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3.
J Am Acad Dermatol ; 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32171811

RESUMO

BACKGROUND: Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes. OBJECTIVE: To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs. METHODS: Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement. RESULTS: Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels. LIMITATIONS: Retrospective design, limited sample size, and high-risk population. CONCLUSIONS: Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.

4.
Dermatol Surg ; 46(4): 514-518, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31592922

RESUMO

BACKGROUND: Postoperative concerns after Mohs micrographic surgery (MMS) are not well characterized. OBJECTIVE: To better define patient concerns and contributing characteristics in the immediate postoperative period after MMS. MATERIALS AND METHODS: A standardized telephone encounter template was implemented to better assess patient concerns in the 24-hour postoperative period. A review was then performed of patients undergoing MMS from October 2016 to July 2017 to assess for the most common patient concerns and association with clinical characteristics. RESULTS: We included 307 patients. Overall, 60.6% of patients reported a concern. Fifty-four percent of patients reported pain. Most pain was characterized as "a little" (67.7%). On univariate analysis, flap repairs, location on the upper extremities, and swelling were associated with higher mean postoperative pain. Tumor type was not associated with increased pain. On multivariate analyses, patients with larger defects and associated edema were statistically significantly associated with higher degrees of pain. CONCLUSION: Over half of patients experience postoperative concerns after MMS, most commonly pain. The immediate postoperative period may be an optimal time to identify patient concerns allowing for reassurance or early intervention when necessary.


Assuntos
Assistência ao Convalescente/métodos , Cirurgia de Mohs/efeitos adversos , Dor Pós-Operatória/epidemiologia , Cuidados Pós-Operatórios/métodos , Neoplasias Cutâneas/cirurgia , Adulto , Assistência ao Convalescente/normas , Assistência ao Convalescente/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Cuidados Pós-Operatórios/normas , Cuidados Pós-Operatórios/estatística & dados numéricos , Período Pós-Operatório , Estudos Retrospectivos , Inquéritos e Questionários/normas , Inquéritos e Questionários/estatística & dados numéricos , Telefone
5.
Arch Dermatol Res ; 311(9): 691-696, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31338583

RESUMO

Over 2 million facial skin cancers occur globally each year. Facial skin cancer surgery can leave scars that may alter appearance and impact psychosocial functioning. The objective of this study is to assess patient-reported appearance-related psychosocial distress following facial skin cancer surgery, and to identify independent predictors of psychosocial impairment. This was a single-center, cross-sectional study at a tertiary care cancer center including patients who underwent dermatologic surgery on the face from March 1, 2016 to March 31, 2018. Patients completed the FACE-Q Skin Cancer Appearance-related Psychosocial Distress scale postoperatively between May 21, 2018 and October 1, 2018. Patient responses were rated on a 4-point Likert scale and converted on a scale from 0 to 100. In total, 359 patients completed the questionnaire (34.2% response rate). Overall, patients reported a low level of psychosocial distress. Patients most frequently reported items of self-consciousness, unhappiness, and insecurity < 3 months following surgery. Though psychosocial distress significantly improved over time, self-consciousness continued to be reported in the long-term postoperative period. Linear regression analysis determined that younger age, history of anxiety and/or depression, surgery on the nose, and repair by flap were independently predictive of psychosocial distress. Marginal predicted values for distress scores based on age demonstrated an indirect relationship. Patient-reported appearance-related psychosocial distress is low following facial skin cancer surgery, and report of distress decreases over time. The identified predictors of distress may be used as indicators for offering psycho-oncologic support and early interventions to improve scar appearance.


