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1.
Medicine (Baltimore) ; 100(6): e24671, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578598

RESUMEN

ABSTRACT: The mortality rate of patients diagnosed with sepsis is high. To date, many markers in sepsis patients have been studied to diagnose, determine their prognosis, and contribute to treatment. These studies were conducted in both experimental and clinical settings, but clinical trials remain limited. Therefore, more well-planned clinical studies are needed in patients with sepsis.The current study aimed to examine the prognostic role of signal peptide-CUB-epidermal growth factor-like domain-containing protein 1 (SCUBE-1) in sepsis and sepsis-related mortality. We also wanted to study its relationship with inflammatory markers and scoring systems.This prospective, cross-sectional, observational study included a total of 187 sepsis cases treated in the intensive care unit. Venous samples were obtained after diagnosis. The patients were separated into 2 groups: (1) the survivor group who were discharged or transferred within 28 days of the first diagnosis and (2) the nonsurvivor group who died within 28 days of the first diagnosis.The SCUBE-1, C-reactive protein, procalcitonin, creatinine, lactate values, acute physiology and chronic health evaluation 2, sequential organ failure assessment scores were significantly higher in the survivor group, and platelets were higher in the survivor group. In addition, SCUBE-1 positively correlated with the inflammatory markers C-reactive protein, lactate, sequential organ failure assessment, and acute physiology and chronic health evaluation 2. Additionally, the SCUBE-1 value predicts 28-day mortality, and the optimal cutoff value for predicting mortality is 4,73 pg/mL.Sepsis is a disease with high mortality. SCUBE-1 can be used as a new prognostic factor for sepsis patients.


Asunto(s)
Biomarcadores/metabolismo , Proteínas de Unión al Calcio/metabolismo , Unidades de Cuidados Intensivos/estadística & datos numéricos , Sepsis/metabolismo , Sobrevivientes/estadística & datos numéricos , APACHE , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Reglas de Decisión Clínica , Creatinina/sangre , Estudios Transversales , Femenino , Humanos , Ácido Láctico/análisis , Masculino , Mortalidad/tendencias , Puntuaciones en la Disfunción de Órganos , Polipéptido alfa Relacionado con Calcitonina/metabolismo , Pronóstico , Estudios Prospectivos , Sepsis/diagnóstico , Sepsis/mortalidad , Turquia/epidemiología
2.
Medicine (Baltimore) ; 100(6): e24688, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578601

RESUMEN

RATIONALE: The incidence of nonsmall cell lung cancer (NSCLC) is high. Most nonsmall cell lung cancers have undergone multiple metastases at the time of initial diagnosis, and the 5 year survival rate is low. At present, comprehensive treatments, including systemic chemotherapy, targeted therapy, antiangiogenic therapy, and immunotherapy, prolong the survival of patients with advanced NSCLC. Herein, we report a case of NSCLC with long-term survival. PATIENT CONCERNS: A 61-year-old woman complained of dry cough and shortness of breath and visited our hospital in July 2011. Imaging examination revealed a left upper lung mass with multiple metastases to the liver, adrenal gland, and bone. DIAGNOSES: Stage IVB (cT2aN3M1c) lung adenocarcinoma was diagnosed, with multiple metastases of the lymph nodes, liver, adrenal gland, and bone. INTERVENTIONS AND OUTCOMES: The patient received systemic chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitor-targeted therapy, and has survived for more than 9 years. LESSONS: The patient benefited from maintenance chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitor treatment and achieved long-term survival.


