Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 377
Filtrar
1.
BMC Pulm Med ; 21(1): 56, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573635

RESUMO

BACKGROUND: The effects of comorbidities on chronic obstructive pulmonary disease (COPD) have been usually studied individually in the past. In this study, we aimed to investigate the comorbidities associated with mortality, the effect of multimorbidity on mortality and other factors associated with mortality among Korean COPD population. METHODS: The Korean National Health Insurance Service-National Sample Cohort version 2.0, collected between 2002 and 2015, was used. Among COPD patients [entire cohort (EC), N = 12,779], 44% of the participants underwent additional health examination, and they were analysed separately [health-screening cohort (HSC), N = 5624]. Fifteen comorbidities previously reported as risk factors for mortality were studied using Cox proportional hazards regression models. RESULTS: Total mortality rates were 38.6 per 1000 person-years (95% CI 37.32-40.01) and 27.4 per 1000 person-years (95% CI 25.68-29.22) in EC and HSC, respectively. The most common causes of death were disease progression, lung cancer, and pneumonia. Only some of the comorbidities had a direct impact on mortality. Multimorbidity, assessed by the number of comorbid diseases, was an independent risk factor of all-cause mortality in both cohorts and was a risk factor of respiratory mortality only in HSC. The Kaplan-Meier analysis showed significant differences in survival trajectories according to the number of comorbidities in all-cause mortality but not in respiratory mortality. Low BMI, old age and male sex were independent risk factors for both mortalities in both cohorts. CONCLUSIONS: The number of comorbidities might be an independent risk factor of COPD mortality. Multimorbidity contributes to all-cause mortality in COPD, but the effect of multimorbidity is less evident on respiratory mortality.


Assuntos
Neoplasias Pulmonares/mortalidade , Pneumonia/mortalidade , Doença Pulmonar Obstrutiva Crônica/mortalidade , Idoso , Asma/epidemiologia , Bronquiectasia/epidemiologia , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Estudos de Coortes , Comorbidade , Diabetes Mellitus/epidemiologia , Neoplasias do Sistema Digestório/epidemiologia , Progressão da Doença , Dislipidemias/epidemiologia , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Hepatopatias/epidemiologia , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Multimorbidade , Osteoporose/epidemiologia , Modelos de Riscos Proporcionais , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Insuficiência Renal Crônica/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Neoplasias da Glândula Tireoide/epidemiologia
2.
Medicine (Baltimore) ; 99(30): e21324, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791727

RESUMO

BACKGROUND: To systematically evaluate whether the expression level of long non-coding RNA activated by transforming growth factor-ß (lncRNA-ATB) is correlated with the prognosis of digestive system cancer (DSC) patients. METHODS: PubMed, Embase, Cochrane Library, Web of Science, Springerlink, Nature, and Karger databases were searched up to April 20, 2019 by 2 experienced researchers independently. The quality of studies was assessed with the Newcastle-Ottawa scale. The Review Manager 5.2 and STATA 12.0 software were used for this meta-analysis. RESULT: Eleven studies with 1227 DSC patients were included in the meta-analysis. Except for pancreatic cancer, high expression of lncRNA-ATB was associated with lymph node metastasis (risk ratio (RR) = 1.26, 95% confidence interval (CI): 1.12-1.42, P < .001), advanced clinical staging (RR = 1.44, 95%CI: 1.23-1.69, P < .001), reduced overall survival rate (OS) (hazard ratio (HR) = 2.33, 95%CI: 1.22-4.50, P = .01), and recurrence-free survival (RFS) (HR = 2.61, 95%CI: 1.46-4.65, P = .001) compared with low lncRNA-ATB expression in DSCs. CONCLUSIONS: High expression of lncRNA-ATB was significantly correlated with poor prognosis for most DSCs. The expression level of lncRNA-ATB could be a promising prognostic biomarker for DSC patients.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias do Sistema Digestório/genética , RNA Longo não Codificante/genética , Fator de Crescimento Transformador beta/genética , Idoso , Estudos de Casos e Controles , Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/mortalidade , Neoplasias do Sistema Digestório/patologia , Feminino , Humanos , Metástase Linfática/genética , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida
3.
Medicine (Baltimore) ; 99(19): e20119, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384489

