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1.
Rev Environ Contam Toxicol ; 251: 131-184, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31129734

RESUMEN

Maternal exposure to endocrine-disrupting chemicals (EDCs) is associated with long-term hormone-dependent effects that are sometimes not revealed until maturity, middle age, or adulthood. The aim of this study was to conduct descriptive reviews on animal experimental and human epidemiological evidence of the adverse health effects of in utero and lactational exposure to selected EDCs on the first generation and subsequent generation of the exposed offspring. PubMed, Web of Science, and Toxline databases were searched for relevant human and experimental animal studies on 29 October 29 2018. Search results were screened for relevance, and studies that met the inclusion criteria were evaluated and qualitative data extracted for analysis. The search yielded 73 relevant human and 113 animal studies. Results from studies show that in utero and lactational exposure to EDCs is associated with impairment of reproductive, immunologic, metabolic, neurobehavioral, and growth physiology of the exposed offspring up to the fourth generation without additional exposure. Little convergence is seen between animal experiments and human studies in terms of the reported adverse health effects which might be associated with methodologic challenges across the studies. Based on the available animal and human evidence, in utero and lactational exposure to EDCs is detrimental to the offspring. However, more human studies are necessary to clarify the toxicological and pathophysiological mechanisms underlying these effects.


Asunto(s)
Disruptores Endocrinos , Exposición Materna/estadística & datos numéricos , Animales , Femenino , Humanos , Embarazo
3.
Klin Lab Diagn ; 64(8): 477-480, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31479602

RESUMEN

This research paper presents the results of a study of some indicators of iron metabolism in anaemia in pregnant women. The venous blood of 39 pregnant women with anaemia was examined. Serum ferritin, ferroportin and hepcidin were investigated for this purpose. The comparison group consisted of 19 pregnant women without anaemia. The haemoglobin concentration was measured by using «Mythic-18¼ haematological autoanalyzer. The concentrations of hepcidin and ferroportin were determined by using «Cloud-Clone Corp.¼ (USA), and ferritin concentrations were determined by using «Pishtaz teb¼ (Iran) reagents through enzyme-linked immunosorbent assay (ELISA) method. The study revealed a significant decrease in the level of ferritin, hepcidin and a significant increase in ferroportin level. A comprehensive definition of various indicators of iron metabolism provides important information not only for understanding the pathogenesis of iron deficiency anaemia in pregnant women but also for early diagnosis of the disease and the appointment of the correct treatment.


Asunto(s)
Anemia Ferropénica/sangre , Citocinas/sangre , Hierro/metabolismo , Complicaciones Hematológicas del Embarazo/sangre , Femenino , Ferritinas/sangre , Hepcidinas/sangre , Humanos , Embarazo
4.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 275-281, 2019 May 25.
Artículo en Chino | MEDLINE | ID: mdl-31496159

RESUMEN

OBJECTIVE: To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients. METHODS: A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls. RESULTS: Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (ß=-133.3 mg/L, 95%CI:-200.4--0.1, P<0.01), subcortical infarction (OR=4.05, 95%CI:1.15-14.18, P<0.05) and female (OR=2.54, 95%CI:1.04-6.23, P<0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%CI:2.33-6.41, P<0.01), PHQ-9 increased by 2.17 (95%CI:0.39--3.94, P<0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%CI:-1.79--0.15, P<0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (OR=4.27, 95%CI:1.40-13.10, P<0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (ß=12.85, 95%CI:2.04-23.67, P<0.05). CONCLUSIONS: RLS is common in ischemic stroke patients and has adverse influences on patients.


