highlight the potential of microbial-based therapeutic and risk-stratification strategies in the intermediate/high-risk NMIBC setting.


Asunto(s)
Neoplasias Vesicales sin Invasión Muscular , Neoplasias de la Vejiga Urinaria , Humanos , Masculino , Vejiga Urinaria/patología , Vacuna BCG/uso terapéutico , Disbiosis/tratamiento farmacológico , ARN Ribosómico 16S/genética , Adyuvantes Inmunológicos/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/patología , Administración Intravesical , Invasividad Neoplásica/patología , Recurrencia Local de Neoplasia/patología
12.
REVISA (Online) ; 13(Especial 1): 324-332, 2024.
Artículo en Portugués | LILACS | ID: biblio-1538312

RESUMEN

Objetivo: Sistematizar a assistência de enfermagem à luz da teoria de Callista-Roy no cuidado ao paciente politraumatizado. Método:Trata-se de um estudo do tipo qualitativo de abordagem descritiva e exploratória na modalidade de caso clínico, realizado por estudantes de Enfermagem da Universidade Estadual de Feirade Santana no Hospital Geral Clériston Andrade na Clínica Ortopédica. A prática ocorreu em setembro de 2023, onde foram coletados dados e prestados cuidados à paciente. Resultados:Foi aplicada a Sistematização de Enfermagem, sob perspectiva da teoria deCallista-Roy, onde a coleta de dados foi realizada por meio do prontuário e contato direto com a paciente. Segundo a teoria, foram identificados os modos de adaptação físico-fisiológico, identidade de autoconceito, interdependência e desempenho de papel. Por fim, com base nas informações colhidas, foram realizados o planejamento, implementação e avaliação das condutas adotadas. Considerações finais:. Portanto, através da aplicação da sistematização de Enfermagem e do Modelo de adaptação é possível observara importância do exercício profissional da Enfermagem no processo de cuidado holístico, a fim de garantir as melhores condições de recuperação que perpassam o físico, como também na fundamentação teórico-prática do trabalho de enfermagem.


Objective: Systematize nursing assistance based on Callista-Roy's theory in the care of polytraumatized patients. Method:This is a qualitative study with a descriptive and exploratory approach in the form of a clinical case, carried out by nursing students from the State University of Feira de Santana at Clériston Andrade General Hospital in the Orthopedic Clinic. The practice took place in September 2023, where data were collected, and care was provided to the patient. Results:The Nursing Process was applied from the perspective of Callista-Roy's theory, with data collection performed through medical records and direct contact with the patient. According to the theory, modes of physical-physiological adaptation, self-concept identity, interdependence, and role performance were identified. Finally, based on the gathered information, planning, implementation, and evaluation of the adopted measures were carried out. Final considerations: Therefore, through the application of the nursing process and the Adaptation Model, it is possible to observe the importance of the nursing profession in the holistic care process, aiming to ensure the best conditions for recovery that go beyond the physical, as well as in the theoretical-practical foundation of nursing work.


Objetivo: Sistematizar la asistencia de enfermería a la luz de la teoría de Callista-Roy en el cuidado del paciente politraumatizado. Método:Se trata de un estudio cualitativo con enfoque descriptivo y exploratorio en forma de caso clínico, realizado por estudiantes de enfermería de la Universidad Estatal de Feira de Santana en el Hospital General Clériston Andrade en la Clínica Ortopédica. La práctica tuvo lugar en septiembre de 2023, donde se recopilaron datos y se brindó atención a la paciente. Resultados:Se aplicó el Proceso de Enfermería desde la perspectiva de la teoría de Callista-Roy, con la recopilación de datos realizada a través de expedientes médicos y contacto directo con la paciente. Según la teoría, se identificaron modos de adaptación físico-fisiológica, identidad del autoconcepto, interdependencia y desempeño del rol. Finalmente, con base en la información recopilada, se llevaron a cabo la planificación, implementación y evaluación de las medidas adoptadas. Consideraciones finales: Por lo tanto, mediante la aplicación del proceso de enfermería Y el Modelo de Adaptación, es posible observar la importancia de la profesión de enfermería en el proceso de atención integral, con el objetivo de garantizar las mejores condiciones de recuperación que van más allá de lo físico, así como en la fundamentación teórico-práctica del trabajo de enfermería.