RESUMO

BACKGROUND: A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. We aimed to conduct a meta-analysis to assess the association of omega-3 PUFA consumption with digestive system cancers. METHODS: Relevant observational studies were identified through a comprehensive search of PubMed, Embase, and the Web of Science through December 2019 and by reviewing the references of the retrieved articles. The relative risks (RRs) of digestive system cancers associated with omega-3 PUFA intake were estimated using a random-effect model and were stratified by region, sex, study design, type of omega-3 PUFAs, smoking status, alcohol consumption, BMI, and physical activity. RESULTS: Twenty-five studies (8 case-control studies and 17 cohort studies) involving 1,247,271 participants and 23,173 patients with digestive system cancers were included in this analysis. The risk of digestive system cancers decreased by 17% in individuals who consumed omega-3 PUFAs (RR = 0.83, 95% confidence interval (CI), 0.76-0.91). The risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs, and other confounders (smoking, alcohol consumption, body mass index, and physical activity). Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias. CONCLUSION: The findings show that omega-3 PUFAs should be as a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Ácidos Graxos Ômega-3/administração & dosagem , Consumo de Bebidas Alcoólicas/epidemiologia , Índice de Massa Corporal , Neoplasias do Sistema Digestório/prevenção & controle , Exercício Físico , Humanos , Incidência , Estudos Observacionais como Assunto , Estudos Prospectivos , Características de Residência , Fatores de Risco , Fatores Sexuais , Fumar Tabaco/epidemiologia
6.
J Surg Oncol ; 121(6): 927-935, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32124433

RESUMO

BACKGROUND: The objective of the current study was to define and compare rates of textbook outcomes (TO) among patients undergoing colorectal, lung, esophagus, liver, and pancreatic surgery for cancer at U.S. News & World Report (USNWR) ranked hospitals. METHODS: Medicare Inpatient Standard Analytic Files 2013-2015 were utilized to examine the relationship of TO and USNWR hospital ratings following surgery for colorectal, lung, esophageal, pancreatic, and liver cancer. TO was defined as no postoperative surgical complications, no prolonged length of hospital stay, no readmission within 90 days after discharge, and no postoperative mortality within 90 days after surgery. RESULTS: Among the 35,352 Medicare patients included in the cohort, 16,820 (47.6%) underwent surgery at honor roll hospitals, whereas 18 532 (52.4%) underwent surgery at non-honor roll hospitals. The overall proportion of patients who achieved TO was 50.1%. In examining the clinical outcomes of patients who underwent surgery, there was no difference in the odds of achieving TO at honor roll vs non-honor roll hospitals (colorectal: odds ratio [OR], 0.87; 95% confidence interval [CI], 0.69-1.10; lung: OR, 1.07; 95% CI, 0.87-1.32; esophagus: OR, 1.44; 95% CI, 0.72-2.89; liver: OR, 1.27; 95% CI, 0.87-1.84; pancreas: OR, 1.04; 95% CI, 0.67-1.62). CONCLUSION AND RELEVANCE: Patients undergoing surgery for lung, esophageal, liver, pancreatic, and colorectal cancer had comparable rates of TO at honor roll vs non-honor roll hospitals. No linear association was observed between hospital position in the rank and postoperative outcomes such as TO indicating that patients should not overly focus on the exact position within USNWR ranked hospitals. These data highlight to patients and physicians that up to one-half of patients undergoing surgery for cancer should anticipate at least one adverse outcome.


