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1.
Anticancer Res ; 41(9): 4377-4385, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34475057

RESUMO

BACKGROUND/AIM: Expression of pleckstrin homology-like domain family A member 2 (PHLDA2) has been reported to be suppressed or activated in several cases of malignant tumors. However, its apoptotic regulatory mechanism and role in gastric cancer are not understood. This study examined the role of PHLDA2 in apoptosis in gastric cancer. MATERIALS AND METHODS: We used cell culture, western blotting, semiquantitative reverse transcription polymerase chain reaction, MTT assays, and PHLDA2 knockdown with short hairpin RNA (shRNA). RESULTS: To identify the pathway associated with HGF-induced PHLDA2 up-regulation, the cells were treated with PI3-kinase inhibitor (LY294002), MEK inhibitor (PD098059), or p38 inhibitor (SB203580) and then analyzed by western blotting. HGF-mediated changes in PHLDA2 protein levels were only decreased by LY294002. PHLDA2-shRNA cells showed decreased levels of p53 and increased levels of pAKT. Furthermore, HGF-induced cell proliferation and in vitro invasion were increased in PHLDA2 knockdown cells and HGF-induced cell apoptosis was increased in PHLDA2 knockdown cells. CONCLUSION: PHLDA2 plays a role in gastric cancer tumorigenesis by inhibiting apoptosis through the PI3K/AKT pathway.


Assuntos
Fator de Crescimento de Hepatócito/metabolismo , Proteínas Nucleares/metabolismo , Neoplasias Gástricas/metabolismo , Regulação para Cima , Apoptose , Linhagem Celular Tumoral , Cromonas/farmacologia , Flavonoides/farmacologia , Perfilação da Expressão Gênica/métodos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Técnicas de Silenciamento de Genes , Humanos , Imidazóis , Morfolinas/farmacologia , Proteínas Nucleares/genética , Análise de Sequência com Séries de Oligonucleotídeos , Piridinas
2.
Health Qual Life Outcomes ; 19(1): 217, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521426

RESUMO

BACKGROUND: Health-related quality of life (HRQOL) is an important concept to consider both individuals' ability to manage their daily lives and health status across the lifespan. Despite this variable's importance, there is a lack of clarification on the factors associated with HRQOL, especially for military women. The aim of this study was to examine factors associated with HRQOL of military women in the Republic of Korea (ROK) Army. METHODS: This cross-sectional study included 196 participants who were currently within their 5-year service period. HRQOL was measured by the Korean version of the Short-Form 36 Health Survey Questionnaire version 2.0 (SF-36v2), and depression was assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Differences in HRQOL according to general and occupational factors were analyzed using the independent t-test and analysis of variance (ANOVA). Multiple linear regression analysis was performed to identify factors associated with the HRQOL of women serving as military junior officers. RESULTS: The mean score for the physical component summary (PCS) of SF-36v2 was 56.0 ± 5.8, and that for the mental component summary (MCS) of SF-36v2 was 47.2 ± 10.0. For depression, the mean score was 5.4 ± 5.2, whereas 19.4% of the participants scored more than 10 out of 27 points, which means moderate to severe. No variables showed statistically significant relationships with the PCS. However, military women showed a lower score for MCS when they were officers (adjusted ß = - 3.52; 95% CI = - 5.47, - 1.58), had higher perceived stress (adjusted ß = - 0.62, 95% CI = - 0.83, - 0.41), and a higher score for depression (adjusted ß = - 0.86, 95% CI = - 1.10, - 0.63). CONCLUSIONS: Although depression levels were not severe, it was a significant factor of HRQOL. Stress and depression were found to be significant factors associated with the MCS in military women. Therefore, to improve their HRQOL, the ROK Army should provide early screening, intervention, and management program for high-risk military women. In addition, an appropriate organizational atmosphere within the military must be created to promote such programs.


