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1.
Artigo em Inglês | MEDLINE | ID: mdl-30987309

RESUMO

Mental disorders are consistently and closely related to psychological distress. At the start of the university period, the relationship between a student's psychological distress, family support, and employment status is not well-known. The aims of this study were: To determine the prevalence of psychological distress in first-year university students and to analyze its relationship with family support and the student's employment status. Data from 4166 first-year university students from nine universities across Spain were considered. The prevalence of psychological distress was obtained using the GHQ-12, a valid and reliable screening tool to detect poor mental health. To analyze the relationship between psychological distress, family support, and employment status, logistic regression models were fitted. Regarding the prevalence found, 46.9% of men and 54.2% of women had psychological distress. In both genders, psychological distress levels increased as family support decreased. Among women, psychological distress was associated with their employment status. The prevalence of psychological distress among first-year university students in Spain is high. In addition, family support, and employment status for women, could be factors to take into account when developing psychological distress prevention strategies at the beginning of the university period.


Assuntos
Emprego/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adulto , Estudos Transversais , Emprego/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Prevalência , Apoio Social , Espanha/epidemiologia
2.
Gac. sanit. (Barc., Ed. impr.) ; 33(2): 141-147, mar.-abr. 2019. tab
Artigo em Inglês | LILACS-Express | ID: ibc-ET1-3093

RESUMO

Objective: To assess the prevalence of illegal drug use in college students on any previous occasion, during the previous year and the previous month, and to analyze the relationship between illegal drug use and family support and other factors. Methods: A cross-sectional study using data from students participating in the uniHcos project (n = 3767) was conducted. The prevalence and age of onset of consumption of cannabis, non-prescription sedatives, stimulants and depressants was evaluated. Polyconsumption was also assessed. The independent variables were: family support, age, residence, and employment status. To determine the factors related to drug use multivariate logistic regression models stratified by gender were fitted. Results: Differences between men and women in prevalence of illegal drug use except non-prescription sedatives were observed. In both genders, less family support was associated with higher consumption of all drugs, except depressants, and with polyconsumption. To be studying and looking for work was related to cannabis and stimulant use and to polyconsumption among women, but only to cannabis use among men. Conclusions: These results support the notion that the start of university studies is a particularly relevant stage in the onset of illegal drug use and its prevention, and that consumption may be especially associated with family support


Objetivo: Evaluar la prevalencia del consumo de drogas ilegales en estudiantes universitarios y analizar la relación entre dicho consumo, el apoyo familiar y otros factores. Método: Se realizó un diseño transversal basado en datos de participantes en el proyecto uniHcos (n = 3767). Se evaluaron la prevalencia y la edad de inicio del consumo de cannabis, tranquilizantes sin receta, estimulantes y depresores, y el policonsumo. Como variables independientes se consideraron el apoyo familiar, la edad, la residencia y la situación laboral. Para la determinación de los factores asociados al consumo de drogas se ajustaron modelos de regresión logística estratificados por sexo. Resultados: Se observaron diferencias entre hombres y mujeres en la prevalencia del consumo de todas las drogas ilegales, excepto tranquilizantes sin receta. En ambos sexos, cuanto peor apoyo familiar, mayor consumo de todas las drogas, excepto depresores y policonsumo. Encontrarse estudiando y buscando trabajo se relacionó con el consumo de cannabis, estimulantes y policonsumo en las mujeres, y solo con cannabis en los hombres. Conclusiones: Los resultados de este estudio aportan nueva evidencia a favor de que el inicio de la etapa universitaria es un momento de especial relevancia en el inicio del consumo de drogas ilegales y su prevención, pudiendo este consumo estar especialmente relacionado con el apoyo familiar

3.
Eur J Nutr ; 2018 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-29948218

RESUMO

BACKGROUND: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). METHODS: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. RESULTS: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI < 25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. CONCLUSIONS: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.

