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1.
Contraception ; : 110511, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38844202

RESUMEN

OBJECTIVES: This study aimed to characterize pregnancy outcomes and the incidence of induced abortion among pregnant people with a diagnosis of malignancy. STUDY DESIGN: We conducted a retrospective cohort study among privately insured people aged 12 to 55 years from the fourth quarter of 2015-2020 using US claims data from Merative MarketScan Research Databases. We included pregnancies from seven states with favorable policies for private insurance coverage of abortion. RESULTS: There were 1471 of 183,685 (0.8%) pregnancies with a cancer diagnosis. Among those receiving anticancer therapy, 21.6% (95% CI: 14.4-30.4%) underwent induced abortion compared with 10.9% (95% CI: 10.8-11.1%) of pregnant patients without a cancer diagnosis. CONCLUSIONS: Abortion restrictions may affect many pregnant women requiring cancer treatment in early pregnancy.

2.
Int J Gynecol Cancer ; 34(7): 1001-1010, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38851239

RESUMEN

BACKGROUND: Little is known about real-world patterns of chemotherapy use in patients with cervical cancer. OBJECTIVE: To examine the patterns of chemotherapy use in patients with cervical cancer METHODS: We identified patients with cervical cancer in the IBM MarketScan Database who underwent primary hysterectomy or radiation therapy between 2011 and 2020 and described their treatment in the primary setting and at first recurrence. RESULTS: We identified 5390 patients: 2667 (49.5%) underwent primary hysterectomy and 2723 (50.5%) primary radiotherapy. Among patients who underwent primary hysterectomy, 979 (36.7%) received adjuvant radiation, and 617 (23.1%) received primary chemotherapy. The most common chemotherapy regimens were single-agent platinum (51.7%), platinum combination therapy (42.9%), and non-platinum (3.4%). Among patients treated with primary radiation, 73.6% received primary/concurrent chemotherapy, either platinum alone (66.4% of those who received chemotherapy), platinum combinations (32.2%), or non-platinum (1.4%). The median duration of primary chemotherapy was 1.2 months. Therapy for recurrent cervical cancer was initiated in 959 patients. The most common regimens were platinum combination (63.9%), non-platinum cytotoxic agents (16.5%), single-agent platinum (14.9%), targeted therapy with bevacizumab (6.0%), and immunotherapy with pembrolizumab (3.2%). Overall, the proportion of patients treated with single-agent platinum therapy increased from 17.4% in 2011 to 32.1% in 2019, while platinum combinations decreased from 64.1% to 41.5% over the same years. Use of non-platinum agents increased from 18.5% in 2011 to 32.9% in 2018 and 26.4% in 2019. CONCLUSIONS: Platinum-based chemotherapy is the most commonly used therapy in patients with cervical cancer in the primary setting and at the time of recurrence. The rate of use of non-platinum agents at first recurrence has increased over time.


Asunto(s)
Histerectomía , Recurrencia Local de Neoplasia , Neoplasias del Cuello Uterino , Humanos , Femenino , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/terapia , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estudios Retrospectivos
3.
Opt Express ; 32(9): 15893-15911, 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38859229

RESUMEN

Optical mirror misalignments, which are caused by assembly mistakes and changes in the surrounding environment (such as gravity, temperature, and atmosphere), degrade the system's imaging performance. Therefore, active misalignment correction is essential for ensuring the image quality of the off-axis telescope. In this paper, a novel misalignment correction method without wavefront sensors is proposed. The point spread functions (PSFs) of the system are analytically related to the optical mirror misalignments. On this basis, a fully connected neural network (FCNN) is used to establish the mapping relationship between the misalignments and the discrete orthogonal unbiased finite impulse response (UFIR) moment features, which can effectively characterize changes of intensity and geometric of the spot image. The simulation and experimental results in this paper justify the effectiveness and practicality of the proposed method. This approach offers a low-cost and straightforward technical method for achieving high imaging quality throughout the alignment and observation phases. This approach can prevent the accumulation of errors caused by wavefront detection and the high delay of multiple iterations.