Assuntos
Depressão/psicologia , Militares/psicologia , Estresse Ocupacional/psicologia , Qualidade de Vida/psicologia , Estresse Fisiológico , Adulto , Estudos Transversais , Feminino , Humanos , República da Coreia , Inquéritos e Questionários
3.
Clin Nurs Res ; : 10547738211047047, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34538117

RESUMO

This longitudinal study aimed to explore the event-specific emotional expressions of persons living with dementia in long-term care during a 6-month period with repeated observations. Emotional expressions at three specific events (mealtime, personal care, and social activity) were videotaped at the beginning, month 3, and month 6. Thirty participants were enrolled, and nine observations were made for each participant. Mixed-effect models were used for statistical analysis. The type of care events, the person who provides care, and the facility type were associated with emotional expressions. Specifically, personal care, interaction with non-nursing providers, and facility type were associated with positive emotional expressions. Negative emotional expressions were related to personal care, interaction with family or volunteer, and facility type. This study provides a better understanding of event-specific emotional expressions and knowledge to support the development of emotion-oriented intervention programs to improve the psychological well-being of persons living with dementia.

4.
Comput Biol Med ; 136: 104750, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34392128

RESUMO

BACKGROUND AND OBJECTIVE: It is important to alleviate annotation efforts and costs by efficiently training on medical images. We performed a stress test on several strong labels for curriculum learning with a convolutional neural network to differentiate normal and five types of pulmonary abnormalities in chest radiograph images. METHODS: The numbers of CXR images of healthy subjects and patients, acquired at Asan Medical Center (AMC), were 6069 and 3465, respectively. The numbers of CXR images of patients with nodules, consolidation, interstitial opacity, pleural effusion, and pneumothorax were 944, 550, 280, 1360, and 331, respectively. The AMC dataset was split into training, tuning, and test, with a ratio of 7:1:2. All lesions were strongly labeled by thoracic expert radiologists, with confirmation of the corresponding CT. For curriculum learning, normal and abnormal patches (N = 26658) were randomly extracted around the normal lung and strongly labeled abnormal lesions, respectively. In addition, 1%, 5%, 20%, 50%, and 100% of strong labels were used to determine an optimal number for them. Each patch dataset was trained with the ResNet-50 architecture, and all CXRs with weak labels were used for fine-tuning them in a transfer-learning manner. A dataset acquired from the Seoul National University Bundang Hospital (SNUBH) was used for external validation. RESULTS: The detection accuracies of the 1%, 5%, 20%, 50%, and 100% datasets were 90.51, 92.15, 93.90, 94.54, and 95.39, respectively, in the AMC dataset and 90.01, 90.14, 90.97, 91.92, and 93.00 in the SNUBH dataset. CONCLUSIONS: Our results showed that curriculum learning with over 20% sampling rate for strong labels are sufficient to train a model with relatively high performance, which can be easily and efficiently developed in an actual clinical setting.


Assuntos
Pneumopatias , Redes Neurais de Computação , Currículo , Humanos , Aprendizagem , Pneumopatias/diagnóstico por imagem , Radiografia
5.
Int J Older People Nurs ; : e12413, 2021 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-34420263

RESUMO

OBJECTIVES: For community-dwelling older adults with hospitalisation experience, it is necessary to be strategic when promoting successful ageing. This study aimed to investigate whether components of successful ageing (i.e., diseases and complications, functions and engagement with life) differ according to hospitalisation experience in community-dwelling older adults. METHODS: A secondary data analysis with the Korean national survey was performed. Using propensity score matching, 1812 older adults with hospitalisation experience were matched to 1812 older adults without hospitalisation experience. Sampling weight of the survey was considered for all statistical analyses. RESULTS: The hospitalisation experienced group had more chronic illnesses, malnourishment, impairment in physical function, and depressive symptoms, and less activity in terms of working and social activities. There were no differences in cognitive function or religious activities. CONCLUSIONS: Older adults with hospitalisation experience were less likely to experience successful ageing. To facilitate successful ageing of community-dwelling older adults with hospitalisation experience, nursing interventions for effective transitional care to encourage the use of community resources and participation in social activities are needed.

7.
Geriatr Nurs ; 42(4): 915-918, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34098445

RESUMO

Since care providers' behavior could be related to resistiveness to care (RTC) among persons living with dementia, developing care providers' behavioral strategies to reduce or prevent RTC is required. This study examined whether care providers' person-centered or task-centered behaviors were related to RTC. A secondary data analysis was conducted using 70 videos of 23 persons living with dementia who received routine oral care in long-term care settings. Data were analyzed using linear mixed models. Among task-centered behaviors, "physically controlling" significantly increased RTC. For person-centered behaviors, "cooperatively negotiating" increased RTC, while "assessing comfort" decreased RTC. Care providers need to consider the comfort or needs of persons living with dementia rather than physically controlling them in oral care situations. These findings may offer insight into the context of RTC occurrences to provide more comfortable oral care for persons living with dementia.