4.
Cancer Prev Res (Phila) ; 11(9): 523-534, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29789344

RESUMO

Colorectal cancer is a significant public health concern. As a multistage and multifactorial disease, environmental and genetic factors interact at each stage of the process, and an individual's lifestyle also plays a relevant role. We set out to review the scientific evidence to study the need to investigate the role of the peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) gene as a biomarker of the physical activity's (PA) effect on colorectal cancer. PA is a protective factor against colorectal cancer and usually increases the expression of PGC-1α This gene has pleiotropic roles and is the main regulator of mitochondrial functions. The development of colorectal cancer has been associated with mitochondrial dysfunction; in addition, alterations in this organelle are associated with colorectal cancer risk factors, such as obesity, decreased muscle mass, and the aging process. These are affected by PA acting, among other aspects, on insulin sensitivity and oxygen reactive species/redox balance. Therefore, this gene demands special attention in the understanding of its operation in the consensual protective effect of PA in colorectal cancer. A significant amount of indirect evidence points to PGC-1α as a potential biomarker in the PA-protective effect on colorectal cancer. The article focuses on the possible involvement of PGC-1α in the protective role that physical activity has on colorectal cancer. This is an important topic both in relation to advances in prevention of the development of this widespread disease and in its therapeutic treatment. We hope to generate an initial hypothesis for future studies associated with physical activity-related mechanisms that may be involved in the development or prevention of colorectal cancer. PGC-1α is highlighted because it is the main regulator of mitochondrial functions. This organelle, on one hand, is positively stimulated by physical activity; on the other hand, its dysfunction or reduction increases the probability of developing colorectal cancer. Therefore, we consider the compilation of existing information about the possible ways to understand the mechanisms of this gene to be highly relevant. This study is based on evidence of PGC-1α and physical activity, on PGC-1α and colorectal cancer, on colorectal cancer and physical activity/inactivity, and the absence of studies that have sought to relate all of these variables. Cancer Prev Res; 11(9); 523-34. ©2018 AACR.

5.
Am J Dermatopathol ; 40(9): 694-698, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29649008

RESUMO

The presence of acquired generalized keratotic follicular papules and comedones developing in adulthood constitute an uncommon clinical situation. Although this clinical presentation has been described in several noninflammatory, inflammatory, and neoplastic skin disorders, its association with an exclusive perifollicular epitheliod or granulomatous inflammatory reaction represents an exceedingly rare phenomenon. We report a case of a 57-year-old male patient presenting clinically numerous acquired disseminated follicular papules and comedones, showing isolated perifollicular sarcoid-like granulomatous inflammatory infiltrates at the histological examination. These lesions experienced a complete spontaneous resolution after several months. The possibility that this disseminated, epithelioid, granulomatous, perifollicular dermatosis may represent an isolated follicular variant of lichen nitidus or a previously nonreported skin disorder is discussed.


Assuntos
Granuloma/patologia , Líquen Nítido/patologia , Dermatopatias/patologia , Pele/patologia , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Remissão Espontânea , Fatores de Tempo
7.
PLoS Med ; 15(3): e1002514, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29494593

RESUMO

BACKGROUND: Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. METHODS AND FINDINGS: Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5-5.2) years for the total cohort and 6.4 (3.6-8.0) years in Europe, 3.7 (2.0-5.4) years in North America, 2.5 (1.2-4.4) years in South and Southeast Asia, 5.0 (2.7-7.5) years in South America and the Caribbean, and 2.1 (0.9-3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3-2.1) years in North America to 7.1 (5.3-8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4-2.6) years in North America to 7.9 (6.0-9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%-2.8%), 15.6% (15.1%-16.0%), and 11.3% (10.9%-11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%-1.1%]) and highest in South America and the Caribbean (4.4% [3.1%-6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%-6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%-13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. CONCLUSION: To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.

8.
Sci Rep ; 8(1): 3036, 2018 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-29445177

RESUMO

A breast-risk score, published in 2016, was developed in white-American women using 92 genetic variants (GRS92), modifiable and non-modifiable risk factors. With the aim of validating the score in the Spanish population, 1,732 breast cancer cases and 1,910 controls were studied. The GRS92, modifiable and non-modifiable risk factor scores were estimated via logistic regression. SNPs without available genotyping were simulated as in the aforementioned 2016 study. The full model score was obtained by combining GRS92, modifiable and non-modifiable risk factor scores. Score performances were tested via the area under the ROC curve (AUROC), net reclassification index (NRI) and integrated discrimination improvement (IDI). Compared with non-modifiable and modifiable factor scores, GRS92 had higher discrimination power (AUROC: 0.6195, 0.5885 and 0.5214, respectively). Adding the non-modifiable factor score to GRS92 improved patient classification by 23.6% (NRI = 0.236), while the modifiable factor score only improved it by 7.2%. The full model AUROC reached 0.6244. A simulation study showed the ability of the full model for identifying women at high risk for breast cancer. In conclusion, a model combining genetic and risk factors can be used for stratifying women by their breast cancer risk, which can be applied to individualizing genetic counseling and screening recommendations.