4.
Chin Med J (Engl) ; 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38710539

RESUMEN

BACKGROUND: Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection. METHODS: A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with COVID-19-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2. RESULTS: Among the infected group, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685-11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068-2.343), traditional systemic (adjusted OR = 1.887, 95% CI = 1.263-2.818), and nonsystemic treatment (adjusted OR = 1.602, 95% CI = 1.117-2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680-1.274, compared to no treatment), according to multivariable logistic regression analysis. CONCLUSIONS: A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension. TRIAL REGISTRATION: ClinicalTrials.gov (No. NCT05961605).

5.
Clin Exp Dermatol ; 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38618759

RESUMEN

BACKGROUND: No trial of supramolecular salicylic acid (SSA) for chloasma is available yet. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of Bole DA 30% supramolecular salicylic acid (SSA) combined with 10% niacinamide in treating chloasma. METHODS: This multicenter (n=15), randomized, double-blind, parallel placebo-controlled trial randomized the subjects (1:1) to Bole DA 30% SSA or placebo. The primary endpoint was the effective rate after 16 weeks using the modified melasma area severity index (mMASI) [(pretreatment-posttreatment)/pretreatment×100%]. RESULTS: This study randomized 300 subjects (150/group in the full analysis set, 144 and 147 in the per-protocol set). The total mMASI score, overall Griffiths 10 score, left Griffiths 10 score, and right Griffiths 10 score were significantly lower in the Bole DA 30% SSA group than in the placebo group (all P<0.001). One study drug-related AE and one study drug-unrelated adverse events (AE) were reported in the Bole DA 30% SSA group. No AE was reported in the placebo group. CONCLUSION: Bole DA 30% SSA combined with 10% niacinamide is effective and safe for treating chloasma. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2200065346.

6.
Gynecol Oncol ; 186: 85-93, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38603956

RESUMEN

OBJECTIVE: To assess (i) clinical and pregnancy characteristics, (ii) patterns of surgical procedures, and (iii) surgical morbidity associated with cesarean hysterectomy for placenta accreta spectrum based on the specialty of the attending surgeon. METHODS: The Premier Healthcare Database was queried retrospectively to study patients with placenta accreta spectrum who underwent cesarean delivery and concurrent hysterectomy from 2016 to 2020. Surgical morbidity was assessed with propensity score inverse probability of treatment weighting based on surgeon specialty for hysterectomy: general obstetrician-gynecologists, maternal-fetal medicine specialists, and gynecologic oncologists. RESULTS: A total of 2240 cesarean hysterectomies were studies. The most common surgeon type was general obstetrician-gynecologist (n = 1534, 68.5%), followed by gynecologic oncologist (n = 532, 23.8%) and maternal-fetal medicine specialist (n = 174, 7.8%). Patients in the gynecologic oncologist group had the highest rate of placenta increta or percreta, followed by the maternal-fetal medicine specialist and general obstetrician-gynecologist groups (43.4%, 39.6%, and 30.6%, P < .001). In a propensity score-weighted model, measured surgical morbidity was similar across the three subspecialty groups, including hemorrhage / blood transfusion (59.4-63.7%), bladder injury (18.3-24.0%), ureteral injury (2.2-4.3%), shock (8.6-10.5%), and coagulopathy (3.3-7.4%) (all, P > .05). Among the cesarean hysterectomy performed by gynecologic oncologist, hemorrhage / transfusion rates remained substantial despite additional surgical procedures: tranexamic acid / ureteral stent (60.4%), tranexamic acid / endo-arterial procedure (76.2%), ureteral stent / endo-arterial procedure (51.6%), and all three procedures (55.4%). Tranexamic acid administration with ureteral stent placement was associated with decreased bladder injury (12.8% vs 23.8-32.2%, P < .001). CONCLUSION: These data suggest that patient characteristics and surgical procedures related to cesarean hysterectomy for placenta accreta spectrum differ based on surgeon specialty. Gynecologic oncologists appear to manage more severe forms of placenta accreta spectrum. Regardless of surgeon's specialty, surgical morbidity of cesarean hysterectomy for placenta accreta spectrum is significant.