8.
Radiology ; 300(2): 450-457, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34060941

RESUMO

Background Patients with N1 or N2 non-small cell lung cancer exhibit prognostic heterogeneity. To refine the current N staging system, new N stages were proposed by the International Association for the Study of Lung Cancer. However, those proposed new N stages have not been validated. Purpose To evaluate the prognostic performance of the proposed N descriptors for clinical staging. Materials and Methods Participants with non-small cell lung cancer without distant metastasis from January 2010 to December 2014 were retrospectively included. Each patient's clinical N (cN) stage was assigned to one of seven categories (cN0, cN1a, cN1b, cN2a1, cN2a2, cN2b, cN3). The 5-year overall survival rates were estimated with the Kaplan-Meier method. The adjusted hazard ratios (HRs) and their 95% CIs were estimated by using a multivariable Cox proportional hazard model. Ad hoc analyses according to lymph node (LN) size were performed. Results A total of 1271 patients (median age, 66 years; interquartile range, 59-73 years; 812 men) were included. The 5-year overall survival rates were 77.3%, 53.7%, 36.0%, 29.2%, 34.4%, 18.0%, and 12.4% for stages cN0, cN1a, cN1b, cN2a1, cN2a2, cN2b, and cN3, respectively. Patients with cN2b disease had a worse prognosis than patients with cN2a disease (HR, 1.53; 95% CI: 1.06, 2.22; P = .02). There was no prognostic difference between cN1b and cN1a (HR, 1.13; 95% CI: 0.61, 2.09; P = .71); however, there was a difference between cN1 subgroups when stratified by LN size (≥2 cm; HR, 2.26; 95% CI: 1.16, 4.44; P = .02). Within cN2a disease, there were no differences between cN2a1 and cN2a2 (HR, 0.98; 95% CI: 0.61, 1.56; P = .93) or between subgroups according to LN size (HR, 0.74; 95% CI: 0.40, 1.37; P = .34). Conclusion A survival difference was observed between single- and multistation involvement among cN2 disease. The number of involved lymph node stations in patients with cN1 disease and the presence of skip metastasis in patients with cN2 disease were not associated with survival differences. © RSNA, 2021 Online supplemental material is available for this article.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Metástase Linfática/patologia , Estadiamento de Neoplasias/métodos , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Feminino , Humanos , Agências Internacionais , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida
9.
Medicine (Baltimore) ; 100(18): e25692, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950950

RESUMO

INTRODUCTION: The relationship between chronic empyema and malignant tumors, most of which are lymphoma, has been recognized for many decades. Sarcomatoid carcinoma associated with chronic empyema is extremely rare, may metastasize to other organs in the early stage, and rapidly progresses to death. As far as we know, this was the first case report on sarcomatoid carcinoma associated chronic empyema. THE PATIENTS MAIN CONCERNS AND IMPORTANT CLINICAL FINDINGS: A 59-year-old man presented to our hospital with a 9-year history of chronic empyema and a chief complaint of left chest wall pain for 5 months. The diagnostic contrast-enhanced computed tomography (CT) showed a large irregular soft tissue mass located on the left lower hemithorax at the margin of the empyema cavity extending to the adjacent chest wall and lung parenchyma. In addition, CT revealed pleural and pulmonary metastases surrounded by ground glass opacity. THE MAIN DIAGNOSIS, THERAPEUTICS INTERVENTIONS, AND OUTCOMES: The patient underwent CT guided percutaneous core needle biopsy (PCNB). The histopathological evaluation showed carcinomatous proliferation of pleomorphic spindle cells with extensive necrosis. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. The final histopathological diagnosis was sarcomatoid carcinoma underlying chronic empyema. The tumors showed rapid progression on serial simple radiography. Palliative treatments were performed, but the patient still developed severe dyspnea and died shortly after on day 16. CONCLUSION: Sarcomatoid carcinoma can occur very rarely as a complication of chronic empyema, and is more aggressive than usual. Early detection of developing malignancy during the follow-up of chronic empyema is an important factor for patient prognosis.