Assuntos
Cicatriz/psicologia , Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Face/cirurgia , Neoplasias Cutâneas/cirurgia , Estresse Psicológico/epidemiologia , Fatores Etários , Idoso , Cicatriz/etiologia , Estado de Consciência , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aparência Física , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Neoplasias Cutâneas/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo
6.
Biophys J ; 117(1): 99-110, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31164197

RESUMO

After a nascent chain of a membrane protein emerges from the ribosomal tunnel, the protein is integrated into the cell membrane. This process is controlled by a series of proteinaceous molecular devices, such as signal recognition particles and Sec translocons. In addition to these proteins, we discovered two endogenous components regulating membrane protein integration in the inner membrane of Escherichia coli. The integration is blocked by diacylglycerol (DAG), whereas the blocking is relieved by a glycolipid named membrane protein integrase (MPIase). Here, we investigated the influence of these integration-blocking and integration-promoting factors on the physicochemical properties of membrane lipids via solid-state NMR and fluorescence measurements. These factors did not have destructive effects on membrane morphology because the membrane maintained its lamellar structure and did not fuse in the presence of DAG and/or MPIase at their effective concentrations. We next focused on membrane flexibility. DAG did not affect the mobility of the membrane surface, whereas the sugar chain in MPIase was highly mobile and enhanced the flexibility of membrane lipid headgroups. Comparison with a synthetic MPIase analog revealed the effects of the long sugar chain on membrane properties. The acyl chain order inside the membrane was increased by DAG, whereas the increase was cancelled by the addition of MPIase. MPIase also loosened the membrane lipid packing. Focusing on the transbilayer movement, MPIase reduced the rapid flip-flop motion of DAG. On the other hand, MPIase could not compensate for the diminished lateral diffusion by DAG. These results suggest that by manipulating the membrane lipids dynamics, DAG inhibits the protein from contacting the inner membrane, whereas the flexible long sugar chain of MPIase increases the opportunity for interaction between the membrane and the protein, leading to membrane integration of the newly formed protein.


Assuntos
Diglicerídeos/química , Proteínas de Escherichia coli/química , Glicoproteínas/química , Bicamadas Lipídicas/química , Proteínas de Membrana/química , Espectroscopia de Ressonância Magnética , Lipídeos de Membrana/química
7.
Sci Rep ; 9(1): 8631, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31201340

RESUMO

Sesamin is a furofuran-type lignan that is found abundantly in seeds of Sesamum indicum (sesame) and has been widely accepted as a dietary supplement with positive effects on human health. The biological activity of sesamin in human cells and organs has been analysed extensively, although comparatively few studies show biological functions for sesamin in planta. Herein we screened sesamin-binding proteins (SBP) from sesame seedling extracts using sesamin-immobilized nano-beads. In subsequent peptide mass fingerprinting analyses, we identified a SBP, Steroleosin B, which is one of the membrane proteins found in oil bodies. In addition, pull-down assays and saturation transfer difference-nuclear magnetic resonance (STD-NMR) experiments demonstrated that sesamin binds directly to recombinant Steroleosin B in vitro. Finally, ectopic accumulations of sesamin and Steroleosin B in transgenic Arabidopsis thaliana plants induced severe growth defects including suppression of leaf expansion and root elongation. Collectively, these results indicate that sesamin influences tissue development in the presence of Steroleosin B.


Assuntos
Proteínas de Transporte/metabolismo , Dioxóis/metabolismo , Lignanas/metabolismo , Desenvolvimento Vegetal , Proteínas de Plantas/metabolismo , Arabidopsis/genética , Dioxóis/química , Germinação , Lignanas/química , Plantas Geneticamente Modificadas , Espectroscopia de Prótons por Ressonância Magnética , Sementes/crescimento & desenvolvimento
8.
ACS Chem Biol ; 14(7): 1546-1555, 2019 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-31246411