Asunto(s)
Isquemia Encefálica , Síndrome de las Piernas Inquietas , Accidente Cerebrovascular , Isquemia Encefálica/complicaciones , Isquemia Encefálica/patología , Depresión/complicaciones , Femenino , Humanos , Masculino , Polisomnografía , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de las Piernas Inquietas/patología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/patología
5.
Gan To Kagaku Ryoho ; 46(8): 1259-1263, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501367

RESUMEN

We retrospectively analyzed adverse effects(AEs), overall survival(OS), and progression-free survival(PFS)in 15 consecutive patients treated with FOLFIRINOX as the first-line treatment for recurrent or unresectable pancreatic ductal adenocarcinoma( PDAC)between February 2014 and December 2017 in our hospital. Eleven patients were treated for unresectable PDAC with distant metastases(UR-M), and 4 were treated for locally advanced unresectable PDAC(UR-LA). The median age was 56(range: 40-75)years. Nine patients were male, and 6 were female. The performance status was 0 or 1 in all patients. Tumors were located in the pancreas head in 8 cases and in the body-tail in 7 cases. Grade 5 AEs were observed in 1 case in which liver abscess causing sepsis resulted in mortality. The response rate was 20.0%, and the disease control rate was 66.7%. Two patients underwent conversion surgery after FOLFIRINOX treatment. Seven patients received a nab-paclitaxel plus gemcitabine regimen as second-line treatment. The median OS and PFS were 17.0 and 8.4 months, respectively, and the 1-year survival rate was 66.7%. FOLFIRINOX for recurrent and unresectable PDAC showed relatively good tumor control. However, strict attention is required for severe AEs. Conversion surgery might be effective in patients who are good responders even if they have metastatic disease.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Pancreáticas , Adulto , Anciano , Carcinoma Ductal Pancreático , Femenino , Fluorouracilo , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/tratamiento farmacológico , Estudios Retrospectivos
6.
Gan To Kagaku Ryoho ; 46(8): 1291-1293, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501372

RESUMEN

A 63-year-old woman underwent right lower lobectomy and mediastinal dissection for lung cancer. At 5 years and 5 months after surgery, chest computed tomography revealed multiple liver metastasis. EGFR gene mutations of L858R and T790M were detected in both the primary lung cancer lesion and the liver metastasis specimen. Gefitinib was initiated as the first-line treatment, but the tumors increased in size. Osimertinib, as second-line treatment, was remarkably effective against the liver metastatic lesions and it maintained a partial response for approximately 1 year. Thus, osimertinib was effective for liver metastasis of lung cancer with EGFR mutations of L858R and T790M.


Asunto(s)
Acrilamidas/uso terapéutico , Compuestos de Anilina/uso terapéutico , Neoplasias Hepáticas , Neoplasias Pulmonares , Carcinoma de Pulmón de Células no Pequeñas , Receptores ErbB , Femenino , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Persona de Mediana Edad , Mutación , Inhibidores de Proteínas Quinasas
7.
Gan To Kagaku Ryoho ; 46(8): 1303-1306, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501375

RESUMEN

A 75-year-old woman presented with difficulty in swallowing. Esophagogastroduodenoscopy(EGD)revealed a Borrmann type 3 advanced gastric cardia carcinoma. Computed tomography(CT)revealed three lymph node metastases, and thus, the preoperative diagnosis was cT4aN2M0, cStage ⅢB. However, the patient refused resection, and chemotherapy was initiated. The chemotherapy regimen was sequentially changed based on the macroscopic characteristics of the lesion: S-1 plus CDDP followed by S-1 alone, S-1 plus PTX, and PTX alone. We have continued to follow-upthe lesion using EGD and CT, and have observed the macroscopic characteristics of the advanced gastric carcinoma treated without resection for 7 years.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Gástricas , Anciano , Cisplatino , Femenino , Estudios de Seguimiento , Gastrectomía , Humanos , Ácido Oxónico , Neoplasias Gástricas/tratamiento farmacológico , Tegafur
8.
Gan To Kagaku Ryoho ; 46(8): 1307-1309, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501376