Asunto(s)
Adenocarcinoma del Pulmón/tratamiento farmacológico , Adenocarcinoma del Pulmón/secundario , Receptores ErbB/antagonistas & inhibidores , Neoplasias Pulmonares/patología , Quimioterapia de Mantención/métodos , Adenocarcinoma del Pulmón/diagnóstico por imagen , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Terapia Molecular Dirigida/métodos , Estadificación de Neoplasias/métodos , Inhibidores de Proteínas Quinasas/uso terapéutico , Sobrevivientes , Tomografía Computarizada por Rayos X/métodos
3.
Int Heart J ; 62(1): 148-152, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33518653

RESUMEN

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is erupting and spreading globally. Cardiovascular complications secondary to the infection have caught notice. This study aims to delineate the relationship of cardiac biomarkers and outcomes in severe cases of corona virus disease 2019 (COVID-19). One hundred forty-eight critically ill adult patients with COVID-19 were enrolled. From these patients, the demographic data, symptoms, cardiac biomarkers, treatments, and clinical outcomes were collected. Data were compared between survivors and non-survivors. Four patients in the non-survivor group were selected, and their cardiac biomarkers were collected and analyzed. Among the 148 patients, the incidence of cardiovascular complications was 19 (12.8%). Five of them were survivors (5.2%), and 14 of them were non-survivors (26.9%). Compared with the survivors, the non-survivors had higher levels of high-sensitivity cardiac troponin I, creatine kinase isoenzyme-MB, myoglobin, and N-terminal pro-brain natriuretic peptide (P < 0.05). The occurrence of cardiovascular events began at 11-15 days after the onset of the disease and reached a peak at 14-20 days. COVID-19 not only is a respiratory disease but also causes damage to the cardiovascular system. Cardiac biomarkers have the potential for early warning and prognostic evaluation in patients with COVID-19. It is recommended that cardiac biomarker monitoring in patients with COVID-19 should be initiated at least from the 11th day of the disease course.


Asunto(s)
Biomarcadores/metabolismo , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/metabolismo , Adulto , Anciano , Factor Natriurético Atrial/metabolismo , /epidemiología , Enfermedades Cardiovasculares/epidemiología , Estudios de Casos y Controles , China/epidemiología , Forma MB de la Creatina-Quinasa/metabolismo , Enfermedad Crítica/mortalidad , Enfermedad Crítica/enfermería , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Precursores de Proteínas/metabolismo , Tasa de Supervivencia , Sobrevivientes/estadística & datos numéricos , Troponina I/metabolismo
4.
Cytokine ; 140: 155439, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33524886

RESUMEN

BACKGROUND: Immunodeficiency has pivotal role in the pathogenesis of coronavirus disease 2019 (COVID-19). Several studies have indicated defects in the immune system of COVID-19 patients at different disease stages. Therefore, this study investigated whether alters in immune responses of COVID-19 patients may be considered as predicting factors for disease outcome. METHODS: The percentages of innate and adoptive immune cells in the recovered and dead patients with COVID-19, and healthy subjects were determined by flow cytometry. The levels of pro- and anti-inflammatory cytokines and other immune factors were also measured by enzyme-linked immunosorbent assay. RESULTS: At the first day of hospitalization, the frequencies of CD56dim CD16+ NK cells and CD56bright CD16dim/- NK cells in patients who died during treatment were significantly increased compared to recovered and healthy individuals (P < 0.0001). The recovered and dead patients had a significant increase in monocyte number in comparison with healthy subjects (P < 0.05). No significant change was observed in Th1 cell numbers between the recovered and dead patients while Th2, Th17 cell, and Treg percentages in death cases were significantly lower than healthy control and those recovered, unlike exhausted CD4 + and CD8 + T cells and activated CD4 + T cells (P < 0.0001-0.05). The activated CD8 + T cell was significantly higher in the recovered patients than healthy individuals (P < 0.0001-0.05). IL-1α, IL-1ß, IL-6, and TNF-α levels in patients were significantly increased (P < 0.0001-0.01). However, there were no differences in TNF-α and IL-1ß levels between dead and recovered patients. Unlike TGF-ß1 level, IL-10 was significantly increased in recovered patients (P < 0.05). Lymphocyte numbers in recovered patients were significantly increased compared to dead patients, unlike ESR value (P < 0.001-0.01). CRP value in recovered patients significantly differed from dead patients (P < 0.001). CONCLUSION: Changes in frequencies of some immune cells and levels of some immune factors may be considered as predictors of mortality in COVID-19 patients.