RESUMO

Plant pathogenic bacteria possess sophisticated mechanisms to detect the presence of host plants by sensing host-derived compounds. Ralstonia solanacearum, the causative agent of bacterial wilt on solanaceous plants, employs quorum sensing to control the production of the secondary metabolite ralfuranones/ralstonins, which have been suggested to be involved in virulence. Here, we report that d-galactose and d-glucose, plant sugars, activate the production of ralfuranones/ralstonins in R. solanacearum. As a result, two new derivatives, ralfuranone M (1) and ralstonin C (2), were found in the culture extracts, and their structures were elucidated by spectroscopic and chemical methods. Ralstonin C (2) is a cyclic lipopeptide containing a unique fatty acid, (2S,3S,Z)-3-amino-2-hydroxyicos-13-enoic acid, whereas ralfuranone M (1) has a common aryl-furanone structure with other ralfuranones. d-Galactose and d-glucose activated the expression of the biosynthetic ralfuranone/ralstonin genes and in part became the biosynthetic source of ralfuranones/ralstonins. Ralfuranones and ralstonins were detected from the xylem fluid of the infected tomato plants, and their production-deficient mutants exhibited reduced virulence on tomato and tobacco plants. Taken together, these results suggest that activation of ralfuranone/ralstonin production by host sugars functions in R. solanacearum virulence.


Assuntos
Galactose/metabolismo , Glucose/metabolismo , Lactonas/metabolismo , Doenças das Plantas/microbiologia , Ralstonia solanacearum/fisiologia , Solanaceae/microbiologia , Interações Hospedeiro-Patógeno , Lycopersicon esculentum/metabolismo , Lycopersicon esculentum/microbiologia , Percepção de Quorum , Ralstonia solanacearum/patogenicidade , Solanaceae/metabolismo , Tabaco/metabolismo , Tabaco/microbiologia
9.
Plant Cell Physiol ; 60(8): 1871-1879, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31135027

RESUMO

Wild-type plants of the Japanese morning glory (Ipomoea nil) produce blue flowers that accumulate anthocyanin pigments, whereas its mutant cultivars show wide range flower color such as red, magenta and white. However, I. nil lacks yellow color varieties even though yellow flowers were curiously described in words and woodblocks printed in the 19th century. Such yellow flowers have been regarded as 'phantom morning glories', and their production has not been achieved despite efforts by breeders of I. nil. The chalcone isomerase (CHI) mutants (including line 54Y) bloom very pale yellow or cream-colored flowers conferred by the accumulation of 2', 4', 6', 4-tetrahydoroxychalcone (THC) 2'-O-glucoside. To produce yellow phantom morning glories, we introduced two snapdragon (Antirrhinum majus) genes to the 54Y line by encoding aureusidin synthase (AmAS1) and chalcone 4'-O-glucosyltransferase (Am4'CGT), which are necessary for the accumulation of aureusidin 6-O-glucoside and yellow coloration in A. majus. The transgenic plants expressing both genes exhibit yellow flowers, a character sought for many years. The flower petals of the transgenic plants contained aureusidin 6-O-glucoside, as well as a reduced amount of THC 2'-O-glucoside. In addition, we identified a novel aurone compound, aureusidin 6-O-(6″-O-malonyl)-glucoside, in the yellow petals. A combination of the coexpression of AmAS1 and Am4'CGT and suppression of CHI is an effective strategy for generating yellow varieties in horticultural plants.


Assuntos
Benzofuranos/metabolismo , Flavonoides/metabolismo , Flores/metabolismo , Ipomoea nil/metabolismo , Engenharia Metabólica/métodos , Regulação da Expressão Gênica de Plantas , Transdução de Sinais/fisiologia
10.
J Am Acad Dermatol ; 80(3): 608-616, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30612984