RESUMEN

Neoadjuvant imatinib may prevent tumor rupture and the need for extended surgery by reducing the tumor size by approximately 35%, especially for large gastric gastrointestinal stromal tumors(GISTs), as shown in a previous phase Ⅱ study (Kurokawa et al. BJC 2017); however, the use ofneoadjuvant imatinib is not prevalent in clinical practice. Herein, we report a large gastric GIST that was successfully treated with neoadjuvant imatinib. A 74-year-old woman complained ofabdominal pain, and abdominal computed tomography(CT)revealed a 14 cm oval tumor in the left upper abdominal cavity. Gastric biopsy revealed that the tumor was a GIST. The patient also had a small lung tumor that was diagnosed as a primary lung carcinoma in the right upper lobe. We performed neoadjuvant imatinib for 6 months as the primary treatment. After 7 months ofimatinib administration, CT revealed that the GIST decreased in size but the lung cancer was slightly enlarged. Therefore, we performed right upper lung lobectomy and continued imatinib therapy for an additional 3 months. After a total of9 months ofneoadjuvant imatinib treatment, we performed partial gastrectomy combined with splenectomy without tumor rupture. The patient is scheduled to continue imatinib therapy for a total of 3 years.


Asunto(s)
Tumores del Estroma Gastrointestinal , Terapia Neoadyuvante , Neoplasias Gástricas , Anciano , Antineoplásicos , Femenino , Tumores del Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Neoplasias Gástricas/terapia
9.
Gan To Kagaku Ryoho ; 46(8): 1311-1313, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501377

RESUMEN

An 84-year-old woman had locally advanced sigmoid colon cancer that was unresectable because of deep invasion in the left pelvic wall. Transverse double-barrel colostomy was performed owing to stenosis in the sigmoid colon. The patient's performance status score was 2, and it was difficult to administer cytotoxic chemotherapy. Single-agent panitumumab chemotherapy was initiated. In addition, although S-1 was administered for 4 days in the fourth cycle, it was discontinued owing to drug intolerance. Panitumumab was administered seven times. The tumor size markedly reduced, and sigmoid colectomy was performed. Thus, single-agent panitumumab chemotherapy is a possible treatment option for advanced colorectal cancer in elderly patients.


Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Panitumumab/uso terapéutico , Neoplasias del Colon Sigmoide , Anciano de 80 o más Años , Colon Sigmoide , Femenino , Humanos , Neoplasias del Colon Sigmoide/tratamiento farmacológico , Neoplasias del Colon Sigmoide/cirugía
10.
Gan To Kagaku Ryoho ; 46(8): 1315-1317, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501378

RESUMEN

We report synchronous resection of gallbladder hyperplasia polyps with pancreaticobiliary maljunction without dilation of the bile duct and sigmoid colon carcinoma. The patient was a 60-year-old woman diagnosed with sigmoid colon cancer. Gallbladder polyps were detected incidentally during a preoperative examination for sigmoid colon cancer that was discovered because of anemia. Detailed examination revealed a suspected gallbladder carcinoma along with pancreaticobiliary maljunction without dilation of the bile duct. The patient underwent synchronous open colectomy and cholecystectomy. Histopathological diagnosis excluded gallbladder carcinoma, so we did not perform bile duct resection or lymph node resection around the bile duct. The final diagnosis was gallbladder hyperplasia polyps, chronic cholecystitis, and sigmoid colon cancer (pT3N2M0, stage Ⅲb). Therefore, physicians should pay attention to the possibility of pancreaticobiliary maljunction if gallbladder polyps are detected incidentally during preoperative examination for other diseases. In the present case, we could treat the patient with minimally invasive techniques by adding the treatment to that performed for the other disease.


Asunto(s)
Neoplasias de la Vesícula Biliar , Neoplasias del Colon Sigmoide , Conductos Biliares , Colon Sigmoide , Dilatación , Femenino , Humanos , Hiperplasia , Persona de Mediana Edad , Conductos Pancreáticos
11.
Gan To Kagaku Ryoho ; 46(8): 1323-1325, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501380