Asunto(s)
Cesárea , Histerectomía , Placenta Accreta , Humanos , Placenta Accreta/cirugía , Femenino , Histerectomía/efectos adversos , Histerectomía/métodos , Histerectomía/estadística & datos numéricos , Embarazo , Adulto , Estudios Retrospectivos , Cesárea/efectos adversos , Especialidades Quirúrgicas/estadística & datos numéricos , Cirujanos/estadística & datos numéricos
7.
Gynecol Oncol ; 186: 9-16, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38554626

RESUMEN

OBJECTIVE: To develop and evaluate a multidimensional comorbidity index (MCI) that identifies ovarian cancer patients at risk of early mortality more accurately than the Charlson Comorbidity Index (CCI) for use in health services research. METHODS: We utilized SEER-Medicare data to identify patients with stage IIIC and IV ovarian cancer, diagnosed in 2010-2015. We employed partial least squares regression, a supervised machine learning algorithm, to develop the MCI by extracting latent factors that optimally captured the variation in health insurance claims made in the year preceding cancer diagnosis, and 1-year mortality. We assessed the discrimination and calibration of the MCI for 1-year mortality and compared its performance to the commonly-used CCI. Finally, we evaluated the MCI's ability to reduce confounding in the association of neoadjuvant chemotherapy (NACT) and all-cause mortality. RESULTS: We included 4723 patients in the development cohort and 933 in the validation cohort. The MCI demonstrated good discrimination for 1-year mortality (c-index: 0.75, 95% CI: 0.72-0.79), while the CCI had poor discrimination (c-index: 0.59, 95% CI: 0.56-0.63). Calibration plots showed better agreement between predicted and observed 1-year mortality risk for the MCI compared with CCI. When comparing all-cause mortality between NACT with primary cytoreductive surgery, NACT was associated with a higher hazard of death (HR: 1.13, 95% CI: 1.04-1.23) after controlling for tumor characteristics, demographic factors, and the CCI. However, when controlling for the MCI instead of the CCI, there was no longer a significant difference (HR: 1.05, 95% CI: 0.96-1.14). CONCLUSIONS: The MCI outperformed the conventional CCI in predicting 1-year mortality, and reducing confounding due to differences in baseline health status in comparative effectiveness analysis of NACT versus primary surgery.


Asunto(s)
Procedimientos Quirúrgicos de Citorreducción , Aprendizaje Automático , Terapia Neoadyuvante , Neoplasias Ováricas , Programa de VERF , Humanos , Femenino , Procedimientos Quirúrgicos de Citorreducción/métodos , Anciano , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/patología , Anciano de 80 o más Años , Estados Unidos/epidemiología , Quimioterapia Adyuvante , Sesgo , Carcinoma Epitelial de Ovario/mortalidad , Carcinoma Epitelial de Ovario/cirugía , Carcinoma Epitelial de Ovario/tratamiento farmacológico , Carcinoma Epitelial de Ovario/patología , Estadificación de Neoplasias , Medicare/estadística & datos numéricos
8.
J Ovarian Res ; 17(1): 49, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38396022