RESUMO

BACKGROUND: Severe cutaneous adverse reactions (SCARs) are frequent in inpatient oncology. Early intervention might reduce morbidity, mortality, and hospitalization costs; however, current clinical and histologic features are unreliable SCAR predictors. There is a need to identify rational markers of SCARs that could lead to effective therapeutic interventions. OBJECTIVE: To characterize the clinical and serologic features of hospitalized patients with cancer who developed SCARs. METHODS: Retrospective review of 49 hospitalized cancer patients with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL] 6, IL-10, and tumor necrosis factor [TNF] α) or elafin, and a prior dermatology consultation. Patients were categorized as having a simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement. RESULTS: Fifteen out of 49 patients (30.6%) were deceased at 6 months from time of dermatologic consultation. Elafin, IL-6, and TNF-α were significantly higher in patients who died compared with patients who were still alive at 6 months. IL-6 and IL-10 were significantly higher in patients with a drug-related complex rash. LIMITATIONS: Retrospective design, limited sample size, and high-risk patient population. CONCLUSION: In cancer patients with SCARs, elafin, IL-6, and TNF-α levels might predict a poor outcome. Agents directed against these targets might represent rational treatments for the prevention of fatal SCARs.


Assuntos
Citocinas/sangue , Síndrome de Hipersensibilidade a Medicamentos/sangue , Elafina/sangue , Mortalidade Hospitalar , Neoplasias/tratamento farmacológico , Síndrome de Stevens-Johnson/sangue , Adulto , Antineoplásicos/efeitos adversos , Biomarcadores/sangue , Superfície Corporal , Síndrome de Hipersensibilidade a Medicamentos/etiologia , Edema/etiologia , Eosinofilia/etiologia , Face , Feminino , Febre/etiologia , Doença Enxerto-Hospedeiro/sangue , Doença Enxerto-Hospedeiro/diagnóstico , Hospitalização , Humanos , Interleucina-10/sangue , Interleucina-6/sangue , Linfócitos/patologia , Masculino , Púrpura/etiologia , Estudos Retrospectivos , Síndrome de Stevens-Johnson/etiologia , Fator de Necrose Tumoral alfa/sangue
11.
JAMA Dermatol ; 155(3): 361-369, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30601909

RESUMO

Importance: Dermatofibrosarcoma protuberans (DFSP) has the potential for local destruction and recurrence, although it carries a low risk of metastasis. Complete surgical resection with negative margins is considered the gold standard for treatment; however, there are cases that are unresectable owing to tumor extension or size or owing to risk of cosmetic and/or functional impairment. Imatinib treatment has been used for locally advanced or metastatic DFSP. Objective: To evaluate the usefulness of imatinib for treating DFSP. Evidence Review: We conducted a systematic review on the PubMed and Embase databases for articles published from September 2002 through October 2017 using the key words "dermatofibrosarcoma" or "dermatofibrosarcoma protuberans" AND "therapy" AND "imatinib." References within retrieved articles were also reviewed to identify additional studies. Studies of adults with histologically proven DFSP treated with imatinib as monotherapy or as an adjuvant or neoadjuvant therapy to surgery were included. Extracted data were analyzed using descriptive statistics. PRISMA guidelines were followed. All analysis took place October through December 2017. Findings: Nine studies met inclusion criteria; 152 patients were included. The calculated mean patient age was 49.3 years (range, 20-73 years). Calculated mean tumor diameter was 9.9 cm (range, 1.2-49.0 cm). When COL1A1-PDGFß protein translocation (collagen, type 1, alpha 1-platelet-derived growth factor ß) was reported, it was present in 90.9% of patients (111 of 122). Complete response was seen in 5.2% of patients (8 of 152), partial response in 55.2% (84 of 152), stable disease in 27.6% (42 of 152), and progression in 9.2% (14 of 152). Four of the 152 patients (2.6%) were excluded from the analysis owing to unknown or unevaluable response. There were no differences in response rate using 400-mg or 800-mg daily doses (67.5% or 27 of 40 patients for 400-mg dose vs 67.1% or 49 of 73 patients for 800-mg dose complete or partial response; P > .99). Adverse events were present in at least 73.5% of cases (78 of 106); severe adverse events were present in 15.1% of cases (20 of 132). Conclusions and Relevance: Imatinib is a useful directed therapy in patients with DFSP who are not surgical candidates owing to disease extension or significant cosmetic or functional impairment. There seems to be no difference between 400- or 800-mg daily doses.