Asunto(s)
/inmunología , Citocinas/inmunología , Sistema Inmunológico/inmunología , Inmunidad/inmunología , Sobrevivientes/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , /virología , Citocinas/sangre , Femenino , Humanos , Sistema Inmunológico/citología , Masculino , Persona de Mediana Edad , Monocitos/inmunología , Tasa de Supervivencia , Linfocitos T/inmunología , Linfocitos T Colaboradores-Inductores/clasificación , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Reguladores/inmunología
5.
PLoS One ; 16(2): e0246515, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33544772

RESUMEN

BACKGROUND: During health disaster events such as the current devastating havoc being inflicted on countries globally by the SARS-CoV-19 pandemic, mental health problems among survivors and frontline workers are likely concerns. However, during such health disaster events, stakeholders tend to give more precedence to the socio-economic and biomedical health consequences at the expense of mental health. Meanwhile, studies show that regardless of the kind of disaster/antecedent, all traumatic events trigger similar post-traumatic stress symptoms among survivors, families, and frontline workers. Thus, our study investigated the prevalence of anxiety, depression and insomnia symptoms among survivors of the 2014-2016 Ebola virus disease that plagued the West African sub-region. METHODS: We systematically retrieved peer-reviewed articles published between 1970 and 2019 from seven electronic databases, including Google Scholar, MEDLINE, PsychInfo, PubMed, Scopus, Springer Link, Web of Science on Ebola and post-traumatic stress disorder symptoms. A comprehensive hand search complemented this literature search. Of the 87 articles retrieved, only 13 met the inclusion criteria for this meta-analysis. RESULTS: After heterogeneity, influence, and publication bias analysis, our meta-analysis pooled proportion effects estimates showed a moderate to a high prevalence of anxiety (14%; 99% CI: 0.05-0.30), depression (15%; 99% CI: 0.11-0.21), and insomnia (22%; 99% CI: 0.13-0.36). Effect estimates ranging from (0.13; 99% CI: 0.05, 0.28) through to (0.11; 99% CI: 0.05-0.22), (0.15; 99% CI: 0.09-0.25) through to (0.13; 99% CI: 0.08-0.21) and (0.23; 99% CI: 0.11-0.41) to (0.23; 99% CI: 0.11-0.41) were respectively reported for anxiety, depression and insomnia symptoms. These findings suggest a significant amount of EVD survivors are struggling with anxiety, depression and insomnia symptoms. CONCLUSION: Our study provided the first-ever meta-analysis evidence of anxiety, depression, and insomnia symptoms among EVD survivors, and suggest that the predominant biomedical health response to regional and global health disasters should be complemented with trauma-related mental health services.


Asunto(s)
Ansiedad/complicaciones , Depresión/complicaciones , Fiebre Hemorrágica Ebola/complicaciones , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , África Occidental/epidemiología , Ansiedad/epidemiología , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/epidemiología , Depresión/epidemiología , Trastorno Depresivo/complicaciones , Trastorno Depresivo/epidemiología , Ebolavirus/aislamiento & purificación , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Prevalencia , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Sobrevivientes
8.
Isr Med Assoc J ; 23(1): 7-10, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33443334

RESUMEN

BACKGROUND: During the coronavirus disease-2019 (COVID-19) pandemic outbreak our blood bank developed protocols to guarantee accurate blood components to COVID-19 patients. OBJECTIVES: To provide convalescent whole blood donor screening strategies for patients recovering from COVID-19. METHODS: We recruited COVID-19 recovering patients who met our defined inclusion criteria for whole blood donation. All blood units were screened for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA by real time reverse transcription polymerase chain reaction (RT-PCR) and SARS-COV-2 immunoglobulin G (IgG) antibodies against the S1 domain. RESULTS: We screened 180 blood units from patients recovering from COVID-19. All results were negative for SARS-CoV-2 RNA and 87.2% were positive for SARS-COV-2 IgG antibodies in the plasma. CONCLUSIONS: Blood component units from recovering COVID-19 patients are safe. Plasma units with positive IgG antibodies could serve as an efficient passive immunization for COVID-19 patients. Moreover, in the face of increased transfusion demand for treatment of anemia and coagulation dysfunction in critical ill COVID-19 patients, red blood cells units and random platelets units from convalescent donors can be safely transfused.