Assuntos
Neoplasias do Sistema Digestório/cirurgia , Hospitais/normas , Neoplasias Pulmonares/cirurgia , Oncologia Cirúrgica/normas , Idoso , Neoplasias do Sistema Digestório/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Oncologia Cirúrgica/métodos , Oncologia Cirúrgica/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos/epidemiologia
7.
Eur J Cancer Care (Engl) ; 29(1): e13170, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31571340

RESUMO

OBJECTIVE: We aimed to compare frailty status between patients with head and neck cancer (HNC) and other solid malignancies. METHODS: Data collection was prospective, and the following were compared between cohorts at baseline: patient and tumour characteristics, Charlson Comorbidity Index (CCI), Groningen Frailty Indicator (GFI), Mini Mental State Examination (MMSE), Activities of Daily Living (ADLs), Instrumental ADLs (IADLs), Timed Up and Go (TUG) and Quality of Life (QoL). Univariate and multivariate logistic regression analyses were performed, and odds ratios (ORs) with their 95% confidence intervals (95% CIs) were estimated. RESULTS: In total, 242 patients with HNC and 180 with other oncology diagnoses were enrolled, of whom 32.6% and 21.8% were frail according to the GFI respectively. Comorbidity scores were not significantly different between the cohorts (7.4% vs. 13.1%; OR 0.54; 95% CI 0.28-1.02). In the univariate analysis, the GFI was significantly worse in the HNC cohort (OR 1.74; 95% CI 1.11-2.71). However, in the multivariate analysis, the MMSE, TUG and global QoL were significantly worse in the HNC cohort, with ORs of 20.03 (95% CI 2.44-164.31), 11.56 (95% CI 1.86-71.68) and 0.98 (95% CI 0.97-1.00) respectively. CONCLUSION: Patients with HNC appear to be frailer than patients with other solid malignancies despite comparable levels of comorbidity.


Assuntos
Fragilidade/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Atividades Cotidianas , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/fisiopatologia , Estudos de Casos e Controles , Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/patologia , Neoplasias do Sistema Digestório/fisiopatologia , Feminino , Fragilidade/fisiopatologia , Neoplasias dos Genitais Femininos/epidemiologia , Neoplasias dos Genitais Femininos/patologia , Neoplasias dos Genitais Femininos/fisiopatologia , Avaliação Geriátrica , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/fisiopatologia , Humanos , Neoplasias Renais/epidemiologia , Neoplasias Renais/patologia , Neoplasias Renais/fisiopatologia , Modelos Logísticos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Países Baixos/epidemiologia , Razão de Chances , Desempenho Físico Funcional , Qualidade de Vida , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/fisiopatologia , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/fisiopatologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/fisiopatologia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/fisiopatologia
8.
J Surg Res ; 245: 89-98, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31404895

RESUMO

BACKGROUND: Hepatic, pancreas, and biliary (HPB) cancers pose serious challenges to global health care systems. These malignancies demonstrate great geographical variations with shifting trends over time. The aim of the present study was to determine the recent trends in incidence, prevalence, and mortality of primary HPB malignancies to guide the further development of effective strategies for prevention, screening, and treatment. METHODS: The Global Burden of Disease (GBD) dataset 1990-2017 was interrogated for end point variables by age, sex, year, and geography. Epidemiologic data were modeled in DisMod-MR 2.1, a Bayesian meta-regression tool that pools data points from different sources and adjusts for known sources of variability. Global Burden of Disease data were extracted from 284 country-year, and 976 subnational-year combinations from 27 countries in North America, Latin America, Europe, India, and New Zealand. RESULTS: Although the global incidence of primary HPB malignancies increased by 1.43% from 1990 to 2017 (1,400,739 cases), the incidence of extrahepatic biliary and gallbladder malignancies decreased by -0.32% (210,878 cases) over the same period. There was significant variability in the incidence, prevalence, and mortality of HPB cancers by the sociodemographic index (SDI), as well as by geography. The largest incidence increase of primary liver and pancreas cancers was seen in the high-income Asia-Pacific group, followed by the high-income North America and Western Europe groups. The highest incidences and prevalence of extrahepatic biliary and gallbladder malignancies were observed in Asia-Pacific, Southern Latin American, and Andean Latin American regions. In general, mortality rates of HPB malignancies were larger in the low SDI when compared with the high SDI group in all geographical regions. CONCLUSIONS: The global incidence and prevalence of primary liver and pancreatic malignancies continue to increase with great geographical variation. The mortality trends mirror those of the incidence. Although the global incidence and prevalence of extrahepatic biliary and gallbladder malignancies has decreased, the mortality rate has not significantly changed. The results of this article can assist local and regional authorities in policy development to improve health care access for screening, early detection, and treatment of HPB malignancies.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Carga Global da Doença , Mortalidade/tendências , Análise Espaço-Temporal , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Neoplasias do Sistema Digestório/prevenção & controle , Europa (Continente)/epidemiologia , Feminino , Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/organização & administração , Humanos , Incidência , Índia/epidemiologia , América Latina/epidemiologia , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , América do Norte/epidemiologia , Prevalência , Adulto Jovem
9.
United European Gastroenterol J ; 7(9): 1241-1249, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31700637