Asunto(s)
Salud del Adulto , Teoría de Enfermería , Traumatismo Múltiple , Atención de Enfermería
13.
Rev. baiana enferm ; 38: e54897, 2024. tab
Artículo en Portugués | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1559301

RESUMEN

Objetivo: descrever a prevalência de casos graves pelo SARS-Cov-2 e fatores associados à ocorrência em crianças e adolescentes. Método: estudo transversal, num hospital pediátrico, com 236 crianças e adolescentes com COVID-19 entre março-2020 até fevereiro-2022. Resultados: a prevalência de casos graves da COVID-19 foi de 37%. A maior frequência foram do sexo masculino (41%), até 1 ano de idade (41,8%) e municípios circunvizinhos (46,5%). As manifestações clínicas em até 72 horas após hospitalização, associados aos casos graves foram: desconforto respiratório (RPb: 1,91; IC 95% 1,36 - 2,67), saturação de O2 < 92% (RPb: 9,27 IC 95% 5,99 - 14,35), necessidade de cuidados intensivos (RPb: 5,25; IC 95% 3,87 - 7,12) e comorbidades (RPb: 1,73 IC 95% 1,25 - 2,40). Os desfechos, óbito/transferência, associaram-se com maior proporção de casos graves. Conclusão: conhecer o perfil de casos de COVID-19 na população pediátrica e fatores associados pode contribuir para revisar processos a fim de manejo adequado dos casos.


Objetivo: describir la prevalencia de casos graves por el SARS-Cov-2 y factores asociados a la ocurrencia en niños y adolescentes. Método: estudio transversal, en un hospital pediátrico, con 236 niños y adolescentes con COVID-19 entre marzo-2020 hasta febrero-2022. Resultados: la prevalencia de casos graves de COVID-19 fue del 37%. La mayor frecuencia fueron del sexo masculino (41%), hasta 1 año de edad (41,8%) y municipios circundantes (46,5%). Las manifestaciones clínicas en hasta 72 horas después de la hospitalización, asociados a los casos graves fueron: malestar respiratorio (RPb: 1,91; IC 95% 1,36 - 2,67), saturación de O2 < 92% (RPb: 9,27 IC 95% 5,99 - 14,35), necesidad de cuidados intensivos (RPb: 5,25; IC 95% 3,87 - 7,12) y comorbilidades (RPb: 1,73 IC 95% 1,25 - 2,40). Los resultados, muerte/transferencia, se asociaron con mayor proporción de casos graves. Conclusión: conocer el perfil de casos de COVID-19 en la población pediátrica y factores asociados puede contribuir para revisar procesos a fin de manejo adecuado de los casos.


Objective: to describe the prevalence of severe cases by SARS-Cov-2 and factors associated with the occurrence in children and adolescents. Method: cross-sectional study, in a pediatric hospital, with 236 children and adolescents with COVID-19 between March 2020 and February 2022. Results: the prevalence of severe cases of COVID-19 was 37%. The highest frequency was male (41%), up to 1 year of age (41.8%) and surrounding cities (46.5%). Clinical manifestations within 72 hours of hospitalization, associated with severe cases, were respiratory distress (PRc: 1.91; 95% CI 1.36 -2.67), O2saturation < 92% (PRc: 9.27 95% CI 5.99 - 14.35), need for intensive care (PRc: 5.25; 95% CI 3.7 - 87) and comorbidities (PRc: 1.73 95% CI 1.25 - 2.40). The outcomes death/transfer were associated with a higher proportion of severe cases. Conclusion: knowing the profile of COVID-19 cases in the pediatric population and associated factors can contribute to review processes for proper management of cases.

