RESUMEN
PURPOSE: To determine whether invasive pneumococcal disease (IPD) due to serotype 5, which occurred as a local outbreak in 2006 to 2007, is associated with intensive care unit (ICU) admission, hospital mortality, or organ supports in those who are critically ill. MATERIALS AND METHODS: Retrospective review of patients who presented with IPD to 2 tertiary hospitals in Vancouver, Canada, from July 2004 to June 2007. We compared patient characteristics, interventions, and outcomes between patients who had serotype 5 and other serotypes using bivariate and multivariate analyses. RESULTS: A total of 149 patients had serotype 5 and 106 had nonserotype 5. Patients with serotype 5 were younger, had lower prevalence of comorbid diseases, and had higher rates of substance use than patients with nonserotype 5. There were no differences in chest tube placement for complications of pneumonia or in ICU admission. Frequency of necrotizing pneumonia and hospital mortality were lower in the serotype 5 group. For the 71 patients with IPD who were admitted to ICU, there was no difference in severity of illness, ICU length of stay, or ICU mortality between the groups. There was also no difference in organ supports except that the serotype 5 group was more likely to receive vasopressors. CONCLUSION: Serotype 5 in patients who have IPD is associated with no difference in ICU admission but with increased use of vasopressors and lower hospital mortality.
Asunto(s)
Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/clasificación , Adulto , Factores de Edad , Anciano , Enfermedad Crítica , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Infecciones Neumocócicas/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , SerogrupoRESUMEN
The Big Five personality traits-neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness-represent continuous, individual features that affect a number of vital health aspects, including morbidity, self-reported health status, or lifestyle. The aim of this study was to analyze the relationship between the eating behaviors and engagement in physical activity of women with a hereditary predisposition to breast or ovarian cancer and the Big Five personality traits. A total of 357 women, participants of 'The National Program for Families With Genetic/Familial High Risk for Cancer', were included in the study. In the healthy group, the following statistically significant predictors were found in variables: agreeableness-meal frequency (ß = 0.151; p = 0.030); neuroticism-consumption of fruits and vegetables (ß = -0.177; p = 0.016) and cereal products (ß = -0.223; p = 0.002); openness to experience-consumption of plant-based fats (ß = 0.141; p = 0.034) and physical activity (ß = 0.153; p = 0.021). In the cancer group, the frequency of dairy consumption (ß = 0.286; p = 0.003) and physical activity (ß = 0.370; p = 0.000) were found to be statistically significant predictors for the openness to experience variable. Neuroticism is associated with less frequent consumption of fresh fruits and vegetables as well as cereal products. Openness to experience was more often linked with a higher frequency of dairy consumption, plant-based fats, and physical activity. Women with breast or ovarian cancer and a higher openness to experience consumed dairy and engaged in physical activity more often than their peers with the remaining personality traits.
Asunto(s)
Neoplasias de la Mama , Ejercicio Físico , Conducta Alimentaria , Predisposición Genética a la Enfermedad , Neoplasias Ováricas , Personalidad , Humanos , Femenino , Neoplasias de la Mama/genética , Neoplasias de la Mama/psicología , Neoplasias Ováricas/genética , Neoplasias Ováricas/psicología , Ejercicio Físico/psicología , Persona de Mediana Edad , Conducta Alimentaria/psicología , Adulto , Dieta , AncianoRESUMEN
Objective: The aim of the study was to identify a group of women needed psychological support after delivery by identifying the medical and social factors that may influence the emotional changes during the postpartum period.Materials and method: A group of 835 pregnant women in second, third trimester of pregnancy, and during the postpartum period completed the Edinburgh Postnatal Depression Scale and the questionnaire consisting of difficulties that might occur in the four life fields: practical, family, emotional, and physical. The calculations have been carried out with the statistical package Statistica v10 and Cytel Studio v 9.0.0. At the Faculty of Information Science and Statistics of the Poznan University of Medical Sciences.Results: There is a series of medical and social risk factors potentially increasing the risk of postpartum depression, such as psychiatric disorders in the past, difficulties in the professional work, unsatisfactory relationship with partner, and others.Conclusions: Having selected a group of women with risk factors it seems reasonable to apply the Edinburgh Postnatal Depression Scale.
Asunto(s)
Depresión Posparto , Depresión , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Femenino , Humanos , Periodo Posparto , Embarazo , Tercer Trimestre del Embarazo , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Problemas Sociales , Apoyo SocialRESUMEN
OBJECTIVES: The aim of the study was to identify socio-economic factors that may influence the emotional changes which occur among new mothers in the first days postpartum. MATERIAL AND METHODS: A group of 541 women completed a questionnaire consisting of 30 multiple-choice questions, Edinburgh Postnatal Depression Scale (EPDS), and Hospital Anxiety and Depression Scale (HADS). Statistical calculations were performed with the use of Statistica v.10 and Cytel Studio v. 9.0.0. RESULTS: The findings revealed the presence of factors which might increase the risk of mood disorders during the postpartum period. CONCLUSIONS: Women who demonstrate warning symptoms should be screened for postnatal emotional changes and mood swings during their hospitalization after delivery. EPDS seems to be a suitable tool for early detection of emotional disturbances.