RESUMEN

A 63-year-old woman was admitted to our hospital owing to advanced rectal carcinoma. The patient underwent laparoscopic lowanterior resectionwith D3 lymph node dissection and partial resection of the uterus. The histopathological diagnosis was fT4bN2M0, fStage Ⅲb. Thus, capecitabine plus oxaliplatin(CapeOX)therapy as adjuvant chemotherapy was scheduled for 6 months. However, after the 4th course of chemotherapy, contrast-enhanced CT revealed multiple metastases of the rectal carcinoma including metastases in the liver, peritoneum, retroperitoneum, and subcutaneous tissue of the left lower back. The patient received palliative treatment and died 8 months after surgery. Only a fewcases of subcutaneous metastasis of rectal carcinoma have been reported. Therefore, we herein report this case with a review of the literature.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Recto , Capecitabina , Quimioterapia Adyuvante , Femenino , Humanos , Persona de Mediana Edad , Oxaliplatino , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/cirugía , Tejido Subcutáneo
12.
Gan To Kagaku Ryoho ; 46(8): 1337-1339, 2019 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-31501384

RESUMEN

We conducted a retrospective study to evaluate the efficacy and the problem of the neoadjuvant chemotherapy using DCF for cStage Ⅲ/Ⅳ(squamous cell)esophageal cancer. Eleven patients from January 2017 to December 2018 were enrolled into this study. The median age was 67 years old, male/female ratio was 9:2, performance status was 0 in all patients, and UICC cStage Ⅲ/Ⅳa was 7:4. Cycles of chemotherapy was 2 in 1 patients, 3 in 5 patients and additional 2 courses in 1 patient. Four patients switched to FP therapy after a course of DCF. The efficacy of chemotherapy was evaluated by the clinical response rate, average tumor reduction rate, and histological therapeutic effect rate over Grade 2 which was 63.6%, 48.3%, and 40%, respectively. Neutropenia over Grade 3 was observed in all patients and Grade 4 was observed in 6 patients. In conclusion, preoperative chemotherapy with DCF therapy is useful for the treatment of cStage Ⅲ/Ⅳ(squamous cell) esophageal cancer as long as bone marrow suppression is managed.


Asunto(s)
Neoplasias Esofágicas , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica , Docetaxel , Femenino , Fluorouracilo , Humanos , Masculino , Terapia Neoadyuvante , Estudios Retrospectivos , Taxoides , Resultado del Tratamiento
13.
Einstein (Sao Paulo) ; 17(4): eAO4742, 2019 Sep 09.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31508660

RESUMEN

OBJECTIVE: To evaluate the induction of DNA damage in peripheral blood mononuclear cells of patients with sickle cell disease, SS and SC genotypes, treated with hydroxyurea. METHODS: The study subjects were divided into two groups: one group of 22 patients with sickle cell disease, SS and SC genotypes, treated with hydroxyurea, and a Control Group composed of 24 patients with sickle cell disease who were not treated with hydroxyurea. Peripheral blood samples were submitted to peripheral blood mononuclear cell isolation to assess genotoxicity by the cytokinesis-block micronucleus cytome assay, in which DNA damage biomarkers - micronuclei, nucleoplasmic bridges and nuclear buds - were counted. RESULTS: Patients with sickle cell disease treated with hydroxyurea had a mean age of 25.4 years, whereas patients with sickle cell disease not treated with hydroxyurea had a mean age of 17.6 years. The mean dose of hydroxyurea used by the patients was 12.8mg/kg/day, for a mean period of 44 months. The mean micronucleus frequency per 1,000 cells of 8.591±1.568 was observed in the Hydroxyurea Group and 10.040±1.003 in the Control Group. The mean frequency of nucleoplasmic bridges per 1,000 cells and nuclear buds per 1,000 cells for the hydroxyurea and Control Groups were 0.4545±0.1707 versus 0.5833±0.2078, and 0.8182±0.2430 versus 0.9583±0.1853, respectively. There was no statistically significant difference between groups. CONCLUSION: In the study population, patients with sickle cell disease treated with the standard dose of hydroxyurea treatment did not show evidence of DNA damage induction.