9.
Sci Rep ; 8(1): 2040, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29391578

RESUMO

A safe and effective colorectal cancer (CRC) chemoprevention agent remains to be discovered. We aim to evaluate the association between the use of glucosamine and/or chondroitin sulphate and risk of colorectal cancer (CRC) in the MCC-Spain study, a case-control study performed in Spain that included 2140 cases of CRC and 3950 population controls. Subjects were interviewed on sociodemographic factors, lifestyle, family and medical history and regular drug use. Adjusted odds ratios and their 95% confidence intervals were estimated. The reported frequency of chondroitin and/or glucosamine use was 2.03% in controls and 0.89% in cases. Users had a reduced risk of CRC (OR: 0.47; 95% CI: 0.28-0.79), but it was no longer significant when adjusted for NSAID (nonsteroidal anti-inflammatory drugs) use (OR: 0.82; 95% CI: 0.47-1.40). A meta-analysis with previous studies suggested a protective effect, overall and stratified by NSAID use (OR: 0.77; 95% CI: 0.62-0.97). We have not found strong evidence of an independent preventive effect of CG on CRC in our population because the observed effects of our study could be attributed to NSAIDs concurrent use. These results merit further research due to the safety profile of these drugs.


Assuntos
Sulfatos de Condroitina/administração & dosagem , Neoplasias Colorretais/epidemiologia , Glucosamina/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Estudos de Casos e Controles , Neoplasias Colorretais/prevenção & controle , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Gac Sanit ; 2018 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-29329793

RESUMO

OBJECTIVE: To assess the prevalence of illegal drug use in college students on any previous occasion, during the previous year and the previous month, and to analyze the relationship between illegal drug use and family support and other factors. METHODS: A cross-sectional study using data from students participating in the uniHcos project (n = 3767) was conducted. The prevalence and age of onset of consumption of cannabis, non-prescription sedatives, stimulants and depressants was evaluated. Polyconsumption was also assessed. The independent variables were: family support, age, residence, and employment status. To determine the factors related to drug use multivariate logistic regression models stratified by gender were fitted. RESULTS: Differences between men and women in prevalence of illegal drug use except non-prescription sedatives were observed. In both genders, less family support was associated with higher consumption of all drugs, except depressants, and with polyconsumption. To be studying and looking for work was related to cannabis and stimulant use and to polyconsumption among women, but only to cannabis use among men. CONCLUSIONS: These results support the notion that the start of university studies is a particularly relevant stage in the onset of illegal drug use and its prevention, and that consumption may be especially associated with family support.

11.
PLoS Med ; 15(1): e1002491, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29381702

RESUMO

BACKGROUND: Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART) in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE), Eastern Europe (Russia and Ukraine), and Thailand. METHODS AND FINDINGS: Children with perinatal HIV aged <18 years initiating cART were followed until their 21st birthday, transfer to adult care, death, loss to follow-up, or last visit up until 31 December 2013. Rates of death and first AIDS-defining events were calculated. Baseline and time-updated risk factors for early/late (≤/>6 months of cART) death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4-9.3) years; 35% of children aged <5 years had a CD4 lymphocyte percentage <15% in 1997-2003, which fell to 15% of children in 2011 onwards (p < 0.001). Similarly, 53% and 18% of children ≥5 years had a CD4 count <200 cells/mm3 in 1997-2003 and in 2011 onwards, respectively (p < 0.001). Median follow-up was 5.6 (2.9-8.7) years. Of 94 deaths and 237 first AIDS-defining events, 43 (46%) and 100 (42%) were within 6 months of initiating cART, respectively. Multivariable predictors of early death were: being in the first year of life; residence in Russia, Ukraine, or Thailand; AIDS at cART start; initiating cART on a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen; severe immune suppression; and low BMI-for-age z-score. Current severe immune suppression, low current BMI-for-age z-score, and current viral load >400 c/mL predicted late death. Predictors of early and late progression to AIDS were similar. Study limitations include incomplete recording of US Centers for Disease Control (CDC) disease stage B events and serious adverse events in some countries; events that were distributed over a long time period, and that we lacked power to analyse trends in patterns and causes of death over time. CONCLUSIONS: In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART) in countries in Europe and Thailand. We observed that over 40% of deaths occurred ≤6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART.