RESUMEN

Ovarian cancer is a significant challenge in women's health due to the lack of effective screening and diagnostic methods, often leading to late detection and the highest mortality rate among all gynecologic tumors worldwide. Recent research has shown that ovarian cancer has an "iron addiction" phenotype which makes it vulnerable to ferroptosis inducers. We tested the combination of NRF2-targeted inhibitors with GPX4-targeted inhibitors in ovarian cancer through in vitro and in vivo experiment. The data showed that combination treatment effectively suppressed adherent cell growth, inhibited suspended cell spheroid formation, and restrained the ability of spheroid formation in 3D-culture. Mechanistically, the combination induced accumulation of ROS, 4-HNE, as well as activation of caspase-3 which indicates that this combination simultaneously increases cell ferroptosis and apoptosis. Notably, inhibition of GPX4 or NRF2 can suppress ovarian cancer spreading and growth in the peritoneal cavity of mice, while the combination of NRF2 inhibitor ML385 with GPX4 inhibitors showed a significant synergistic effect compared to individual drug treatment in a syngeneic mouse ovarian cancer model. Overall, these findings suggest that combining NRF2 inhibitors with GPX4 inhibitors results in a synergy suppression of ovarian cancer in vitro and in vivo, and maybe a promising therapeutic strategy for the treatment of ovarian cancer.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias Ováricas , Animales , Femenino , Humanos , Ratones , Apoptosis , Ciclo Celular , Neoplasias de los Genitales Femeninos/tratamiento farmacológico , Factor 2 Relacionado con NF-E2/antagonistas & inhibidores , Neoplasias Ováricas/tratamiento farmacológico , Fosfolípido Hidroperóxido Glutatión Peroxidasa/antagonistas & inhibidores , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico
9.
Phytochemistry ; 220: 114033, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38373572

RESUMEN

Ten previously undescribed cucurbitane-type triterpenoids, namely hemslyencins A-F (1-6) and hemslyencosides A-D (7-10), together with twenty previously reported compounds (11-30), were isolated from the tubers of Hemsleya chinensis. Their structures were elucidated by unambiguous spectroscopic data (UV, IR, HR-ESI-MS, 1D and 2D NMR data). Hemslyencins A and B (1 and 2) possessing unique 9, 11-seco-ring system with a six-membered lactone moiety, were the first examples among of the cucurbitane-type triterpenoids, and hemslyencins C and D (3 and 4) and hemslyencoside D (10) are the infrequent pentacyclic cucurbitane triterpenes featuring a 6/6/6/5/6 fused system. The cytotoxic activities of all isolated compounds were evaluated against MCF-7, HCT-116, HeLa, and HepG2 cancer cells, and their structure-activity relationships (SARs) was discussed as well. Compounds 17, 25, and 26 showed significant cytotoxic effects with IC50 values ranging from 1.31 to 9.89 µM, among which compound 25 induced both apoptosis and cell cycle arrest at G2/M phase in a dose dependent manner against MCF-7 cells.


Asunto(s)
Antineoplásicos , Triterpenos , Humanos , Triterpenos/farmacología , Triterpenos/química , Glicósidos/química , Tubérculos de la Planta/química , Células HeLa , Estructura Molecular
10.
Gynecol Oncol ; 184: 214-223, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38340647

RESUMEN

BACKGROUND: Failure to deliver guideline-concordant treatment may contribute to disparities among Hispanic/Latinx cervical cancer patients. This study investigated the association between survival rates in Hispanic/Latinx subpopulations and the provision of guideline-concordant care. METHODS: We analyzed patients with primary cervical cancer from 2004 to 2019 (National Cancer Database). We developed nine quality metrics based on FIGO staging (2009). Clinical and demographic covariates were analyzed using Chi-squared tests. Adjusted associations between receipt of guideline-concordant care and races and ethnicities were analyzed using multivariable marginal Poisson regression models. Adjusted Cox proportional hazard models were utilized to evaluate survival probability. RESULTS: A total of 95,589 patients were included. Hispanic/Latinx and Non-Hispanic Black (NHB) populations were less likely to receive guideline-concordant care in four and five out of nine quality metrics, respectively. Nonetheless, the Hispanic/Latinx group exhibited better survival outcomes in seven of nine quality metrics. Compared to Mexican patients, Cuban patients were 1.17 times as likely to receive timely initiation of treatment in early-stage disease (RR 1.17, 95% CI 1.04-1.37, p < 0.001). Puerto Rican and Dominican patients were, respectively, 1.16 (RR 1.16, 95% CI 1.07-1.27, p < 0.001) and 1.19 (RR 1.19, 95% 1.04-1.37, p > 0.01) times as likely to undergo timely initiation of treatment in early-stage disease. Patients of South or Central American (RR 1.18, 95% CI 1.10-1.27, p < 0.001) origin were more likely to undergo timely initiation of treatment in locally advanced disease. CONCLUSION: Significant differences in survival were identified among our cohort despite the receipt of guideline concordant care, with notably higher survival among Hispanic/Latinx populations.


