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2.
J Int Med Res ; 47(11): 5844-5848, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31552763

RESUMO

Highlights • Dissecting basilar artery aneurysm (DBAA) is relatively rare. • We report the first case of a DBAA manifesting as sudden sensorineural hearing loss. • This case report adds to the symptom spectrum of DBAA.

3.
Res Social Adm Pharm ; 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31303479

RESUMO

BACKGROUND: The ability of questionnaires such as the Patients' Attitudes Towards Deprescribing (PATD) or the Beliefs about Medicines Questionnaire (Specific section) (BMQ-Specific) to successfully identify patients who will deprescribe remains unknown. OBJECTIVE: To determine if screening questionnaires assessing patients' attitudes and beliefs towards medications and deprescribing can predict deprescribing outcomes. METHODS: This is a post-hoc secondary analysis of the D-PRESCRIBE trial. 489 community-dwelling adults (≥65 years) who were chronic users (≥3 months) of a potentially inappropriate medication were randomized to a pharmacist-led educational intervention or usual care. Association between baseline responses to PATD and BMQ-Specific items and successful deprescribing was calculated. To determine predictive ability of questionnaire items, receiver operating characteristic curves (ROC) were constructed and area under the curve was calculated. RESULTS: At baseline, 86% of participants (95% confidence interval [CI] 83-89%) indicated a willingness to deprescribe, yet only 41% (95%CI 37-46%) successfully deprescribed. Six items were associated with deprescribing success, however, no PATD or BMQ-Specific item - either independently or in combination - meaningfully distinguished which participants succeeded or failed deprescribing attempts at 6-months (AUC < 0.7). CONCLUSION: Current tools to assess patient's attitudes and beliefs towards medication use and/or deprescribing have low predictive validity for successful deprescribing.

4.
Pharmacy (Basel) ; 6(2)2018 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-29659488

RESUMO

One in four community-dwelling older adults is prescribed an inappropriate medication. Educational interventions aimed at patients to reduce inappropriate medications may cause patients to question their prescriber’s judgment. The objective of this study was to determine whether a patient-focused deprescribing intervention compromised trust between older adults and their healthcare providers. An educational brochure was distributed to community-dwelling older adults by community pharmacists in order to trigger deprescribing conversations. At baseline and 6-months post-intervention, participants completed the Primary Care Assessment Survey, which measures patient trust in doctors and pharmacists. Changes in trust were ascertained post-intervention. Proportions with 95% confidence intervals (CI), and logistic regression were used to determine a shift in trust and associated predictors. 352 participants responded to the questionnaire at both time points. The majority of participants had no change or gained trust in their doctors for items related to the choice of medical care (78.5%, 95% CI = 74.2–82.8), communication transparency (75.4%, 95% CI = 70.7–79.8), and overall trust (81.9%, 95% CI = 77.9–86.0). Similar results were obtained for participants’ perceptions of their pharmacists, with trust remaining intact for items related to the choice of medical care (79.4%, 95% CI = 75.3–83.9), transparency in communicating (82.0%, 95% CI = 78.0–86.1), and overall trust (81.6%, 95% CI = 77.5–85.7). Neither age, sex nor the medication class targeted for deprescribing was associated with a loss of trust. Overall, the results indicate that patient-focused deprescribing interventions do not shift patients’ trust in their healthcare providers in a negative direction.

5.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 25(4): 1101-1104, 2017 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-28823276