Assuntos
Carcinoma de Células Renais/diagnóstico , Dor no Peito/etiologia , Empiema Pleural/diagnóstico , Neoplasias Renais/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pleurais/diagnóstico , Biópsia com Agulha de Grande Calibre , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/secundário , Empiema Pleural/etiologia , Evolução Fatal , Humanos , Neoplasias Renais/diagnóstico , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Pleura/diagnóstico por imagem , Pleura/patologia , Neoplasias Pleurais/complicações , Neoplasias Pleurais/secundário , Tomografia Computadorizada por Raios X
10.
Eur Radiol ; 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34003347

RESUMO

OBJECTIVES: To determine the accuracy of CT-guided percutaneous transthoracic needle lung biopsy (PTNB) for the diagnosis of malignancy and the associated complication rates in patients with idiopathic pulmonary fibrosis (IPF). METHODS: This retrospective study included 91 CT-guided PTNBs performed in 80 patients with IPF from April 2003 through December 2016. Data regarding patients, target lesions, procedures, complications, and pathological reports were collected, and the final diagnosis was made. The diagnostic accuracy, sensitivity, specificity, percentage of nondiagnostic results, and complication rates were determined. Multivariable logistic regression analyses were performed to identify risk factors for nondiagnostic results and major complications. RESULTS: Three biopsies (technical failure [n = 2] and undetermined final diagnosis [n = 1]) were excluded from the diagnostic accuracy calculation. The diagnostic accuracy, sensitivity, and specificity were 89% (78/88), 90% (62/69), and 84% (16/19), respectively. The percentage of nondiagnostic results was 34% (30/88). Lesion size ≤ 3 cm (odds ratio [OR], 8.8; 95% confidence interval [CI], 2.5-31.2; p = 0.001) and needle tip placement outside the target lesion (OR, 13.7; 95% CI, 1.4-132.2; p = 0.02) were risk factors for nondiagnostic results. The overall and major complication rates were 51% (46/91) and 12% (11/91), respectively. The presence of honeycombing along the path of the needle (OR, 11.2; 95% CI, 1.4-89.1; p = 0.02) was an independent risk factor for major complications. CONCLUSIONS: CT-guided PTNB shows a relatively reasonable accuracy in diagnosing malignancy in patients with IPF. The complication rate may be high, especially when the needle passes through honeycomb lesions. KEY POINTS: • In patients with idiopathic pulmonary fibrosis (IPF), CT-guided percutaneous transthoracic needle lung biopsy (PTNB) showed a relatively reasonable accuracy for the diagnosis of malignancy. • Target lesion size ≤ 3 cm and biopsy needle tip placement outside the target lesion were risk factors for nondiagnostic results of CT-guided PTNB. • The complication rate may be high, especially in cases where the biopsy needle passes through honeycomb lesions.

11.
Eur Radiol ; 31(9): 7184-7191, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33733688

RESUMO

OBJECTIVES: To assess interobserver agreement in Lung CT Screening Reporting and Data System (Lung-RADS) categorisation in subsolid nodule-enriched low-dose screening CTs. METHODS: A retrospective review of low-dose screening CT reports from 2013 to 2017 using keyword searches for subsolid nodules identified 54 baseline CT scans. With an additional 108 negative screening CT scans, a total of 162 CT scans were categorised according to the Lung-RADS by two fellowship-trained thoracic radiologists in consensus. We randomly selected 20, 20, 10, and 10 scans from categories 1/2, 3, 4A, and 4B CT scans, respectively, to ensure balanced category representation. Five radiologists classified the 60 CT scans into Lung-RADS categories. The frequencies of concordance and minor and major discordance were calculated, with major discordance defined as at least 6 months of management discrepancy. We used Cohen's κ statistics to analyse reader agreement. RESULTS: An average of 60.3% (181 of 300) of all cases and 45.0% (90 of 200) of positive screens were correctly categorised. The minor and major discordance rates were 12.3% and 27.3% overall and 18.5% and 36.5% in positive screens, respectively. The concordance rate was significantly higher among experienced thoracic radiologists. Overall, the interobserver agreement was moderate (mean κ, 0.45; 95% confidence interval: 0.40-0.51). The proportion of part-solid risk-dominant nodules was significantly higher in cases with low rates of accurate categorisation. CONCLUSION: This retrospective study observed variable accuracy and moderate interobserver agreement in radiologist categorisation of subsolid nodules in screening CTs. This inconsistency may affect management recommendations for lung cancer screening. KEY POINTS: • Diagnostic performance for Lung-RADS categorisation is variable among radiologists with fair to moderate interobserver agreement in subsolid nodule-enriched CT scans. • Experienced thoracic radiologists showed more accurate and consistent Lung-RADS categorisation than radiology residents. • The relative abundance of part-solid nodules was a potential factor related to increased disagreement in Lung-RADS categorisation.