RESUMO

Background: Controversy remains as to whether poor oral health is independently associated with gastrointestinal cancers, due to potential confounding by smoking, alcohol and poor nutrition. The aim of this study was to investigate the association between oral health conditions and gastrointestinal cancer risk. Methods: Data from the large, prospective UK Biobank cohort, which includes n = 475,766 participants, were analysed. Cox proportional hazard models were applied to estimate the relationship between gastrointestinal cancer risk and self-reported poor oral health (defined as painful gums, bleeding gums and/or having loose teeth), adjusting for confounders. Results: During an average six years of follow-up, n = 4069 gastrointestinal cancer cases were detected, of which 13% self-reported poor oral health. Overall, there was no association between self-reported poor oral health and risk of gastrointestinal cancer detected (hazard ratio 0.97, 95% confidence interval 0.88-1.07). In site-specific analysis, an increased risk of hepatobiliary cancers was observed in those with self-reported poor oral health (hazard ratio 1.32, 95% confidence interval 0.95-1.80), which was stronger for hepatocellular carcinoma (hazard ratio 1.75, 95% confidence interval 1.04-2.92). Conclusion: Overall there was no association between self-reported poor oral health and gastrointestinal cancer risk. However, there was a suggestion of an increased risk of hepatobiliary cancer, specifically hepatocellular carcinoma.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Doenças da Boca/epidemiologia , Saúde Bucal/estatística & dados numéricos , Adenocarcinoma/epidemiologia , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias do Sistema Biliar/epidemiologia , Bancos de Espécimes Biológicos , Carcinoma Hepatocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Colangiocarcinoma/epidemiologia , Estudos de Coortes , Feminino , Neoplasias Gastrointestinais/epidemiologia , Humanos , Neoplasias Hepáticas/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/epidemiologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Autorrelato , Fumar/epidemiologia , Reino Unido/epidemiologia
10.
Br J Nutr ; 122(3): 293-300, 2019 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-31352906

RESUMO

We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case-control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 µg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 µg/dl), a significantly lower cancer risk was found in participants in quartile 2-4 ( ≥ 52·3 µg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 µg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 µg/dl, and then increased significantly with retinol (per 10 µg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 µg/dl. In conclusion, there was a significant inverse dose-response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 µg/dl).


Assuntos
Neoplasias do Sistema Digestório/sangue , Neoplasias do Sistema Digestório/epidemiologia , Hipertensão/sangue , Hipertensão/epidemiologia , Vitamina A/sangue , Idoso , Estudos de Casos e Controles , China/epidemiologia , Diástole , Neoplasias do Sistema Digestório/complicações , Humanos , Hipertensão/complicações , Incidência , Pessoa de Meia-Idade , Prevenção Primária , Análise de Regressão , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle , Sístole
11.
Minerva Gastroenterol Dietol ; 65(3): 214-228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31220911