14.
Breast Cancer Res Treat ; 200(3): 355-362, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37273150

RESUMEN

BACKGROUND: Elevated pre-treatment baseline inflammation has been associated with cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer. Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio and systemic immune-inflammation index (NLR × platelets) have emerged in clinical context as markers of disease-related inflammation. OBJECTIVES: To evaluate development of CTRCD according to pre-treatment blood inflammatory biomarkers in patients with breast cancer. METHODS: Pilot cohort study including consecutive female patients ≥ 18 years with HER2-positive early breast cancer who consulted at the institution's breast oncology outpatient clinic between march/2019 and march/2022. CTRCD: absolute reduction in LVEF > 10% to below 53% (2D-echocardiogram). Survival analysis was performed using Kaplan-Meier curves, compared by the log-rank test, and discrimination ability was evaluated through AUC-ROC. RESULTS: Forty-nine patients (53.3 ± 13.3 y) were included and followed-up for a median of 13.2 months. CTRCD was observed in 6 (12.2%) patients. Patients with high blood inflammatory biomarkers had lower CTRCD-free survival (P < 0.050 for all). MLR showed statistically significant AUC (0.802; P = 0.017). CTRCD was observed in 27.8% of patients with high MLR versus 3.2% with low MLR (P = 0.020); negative predictive value was 96.8% (95%CI 83.3-99.4%). CONCLUSION: In patients with breast cancer, elevated pre-treatment inflammatory markers were associated with increased risk of cardiotoxicity. Among these markers, MLR had good discriminatory performance and high negative predictive value. The incorporation of MLR might improve risk evaluation and selection of patients for follow-up during cancer therapy.


Asunto(s)
Neoplasias de la Mama , Cardiopatías , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Monocitos , Cardiotoxicidad/diagnóstico , Cardiotoxicidad/etiología , Proyectos Piloto , Linfocitos , Neutrófilos , Estudios de Cohortes , Inflamación , Pronóstico , Estudios Retrospectivos
15.
Cancer Epidemiol ; 85: 102397, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37327505

RESUMEN

INTRODUCTION: To determine the incidence, morbidity, and mortality rate of laryngeal cancer in two decades and its epidemiological, clinical, and histological characteristics by sex in Brazil. METHODS: This ecological study used three reliable sources of secondary data: population- and hospital-based cancer registries and the national mortality database. All data available from 2000 to 2019 were considered. RESULTS: The incidence of male laryngeal cancer decreased from 9.20 to 4.95 per 100,000 from 2000 to 2018, while mortality slightly decreased from 3.37 to 3.30 per 100,000 from 2000 to 2019. In the same period, the female incidence decreased from 1.26 to 0.48 per 100,000; however, mortality slightly increased from 0.34 to 0.36 per 100,000. Of 221,566 individuals with head and neck cancer, 27 % presented laryngeal cancer. The median age was 61 years (54-69), and most individuals were male (86.6 %), smokers (66.2 %), diagnosed with locally advanced cancer (66.7 %), and squamous cell carcinoma as the main histological type (93.2 %). Male tended to be older (p < 0.001), white (p < 0.001), smokers (p < 0.001), and present late treatment initiation (p < 0.001) and early death (p < 0.001) compared with female. CONCLUSION: The male laryngeal cancer affected mainly at productive age but with a decreased incidence, probably due to a reduction in smoking habit. However, mortality did not change, which may be explained by the late diagnosis and lack of access to radiotherapy.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias Laríngeas , Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias Laríngeas/epidemiología , Neoplasias Laríngeas/radioterapia , Brasil/epidemiología , Carcinoma de Células Escamosas/epidemiología , Incidencia , Sistema de Registros
16.
Int J Mol Sci ; 24(12)2023 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-37373266