Assuntos
Neoplasias Pulmonares , Detecção Precoce de Câncer , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Variações Dependentes do Observador , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
12.
Int J Mol Sci ; 22(4)2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33562628

RESUMO

Increased oxidative damage in the brain, which increases with age, is the cause of abnormal brain function and various diseases. Ascorbic acid (AA) is known as an endogenous antioxidant that provides neuronal protection against oxidative damage. However, with aging, its extracellular concentrations and uptake decrease in the brain. Few studies have dealt with age-related functional changes in the brain to sustained ascorbate supplementation. This study aimed to investigate the susceptibility of hippocampal neurons to oxidative injury following acute and chronic AA administration. Oxidative stress was induced by kainic acid (KA, 5 µM) for 18 h in hippocampal slice cultures. After KA exposure, less neuronal cell death was observed in the 3 w cultured slice compared to the 9 w cultured slice. In the chronic AA treatment (6 w), the 9 w-daily group showed reduced neuronal cell death and increased superoxide dismutase (SOD) and Nrf2 expressions compared to the 9 w. In addition, the 9 w group showed delayed latencies and reduced signal activity compared to the 3 w, while the 9 w-daily group showed shorter latencies and increased signal activity than the 9 w. These results suggest that the maintenance of the antioxidant system by chronic AA treatment during aging could preserve redox capacity to protect hippocampal neurons from age-related oxidative stress.


Assuntos
Ácido Ascórbico/administração & dosagem , Hipocampo/efeitos dos fármacos , Fármacos Neuroprotetores/administração & dosagem , Envelhecimento/efeitos dos fármacos , Envelhecimento/metabolismo , Animais , Antioxidantes/administração & dosagem , Agonistas de Aminoácidos Excitatórios/toxicidade , Hipocampo/lesões , Hipocampo/metabolismo , Ácido Caínico/toxicidade , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Neuroproteção/efeitos dos fármacos , Técnicas de Cultura de Órgãos , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo
14.
Sci Rep ; 11(1): 874, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33441650

RESUMO

Currently, there is no appropriate treatment option for patients with sorafenib-resistant hepatocellular carcinoma (HCC). Meanwhile, pronounced anticancer activities of newly-developed mitochondria-accumulating self-assembly peptides (Mito-FF) have been demonstrated. This study intended to determine the anticancer effects of Mito-FF against sorafenib-resistant Huh7 (Huh7-R) cells. Compared to sorafenib, Mito-FF led to the generation of relatively higher amounts of mitochondrial reactive oxygen species (ROS) as well as the greater reduction in the expression of antioxidant enzymes (P < 0.05). Mito-FF was found to significantly promote cell apoptosis while inhibiting cell proliferation of Huh7-R cells. Mito-FF also reduces the expression of antioxidant enzymes while significantly increasing mitochondrial ROS in Huh7-R cells. The pro-apoptotic effect of Mito-FFs for Huh7-R cells is possibly caused by their up-regulation of mitochondrial ROS, which is caused by the destruction of the mitochondria of HCC cells.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Sistemas de Liberação de Medicamentos/métodos , Compostos Organofosforados/uso terapêutico , Peptídeos/farmacologia , Fenilalanina/uso terapêutico , Pirenos/uso terapêutico , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos/fisiologia , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Mitocôndrias/metabolismo , Compostos Organofosforados/farmacologia , Peptídeos/metabolismo , Peptídeos/uso terapêutico , Fenilalanina/farmacologia , Pirenos/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Sorafenibe/farmacologia
15.
JAMA Surg ; 156(4): 343-351, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33471110