RESUMO

Primary sclerosing cholangitis (PSC) is a rare chronic inflammatory condition mainly of the large bile ducts, affecting predominantly young men, and is associated with the presence of inflammatory bowel disease. There is no known cure for PSC, which progresses to cirrhosis or death over 10-20 years. Hepatobiliary malignancy, especially cholangiocarcinoma, is a feared complication associated with poor overall survival. Screening and surveillance appear to improve overall outcomes. To capture as many relevant studies, broad search criteria were employed within the PubMed database. Given the high prevalence of IBD and its own associations with the development of malignancy two separate search strategies were employed. Results were filtered by English language. The first search identified the risks, epidemiological factors and surveillance strategies for patients with PSC at risk for developing malignancy. MeSH terms included: cholangitis, sclerosing, digestive system neoplasms, liver neoplasms, biliary tract neoplasms, cholangiocarcinoma, gallbladder neoplasms, colonic neoplasms, rectal neoplasms, or pancreatic neoplasms, risk factors, risk, surveillance, epidemiology and screen. The second included inflammatory bowel diseases, Crohn's, or colitis, and assessed for additional malignancies such as lymphoma and skin neoplasms. A total of 288 results returned with 21 duplicates; 267 remaining abstracts were assessed for relevance for inclusion by the authors. Patients with PSC show significantly higher than average risk for the development of hepatobiliary and colonic malignancies including cholangiocarcinoma, gallbladder carcinoma and colorectal carcinoma. Yearly ultrasound surveillance followed with more definitive cross-sectional imaging is prudent to arrive in a timely diagnosis of carcinoma, reducing morbidity and mortality.


Assuntos
Colangite Esclerosante/complicações , Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/etiologia , Neoplasias dos Ductos Biliares/epidemiologia , Neoplasias dos Ductos Biliares/etiologia , Neoplasias dos Ductos Biliares/prevenção & controle , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/prevenção & controle , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/etiologia , Colangiocarcinoma/prevenção & controle , Neoplasias do Colo/epidemiologia , Neoplasias do Colo/etiologia , Neoplasias do Colo/prevenção & controle , Neoplasias do Sistema Digestório/prevenção & controle , Detecção Precoce de Câncer , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/etiologia , Neoplasias da Vesícula Biliar/prevenção & controle , Humanos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/prevenção & controle , Vigilância da População , Medição de Risco
12.
Br J Cancer ; 120(11): 1059-1066, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31040384

RESUMO

BACKGROUND: Inverse associations have been observed between coffee consumption and liver cancer, but associations for other digestive cancers are unclear. Few previous studies have investigated coffee type (specifically instant or ground coffee) or a range of digestive cancer types within one cohort. We therefore investigated coffee consumption by type and digestive cancer risks in a population-based cohort. METHODS: The UK Biobank captured self-reported coffee consumption and cancer-registry recorded incident digestive cancers. Hazard ratios (HRs) and 95% CIs were calculated using Cox regression. The risk of every type of digestive cancer was investigated in association with coffee consumption by dose-response and by coffee type (decaffeinated, instant and ground). RESULTS: Over 7.5 years of follow-up, 3567 developed digestive cancer among 471,779 participants. There were 88 cases of hepatocellular carcinoma and a marked association was observed for hepatocellular carcinoma in coffee drinkers (HR 0.50, 95% CI 0.29, 0.87), which was similar for instant (HR 0.51, 95% CI 0.28, 0.93) and ground coffee (HR 0.47, 95% CI 0.20, 1.08). We did not observe significant consistently reduced risks of other individual digestive cancers amongst coffee drinkers. CONCLUSIONS: We found some evidence that coffee consumption was inversely associated with hepatocellular carcinoma which was similar by coffee type.