Asunto(s)
Donantes de Sangre , Selección de Donante , /inmunología , Adulto , Anticuerpos Antivirales/inmunología , Femenino , Humanos , Inmunización Pasiva/métodos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , ARN Viral/sangre , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Sobrevivientes , Adulto Joven
9.
Cell Host Microbe ; 29(1): 7-9, 2021 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-33444556

RESUMEN

High-dose ionizing radiation used during cancer radiotherapy is associated with the induction of hematopoietic, gastrointestinal, and cerebrovascular injuries. In a recent Science issue, Guo et al. demonstrated that the gut microbiota-and its associated metabolites-play a central role in protecting against high-dose radiation.


Asunto(s)
Microbioma Gastrointestinal , Radiación , Tracto Gastrointestinal , Humanos , Sobrevivientes
11.
J Alzheimers Dis ; 79(3): 931-948, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33459706

RESUMEN

Proinflammatory cytokines such as tumor necrosis factor (TNF), with its now appreciated key roles in neurophysiology as well as neuropathophysiology, are sufficiently well-documented to be useful tools for enquiry into the natural history of neurodegenerative diseases. We review the broader literature on TNF to rationalize why abruptly-acquired neurodegenerative states do not exhibit the remorseless clinical progression seen in those states with gradual onsets. We propose that the three typically non-worsening neurodegenerative syndromes, post-stroke, post-traumatic brain injury (TBI), and post cardiac arrest, usually become and remain static because of excess cerebral TNF induced by the initial dramatic peak keeping microglia chronically activated through an autocrine loop of microglial activation through excess cerebral TNF. The existence of this autocrine loop rationalizes post-damage repair with perispinal etanercept and proposes a treatment for cerebral aspects of COVID-19 chronicity. Another insufficiently considered aspect of cerebral proinflammatory cytokines is the fitness of the endogenous cerebral anti-TNF system provided by norepinephrine (NE), generated and distributed throughout the brain from the locus coeruleus (LC). We propose that an intact LC, and therefore an intact NE-mediated endogenous anti-cerebral TNF system, plus the DAMP (damage or danger-associated molecular pattern) input having diminished, is what allows post-stroke, post-TBI, and post cardiac arrest patients a strong long-term survival advantage over Alzheimer's disease and Parkinson's disease sufferers. In contrast, Alzheimer's disease and Parkinson's disease patients remorselessly worsen, being handicapped by sustained, accumulating, DAMP and PAMP (pathogen-associated molecular patterns) input, as well as loss of the LC-origin, NE-mediated, endogenous anti-cerebral TNF system. Adrenergic receptor agonists may counter this.


Asunto(s)
Lesiones Encefálicas/fisiopatología , Enfermedades Neurodegenerativas/fisiopatología , Accidente Cerebrovascular/fisiopatología , Factor de Necrosis Tumoral alfa/fisiología , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/fisiopatología , Enfermedad de Alzheimer/terapia , Antiinflamatorios no Esteroideos/uso terapéutico , Encéfalo/fisiopatología , Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/terapia , /fisiopatología , Progresión de la Enfermedad , Etanercept/uso terapéutico , Paro Cardíaco/diagnóstico , Paro Cardíaco/fisiopatología , Paro Cardíaco/terapia , Humanos , Locus Coeruleus/fisiopatología , Enfermedades Neurodegenerativas/diagnóstico , Enfermedades Neurodegenerativas/terapia , Norepinefrina/fisiología , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia , Sobrevivientes , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
12.
Arq Bras Cir Dig ; 33(3): e1547, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33470377