RESUMO

OBJECTIVE: To observe the efficacy of chemotherapy consisted of bortezomib as main druy in maintenance therapy for recurrence of newly diagnosed MM patients. METHODS: The clinical data and outcome of 37 MM patients during 2008-2013 were analyzed retrospectively, the 37 MM patients were divided into 2 group: 19 cases including 13 cases of newly diagnosed MM with symptoms and 6 cases of relapsed refractory MM were enrolled in group A; 17 cases of newly diagnosed MM with symptoms were enrolled in group B. The patients of group A received maintenance therapy consisted of bortezomib plus dexamethasone (VD group), while the patient group B received maintenance therapy consisted of melphalan plus prednisone(MP group), then the therapeutic efficacy of 2 group was compared. RESULTS: The overall response rate(ORR) in VD groupe was 84.2%(16/19), out of which CR rate reached 42%(8/19), PR rate reached 31.6%(6/19), MR rate reached 10.5%(3/19). During median follow-up for 21.8(5-51) months, death occurred, while the ORR in MP group was 52(9/17), out of which CR rate was 23.5%(4/17), PR rate reached 23.5%(4/17), MR rate reached 5.9%(1/17). Druing median follow-up for 16.4(4-39) months, the worteity reaced 64.7%(11/17). The differencr between 2 groups was significant(P<0.05). The median OS time of patients in VD group was 21.6 months, that in MP group was 17.9 months(P<0.05). The median PFS in VD group and MP group were 13.4 and 9.4 months respectively(P<0.001). CONCLUSION: The ORR and CR rates of bortezomib maintenance therapy for newly diagnosed and relapsed / refractory MM patients are very high, and its toxicity can be controlled, therefore, the patients need maintenance therapy after remission.


Assuntos
Mieloma Múltiplo , Protocolos de Quimioterapia Combinada Antineoplásica , Ácidos Borônicos , Bortezomib , Dexametasona , Humanos , Recidiva Local de Neoplasia , Estudos Retrospectivos , Resultado do Tratamento
6.
Int J Cancer ; 141(7): 1445-1457, 2017 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-28643325

RESUMO

Tumor antigens is at the core of cancer immunotherapy, however, the ideal antigen selection is difficult especially in poorly immunogenic tumors. In this study, we designed a strategy to modify hepatocellular carcinoma (HCC) cells by surface expressing anti-CD3scfv within the tumor site strictly, which depended on the E1A-engineered human umbilical cord mesenchymal stem cells (HUMSC.E1A) delivery system. Subsequently, membrane-bound anti-CD3scfv actived the lymphocytes which lysed HCC cells bypassing the expression of antigens or MHC restriction. First, we constructed the anti-CD3scfv gene driven by human α-fetoprotein (AFP) promoter into an adenoviral vector and the E1A gene into the lentiviral vector. Our results showed that anti-CD3scfv could specifically express on the surface of HCC cells and activate the lymphocytes to kill target cells effectively in vitro. HUMSC infected by AdCD3scfv followed by LentiR.E1A could support the adenoviral replication and packaging in vitro 36 h after LentiR.E1A infection. Using a subcutaneous HepG2 xenograft model, we confirmed that AdCD3scfv and LentiR.E1A co-transfected HUMSC could migrate selectively to the tumor site and produce considerable adenoviruses. The new generated AdCD3scfv infected and modified tumor cells successfully. Mice injected with the MSC.E1A.AdCD3scfv and lymphocytes significantly inhibited the tumor growth compared with control groups. Furthermore, 5-fluorouracil (5-FU) could sensitize adenovirus infection at low MOI resulting in improved lymphocytes cytotoxicity in vitro and in vivo. In summary, this study provides a promising strategy for solid tumor immunotherapy.


Assuntos
Complexo CD3/imunologia , Carcinoma Hepatocelular/terapia , Imunoterapia/métodos , Neoplasias Hepáticas/terapia , Anticorpos de Cadeia Única/imunologia , Cordão Umbilical/citologia , Adenoviridae/genética , Adenoviridae/fisiologia , Animais , Citotoxicidade Celular Dependente de Anticorpos , Antimetabólitos Antineoplásicos/farmacologia , Complexo CD3/genética , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/virologia , Membrana Celular/imunologia , Movimento Celular , Fluoruracila/farmacologia , Vetores Genéticos , Xenoenxertos , Humanos , Lentivirus/genética , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/virologia , Linfócitos/imunologia , Células-Tronco Mesenquimais/imunologia , Camundongos , Anticorpos de Cadeia Única/genética , Anticorpos de Cadeia Única/metabolismo , Fatores de Tempo , Replicação Viral , Ensaios Antitumorais Modelo de Xenoenxerto/métodos , alfa-Fetoproteínas/genética
7.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 22(2): 263-8, 2014 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-24762989

