RESUMO
OBJECTIVE: To investigate if handgrip strength (HGS) could be used as a single screening procedure in identifying patients who are classified as being undernourished or nutritionally-at-risk at hospital admission. DESIGN: Cross-sectional study. In the second day of hospital admission, HGS was evaluated and results were compared with Nutritional Risk Screening (NRS-2002). SETTING: Two public hospitals in Porto, Portugal, a university and a district one. SUBJECTS: A probabilistic sample of 50% in-patients from each hospital of 314 patients (age range of 18-96) was studied. Patients were considered eligible if they were >or=18 years old and able to give informed consent. Hand pain, upper limb deformities, incapacity to perform muscle strength measurements and pregnancy were considered further exclusion criteria. RESULTS: Patients identified as undernourished by NRS-2002 (37.9%) were older, shorter and lighter, with a lower functional capacity, a longer length of stay and a lower HGS (P<0.001). When comparing patients with lower HGS (first quartile) with those with the highest HGS (fourth quartile), this parameter revealed good sensitivity (86.7%) and specificity (70.2%) and a k=0.56. Multivariate analysis showed that patients with higher HGS had an independent decreased risk of being at nutritional risk (P for trend <0.001) odds ratio=0.19 (95% confidence interval=0.08-0.48). Our entire sample of hospitalized patients was -1.96 Z-score below the HGS cutoff of distribution data for healthy individuals. CONCLUSIONS: HGS identifies a high proportion of nutritionally-at-risk patients and can be a reliable first screening tool for nutritional risk in hospitals.
Assuntos
Força da Mão/fisiologia , Hospitalização , Programas de Rastreamento/métodos , Avaliação Nutricional , Estado Nutricional , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade , EspanhaRESUMO
BACKGROUND: Here we evaluate auto-antibody response against two potential antigenic determinants of genes highly expressed in low Gleason Score prostate cancer (PC) tumor samples, namely FLJ23438 and VAMP3. METHODS: RT-PCR assays were used to analyze mRNA expression profiles of FLJ23438 and VAMP3 transcripts. The auto-antibody response against FLJ23438 and VAMP3 recombinant proteins was tested by immunoblot assays using PC, benign prostate hyperplasia (BPH), healthy donors (HD), and other human cancers plasma samples. RESULTS: Our data showed that 37% (10/27) and 7.4% (2/27) of PC plasma samples presented auto-antibodies against FLJ23438 and VAMP3, respectively. Only 8.3% (1/12) of BPH plasma samples were reactive for both auto-antibodies, while none (0/12) of HD plasma samples tested were reactive. CONCLUSIONS: The prevalence of 37% of positive PC plasma samples for anti-FLJ23438 antibodies suggests that humoral immune response against this antigenic determinant could be a potential serum marker for this cancer.
Assuntos
Adenocarcinoma/imunologia , Autoanticorpos/sangue , Biomarcadores Tumorais/imunologia , Neoplasias da Próstata/imunologia , Proteína 3 Associada à Membrana da Vesícula/imunologia , Adenocarcinoma/epidemiologia , Adenocarcinoma/fisiopatologia , Idoso , Antígenos/genética , Antígenos/imunologia , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Neoplasias da Mama , Carcinoma de Células Escamosas , Linhagem Celular Tumoral , Neoplasias Colorretais , Neoplasias Esofágicas , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares , Masculino , Pessoa de Meia-Idade , Fases de Leitura Aberta/genética , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/imunologia , Hiperplasia Prostática/fisiopatologia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/fisiopatologia , RNA Mensageiro/genética , RNA Nuclear Pequeno/genética , RNA Nuclear Pequeno/imunologia , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Estudos Soroepidemiológicos , Proteína 3 Associada à Membrana da Vesícula/genéticaRESUMO
Mutations in different exons of ret proto-oncogene are responsible for the development of medullary thyroid carcinoma (MTC). The mutations can occur as sporadic or as part of multiple endocrine neoplasia (MEN) type 2 hereditary syndromes. Here we report the first focused study of sporadic MTC in Brazilian patients regarding clinical and molecular analysis of ret proto-oncogene. Our study seeks to estimate the risk of hereditary MTC cases among apparently sporadic cases in a Brazilian population and describe ret genetic variants in their germinative lineage. Germinative sequence variants were screened by DNA sequencing and denaturing gradient gel electrophoresis (DGGE) analysis of exons 10, 11, 13, 14, 15, and 16 of 24 Brazilian patients with apparently sporadic MTC. We identified 1 inherited case of 24 (4%) patients with apparently sporadic MTC. Polymorphisms for the ret proto-oncogene coding region were identified in codon 769 of exon 13 (LeuCTT--> LeuCTG) at a frequency of 13% (3/24) and in codon 904 of exon 15 (SerTCC--> SerTCG) at a frequency of 16.6% (4/24). The observed frequency (4%) of inherited disease among apparent sporadic MTC strengthens routine application of ret proto-oncogene germinative DNA screening in all cases of apparently sporadic MTC ascertained at Brazilian cancer hospitals.