RESUMEN

BACKGROUND: The identification of prognostic factors of esophageal cancer has allowed to predict the evolution of patients. AIM: Assess different prognostic factors of long-term survival of esophageal cancer and evaluate a new prognostic factor of long-term survival called lymphoparietal index (N+/T). METHOD: Prospective study of the Universidad de Chile Clinical Hospital, between January 2004 and December 2013. Included all esophageal cancer surgeries with curative intent and cervical anastomosis. Exclusion criteria included: stage 4 cancers, R1 resections, palliative procedures and emergency surgeries. RESULTS: Fifty-eight patients were included, 62.1% were men, the average age was 63.3 years. A total of 48.3% were squamous, 88% were advanced cancers, the average lymph node harvest was 17.1. Post-operative surgical morbidity was 75%, with a 17.2% of reoperations and 3.4% of mortality. The average overall survival was 41.3 months, the 3-year survival was 31%. Multivariate analysis of the prognostic factors showed that significant variables were anterior mediastinal ascent (p=0.01, OR: 6.7 [1.43-31.6]), anastomotic fistula (p=0.03, OR: 0.21 [0.05-0.87]), N classification (p=0.02, OR: 3.8 [1.16-12.73]), TNM stage (p=0.04, OR: 2.8 [1.01-9.26]), and lymphoparietal index (p=0.04, RR: 3.9 [1.01-15.17]. The ROC curves of lymphoparietal index, N classification and TNM stage have areas under the curve of 0.71, 0.63 and 0.64 respectively, with significant statistical difference (p=0.01). CONCLUSION: The independent prognostic factors of long-term survival in esophageal cancer are anterior mediastinal ascent, anastomotic fistula, N classification, TNM stage and lymphoparietal index. In esophageal cancer the new lymphoparietal index is stronger than TNM stage in long-term survival prognosis.


Asunto(s)
Supervivientes de Cáncer/estadística & datos numéricos , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/patología , Carcinoma de Células Escamosas de Esófago/mortalidad , Carcinoma de Células Escamosas de Esófago/patología , Esofagectomía/métodos , Ganglios Linfáticos/patología , Chile/epidemiología , Neoplasias Esofágicas/cirugía , Carcinoma de Células Escamosas de Esófago/cirugía , Esófago/patología , Femenino , Humanos , Escisión del Ganglio Linfático , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Tasa de Supervivencia , Sobrevivientes
13.
Gan To Kagaku Ryoho ; 48(1): 1-6, 2021 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-33468713

RESUMEN

Recent progress in cancer therapy has decreased all-cancer mortality, but cardiovascular adverse events owing to chemotherapy and radiotherapy have greater impact on clinical outcome and quality of life in cancer patients and survivors. There are a wide variety of cardiovascular adverse events related to cancer therapy, and the opportunities requiring specialized care by cardiovascular experts are increasing in clinical practice. Under such circumstances, onco-cardiology is becoming very important as a new discipline and attracting much attention in Japan. The Japanese Onco-Cardiology Society was established in 2017, and continues integration of academic activities to solve challenging problems in this field. Interdisciplinary collaborations between cardiologists and oncologists will be further progressed in medical care, clinical and basic research, and education.


Asunto(s)
Cardiología , Neoplasias , Humanos , Japón , Neoplasias/terapia , Calidad de Vida , Sobrevivientes
14.
Pediatr Cardiol ; 42(1): 1-18, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33373013

RESUMEN

Congenital heart defects (CHD) is one of the most common types of birth defects. Thanks to advances in surgical techniques and intensive care, the majority of children with severe forms of CHD survive into adulthood. However, this increase in survival comes with a cost. CHD survivors have neurological functioning at the bottom of the normal range. A large spectrum of central nervous system dysmaturation leads to the deficits seen in critical CHD. The heart develops early during gestation, and CHD has a profound effect on fetal brain development for the remainder of gestation. Term infants with critical CHD are born with an immature brain, which is highly susceptible to hypoxic-ischemic injuries. Perioperative blood flow disturbances due to the CHD and the use of cardiopulmonary bypass or circulatory arrest during surgery cause additional neurological injuries. Innate patient factors, such as genetic syndromes and preterm birth, and postoperative complications play a larger role in neurological injury than perioperative factors. Strategies to reduce the disability burden in critical CHD survivors are urgently needed.