Asunto(s)
Disparidades en Atención de Salud , Hispánicos o Latinos , Neoplasias del Cuello Uterino , Humanos , Femenino , Neoplasias del Cuello Uterino/terapia , Neoplasias del Cuello Uterino/etnología , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patología , Hispánicos o Latinos/estadística & datos numéricos , Persona de Mediana Edad , Disparidades en Atención de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Tasa de Supervivencia , Adulto , Anciano , Estados Unidos/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Estadificación de Neoplasias , Guías de Práctica Clínica como Asunto
11.
Thyroid ; 34(3): 388-398, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38251649

RESUMEN

Background: Over the last decade, the utilization of molecular testing (MT) for the evaluation of thyroid nodules has increased. Rates and patterns of adoption of MT and its effect on thyroidectomy rates nationally are unknown. Varying rates of MT adoption at the state level provide an opportunity to study the effects of MT on thyroidectomy rates using a quasiexperimental study design. Methods: We performed a retrospective analysis of American adult patients in the Merative™ MarketScan® Research Databases who underwent thyroid fine-needle aspiration (FNA) from 2011 to 2021. MT included commercially available DNA and RNA platforms and traditional targeted mutational analysis. Interrupted time series analysis was used to evaluate the inflection of MT adoption and thyroidectomy rates after 2015. Difference-in-differences (DID) analysis was used to causally analyze the effect of MT adoption on thyroidectomy rates in high-adoption (at least a 10% increase in MT utilization) versus low-adoption states (no more than 5% increase in MT utilization) from 2015 to 2021. Results: We identified 471,364 patients who underwent thyroid FNA. The utilization of MT increased over the study period from 0.01% [confidence interval, CI: 0.00% to 0.02%] to 10.1% [CI: 9.7% to 10.5%], in 2021, with an immediate (ß2 = 1.61, p = 0.002) and deeper (ß3 = 0.6, p < 0.001) increase in MT adoption after 2015. Utilization of MT was lower in black patients, the elderly, rural areas, and patients with Medicaid (p < 0.05). Thyroidectomy rates were inversely correlated with MT utilization (r = -0.98, p < 0.0001). From 2015 to 2021, the average MT utilization rate increased from 2.4% to 15.3% in high-adoption states and 1.6% to 5.6% in low-adoption states. In low-adoption states, thyroidectomy rates decreased more but to similar levels (18.5-13.2%) compared with high-adoption states (15.9-13.4%) with an adjusted DID rate of -3.3% [CI -5.6% to -0.8%]. Conclusions: The acceleration in adoption of MT after 2015 likely coincides with the publication of American Thyroid Association guidelines. Black, elderly, and rural patients are less likely to receive MT. Although thyroidectomy rates were inversely correlated with MT utilization, our study suggests that this correlation is not causal. The effect of MT on thyroidectomy rates may be overshadowed by decreasing aggressiveness of thyroid nodule evaluation.


Asunto(s)
Neoplasias de la Tiroides , Nódulo Tiroideo , Adulto , Humanos , Anciano , Tiroidectomía , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/cirugía , Estudios Retrospectivos , Nódulo Tiroideo/cirugía , Nódulo Tiroideo/genética , Técnicas de Diagnóstico Molecular
12.
Endocr J ; 71(3): 233-244, 2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38233122