Assuntos
Café , Neoplasias do Sistema Digestório/epidemiologia , Adulto , Idoso , Carcinoma Hepatocelular/epidemiologia , Feminino , Humanos , Neoplasias Hepáticas/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Risco
13.
Cancer Med ; 8(8): 3677-3684, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31115188

RESUMO

BACKGROUND: FIGHTDIGO study has shown the feasibility of handgrip strength (HGS) measurements in 201 consecutive digestive cancer patients undergoing chemotherapy. OBJECTIVE: This study focuses on a secondary aim of FIGHTDIGO study: the relationship between muscle mass and HGS. DESIGN: Two consecutive bilateral measures of HGS were performed using a Jamar dynamometer before the start of each chemotherapy. The highest value was chosen for final evaluation. Dynapenia (loss of muscle strength) was defined as HGS < 30 kg (men) and < 20 kg (women). Muscle mass was measured at lumbar level (L3) on Computed Tomography (CT) scans performed less than 3 weeks before or after the measurement of HGS. Muscle mass loss was defined by skeletal muscle index (SMI) < 53 cm2 /m2 (in men with a body mass index (BMI)> 25 kg/m2 ), < 43 cm2 /m2 (in men with a BMI < 25 kg/m2 ), and < 41 cm2 /m2 (in women regardless of BMI). Sarcopenia was defined by the association of a dynapenia and a loss of muscle mass. RESULTS: A total of 150 patients were included in this analysis (mean age: 65.6 ± 10.9 years, 87 males (58%), colorectal cancer (47.3%), metastatic stage (76.7%)). A total of 348 CT scans were evaluated. For the 348 measurements, mean SMI and HGS were 41.8 ± 8.7 cm2 /m2 and 32.1 ± 11.0 kg, respectively. Muscle mass loss, dynapenia, or sarcopenia were reported at least once, in 120 (80%), 45 (30%), and 30 (20%) patients, respectively. SMI was significantly correlated with HGS (Pearson coefficient = 0.53, P < 0.0001). At concordance analysis, 188 dyad SMI/HGS (54%) were in agreement (Kappa = 0.14 [95% CI, 0.07-0.21]). CONCLUSION: Correlation between the measurements of HGS and SMI is strong but the concordance between dynapenia and muscle mass loss is poor. Further studies should be performed to confirm the diagnostic thresholds, and to study the chronology of dynapenia and loss of muscle mass.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Força da Mão , Desnutrição/epidemiologia , Desnutrição/patologia , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Idoso , Índice de Massa Corporal , Neoplasias do Sistema Digestório/complicações , Neoplasias do Sistema Digestório/diagnóstico , Feminino , Humanos , Masculino , Desnutrição/etiologia , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Tamanho do Órgão , Tomografia Computadorizada por Raios X
14.
Medicine (Baltimore) ; 98(13): e14771, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30921181

RESUMO

The relationship between dental diseases and the prevalence of digestive system cancers remains unclear. The aim of the present study was to examine the prevalence of dental diseases in patients treated for digestive system cancers.The medical and dental records of patients treated for digestive system cancers were retrospectively reviewed, and the results obtained (decayed/filled/missing teeth [DMFT] indices and community periodontal index [CPI] codes) were compared with data from the national survey of dental diseases in order to investigate the relationship between oral health and digestive system cancers.DMFT, D, and F indices were significantly lower, while the M index was slightly higher in digestive system cancer patients than in the national survey. The proportions of individuals with more than 20 residual teeth and denture wearers were significantly lower in cancer patients than in the national survey. The prevalence of periodontitis (CPI codes 3 and 4) and severe periodontitis (CPI code 4) were significantly higher in cancer patients than in the national survey.The present results showed that digestive system cancers were closely associated with multi-tooth loss and/or a low denture-wearing rate. The prevalence of severe periodontitis was also found to be higher in cancer patients. These results suggest that periodontitis and associated multi-tooth loss play a potential role in digestive system cancers.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Doenças Periodontais/complicações , Periodontite/complicações , Doenças Estomatognáticas/epidemiologia , Idoso , Feminino , Humanos , Japão/epidemiologia , Masculino , Saúde Bucal/estatística & dados numéricos , Saúde Bucal/tendências , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Índice Periodontal , Periodontite/diagnóstico , Periodontite/epidemiologia , Prevalência , Estudos Retrospectivos , Doenças Estomatognáticas/complicações , Perda de Dente/complicações , Perda de Dente/epidemiologia
15.
Geriatr Gerontol Int ; 19(4): 335-341, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30761710