Assuntos
Dermatofibrossarcoma/tratamento farmacológico , Dermatofibrossarcoma/patologia , Mesilato de Imatinib/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Adulto , Idoso , Dermatofibrossarcoma/mortalidade , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Neoplasias Cutâneas/mortalidade , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
12.
Plast Reconstr Surg Glob Open ; 7(9): e2423, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31942391

RESUMO

Over 5 million basal and squamous cell skin cancers are diagnosed each year. Seventy to 80% of these cancers occur in the head and neck region, for which surgical excision is the standard treatment. As patient satisfaction and quality of life are among the most important outcomes in plastic and reconstructive surgery, understanding patient perception of aesthetic postoperative outcome is critical. The objective of this study was to assess aesthetic satisfaction following facial skin cancer surgery using the FACE-Q Skin Cancer Module in the context of sociodemographic and clinical factors. Methods: This is a single-center, cross-sectional study in a tertiary care cancer setting of patients who underwent facial skin cancer surgery from March 1, 2016, to March 31, 2018. Patients completed the FACE-Q Skin Cancer Satisfaction with Facial Appearance and Appraisal of Scar scales postoperatively, between May 21, 2018, and October 1, 2018. Results: Patients completed the Satisfaction with Facial Appearance (n = 405) and Appraisal of Scar scales (n = 408) postoperatively (response rate 39%). Lower postoperative facial appearance and scar satisfaction scores were associated with female gender, younger age (<65 years), surgery location on the lip or nose, repair by flap or graft, and greater defect size. Linear regression models established that younger age, female gender, nose location, and flap repair were independently predictive of lower aesthetic satisfaction. Conclusions: Sociodemographic factors, central facial location, and repair type strongly contribute to aesthetic satisfaction following facial skin cancer surgery. This patient-reported data may guide counseling regarding postoperative aesthetic outcome and inform patient expectations.

13.
J Am Acad Dermatol ; 80(2): 303-317, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29782900

RESUMO

As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education article will provide a comprehensive and contemporary review of basal cell carcinoma. The first article in this series describes our current understanding of this disease regarding epidemiology, cost, clinical and histopathologic presentations, carcinogenesis, natural history, and disease associations.


Assuntos
Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Raios Ultravioleta/efeitos adversos , Biópsia por Agulha , Carcinogênese/efeitos da radiação , Carcinoma Basocelular/fisiopatologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/fisiopatologia , Feminino , Humanos , Imuno-Histoquímica , Incidência , Masculino , Prognóstico , Medição de Risco , Neoplasias Cutâneas/fisiopatologia
14.
J Am Acad Dermatol ; 80(2): 321-339, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29782901

RESUMO

As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education series provides a comprehensive and contemporary review of basal cell carcinoma. The second article in this series will present both the current standard of care and newly developed approaches to diagnosis, treatment, and prevention of this disease.


Assuntos
Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Cirurgia de Mohs/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Idoso , Anilidas/uso terapêutico , Biópsia por Agulha , Carcinoma Basocelular/prevenção & controle , Dermoscopia/métodos , Detecção Precoce de Câncer , Educação Médica Continuada , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia/métodos , Prognóstico , Piridinas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Neoplasias Cutâneas/prevenção & controle , Tomografia de Coerência Óptica/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
16.
JAMA Dermatol ; 155(1): 85-89, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30422228