Asunto(s)
Trastornos del Humor/psicología , Madres/psicología , Periodo Posparto/psicología , Adolescente , Adulto , Emociones , Femenino , Humanos , Trastornos del Humor/diagnóstico , Trastornos del Humor/economía , Madres/educación , Escalas de Valoración Psiquiátrica , Factores Socioeconómicos , Adulto JovenRESUMEN
BACKGROUND/AIMS: The identification of prognostic factors of metastatic development is one of the most important issues in colorectal cancer (CRC) research. The aim of this study was to determine the usefulness of colon tumor characteristics, including location, circumferential location, histological type, and histological grade, as predictors of metastases. MATERIALS AND METHODS: To identify potential predictors of CRC spread, we analyzed data of 191 patients who had undergone surgery for colon tumors. We searched for potential associations between the location in the right or left colon, circumferential location, histological type, and histological grade (G-parameter) of colon tumors and the incidence of lymph node and distal metastases. The analysis was based on Pearson's chi-square (χ2) test with a statistical significance of p<0.05. RESULTS: Lymph node metastases were found in 100 patients, including 44 patients with synchronous liver metastases. Lymph node involvement was detected in 43 (52.4%) patients with right-sided and in 57 (52.3%) patients with left-sided tumors (p=0.984). Liver metastases were detected in 19 (23.17%) patients with right-sided colon tumors and in 25 (22.9%) patients with left-sided tumors (p=0.969). Lymph node and liver metastases were found in 60 (47.6%) and 24 (19.0%) patients with annular tumors, respectively (p=NS), and these were found on the mesenteric side in 75.0% (n=30) and 20.0% (n=8) patients (p=0.004) and on the antimesenteric side in 47.6% (n=10) and 48.0% (n=12) patients (p=0.044), respectively. CONCLUSION: The circumferential location of primary colon tumors is a significant predictor of their metastatic potential. The mesenteric location of the tumor is predisposed to lymphatic spread, whereas the antimesenteric location predicts hematogenous spread.
Asunto(s)
Neoplasias del Colon/patología , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Adulto , Anciano , Anciano de 80 o más Años , Colon/patología , Femenino , Humanos , Neoplasias Hepáticas/secundario , Masculino , Mesenterio/patología , Persona de Mediana Edad , Metástasis de la Neoplasia , PronósticoRESUMEN
INTRODUCTION: Colorectal cancer is the second most common cancer in terms of incidence in Poland. It is also the second most common cause of cancer deaths in men and the third women. In 75-80% of cases, depending on sources, it is of an occasional nature, and in the remaining 20-25% it has a hereditary character. AIM: To compare the levels of E-cadherin in blood serum with some histopathological and clinical features. E-cadherin is an adhesion molecule, loss of function of which is suspected to influence both cancer progression and metastasis. MATERIAL AND METHODS: The study group comprised 48 patients diagnosed with colorectal cancer treated surgically in the Second Department of General and Gastroenterological Surgery, Medical University Hospital in Bialystok. RESULTS: As has been shown here, there is no statistically significant relationship between the levels of E-cadherin in blood serum and the possible prognosis to the progression of colorectal cancer. However, it was indicated that there appears to be a statistically significant relationship between blood serum E-cadherin levels and the levels of alanine aminotransferase and aspartate aminotransferase in patients with colorectal cancer. CONCLUSIONS: The authors suggest that this significance may require further study.
RESUMEN
INTRODUCTION: Determination of the type of mutations in gastrointestinal stromal tumours (GIST) plays a major role in assessing the risk of progression of the disease, and also allows determination of the clinical management and treatment. More accurate GIST diagnosis is possible by using simultaneously various types of antibodies to immunohistochemistry methods in routine procedures. AIM: To evaluate the expression of CD117, DOG-1, and IGF-1R in patients with gastrointestinal stromal tumours, and analysis of the impact of the examined protein expression on patient survival with emphasis on specific recognition and prognostication of these tumours. MATERIAL AND METHODS: The protein expression was analyzed in 70 patients who had undergone surgical treatment for mesenchymal tumours of the gastrointestinal tract, using the immunohistochemical method. RESULTS: Positive expression of CD117, DOG-1, and IGF1R included 95.71%, 88.57% and 11.43% of study GISTs, respectively. Statistical analysis showed positive significant correlation between DOG-1 expression and histological type of tumour (p = 0.024). Analysis of overall survival curves of 70 GIST patients according to expression of CD117, DOG-1, and IGF1R did not show a tendency towards longer survival of patients with positive expression (p > 0.05). CONCLUSIONS: Predictive factors determining the survival time of patients are strongly associated with morphological features of tumours. A thorough analysis of each case plays a key role in predicting survival time of patients and may be a clue in targeting the therapeutic procedure.
RESUMEN
We studied the effect of heavy metal cations: Fe²âº, Cu²âº, Zn²âº, Cd²âº, Hg²âº, Pb²âº on the activity of cathepsin D in human aorta homogenate and blood serum. The concentration of cations was 1 mmol/l. Hemoglobin was the cathepsin D substrate. The activity of cathepsin D was determined at pH 3.5. Only Hg²âº cations inhibit the activity of cathepsin D. Cations Hg²âº damage lysosomes and release cathepsin D from these organelles.