Asunto(s)
Encefalopatías/epidemiología , Cardiopatías Congénitas/epidemiología , Complicaciones Posoperatorias/epidemiología , Adulto , Encéfalo/crecimiento & desarrollo , Lesiones Encefálicas/epidemiología , Puente Cardiopulmonar/métodos , Niño , Femenino , Cardiopatías Congénitas/cirugía , Humanos , Hipoxia-Isquemia Encefálica/epidemiología , Lactante , Recién Nacido , Trastornos del Neurodesarrollo/epidemiología , Embarazo , Nacimiento Prematuro/epidemiología , Sobrevivientes
16.
Nurs Res ; 70(1): 51-57, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32956257

RESUMEN

BACKGROUND: Poststroke depression is common and includes depressive and somatic symptoms. However, few studies have confirmed the influence of family functioning on poststroke depression or explored the association among daily activities, family functioning, and poststroke depression. OBJECTIVES: We examined the independent risk factors of daily activities and family functioning for poststroke depression and identified the mediating effect of family functioning on the association between daily activities and poststroke depression. METHODS: This cross-sectional study design used convenience sampling to recruit 422 stroke survivors from the neurology department of a hospital in Harbin, China, from February to July 2018. We assessed participants' demographic and clinical variables, including depression, daily activities, and family functioning. Pearson's correlations and multiple linear regression analyses were conducted, and a path analysis with bootstrapping was utilized to define direct/indirect effects. RESULTS: Daily activities and family functioning had a significant and direct negative effect on participants' depression. The indirect effect of 1,000 bootstrap samples after bias correction with a 95% confidence interval was below zero, indicating that family function had a significant mediating effect on the association between depression and daily activities. DISCUSSION: This study revealed the importance of family functioning in the association between depression and daily activities in stroke survivors. To the best of our knowledge, this study was the first to explore the mediating role of family functioning in poststroke depression, emphasizing the importance of family for the mental health of stroke patients. To reduce the incidence of poststroke depression, interventions that enhance daily activities and family functioning may include nurses, family therapists, rehabilitation physicians, and community workers.


Asunto(s)
Actividades Cotidianas/psicología , Depresión/psicología , Familia/psicología , Calidad de Vida/psicología , Recuperación de la Función , Accidente Cerebrovascular/psicología , Sobrevivientes/psicología , Adulto , Anciano , Anciano de 80 o más Años , China , Estudios Transversales , Femenino , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Factores de Riesgo
17.
Crit Rev Oncol Hematol ; 157: 103175, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33321295

RESUMEN

Second breast cancer (SBC) is the most common solid cancer among Hodgkin Lymphoma (HL) female survivors. We reviewed the related modifying risk factors, radiation-induced carcinogenesis, tumors characteristics, management specificities, prevention and surveillance modalities based on current evidence. The risk of developing SBC may be influenced essentially by the age at HL treatment, follow-up latency, dose of irradiation received and the extent of irradiated field. SBCs generally develop at younger age, they are often bilateral, and exhibit more aggressive biological features and worse prognosis. No firm answer about the benefits of breast surveillance is provided by literature, but compelling evidence tends toward a clinical benefit in early detection. Increasing awareness among health providers' care and current survivors as well as the implementation of screening measures is crucial. Great efforts are ongoing in individualizing treatment strategies for future HL patients and response-adapted approaches are holding promise in prevention of these second malignancies.


Asunto(s)
Neoplasias de la Mama , Enfermedad de Hodgkin , Neoplasias Primarias Secundarias , Mama , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/terapia , Femenino , Enfermedad de Hodgkin/diagnóstico , Enfermedad de Hodgkin/epidemiología , Enfermedad de Hodgkin/terapia , Humanos , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Primarias Secundarias/etiología , Sobrevivientes
18.
Life Sci ; 266: 118883, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33316266