RESUMEN

Chronic myeloid leukemia (CML) is a well-characterized oncological disease in which virtually all patients possess a translocation (9;22) that generates the tyrosine kinase BCR::ABL1 protein. This translocation represents one of the milestones in molecular oncology in terms of both diagnostic and prognostic evaluations. The molecular detection of the BCR::ABL1 transcription is a required factor for CML diagnosis, and its molecular quantification is essential for assessing treatment options and clinical approaches. In the CML molecular context, point mutations on the ABL1 gene are also a challenge for clinical guidelines because several mutations are responsible for tyrosine kinase inhibitor resistance, indicating that a change may be necessary in the treatment protocol. So far, the European LeukemiaNet and the National Comprehensive Cancer Network (NCCN) have presented international guidelines on CML molecular approaches, especially those related to BCR::ABL1 expression. In this study, we show almost three years' worth of data regarding the clinical treatment of CML patients at the Erasto Gaertner Hospital, Curitiba, Brazil. These data primarily comprise 155 patients and 532 clinical samples. BCR::ABL1 quantification by a duplex-one-step RT-qPCR and ABL1 mutations detection were conducted. Furthermore, digital PCR for both BCR::ABL1 expression and ABL1 mutations were conducted in a sub-cohort. This manuscript describes and discusses the clinical importance and relevance of molecular biology testing in Brazilian CML patients, demonstrating its cost-effectiveness.


Asunto(s)
Proteínas de Fusión bcr-abl , Leucemia Mielógena Crónica BCR-ABL Positiva , Humanos , Brasil , Proteínas de Fusión bcr-abl/genética , Resistencia a Antineoplásicos/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Mutación , Inhibidores de Proteínas Quinasas/farmacología , Translocación Genética
17.
Int. j. cardiovasc. sci. (Impr.) ; 36: e20220132, jun.2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1528759

RESUMEN

Abstract Background: Ischemic heart disease is one of the most common causes of death worldwide. There are few data in the literature about the association of clinical profile and coronary angiography results in the Brazilian population. Objectives: To assess clinical variables and their associations with the results of coronary angiography and to evaluate the safety of coronary angiography in a public university hospital. Methods: From August 2015 to April 2018, 1 844 patients submitted to coronary angiography at the Pedro Ernesto University Hospital (HUPE, acronym in Portuguese) were enrolled in this cross-sectional study. They were evaluated by their clinical variables, angiographic results, and procedure complications. Logistic regression was used, and the criterion for determining significance was set at 5%. Results: The median age was 62 years, and most of the population (71%) were outpatients. Stable angina was the most common indication (62.9%). Only 19.7% underwent noninvasive cardiac testing. Arterial hypertension was the most prevalent (88.2%), followed by dyslipidemia (60.2%). Most patients (65%) had obstructive coronary artery disease (CAD). Left main coronary artery (LMCA) stenosis was found in 8.1% of patients. Older age, male sex, quantity of risk factors (RF), and peripheral artery disease were risk predictors for CAD. Death occurred only in 0.16% of the population, and acute coronary artery occlusion in 0.2%. Conclusion: Classic RF showed an association with CAD. The low incidence of complications suggests that coronary angiography is a safe procedure to be conducted in a public university hospital.

18.
Toxicology ; 492: 153543, 2023 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-37150288

RESUMEN

This study aimed to evaluate the gold nanoparticles (AuNPs) animal sterilizing potential after intratesticular injections and long-term adverse reproductive and systemic effects. Adult male Wistar rats were divided into control and gold nanoparticle (AuNPs) groups. The rats received 200 µL of saline or AuNPs solution (16 µg/mL) on experimental days 1 and 7 (ED1 and ED7). After 150 days, the testicular blood flow was measured, and the rats were mated with females. After mating, male animals were euthanized for histological, cellular, and molecular evaluations. The female fertility indices and fetal development were also recorded. The results indicated increased blood flow in the testes of treated animals. Testes from treated rats had histological abnormalities, shorter seminiferous epithelia, and oxidative stress. Although the sperm concentration was lower in the AuNP-treated rats, there were no alterations in sperm morphology. Animals exposed to AuNPs had decreased male fertility indices, and their offspring had lighter and less efficient placentas. Additionally, the anogenital distance was longer in female fetuses. There were no changes in the histology of the kidney and liver, the lipid profile, and the serum levels of LH, testosterone, AST, ALT, ALP, albumin, and creatinine. The primary systemic effect was an increase in MDA levels in the liver and kidney, with only the liver experiencing an increase in CAT activity. In conclusion, AuNPs have a long-term impact on reproduction with very slight alterations in animal health. The development of reproductive biotechnologies that eliminate germ cells or treat local cancers can benefit from using AuNPs.