12.
Ecol Appl ; 28(1): 95-105, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28944610

RESUMO

Climate change in the Mediterranean, associated with warmer temperatures and more frequent droughts, is expected to impact forest productivity and the functioning of forests ecosystems as carbon reservoirs in the region. Climate warming can positively affect forest growth by extending the growing season, whereas increasing summer drought generally reduces forest productivity and may cause growth decline, trigger dieback, hamper regeneration, and increase mortality. Forest management could potentially counteract such negative effects by reducing stand density and thereby competition for water. The effectiveness of such interventions, however, has so far mostly been evaluated for short time periods at the tree and stand levels, which limits our confidence regarding the efficacy of thinning interventions over longer time scales under the complex interplay between climate, stand structure, and forest management. In this study, we use a century-long historical data set to assess the effects of climate and management on forest productivity. We consider rear-edge Scots pine (Pinus sylvestris) populations covering continental and Mediterranean conditions along an altitudinal gradient in Central Spain. We use linear mixed-effects models to disentangle the effects of altitude, climate, and stand volume on forest growth and ingrowth (recruitment and young trees' growth). We find that warming tends to benefit these tree populations, warmer winter temperature has a significant positive effect on both forest growth and ingrowth, and the effect is more pronounced at low elevations. However, drought conditions severely reduce growth and ingrowth, in particular when competition (stand volume) is high. We conclude that summer droughts are the main threat to Scots pine populations in the region, and that a reduction of stand volume can partially mitigate the negative impacts of more arid conditions. Mitigation and adaptation measures could therefore manage stand structure to adopt for the anticipated impacts of climate change in Mediterranean forest ecosystems.

13.
Acta méd. (Porto Alegre) ; 39(1): 349-357, 2018.
Artigo em Português | LILACS | ID: biblio-911295

RESUMO

Objetivos: O artigo revisa os métodos de tratamento atualmente mais indicados para cessação do tabagismo. Métodos: Uma busca nas bases Medline/Pubmed e Lilacs foi realizada com termos referentes a cessação do tabagismo, produtos utilizados para cessar o tabagismo e taxa de abstinência. Foram selecionadas revisões sistemáticas e ensaios clínicos em texto completo, publicados nos últimos 5 anos, em língua inglesa ou portuguesa, tendo como participantes humanos adultos. Após análise foram incluídos 10 artigos para revisão. Resultados: Em relação à terapia comportamental, o emprego de aconselhamento telefônico teve pior desfecho em comparação aos contatos pessoais (p=0.01) e à combinação de ambos (p=0.01). A abordagem proativa favorece a taxa de abstinência (p<0.001). O incentivo financeiro, no entanto, não teve efeitos sobre a taxa de abstinência a longo prazo (p=0.95). Quanto à terapia farmacológica, a bupropiona (OR 1.84) e a vareniclina (OR 2.88), isoladamente, aumentaram a taxa de abstinência comparadas ao placebo, tendo a vareniclina demonstrado resultados superiores (OR 1.57). A Terapia de Reposição Nicotínica combinada com bupropiona ou nortriptilina não resultou em aumento na taxa de abstinência quando comparada à Terapia de Reposição de Nicotina em monoterapia (OR 0.99). A nortriptilina também aumentou a taxa de abstinência, com poucos efeitos adversos (RR 2.03). A associação de bupropiona e vareniclina gerou maior taxa de abstinência em um mês comparada à monoterapia com vareniclina (p=0.029). Não houve diferença significativa entre Terapia de Reposição de Nicotina por goma comparada ao adesivo transdérmico em relação à redução do tabagismo (p>0.05). Conclusões: Diversos medicamentos são eficazes e estão disponíveis para auxílio à cessação do tabagismo. Deve-se avaliar o contexto clínico de cada paciente, ofertando a terapia mais adequada a cada caso. Abordagens proativas e motivacionais, além da facilitação do acesso aos recursos de tratamento também melhoram as taxas de abstinência.