RESUMO

AIM: Many studies have reported close relationships between oral and systemic health. We explored the association of the number of remaining teeth with medical costs and hospitalization duration in people aged 75 and 80 years. METHODS: Oral health examinations were carried out at dental clinics in 2014. Medical cost and hospitalization duration data for fiscal year 2015 were obtained from the Mie Prefecture health insurer. We analyzed the data of 4700 individuals who met our inclusion criteria: 2745 75-year-olds and 1955 80-year-olds. The effects of remaining tooth numbers on medical costs and hospitalization days were analyzed using a generalized linear model with log link adjustment for confounders. RESULTS: Total medical costs for all diseases were significantly higher in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, compared with those with 28 teeth. Outpatient medical costs for diabetes were significantly higher in those with 20-27 and 1-9 teeth. Inpatient medical costs for digestive cancers were significantly higher in those with 10-19 and 1-9 teeth, and in edentulous older individuals. Hospitalization for digestive cancer was significantly longer in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, than in those with 28 teeth. The number of teeth as a continuous variable was significantly inversely associated with medical costs for cerebrovascular disease and digestive cancer, and hospitalization days for digestive cancer. CONCLUSION: Small numbers of teeth were associated with higher medical costs and longer hospital stays for older Japanese. Geriatr Gerontol Int 2019; 19: 335-341.


Assuntos
Transtornos Cerebrovasculares , Neoplasias do Sistema Digestório , Custos de Cuidados de Saúde/estatística & dados numéricos , Tempo de Internação , Boca Edêntula , Idoso , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/economia , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/terapia , Correlação de Dados , Neoplasias do Sistema Digestório/economia , Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/terapia , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Japão/epidemiologia , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Boca Edêntula/diagnóstico , Boca Edêntula/epidemiologia , Saúde Bucal/economia , Saúde Bucal/estatística & dados numéricos , Fatores de Risco
16.
J Thromb Thrombolysis ; 47(2): 316-323, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30560488

RESUMO

Malignancy and surgery are both independent risk factors for venous thromboembolism (VTE) events. The current NCCN guidelines recommend VTE prophylaxis for up to 28 days after major abdominal or pelvic surgery for malignancy. We set out to evaluate the rate and timing of VTEs among patients with gastric, pancreatic, colorectal, and gynecologic malignancies who underwent surgery. We performed a retrospective review of the NSQIP database (2005-2013) focusing on patients with gastric, colorectal, pancreatic, and gynecologic malignancies. Our primary endpoint was a diagnosis of VTE within 30 days of surgery. We analyzed 128,864 patients in this study. On multivariable analysis, patients with pre-operative sepsis (OR 2.36, CI 2.04-2.76, p < 0.001), disseminated cancer (OR 1.73, CI 1.55-1.92, p < 0.001), congestive heart failure (OR 1.69, CI 1.25-2.28, p = 0.001), gastric cancer (OR 1.3, CI 1.09-1.56, p = 0.004), and pancreatic cancer (OR 1.2, CI 1.03-1.30, p = 0.021) were more likely to have a VTE. Of patients who had a VTE event, 34% occurred after discharge from surgery (gastric: 25%, colorectal 34%, pancreatic 31%, gynecologic malignancy 42%). Our study demonstrates that patients who undergo an operation for malignancy with pre-operative sepsis, disseminated cancer, congestive heart failure, gastric cancer, or pancreatic cancer are more likely to develop a VTE within 30 days of their operation. Of those patients who developed a VTE, approximately one-third occurred after discharge during a 30 day post-operative period. This data supports that further studies are needed to determine the appropriate length of post-operative VTE chemoprophylaxis in patients with cancer.