RESUMEN

Coronavirus disease 2019 (COVID-19) has rapidly spread around the world causing global public health emergency. In the last twenty years, we have witnessed several viral epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV), Influenza A virus subtype H1N1 and most recently Middle East respiratory syndrome coronavirus (MERS-CoV). There were tremendous efforts endeavoured globally by scientists to combat these viral diseases and now for SARS-CoV-2. Several drugs such as chloroquine, arbidol, remdesivir, favipiravir and dexamethasone are adopted for use against COVID-19 and currently clinical studies are underway to test their safety and efficacy for treating COVID-19 patients. As per World Health Organization reports, so far more than 16 million people are affected by COVID-19 with a recovery of close to 10 million and deaths at 600,000 globally. SARS-CoV-2 infection is reported to cause extensive pulmonary damages in affected people. Given the large number of recoveries, it is important to follow-up the recovered patients for apparent lung function abnormalities. In this review, we discuss our understanding about the development of long-term pulmonary abnormalities such as lung fibrosis observed in patients recovered from coronavirus infections (SARS-CoV and MERS-CoV) and probable epigenetic therapeutic strategy to prevent the development of similar pulmonary abnormalities in SARS-CoV-2 recovered patients. In this regard, we address the use of U.S. Food and Drug Administration (FDA) approved histone deacetylase (HDAC) inhibitors therapy to manage pulmonary fibrosis and their underlying molecular mechanisms in managing the pathologic processes in COVID-19 recovered patients.


Asunto(s)
/complicaciones , Reposicionamiento de Medicamentos , Inhibidores de Histona Desacetilasas/uso terapéutico , Fibrosis Pulmonar/tratamiento farmacológico , Factor de Crecimiento Transformador beta/metabolismo , Adulto , Anciano , /terapia , Infecciones por Coronavirus/patología , Matriz Extracelular/patología , Matriz Extracelular/virología , Inhibidores de Histona Desacetilasas/farmacología , Humanos , Persona de Mediana Edad , Fibrosis Pulmonar/virología , Factores de Riesgo , Transducción de Señal , Sobrevivientes
19.
Support Care Cancer ; 29(1): 289-300, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32358776

RESUMEN

PURPOSE: To investigate lifestyle in a population-based sample of long-term (≥ 5 years since diagnosis) young adult cancer survivors (YACSs), and explore factors associated with not meeting the lifestyle guidelines for physical activity (PA), body mass index (BMI), and smoking. METHODS: YACSs (n = 3558) diagnosed with breast cancer (BC), colorectal cancer (CRC), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or localized malignant melanoma (MM) between the ages of 19 and 39 years and treated between 1985 and 2009 were invited to complete a mailed questionnaire. Survivors of localized MM treated with limited skin surgery served as a reference group for treatment burden. RESULTS: In total, 1488 YACSs responded (42%), and 1056 YACSs were evaluable and included in the present study (74% females, average age at survey 49 years, average 15 years since diagnosis). Forty-four percent did not meet PA guidelines, 50% reported BMI ≥ 25 and 20% smoked, with no statistically significant differences across diagnostic groups. Male gender, education ≤ 13 years, comorbidity, lymphedema, pain, chronic fatigue, and depressive symptoms were associated with not meeting single and/or an increasing number of lifestyle guidelines. CONCLUSION: A large proportion of long-term YACSs do not meet the lifestyle guidelines for PA, BMI, and/or smoking. Non-adherence to guidelines is associated with several late effects and/or comorbidities that should be considered when designing lifestyle interventions for YACSs.


Asunto(s)
Supervivientes de Cáncer/estadística & datos numéricos , Ejercicio Físico/psicología , Estilo de Vida Saludable , Cooperación del Paciente/estadística & datos numéricos , Sobrevivientes/estadística & datos numéricos , Adulto , Índice de Masa Corporal , Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Neoplasias Colorrectales/terapia , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Melanoma/terapia , Persona de Mediana Edad , Dolor/complicaciones , Neoplasias Cutáneas/terapia , Fumar/epidemiología , Encuestas y Cuestionarios , Sobrevivientes/psicología , Adulto Joven
20.
J Psychiatr Res ; 132: 23-31, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33038562

RESUMEN

Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.


Asunto(s)
Estado de Salud , Crecimiento Psicológico Postraumático , Trauma Psicológico/psicología , Cuarentena/psicología , Trastornos de Estrés Traumático/psicología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Autoevaluación Diagnóstica , Femenino , Humanos , Israel , Masculino , Persona de Mediana Edad , Adulto Joven
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