Aims: This article aims to present a review of tobacco cessation methods currently most indicated in order to update health professionals. Methods: It was performed a search in Medline/Pubmed and Lilacs using terms referring to smoking cessation, smoking cessation products and Abstinence Rate. Systematic reviews and clinical trials in full text articles, published in the last five years in English or Portuguese, having human adults as participants, were selected. After analysing adequacy to the subject, 10 articles were included to be reviewed. Results: Regarding to non-pharmacological therapies, telephone counselling showed worse results in comparison to personal therapy (p=0.01) and also comparing to the combination of them (p=0.01). Besides, a proactive approach enhances abstinence rate when compared to usual approach (p<0.001). Cash incentive did not result in a higher abstinences rates in long term when compared to control group (p=0.95). In relation to pharmacological therapy, bupropion (OR 1.84) and varenicline (OR 2.88), separately, increased abstinence rate in comparison to placebo, although varenicline showed superior results (OR 1.57). Nicotine Replacement Therapy in combination with bupropion or nortriptilin did not result in a higher abstinence rate when compared to Nicotine Replacement Therapy as monotherapy (OR 0.99). Nortriptilin enhances abstinence rate, with little adverse events (RR 2.03). Combination of bupropion and varenicline resulted in an increased abstinence rate in one month in comparison to varenicline as single therapy (p=0.029). There was no significant difference between Nicotine Replacement Therapy with nicotine gum and patch in relation to smoking reduction (p>0.05). Conclusions: Many medications were found to be effective and are available for smoking cessation. Clinical context of each patient should be evaluated, offering the most appropriate therapy. Proactive approaches and simplified access to resources also improve abstinence rates.


Assuntos
Abandono do Uso de Tabaco , Tabagismo/terapia
14.
BMC Cancer ; 17(1): 731, 2017 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-29121859

RESUMO

BACKGROUND: Colorectal cancer (CRC) is a major global public health problem and the second leading cause of cancer-related death. Mitochondrial dysfunction has long been suspected to be involved in this type of tumorigenesis, as supported by an accumulating body of research evidence. However, little is known about how mitochondrial alterations contribute to tumorigenesis. Mitochondrial biogenesis is a fundamental cellular process required to maintain functional mitochondria and as an adaptive mechanism in response to changing energy requirements. Mitochondrial biogenesis is regulated by peroxisome proliferator-activated receptor gamma coactivator 1-α (PPARGC1A or PGC1α). In this paper, we report a systematic review to summarize current evidence on the role of PGC1α in the initiation and progression of CRC. The aim is to provide a basis for more comprehensive research. METHODS: The literature search, data extraction and quality assessment were performed according to the document Guidance on the Conduct of Narrative Synthesis in Systematic Reviews and the PRISMA declaration. RESULTS: The studies included in this review aimed to evaluate whether increased or decreased PGC1α expression affects the development of CRC. Each article proposes a possible molecular mechanism of action and we create two concept maps. CONCLUSION: Our systematic review indicates that altered expression of PGC1α modifies CRC risk. Most studies showed that overexpression of this gene increases CRC risk, while some studies indicated that lower than normal expression levels could increase CRC risk. Thus, various authors propose PGC1α as a good candidate molecular target for cancer therapy. Reducing expression of this gene could help to reduce risk or progression of CRC.


Assuntos
Neoplasias Colorretais/metabolismo , Estudos de Avaliação como Assunto , Regulação Neoplásica da Expressão Gênica , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/biossíntese , Animais , Carcinogênese/metabolismo , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/genética , Humanos , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/genética , Fatores de Risco
15.
Sci Rep ; 7(1): 13806, 2017 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-29061982

RESUMO

Enhancer of zeste homolog 2 (EZH2) is the catalitic subunit of polycomb repressive complex 2 and mediates gene silencing. EZH2 is overexpressed in many cancers and correlates with poor prognosis. The role of the gene EZH2 in colorectal cancer survival is uncertainly, the aim of this study is clear this relationship. Relevant literaure was searched from electronic databases. A meta-analysis was performed with elegible studies which quantitatively evaluated the relationship between EZH2 overexpression and survival of patients with colorectal cancer. Survival data were aggregated and quantitatively analyzed. We performed a meta-analysis of 8 studies (n = 1059 patients) that evaluated the correlation between EZH2 overexpression and survival in patients with colorectal cancer. Combined hazard ratios suggested that EZH2 overexpression was associated with better prognosis of overall survival (OS) HR(hazard ratio) = 0.61 95% CI (0.38-0.84) We performed bias analysis according Egger and Begg,s test and we did not find publication bias. EZH2 overexpression indicates a better prognosis for colorectal cancer.