RESUMO

The purpose of this study was to evaluate the potential associations between HLA-A, B, DRB1 gene and leukemia. A total of 1186 leukemic patients, including 326 patients with acute lymphoblastic leukemia (ALL), 545 patients with acute myeloid leukemia (AML), 315 patients with chronic myeloid leukemia (CML), and 1234 healthy unrelated donors were typed and were compared in a single centre by using same technique, then the Bonferroni correction method was used to correct the Type I error. The results indicated that as compared with the control,the frequency of HLA-DRB1(*)09 in ALL group significantly decreased (10.87% versus 16.08%; Pc = 0.014, OR = 0.637, 95% CI = 0.487-0.834), while in comparison with control, the frequency of HLA-B(*)18 in CML group was significantly higher (1.28% vs 0.20%; Pc = 0.039, OR = 6.336, 95% CI = 2.066-19.434). The positive and negative relation may exist between certain HLA molecules and leukemia. The negative relation between HLA-DRB1(*)09 and ALL indicated that DRB1*09 might play an important role by a restricted T-cell immune response in the early leukemogenic events, whereas the positive relation between HLA-B(*)18 and CML suggests that the B(*)18 molecules may not actively present leukemia-specific antigens resulting in immune escape. It is concluded that these findings can contribute to developing more appropriate method in leukemic immunotherapy.


Assuntos
Leucemia/genética , Leucemia/imunologia , Complexo Principal de Histocompatibilidade/genética , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Cadeias HLA-DRB1/genética , Teste de Histocompatibilidade , Humanos , Lactente , Leucemia/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos , Evasão Tumoral , Adulto Jovem
9.
Pediatr Dermatol ; 28(2): 198-200, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21371111

RESUMO

Sebaceous hyperplasia is a common, benign condition of the sebaceous glands in adults of middle age or older, occurring primarily on the face and neck. In adolescent or young adult patients, it is a rare entity called premature sebaceous hyperplasia (PSH). Previous reports indicate that the onset of PSH occurs during or shortly after puberty, with an average age-at-onset of 19 years. Here we present an extremely rare prepubescent case of PSH that developed on the right side of a boy's neck when he was 8 years old.


Assuntos
Doenças das Glândulas Sebáceas/patologia , Glândulas Sebáceas/patologia , Adolescente , Idade de Início , Biópsia , Criança , Humanos , Hiperplasia , Masculino
10.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 40(3): 439-41, 2009 May.
Artigo em Chinês | MEDLINE | ID: mdl-19627000

RESUMO

OBJECTIVE: To investigate the expression of PPAR-gamma, COX-2 in the skin lesion of condyloma acuminatum and bowenoid papulosis. METHODS: The expression levels of PPAR-gamma, COX-2 were measured by immunohistochemistry in 17 cases of condyloma acuminatum, 17 cases of bowenoid papulosis, as well as 17 cases of normal foreskin lesions. RESULTS: The immunohistochemical study showed that PPAR-gamma and COX-2 weakly expressed in normal foreskin, but overexepressed in the skin lesions of both condyloma acuminatum and bowenoid papulosis (P<0.01). There was straight linear correlation between the expressions of PPAR-gamma and COX-2 not only in condyloma acuminatum (r=0.505, P=0.038) but also in bowenoid papulosis (r=0.562, P=0.019). CONCLUSION: PPAR-gamma and COX-2 may have important roles in proliferative dermatosis associated with human papilloma virus.