RESUMO

Importance: Surgical excision is the standard-of-care treatment for Tis and T1a melanomas of the head and neck. Currently, however, the association of diagnosis and surgical treatment of these typically slowly progressive and nonfatal melanomas with a patient's health-related quality of life (HRQoL) is unknown. Objective: To characterize and assess HRQoL in patients with Tis and T1a head and neck melanoma, evaluate changes in HRQoL over the surgical treatment course, and identify patient characteristics associated with lower HRQoL. Design, Setting, and Participants: This longitudinal, prospective cohort study involved patients with Tis or T1a melanoma of the head and neck who underwent staged excision at a single tertiary care center (Memorial Sloan Kettering Cancer Center, New York, New York) and were recruited from June 1, 2016, to February 28, 2017. Patients were followed up for 1 year after their surgical procedure. Participants were asked to complete 2 patient-reported outcome measure questionnaires, Skindex-16 and Skin Cancer Index (SCI), at 4 time points: baseline, perioperative (1 to 2 weeks after surgery), and 6-month and 1-year follow-up. Main Outcomes and Measures: Scores on the Skindex-16 and SCI questionnaires. Results: In total, 56 patients were included in the study, among whom 24 (43%) were female and 32 (57%) were male, with a mean (range) age of 67.2 (32-88) years; all patients self-identified as white. Forty-one (73%) questionnaires at perioperative, 49 (88%) at 6-month postoperative, and 41 (73%) at 1-year postoperative time points were completed. At baseline, female patients and those younger than 65 years had statistically significantly worse HRQoL on the Skindex-16 questionnaire (mean score, 14.2 [95% CI, 9.1-21.9] and 16.1 [95% CI, 9.8-26.4]) and on the SCI questionnaire (mean score, 57.2 [95% CI, 48.3-67.6] and 53.2 [95% CI, 44.1-64.3]) compared with males (mean Skindex-16 score, 7.0 [95% CI, 4.8-10.3]; mean SCI score, 73.5 [95% CI, 66.0-81.7]) and those aged 65 years or older (mean Skindex-16 score 7.1 [95% CI, 5.0-10.0]; mean SCI score, 74.3 [95% CI, 67.7-81.6]). Questions that demonstrated the worst scores at baseline were worry about skin condition (Skindex-16) and worry about future skin cancers (SCI). The emotions subscale scores on the Skindex-16 questionnaire showed the greatest improvement from baseline to 1-year follow-up levels (26.6 vs 15.3; P < .001) and so did the appearance subscale scores on the SCI questionnaire (64.0 vs 84.6; P < .001). The score difference in HRQoL by sex diminished over time, whereas the score difference by age persisted through the first year. Conclusions and Relevance: Improvement in HRQoL at the 6-month and 1-year follow-up was associated with surgical excision in patients with early-stage head and neck melanoma, and younger and female patients experienced worse HRQoL. These results may be used in tailoring counseling for this patient population.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Melanoma/cirurgia , Estadiamento de Neoplasias , Qualidade de Vida , Neoplasias Cutâneas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Melanoma/diagnóstico , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias Cutâneas/diagnóstico , Inquéritos e Questionários , Resultado do Tratamento
17.
J Food Sci ; 84(1): 59-64, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30557912

RESUMO

Maturation provides whisky with a mild and smooth texture by removing the irritating alcoholic flavor. However, the precise mechanism by which the whisky flavor is improved through the maturation process remains unknown. In this study, we performed mesoscopic structural measurements-dynamic light scattering (DLS) and small-angle X-ray scattering (SAXS)-to elucidate the relationship between the liquid structure and flavor maturation of whiskies. Both techniques detected two scattering components corresponding to the clusters formed by the extractives from oak casks during maturation, which are not present in the new make (freshly distilled whisky). Analyzing the scattering profiles revealed that only the small clusters increase in concentration during maturation. It is concluded the small cluster component is crucial for obtaining flavorful whiskies, while the large cluster component, whose concentration is independent of the maturation time, is related to the alcoholic irritation of the whiskies, as demonstrated by the sonication test.