16.
Vaccine ; 34(46): 5587-5594, 2016 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-27727030

RESUMO

BACKGROUND: Current national immunisation schedules differ between countries in terms of vaccine formulation, timing of vaccinations and immunisation programme funding and co-ordination. As a result, some HIV infected paediatric population may be left susceptible to vaccine preventable infections. Vaccines used in healthy population should be subjected to high quality ethical research and be explicitly validated for use in children with special vaccination needs such as those infected with HIV. This survey was completed to assess current vaccination practices and attitudes toward vaccination among pediatricians who care for vertically HIV infected children. METHODS: An online questionnaire was completed by 46 experts in paediatric HIV-infection from the Paediatric European Network for Treatment of AIDS (PENTA). Data were collected between November 2013 and March 2014. RESULTS: 46units looking after 2465 patients completed the questionnaire. The majority of units (67%) reported that common childhood immunisation were administered by the family doctor or local health services rather than in the HIV specialist centre. Vaccination histories were mostly incomplete and difficult to obtain for 40% of the studied population. Concerns were reported regarding the use of live attenuated vaccines, such as varicella and rotavirus, and these were less frequently recommended (61% and 28% of the units respectively). Monitoring of vaccine responses was employed in a minority of centres (41%). A range of different assays were used resulting in diverse units of measurement and proposed correlates of protection. CONCLUSION: Vaccination practices for perinatally HIV-infected children vary a great deal between countries. Efforts should be made to improve communication and documentation of vaccinations in healthcare settings and to harmonise recommendations relating to additional vaccines for HIV infected children and the use of laboratory assays to guide immunisation. This will ultimately improve coverage and vaccine induced immunity in this vulnerable patient group.


Assuntos
Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Programas de Imunização , Padrões de Prática Médica , Vacinas/administração & dosagem , Criança , Pré-Escolar , Feminino , Infecções por HIV/transmissão , Humanos , Esquemas de Imunização , Lactente , Transmissão Vertical de Doença Infecciosa , Masculino , Inquéritos e Questionários , Vacinação , Cobertura Vacinal , Vacinas Atenuadas
17.
Rev. colomb. cancerol ; 19(4): 193-203, oct.-dic, 2015. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: lil-769095

RESUMO

Objetivos: El cáncer colorrectal (CCR) presenta elevada incidencia y mortalidad con diferentes tendencias según localización anatómica y otras características anatomopatológicas que parecen vinculadas a cambios tanto a la exposición a factores de riesgo como al diagnóstico siendo esencial una adecuada filiación tumoral para valorar el efecto de dichos factores en la aparición, diagnóstico y progresión de la enfermedad. El objetivo fue describir las características clínicas y anatomopatológicas de pacientes diagnosticados de CCR en el Área de Salud de León en función de la localización tumoral y del grado de diferenciación. Métodos: Se estudió una serie de 408 casos de entre 25 y 85 años con diagnóstico confirmado de CCR, recogiéndose información de características clínicas y anatomopatológicas y de los biomarcadores analizados en la rutina clínica. Se realizó análisis univariable y bivariable según el grado de diferenciación y la localización tumoral. Resultados: El tamano tumoral disminuye desde colon proximal a recto (Colon Proximal = 5,13 cm: Colon Distal = 4,09cm: Recto = 3,17cm; p< 0,001) siendo el TNM también mayor en zonas proximales. Los adenocarcinomas mucinosos son más frecuentes en tumores pobremente diferenciados que en bien diferenciados (23,1% vs 5,5%). Las invasiones linfática, venosa y peritumoral son más frecuentes con menor grado de diferenciación. Conclusiones: La distribución del estadio tumoral en función de la localización tiene estadios TNM más avanzados en zonas proximales, lo que podría asociarse a una menor detección precoz en dichos casos. La asociación entre invasión venosa y linfática con el grado de diferenciación es poco conocida requiriéndose estudios que aclaren su posible interés pronóstico.