Asunto(s)
Oro , Nanopartículas del Metal , Embarazo , Masculino , Femenino , Ratas , Animales , Oro/toxicidad , Ratas Wistar , Nanopartículas del Metal/toxicidad , Semen , Reproducción , Testículo , Testosterona , Recuento de Espermatozoides , Motilidad Espermática , Espermatozoides
19.
Cancers (Basel) ; 15(7)2023 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-37046740

RESUMEN

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer affecting people and accounts for more than 300,000 deaths worldwide. Improvements in treatment modalities, including immunotherapy, have demonstrated promising prognoses for eligible patients. Nevertheless, the five-year overall survival rate has not increased significantly, and the tumor recurrence ratio remains at 50% or higher, except for patients with HPV-positive HNSCC. Over the last decades, nanotechnology has provided promising tools, especially for biomedical applications, due to some remarkable physicochemical properties of numerous nanomaterials, particularly gold nanoparticles. This review addresses the features and some applications of gold nanoparticles reported in the literature over the last five years regarding the diagnosis and treatment of head and neck cancer, highlighting the exciting possibilities of this nanomaterial in oncology. METHODS: The scientific papers selected for this review were obtained from the PubMed Advanced, Web of Science, Scopus, ClinicalTrials.gov, and Google Scholar platforms. CONCLUSIONS: Results from papers applying gold nanoparticles have suggested that their application is a feasible approach to diagnostics, prognostics, and the treatment of HNC. Moreover, phase I clinical trials suggest that gold nanoparticles are safe and can potentially become theranostic agents for humans.

20.
Revista Pensar a Prática ; 26(2023)27/02/2023.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1435938

RESUMEN

A presença dos pais em ambientes esportivos é apontada como de grande influência na participação esportiva dos filhos. Contudo, mais do que intervir na trajetória dos filhos, os pais precisam lidar com demandas específicas do esporte que, ao mesmo tempo, influenciam diretamente a maneira como genitores oferecem suporte. Embora a agenda investigativa internacional ofereça contribuições sobre o envolvimento parental, as evidências ainda são pouco sistematizadas no cenário de investigação esportiva nacional. Diante do exposto, o objetivo foi apresentar o papel da família e dos pais como parte de um sistema esportivo integrado baseados na mútua influência dos indivíduos.


The presence of parents in sporting environments is pointed out as having a significant influence on the sport participation of their children. However, more than influencing the trajectory of their children, parents need to deal with specific demands of sports that, at the same time, directly affect how they offer support. Although the international research agenda contributes to parental development, the evidence is still little systematized in the national sports research scenario. Given the above, the aim was to present the role of family and parents as part of an integrated sport system based on the mutual influence of individuals.


Se señala que la presencia de los padres en entornos deportivos tiene una gran influencia en la participación deportiva de sus hijos. Sin embargo, más que influir en la trayectoria de sus hijos, los padres necesitan lidiar con demandas específicas del deporte que, al mismo tiempo, influyen directamente en la forma en que ofrecen apoyo. Aunque la agenda investigativa internacional ofrezca contribuciones sobre el desarrollo parental, las evidencias aún están poco sistematizadas en el escenario de la investigación deportiva nacional. Teniendo en cuenta lo anterior, el objetivo fue presentar el papel de la familia y los padres como parte de un sistema deportivo integrado basado en la influencia mutua de los individuos.

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