Asunto(s)
Catepsina D/metabolismo , Metales Pesados/farmacología , Animales , Catepsina D/sangre , Cationes , Humanos , Hígado/efectos de los fármacos , Hígado/enzimología , Lisosomas/efectos de los fármacos , Lisosomas/enzimología , ConejosRESUMEN
Lung cancer is the leading cause of cancer-related mortality in the United States and around the world. There are > 90 million current and ex-smokers in the United States who are at increased risk of lung cancer. The published data from the National Lung Screening Trial (NLST) suggest that yearly screening with low-dose thoracic CT scan in heavy smokers can reduce lung cancer mortality by 20% and all-cause mortality by 7%. However, to implement this program nationwide using the NLST inclusion and exclusion criteria would be extremely expensive, with CT scan costs alone > $2 billion per annum. In this article, we offer a possible low-cost strategy to risk-stratify smokers on the basis of spirometry measurements and emphysema scoring by radiologists on CT scans.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Tamizaje Masivo , Fumar/efectos adversos , Espirometría , Tomografía Computarizada por Rayos X , Anciano , Algoritmos , Carcinoma de Pulmón de Células no Pequeñas/economía , Carcinoma de Pulmón de Células no Pequeñas/etiología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Causas de Muerte , Análisis Costo-Beneficio , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Neoplasias Pulmonares/economía , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/mortalidad , Masculino , Tamizaje Masivo/economía , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Enfisema Pulmonar/diagnóstico por imagen , Enfisema Pulmonar/economía , Enfisema Pulmonar/etiología , Enfisema Pulmonar/mortalidad , Fumar/mortalidad , Espirometría/economía , Tomografía Computarizada por Rayos X/economíaRESUMEN
PURPOSE OF REVIEW: This review summarizes recent literature on the role of neutrophil granule contents in acute lung injury and the mechanisms by which these contribute to inflammatory tissue injury. RECENT FINDINGS: Neutrophil products such as elastase, reactive oxygen species, and antimicrobial peptides can alter pulmonary cell function in a nondegradative fashion through activation of cell surface receptors or modulation of signal transduction pathways. These effects can be either beneficial or detrimental to the host. SUMMARY: The primary function of neutrophils in the innate immune response--to contain and kill invading microbial pathogens--is achieved through a series of rapid and coordinated responses culminating in phagocytosis and intracellular killing of the pathogens. Neutrophils have a potent antimicrobial arsenal that includes oxidants, proteinases, and cationic peptides. Reactive oxygen species such as oxygen are produced by the phagocyte NADPH oxidase and are microbicidal. Granules within the neutrophil cytoplasm contain potent proteolytic enzymes and cationic proteins that can digest a variety of microbial substrates. These compounds are released directly into the phagosome, compartmentalizing both the pathogen and the cytotoxic products. Under pathological circumstances, however, unregulated release of microbicidal compounds into the extracellular space can paradoxically damage host tissues. Nonspecific inhibition of neutrophils is not clinically realistic, as it would leave the host vulnerable to infection. As the mechanisms of action of neutrophil granule contents are elucidated, therapeutic targets will be identified that will allow for suppression of neutrophils' detrimental effects while avoiding inhibition of their beneficial effects.
Asunto(s)
Gránulos Citoplasmáticos/metabolismo , Pulmón/metabolismo , Activación Neutrófila , Neutrófilos/metabolismo , Neumonía/metabolismo , Animales , Gránulos Citoplasmáticos/patología , Defensinas/metabolismo , Humanos , Inflamación/metabolismo , Inflamación/patología , Pulmón/patología , Lesión Pulmonar , Neutrófilos/patología , Elastasa Pancreática/metabolismo , Neumonía/patología , Especies Reactivas de Oxígeno/metabolismoRESUMEN
Pulmonary infection is the dominant clinical feature of cystic fibrosis (CF), but the basis for this susceptibility remains incompletely understood. One hypothesis is that CF airway surface liquid (ASL) is abnormal and interferes with neutrophil function. To study this possibility, we developed an in vitro system in which we collected ASL from primary cultures of normal and CF airway epithelial cells. Microbial killing was less efficient when bacteria were incubated with neutrophils in the presence of ASL from CF epithelia compared with normal ASL. Antimicrobial functions of human neutrophils were assessed in ASL from CF and normal epithelia using a combination of quantitative bacterial culture, flow cytometry, and microfluorescence imaging. The results of these assays of neutrophil function were indistinguishable in CF and normal ASL. In contrast, the direct bactericidal activity of ASL to Escherichia coli and to clinical isolates of Staphylococcus aureus and Pseudomonas aeruginosa was substantially less in CF than in normal ASL, even when highly diluted in media of identical ionic strength. Together, these observations indicate that the antimicrobial properties of ASL in CF are compromised in a manner independent of ionic strength of the ASL, and that this effect is not mediated through a direct effect of the ASL on phagocyte function.