Aims: Colorectal cancer (CRC) has a high incidence and mortality, with different patterns depending on anatomical location and other pathological characteristics that appear linked to changes in exposure risk factors exposure as well as the diagnosis. All these make it essential to determine the source of the tumour to properly assess the effect of these factors in the development, diagnosis and progression of the disease. The aim was to describe the clinical and anatomical-pathological characteristics of patients diagnosed with CRC in the Health Area of Leon (ASL) based on their location and degree of tumour differentiation. Methods: Information was collected on the clinical and pathological characteristics, including biological markers analysed in clinical routine of 408 patients between 25 and 85 years with a confirmed diagnosis of CRC, and residents in ASL at least six months before diagnosis. Univariate and bivariate analyses were performed according to the degree of differentiation and tumour location. Results: Tumour size decreases from the colon to the rectum from location decline proximal colon to the rectum (Proximal Colon = 5.13cm; Distal Colon = 4.09cm; Rectum = 3.17cm, P< 0.001), with the TNM stage also being higher in proximal areas. Mucinous adenocarcinomas are more frequent in poorly differentiated than in well differentiated tumours (23.1% vs 5.5%). Lymphatic, venous and peri-tumour invasions are more common in poorly differentiated tumours. Conclusions: The distribution in accordance with the location has more advanced TNM stages in the proximal areas, which could be related to the poorer early diagnosis in proximal areas. The association between venous and lymphatic invasion with the degree of differentiation is poorly understood, and requires studies to clarify their possible prognostic interest.

19.
Int J Womens Health ; 7: 595-603, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26089705

RESUMO

Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The main purpose of endometriosis management is alleviating pain associated to the disease. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Long-term medical treatment is usually needed in most women. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Keywords included "endometriosis" matched with "medical treatment", "new treatment", "GnRH antagonists", "Aromatase inhibitors", "selective progesterone receptor modulators", "anti-TNF α", and "anti-angiogenic factors". Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. GnRH antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral). There is a need to find effective treatments that do not block the ovarian function. For this purpose, antiangiogenic factors could be important components of endometriosis therapy in the future. Upcoming researches and controlled clinical trials should focus on these drugs.

20.
J Am Acad Dermatol ; 72(1): 151-8.e1, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25455610

RESUMO

BACKGROUND: Sturge-Weber syndrome (SWS) is characterized by port-wine stains (PWS) affecting the face, eyes, and central nervous system. Pulsed dye laser (PDL) is the standard treatment for PWS. Unfortunately, recurrence is frequent because of reformation and reperfusion of blood vessels. OBJECTIVE: We sought to assess the clinical efficacy of topical rapamycin combined with PDL in PWS of patients with SWS. METHODS: We conducted a phase II, randomized, double-blind, intraindividual placebo-controlled, clinical trial. We recruited 23 patients with SWS and facial PWS (12 women; median age 33 years, age range 17-65 years) from the University Clinic of Navarra, Spain. Four interventions were evaluated: placebo, PDL + placebo, rapamycin, and PDL + rapamycin. Clinical and histologic responses were evaluated using a chromatographic computerized system, spectrometry, and histologic analyses at 6, 12, and 18 weeks after the intervention. RESULTS: PDL + rapamycin yielded the lowest digital photographic image score and the lowest percentage of vessels in histologic analysis, and showed a statistically significant improvement compared with the other interventions. The treatment was generally well tolerated. LIMITATIONS: PDL was only applied to the lateral parts of the PWS area. CONCLUSION: Topical rapamycin associated with PDL seems to be an effective treatment for PWS in patients with SWS.


Assuntos
Capilares/anormalidades , Imunossupressores/administração & dosagem , Lasers de Corante/uso terapêutico , Sirolimo/administração & dosagem , Malformações Vasculares/terapia , Administração Tópica , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mancha Vinho do Porto/complicações , Síndrome de Sturge-Weber/complicações , Malformações Vasculares/etiologia , Adulto Jovem
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