Asunto(s)
Anemia de Células Falciformes/genética , Daño del ADN/efectos de los fármacos , Hidroxiurea/farmacología , Inhibidores de la Síntesis del Ácido Nucleico/farmacología , Adolescente , Adulto , Anemia de Células Falciformes/tratamiento farmacológico , Niño , Preescolar , Citocinesis , Daño del ADN/genética , Femenino , Humanos , Hidroxiurea/efectos adversos , Hidroxiurea/uso terapéutico , Masculino , Pruebas de Micronúcleos , Persona de Mediana Edad , Pruebas de Mutagenicidad , Mutación/efectos de los fármacos , Inhibidores de la Síntesis del Ácido Nucleico/efectos adversos , Inhibidores de la Síntesis del Ácido Nucleico/uso terapéutico , Adulto Joven
19.
Rev Bras Epidemiol ; 22: e190045, 2019 Sep 02.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31482984

RESUMEN

INTRODUCTION: The study assessed interobserver reliability in the classification of record pairs formed during probabilistic linkage of health-related databases, a key step in the methodology validation to be used in a larger on-going study on inequalities in the access to breast and cervical cancer control activities in Brazil (DAAC-SIS). METHODOLOGY: The RecLink software was used to link two databases of the Breast Cancer Control Information System (SISMAMA) in the state of Minas Gerais, Brazil: a reference database, which included 301 screening mammograms with probable benign diagnosis (BI-RADS 3 category) recorded in October 2010, and a database comprising 158,517 mammograms registered in 2011. Subsequently, the 215 pairs of records that were not assigned the maximum RecLink score were independently classified as being true or false by ten independent evaluators from four participating centers. RESULTS: The Kappa coefficient ranged from 0.87 to 1.00. Six evaluators were in perfect agreement with one or more evaluators from the other centers. The global Kappa was 0.96 (95% confidence interval - 95%CI 0.94 - 0.99). DISCUSSION: Assessment of interobserver reliability is key to ensuring the quality of the record linkage, and it should be routine practice in studies of this nature. The disclosure of such results contributes to transparency in the conduct of such studies and in the reporting of their findings. CONCLUSION: Interobserver reliability in this study was excellent, indicating satisfactory team consistency in the classification of record pairs.


Asunto(s)
Neoplasias de la Mama/prevención & control , Sistemas de Información en Salud , Registro Médico Coordinado , Brasil , Bases de Datos Factuales , Femenino , Humanos , Mamografía , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Integración de Sistemas
20.
MMWR Morb Mortal Wkly Rep ; 68(35): 762-765, 2019 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-31487273

RESUMEN

Approximately 700 women die in the United States each year as a result of pregnancy or its complications, and significant racial/ethnic disparities in pregnancy-related mortality exist (1). Data from CDC's Pregnancy Mortality Surveillance System (PMSS) for 2007-2016 were analyzed. Pregnancy-related mortality ratios (PRMRs) (i.e., pregnancy-related deaths per 100,000 live births) were analyzed by demographic characteristics and state PRMR tertiles (i.e., states with lowest, middle, and highest PRMR); cause-specific proportionate mortality by race/ethnicity also was calculated. Over the period analyzed, the U.S. overall PRMR was 16.7 pregnancy-related deaths per 100,000 births. Non-Hispanic black (black) and non-Hispanic American Indian/Alaska Native (AI/AN) women experienced higher PRMRs (40.8 and 29.7, respectively) than did all other racial/ethnic groups. This disparity persisted over time and across age groups. The PRMR for black and AI/AN women aged ≥30 years was approximately four to five times that for their white counterparts. PRMRs for black and AI/AN women with at least some college education were higher than those for all other racial/ethnic groups with less than a high school diploma. Among state PRMR tertiles, the PRMRs for black and AI/AN women were 2.8-3.3 and 1.7-3.3 times as high, respectively, as those for non-Hispanic white (white) women. Significant differences in cause-specific proportionate mortality were observed among racial/ethnic populations. Strategies to address racial/ethnic disparities in pregnancy-related deaths, including improving women's health and access to quality care in the preconception, pregnancy, and postpartum periods, can be implemented through coordination at the community, health facility, patient, provider, and system levels.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Complicaciones del Embarazo/etnología , Complicaciones del Embarazo/mortalidad , Adulto , Femenino , Humanos , Embarazo , Factores de Riesgo , Estados Unidos/epidemiología , Adulto Joven
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