RESUMEN

Dyslipidemia has been considered a risk factor for diabetic peripheral neuropathy. Proprotein convertase subtilisin-like/Kexin 9 inhibitor (PCSK9) inhibitors are a new type of lipid-lowering drug currently in clinical use. The role of PCSK9 in diabetic peripheral neuropathy is still unclear. In this study, the effect of alirocumab, a PCSK9 inhibitor, on the sciatic nerve in rats with diabetic peripheral neuropathy and its underlying mechanisms were investigated. The diabetic peripheral neuropathy rat model was established by using a high-fat diet combined with streptozotocin injection, and experimental subjects were divided into normal, diabetic peripheral neuropathy, and alirocumab groups. The results showed that Alirocumab improved nerve conduction, morphological changes, and small fiber deficits in rats with DPN, possibly related to its amelioration of oxidative stress and the inflammatory response.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Diabetes Mellitus , Neuropatías Diabéticas , Animales , Ratas , Neuropatías Diabéticas/tratamiento farmacológico , Neuropatías Diabéticas/prevención & control , Inhibidores de PCSK9 , Proproteína Convertasa 9 , Proproteína Convertasas , Nervio Ciático , Subtilisina
13.
Obstet Gynecol ; 143(2): 303-311, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38086058

RESUMEN

OBJECTIVE: To evaluate the association between hospital volume and the quality of gynecologic emergency care for tubal ectopic pregnancies, ovarian torsion, and pelvic inflammatory disease (PID). METHODS: In this cross-sectional analysis, we analyzed patients who presented for emergency care for tubal ectopic pregnancies, ovarian torsion, and PID using the Premier Healthcare Database from 2006 to 2020. We measured the following outcomes: methotrexate use for ectopic pregnancy, ovarian cystectomy for torsion, and guideline-based antibiotic use for PID. For each condition, we measured outlier hospitals that performed the above interventions at below the 10th percentile. Multivariable logistic regression models were used to analyze associations between outlier care and hospital factors such as annualized mean case volume, urban or rural location, teaching status, bed capacity, and geographic region, as well as hospital-level patient population factors, including age, insurance status, and race. RESULTS: A total of 602 hospitals treated patients with tubal ectopic pregnancies, of which 21.9% were outliers, with no cases managed with methotrexate. Of 512 hospitals treating patients with ovarian torsion, 17.4% were outliers, with no cases managed with cystectomy. Of 929 hospitals that treated patients with PID, 9.9% were deemed outliers with low rates of guideline-adherent antibiotic administration. Low-volume hospitals were more likely to be outliers with low rates of use of methotrexate for ectopic pregnancy (6.7% of high-volume hospitals vs 49.7% of low-volume hospitals were outliers; adjusted odds ratio [aOR] 0.13, 95% CI, 0.05-0.31 for high-volume hospitals) and cystectomy for torsion (34.9% of low-volume vs 2.4% of high-volume hospitals were outliers; aOR 0.05, 95% CI, 0.01-0.18 for high-volume hospitals). There was no association between hospital volume and lower rates of guideline-based antibiotic use for PID. CONCLUSION: Higher hospital volume is associated with use of conservative, fertility-preserving treatment of emergency gynecologic conditions, including ectopic pregnancy and ovarian torsion.


Asunto(s)
Servicios Médicos de Urgencia , Enfermedad Inflamatoria Pélvica , Embarazo Ectópico , Embarazo Ovárico , Embarazo Tubario , Embarazo , Humanos , Femenino , Metotrexato , Torsión Ovárica/complicaciones , Estudios Transversales , Embarazo Ectópico/cirugía , Hospitales de Alto Volumen , Antibacterianos/uso terapéutico
15.
J Cosmet Dermatol ; 23(3): 999-1003, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37864385

RESUMEN

OBJECTIVE: This study aims at investigating the difference in facial skin barrier function between rosacea patients and the healthy population of different ages in the Qinghai region and its correlation with age, providing a basis for clinical nursing and treatment. METHODS: The data of 216 rosacea patients were collected, and 211 healthy testers were selected as the control group. The skin barrier characteristics of rosacea patients of different ages were evaluated by comparing transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum content (SC), and pH values between the two groups. Then, the correlation between skin barrier function and age in rosacea patients and the healthy population was analyzed. RESULTS: In all four age groups, the TEWL of the rosacea group was higher than that of the healthy control group, and the epidermal hydration was lower than the healthy control group. In the population aged over 40, the sebum content in rosacea was lower than that in the healthy control group. In the age group of 40-59, the pH value of the rosacea group was higher than the healthy control group. In both the rosacea and the control groups, TEWL was positively correlated with age, and epidermal hydration was negatively correlated with age. The sebum content in rosacea group was negatively correlated with age (p < 0.05). CONCLUSION: As age increases, the facial epidermal function of both rosacea patients and the healthy population declines. Therefore, with increasing age, attention should be paid to enhance the epidermal function to slow down the skin aging process.