RESUMO

Importance: Whether computed tomography (CT) radiation is truly carcinogenic remains controversial. Large epidemiological studies that purportedly showed an association between CT radiation and carcinogenesis were limited by confounding by indication and reverse causation, because the reasons for CT examination were unknown. Objective: To measure the risk of hematologic malignant neoplasms associated with perioperative abdominopelvic CT radiation among patients who underwent appendectomy for acute appendicitis. Design, Setting, and Participants: This nationwide population-based cohort study used the National Health Insurance Service claims database in South Korea to assess 825 820 patients who underwent appendectomy for appendicitis from January 1, 2005, to December 31, 2015, and had no underlying risk factors for cancer. Patients were divided into CT-exposed (n = 306 727) or CT-unexposed (n = 519 093) groups. The study was terminated on December 31, 2017, and data were analyzed from October 30, 2018, to September 27, 2020. Exposures: Perioperative abdominopelvic CT examination from 7 days before to 7 days after appendectomy. Main Outcomes and Measures: The primary outcome was the incidence rate ratio (IRR) of hematologic malignant neoplasms for both groups. The secondary outcomes were IRR of abdominopelvic organ cancers and IRR of all cancers. The lag period was 2 years for the primary outcome and 5 years for secondary outcomes. The IRRs were calculated using Poisson regression models with adjustment for age and sex. Results: Among the study population of 825 820 patients (52.9% male; median age, 28 [interquartile range, 15-41] years), hematologic malignant neoplasms developed in 323 patients in the CT-exposed group during 1 486 518 person-years and 500 patients in the CT-unexposed group during 3 422 059 person-years. For all hematologic malignant neoplasms, the IRR for the CT-exposed vs CT-unexposed group was 1.26 (95% CI, 1.09-1.45; P = .002). In terms of individual categories of hematologic malignant neoplasms, the CT-exposed group had an elevated risk only for leukemia (IRR, 1.40 [98.75% CI, 1.04-1.87, adjusted by Bonferroni correction]; P = .005). There was no between-group difference in incidence rate of abdominopelvic organ cancers (IRR, 1.07 [95% CI, 1.00-1.15]; P = .06) and that of all cancers (IRR, 1.04 [95% CI, 0.99-1.09]; P = .14). Conclusions and Relevance: This study controlled for reverse causation bias by defining the reasons for CT scan, and findings suggest that abdominopelvic CT radiation is associated with a higher incidence of hematologic malignant neoplasms. Efforts should be continued for judicious use of CT examinations.

16.
Gastric Cancer ; 24(1): 156-167, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32596783

RESUMO

BACKGROUND: In East Asia, S-1 plus cisplatin (SP) is one of the standard first-line chemotherapy regimens for metastatic or recurrent gastric cancer (MRGC). Oxaliplatin is generally less toxic and more convenient to administer than cisplatin. PATIENTS AND METHODS: This was a multicenter, phase III study assessing whether S-1/oxaliplatin (SOX) was non-inferior/superior to SP in terms of progression-free survival (PFS). Patients with MRGC were randomized 1:1 to receive either SOX (S-1 80 mg/m2/day on days 1-14; oxaliplatin 130 mg/m2 on day 1; every 3 weeks) or SP (S-1 80 mg/m2/day on days 1-14; cisplatin 60 mg/m2 on day 1; every 3 weeks [SP3]). RESULTS: Between October 2012 and October 2014, 338 patients were randomized. The median age was 56 years, and 51% of patients had measurable lesions. SOX was significantly non-inferior but not superior to SP3 in terms of PFS [median 5.6 versus 5.7 months; hazard ratio (HR) 0.85; 95% confidence interval (CI) 0.67-1.07]. In patients with measurable disease, objective response rates were similar between SOX and SP3 (58% versus 60%). Overall, the survival in both groups did not differ (median 12.9 versus 11.4 months; HR 0.86; 95% CI 0.66-1.11). Treatment was well tolerated in both arms. Anemia, leucopenia, neutropenia, febrile neutropenia, and oral mucositis were more common with SP3. In contrast, thrombocytopenia, nausea, vomiting, and peripheral neuropathy were more common with SOX. CONCLUSIONS: SOX was non-inferior to SP3. The two regimens were well tolerated with different toxicity profiles. The SOX regimen can be recommended as a first-line treatment for MRGC. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01671449.