Assuntos
Bebidas Alcoólicas/análise , Fermentação , Manipulação de Alimentos , Análise de Alimentos , Modelos Teóricos , Espalhamento a Baixo Ângulo , Paladar , Difração de Raios X
18.
J Oleo Sci ; 67(10): 1219-1225, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30305554

RESUMO

A volatile compound was isolated from the fruit of Habanero pepper (Capsicum chinense) and related varieties and identified as 6-methyl-(E)-4-heptenyl 3-methylbutyrate by 1H and 13C NMR spectroscopy and two-dimensional NMR experiments, including HMQC, HMBC, and 1H-1H COSY. The compound has a retention index of 1387 and is one of the major volatile compounds in Habanero pepper. This compound would be useful as a new flavor.


Assuntos
Capsicum/química , Compostos Orgânicos Voláteis/isolamento & purificação , Aromatizantes , Espectroscopia de Ressonância Magnética/métodos , Compostos Orgânicos Voláteis/química
19.
J Natl Compr Canc Netw ; 16(10): 1209-1215, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30323091

RESUMO

Background: Tumor board conferences (TBCs) are used by oncologic specialists to review patient cases, exchange knowledge, and discuss options for cancer management. These multidisciplinary meetings are often a cornerstone of treatment at leading cancer centers and are required for accreditation by certain groups, such as the American College of Surgeons' Commission on Cancer. Little is known regarding skin cancer TBCs. The objective of this study was to characterize the structure, function, and impact of existing skin cancer TBCs in the United States. Methods: A cross-sectional online survey was administered to physician leaders of skin cancer TBCs at NCI-designated Comprehensive and Clinical Cancer Centers. Results: Of the 59 centers successfully contacted, 14 (24%) reported not having a conference where skin cancer cases were discussed, and 45 (76%) identified 53 physician leaders. A total of 38 physicians (72%) completed the survey. Half of the meeting leaders were medical and/or surgical oncologists, and dermatologists led one-third of meetings. TBCs had a moderate to significant impact on patient care according to 97% of respondents. All respondents indicated that the meetings enhanced communication among physicians and provided an opportunity for involved specialists and professionals to discuss cases. The most frequently cited barrier to organizing TBCs was determining a common available date and time for attendees (62%). The most common suggestion for improvement was to increase attendance, specialists, and/or motivation. Conclusions: Results showed overall consistency in meeting structure but variability in function, which may be a reflection of institutional resources and investment in the conference. Future directions include defining metrics to evaluate changes in diagnosis or management plan after tumor board discussion, attendance, clinical trial enrollment, and cost analysis. Results of this survey may aid other institutions striving to develop and refine skin cancer TBCs.


Assuntos
Institutos de Câncer/organização & administração , Oncologia/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Neoplasias Cutâneas/terapia , Conselhos de Especialidade Profissional/estatística & dados numéricos , Institutos de Câncer/estatística & dados numéricos , Congressos como Assunto , Humanos , Oncologia/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Neoplasias Cutâneas/diagnóstico , Sociedades Médicas , Conselhos de Especialidade Profissional/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
20.
Skinmed ; 16(4): 265-267, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30207531

RESUMO

Arsenic is a naturally occurring compound that is widely distributed in trace quantities in the environment. Levels toxic to humans have been found contaminating certain regions of the world and their groundwater, leading to deleterious effects. In fact, an estimated 150 million people are affected by arsenic contamination worldwide.1 Arsenic poisoning leads to several adverse health effects, including cancer of the lung, bladder, and kidney, neurologic disorders, cardiovascular disease, peripheral vascular disease, hypertension, pulmonary disease, and diabetes mellitus.2 Skin lesions are a common manifestation of arsenic poisoning. Early findings include diffuse or spotted melanosis, leukomelanosis, and depigmentation. Years of chronic arsenic poisoning can lead to acral keratoses and squamous cell carcinoma of the skin.3.


Assuntos
Intoxicação por Arsênico/epidemiologia , Poluição da Água/efeitos adversos , Poços de Água , Bangladesh , Humanos
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