Asunto(s)
Rosácea , Piel , Humanos , Adulto , Persona de Mediana Edad , Epidermis , Agua , Cara
16.
BJOG ; 131(5): 690-698, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37840233

RESUMEN

OBJECTIVE: To investigate associations between air particulate matter of ≤2.5 µm in diameter (PM2.5 ) and ovarian cancer. DESIGN: County-level ecological study. SETTING: Surveillance, epidemiology, and end results from a collection of state-level cancer registries across 744 counties. Data from the Environmental Protection Agency's network for PM2.5 monitoring was used to calculate trailing 5- and 10-year PM2.5 county-level values. County-level data on demographic characteristics were obtained from the American Community Survey. POPULATION: A total of 98 751 patients with histologically confirmed ovarian cancer as a primary malignancy from 2000 to 2016. METHODS: Generalised linear regression models were developed to estimate the association between PM2.5 and PM10 levels, over 5- and 10-year periods of exposure, and ovarian cancer risk, after accounting for county-level covariates. MAIN OUTCOME MEASURES: Risk ratios for associations between ovarian cancer (both overall and specifically epithelial ovarian cancer) and PM2.5 levels. RESULTS: For the 744 counties included, the average PM2.5 level from 1990 through 2018 was 11.75 µg/m3 (SD = 3.7) and the average PM10 level was 22.7 µg/m3 (SD = 5.7). After adjusting for county-level covariates, the overall annualised ovarian cancer incidence was significantly associated with increases in 5-year PM2.5 (RR = 1.11 per 10 units (µg/m3 ) increase, 95% CI 1.06-1.16). Similarly, when the analysis was limited to epithelial cell tumours and adjusted for county-level covariates there was a significant association with trailing 5-year PM2.5 exposure models (RR = 1.12 per 10 units increase, 95% CI 1.08-1.17). Likewise, 10-year PM2.5 exposure was associated with ovarian cancer overall and with epithelial ovarian cancer. CONCLUSIONS: Higher county-level ambient PM2.5 levels are associated with 5- and 10-year incidences of ovarian cancer, as measurable in an ecological study.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Neoplasias Ováricas , Humanos , Femenino , Material Particulado/efectos adversos , Material Particulado/análisis , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Incidencia , Carcinoma Epitelial de Ovario/epidemiología , Carcinoma Epitelial de Ovario/etiología , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Contaminación del Aire/efectos adversos , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/etiología
17.
Eur J Pharm Sci ; 193: 106672, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38103658

RESUMEN

Changes in RNA editing are closely associated with diseases such as cancer, viral infections, and autoimmune disorders. Adenosine deaminase (ADAR1), which acts on RNA 1, plays a key role in adenosine to inosine editing and is a potential therapeutic target for these various diseases. The p150 subtype of ADAR1 is the only one that contains a Zα domain that binds to both Z-DNA and Z-RNA. The Zα domain modulates immune responses and may be suitable targets for antiviral therapy and cancer immunotherapy. In this study, we attempted to utilize molecular docking to identify potential inhibitors that bind to the ADAR1 Zα domain. The virtual docking method screened the potential activity of more than 100,000 compounds on the Zα domain of ADAR1 and filtered to obtain the highest scoring results.We identified 71 compounds promising to bind to ADAR1 and confirmed that two of them, lithospermic acid and Regaloside B, interacts with the ADAR1 Zα domain by surface plasmonic resonance technique. The molecular dynamics calculation of the complex of lithospermic acid and ADAR1 also showed that the binding effect of lithospermic acid to ADAR1 was stable.This study provides a new perspective for the search of ADAR1 inhibitors, and further studies on the anti-ADAR11 activity of these compounds have broad prospects.