Assuntos
Doença de Bowen/metabolismo , Condiloma Acuminado/metabolismo , Ciclo-Oxigenase 2/metabolismo , PPAR gama/metabolismo , Infecções por Papillomavirus/metabolismo , Adulto , Idoso , Doença de Bowen/virologia , Condiloma Acuminado/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/patologia , Pele/metabolismo , Adulto Jovem
11.
Zhonghua Xin Xue Guan Bing Za Zhi ; 33(9): 796-800, 2005 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-16266454

RESUMO

OBJECTIVE: To investigate the change of the mortality of AMI and influence factors within 20 years. METHODS: Clinic data of 134 AMI patients from 1980 to 1983, 354 AMI patients from 1990 to 1993 and 817 AMI patients from 2000 to 2003 were comparably analyzed. RESULTS: In hospital mortality of AMI was 22.4% from 1980 to 1983, 14.4% from 1990 to 1993 and 9.2% from 2000 to 2003, respectively (P < 0.01). The decrease of in-hospital mortality in male was more significant than in female (P < 0.01). The corresponding factors for decrease of mortality were younger than 60 years old, first onset of AMI, successful rescue of cardiac arrest and reperfusion management of infarction relative artery. The disadvantage factor was female. CONCLUSIONS: Improvement of medical and reperfusion management of AMI conduced in significant decreases of hospital mortality.


Assuntos
Mortalidade Hospitalar , Infarto do Miocárdio/mortalidade , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Causas de Morte , Feminino , Humanos , Pacientes Internados , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Reperfusão Miocárdica , Prognóstico , Estudos Retrospectivos , Fatores de Risco
12.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 36(4): 559-61, 2005 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-16078588

RESUMO

OBJECTIVE: To study the local immune status and its relation to immunotherapy in patients with condyloma acuminatum. METHODS: Clinical efficacy of 5% imiquimod cream in treating 30 patients with condyloma acuminatum was observed. The expressions of Human Leukocyte Antigen (HLA)-DR, CD1a, CD16 and Intercellular Adhesion Molecule (ICAM)-1 were detected by immunohistochemistry in lesions of these patients before treatment. RESULTS: The imiquimod cream was found to be efficacious in 20 cases after 8 weeks' treatment. Before treatment, the expressions of HLA-DR, CD1a, CD16 and ICAM-1 in the lesions of responders were significantly higher than those in the lesions of nonresponders (P<0.05). CONCLUSION: Higher expressions of HLA-DR, CD1a, CD16 and ICAM-1 suggested that immunotherapy might have efficacy in treating condyloma acuminatum.


Assuntos
Aminoquinolinas/administração & dosagem , Condiloma Acuminado/terapia , Doenças dos Genitais Femininos/terapia , Doenças dos Genitais Masculinos/terapia , Imunoterapia , Administração Tópica , Adulto , Condiloma Acuminado/imunologia , Feminino , Doenças dos Genitais Femininos/imunologia , Doenças dos Genitais Masculinos/imunologia , Antígenos HLA-DR/biossíntese , Humanos , Imiquimode , Molécula 1 de Adesão Intercelular/biossíntese , Receptores de Lipopolissacarídeos/biossíntese , Masculino , Pessoa de Meia-Idade , Receptores de IgG/biossíntese
13.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 35(5): 626-9, 2004 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-15460403

RESUMO

OBJECTIVE: To study the role of the dendritic cells, natural killer cells and adhesion molecules play in the pathogenesis of psoriasis. METHODS: The expression levels of human leukocyte antigen (HLA)-DR, CD1a, CD16, CD57, tumor necrosis factor (TNF)-alpha and intercellular adhesion molecule (ICAM)-1 were detected by immunohistochemistry in lesions of 26 patients with psoriasis before and after treatment. RESULTS: The expression of HLA-DR, CD1a, CD16, CD57, TNF-alpha and ICAM-1 showed no significant difference between the active phase and the static phase of psoriatic lesions (P>0.05). After treatment, the positive expression of all markers decreased evidently or even disappeared with histopathological improvement in the resolvent phase of psoriatic lesions. There were statistically significant difference by Wilcoxon rank sum test (P<0.05). CONCLUSION: Dendritic cells, natural killer cells and adhesion molecules play an important role in the pathogenesis of psoriasis.


Assuntos
Células Dendríticas/imunologia , Molécula 1 de Adesão Intercelular/metabolismo , Células Matadoras Naturais/imunologia , Psoríase/imunologia , Adulto , Feminino , Antígenos HLA-DR/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Psoríase/etiologia , Psoríase/metabolismo , Pele/imunologia , Pele/patologia
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