17.
Korean J Radiol ; 22(2): 263-280, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33236542

RESUMO

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.


Assuntos
Pneumopatias/patologia , Neoplasias Pulmonares/patologia , Humanos , Biópsia Guiada por Imagem , Tomografia por Emissão de Pósitrons , Medicina de Precisão , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X
18.
J Clin Med ; 9(12)2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33276433

RESUMO

We aimed to analyse the CT examinations of the previous screening round (CTprev) in NLST participants with incidence lung cancer and evaluate the value of DL-CAD in detection of missed lung cancers. Thoracic radiologists reviewed CTprev in participants with incidence lung cancer, and a DL-CAD analysed CTprev according to NLST criteria and the lung CT screening reporting & data system (Lung-RADS) classification. We calculated patient-wise and lesion-wise sensitivities of the DL-CAD in detection of missed lung cancers. As per the NLST criteria, 88% (100/113) of CTprev were positive and 74 of them had missed lung cancers. The DL-CAD reported 98% (98/100) of the positive screens as positive and detected 95% (70/74) of the missed lung cancers. As per the Lung-RADS classification, 82% (93/113) of CTprev were positive and 60 of them had missed lung cancers. The DL-CAD reported 97% (90/93) of the positive screens as positive and detected 98% (59/60) of the missed lung cancers. The DL-CAD made false positive calls in 10.3% (27/263) of controls, with 0.16 false positive nodules per scan (41/263). In conclusion, the majority of CTprev in participants with incidence lung cancers had missed lung cancers, and the DL-CAD detected them with high sensitivity and a limited false positive rate.

19.
Gerontologist ; 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33326573

RESUMO

BACKGROUND AND OBJECTIVES: The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. RESEARCH DESIGN AND METHODS: A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. RESULTS: In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. DISCUSSION AND IMPLICATIONS: Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

20.
Artigo em Inglês | MEDLINE | ID: mdl-33327395

RESUMO

The environment has direct and indirect effects on mental health. Previous studies acknowledge that the poor design of communities and social environments leads to increased psychological distress, but methodological issues make it difficult to draw clear conclusions. Recent public health, leisure and recreation studies have tried to determine the relationship between recreation opportunities and mental health. However, previous studies have heavily focused on individual contexts rather than national or regional levels; this is a major limitation. It is difficult to reflect the characteristics of community environments effectively with such limited studies, because social environments and infrastructure should be analyzed using a spatial perspective that goes beyond an individual's behavioral patterns. Other limitations include lack of socioeconomic context and appropriate data to represent the characteristics of a local community and its environment. To date, very few studies have tested the spatial relationships between mental health and recreation opportunities on a national level, while controlling for a variety of competing explanations (e.g., the social determinants of mental health). To address these gaps, this study used multi-level spatial data combined with various sources to: (1) identify variables that contribute to spatial disparities of mental health; (2) examine how selected variables influence spatial mental health disparities using a generalized linear model (GLM); (3) specify the spatial variation of the relationships between recreation opportunities and mental health in the continental U.S. using geographically weighted regression (GWR). The findings suggest that multiple factors associated with poor mental health days, particularly walkable access to local parks, showed the strongest explanatory power in both the GLM and GWR models. In addition, negative relationships were found with educational attainment, racial/ethnic dynamics, and lower levels of urbanization, while positive relationships were found with poverty rate and unemployment in the GLM. Finally, the GWR model detected differences in the strength and direction of associations for 3109 counties. These results may address the gaps in previous studies that focused on individual-level scales and did not include a spatial context.


Assuntos
Saúde Mental , Recreação , Meio Ambiente , Humanos , Saúde Mental/estatística & dados numéricos , Modelos Estatísticos , Recreação/psicologia , Fatores Socioeconômicos , Regressão Espacial , Desemprego
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