Asunto(s)
Benzofuranos , Depsidos , Neoplasias , ARN , Humanos , Sitios de Unión , Adenosina Desaminasa/química , Adenosina Desaminasa/metabolismo , Simulación del Acoplamiento Molecular
18.
Appl Opt ; 62(36): 9470-9475, 2023 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-38108771

RESUMEN

In order to suppress the impact of atmosphere turbulence on the space laser communication link, the wavefront correction technology of a liquid crystal spatial light modulator (LCSLM) is studied. Combining with the control mode of the LCSLM, we propose an improved deep learning approach that restores the input image features into the wavefront and then controls the LCSLM to compensate for the phase distortion. This method does not have Zernike coefficient truncation and does not require the calculation of coefficient matrices, thus improving the accuracy and efficiency of the algorithm. At the same time, as for its powerful phase fitting ability, the LCSLM can be used as a turbulence simulator to construct datasets. During the training process of the neural networks, a calibration between the LCSLM and deep learning is established. Finally, a spatial optical coupling experimental system is built. The results show that, under different atmospheric conditions, the liquid crystal wavefront correction method has a significant improvement in terminal coupling efficiency and has certain application prospects in the field of free-space optical communication.

19.
Cureus ; 15(10): e47574, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38021786

RESUMEN

Background The poor prognosis of lung adenocarcinoma (LUAD) has been confirmed by a large number of studies, so it is necessary to construct a prognosis model. In addition, exosome is closely related to tumors, but there are few studies on exosome-related long non-coding RNA (lncRNA) (ExolncRNA). Methods In this study, we designed a prognostic model, exosome-related lncRNA-based signature (ExoLncSig), using ExolncRNA expression profiles of LUAD patients from The Cancer Genome Atlas (TCGA). ExolncRNAs were identified through univariate and multivariate and Lasso analyses. Subsequently, based on the ExoLncSig, gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, immune function and immunotherapy analysis, drug screening, and so on were performed. Results AC026355.2, AC108136.1, AL590428.1, and LINC01312 were examined to establish the ExoLncSig. Gene enrichment analysis identified potential prognostic markers and therapeutic targets, including human leukocyte antigen (HLA), parainflammation, chemokine receptor (CCR), antigen-presenting cell (APC) co-inhibition, cancer-associated fibroblast (CAF), and myeloid-derived suppressor cell (MDSC). Moreover, we ascertained that the high-risk subgroup exhibits heightened susceptibility to pharmaceutical agents. Conclusion Our findings indicate that ExoLncSig holds promise as a valuable prognostic marker in LUAD. Furthermore, the immunogenic properties of ExolncRNAs may pave the way for the development of a therapeutic vaccine against LUAD.

20.
Environ Sci Technol ; 57(37): 13818-13827, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37690063

RESUMEN

In response to climate change, China is making great efforts to increase the green area for carbon sequestration. Road verges, as marginal land with favorable conditions for plant growth and ease of transportation, can be used for biomass production, but the biomass production and carbon sequestration potential have not been assessed. Here, we mapped the biomass production potential of road verges in China by combining a biomass model and Geographic Information System and then evaluated the effect of road runoff and CO2 fertilization on the production according to the runoff coefficient and vehicle emission inventory. Nationwide, road verges can produce 15.86 Mt C yr-1 of biomass. Road runoff contributes to a biomass production of 1.26 Mt C yr-1 through increasing soil water availability, which mainly occurs in arid regions. The CO2 fertilization effect by vehicle emission is considerable in Eastern and Southern China, contributing to a production of 0.09 Mt C yr-1. Life cycle assessment shows that major road verges in China have a carbon sequestration potential of 6.87 Mt C yr-1 currently. Our results revealed that road verges can make a significant contribution to carbon neutrality under proper management.


Asunto(s)
Dióxido de Carbono , Secuestro de Carbono , Biomasa , Emisiones de Vehículos , China
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