Assuntos
Neoplasias do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Neoplasias dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Tromboembolia Venosa/epidemiologia , Idoso , Bases de Dados Factuais , Neoplasias do Sistema Digestório/diagnóstico , Neoplasias do Sistema Digestório/epidemiologia , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologia , Tromboembolia Venosa/diagnóstico
17.
Ann Thorac Surg ; 107(5): 1532-1539, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30576633

RESUMO

BACKGROUND: Patients with thymomas are at high risk of developing extrathymic malignancies. We investigated the impact of extrathymic malignancies on the prognosis of patients with thymoma who underwent surgery and the risk factors for postoperative extrathymic malignancies. METHODS: A multicenter retrospective review of 252 patients who underwent surgical resection of thymomas from January 1977 to March 2016 was conducted. The exclusion criteria were recurrent thymoma, rare types of thymoma, and missing data. The overall number and incidence of extrathymic malignancies were calculated. Potential predictors of extrathymic malignancies were also evaluated. RESULTS: Two hundred twenty-eight patients were analyzed. Fifty-five extrathymic malignancies were observed (23 postoperative, 8 synchronous, and 24 preoperative). Among the overall cohort, the incidence of extrathymic malignancies significantly increased the patients' risk of death (hazard ratio [HR], 4.02; 95% confidence interval [CI], 1.72 to 9.40; p < 0.01). Among patients aged less than 70 years, the incidence of extrathymic malignancies was an independent risk factor for death. The incidence of postoperative extrathymic malignancies was significantly higher in patients with indolent forms of thymoma (type A/AB/B1) than aggressive forms (type B2/B3) (p = 0.02). In the multivariate analysis, indolent forms of thymoma (type A/AB/B1) (HR, 4.03; 95% CI, 1.12 to 14.6, p = 0.03) and a history of ever having smoked (HR, 5.29; 95% CI, 1.30 to 21.6; p = 0.02) were significant risk factors for the cumulative incidence of postoperative extrathymic malignancies. CONCLUSIONS: Extrathymic malignancies increased the risk of death in patients with thymomas. Indolent forms of thymoma and a history of ever having smoked were risk factors for postoperative extrathymic malignancies.


Assuntos
Fumar/efeitos adversos , Timoma/patologia , Neoplasias do Timo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Neoplasias do Sistema Digestório/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias do Sistema Respiratório/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida , Timectomia , Timoma/mortalidade , Timoma/cirurgia , Neoplasias do Timo/mortalidade , Neoplasias do Timo/cirurgia , Neoplasias Urogenitais/epidemiologia , Adulto Jovem
18.
Eur J Clin Nutr ; 73(1): 141-149, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29662231

RESUMO

BACKGROUND/OBJECTIVES: To assess the association between processed meat and the risk of selected digestive tract and laryngeal cancers. SUBJECTS/METHODS: We conducted a series of case-control studies between 1985 and 2007 in Italy. The studies included a total of 1475 cases of cancer of the oral cavity and pharynx, 1077 of the larynx, 716 of the esophagus, 999 of the stomach, 684 of the liver, 159 of the biliary tract, 688 of the pancreas, and a total of 9720 controls. Odds ratios (ORs), and the corresponding 95% confidence intervals (CIs), were estimated by unconditional logistic regression models, including terms for socio-demographic factors, tobacco smoking, and alcohol intake. RESULTS: Compared to the lowest tertile of processed meat consumption, the ORs for subjects in the highest one were 1.18 (95% CI 0.98-1.43) for oral cavity and pharyngeal, 1.51 (95% CI 1.18-1.91) for esophageal, 1.19 (95% CI 0.96-1.47) for laryngeal, 0.98 (95% CI 0.81-1.18) for stomach, 0.85 (95% CI 0.51-1.40) for biliary tract, 1.20 (95% CI 0.94-1.54) for liver, and 1.46 (95% CI 1.15-1.85) for pancreatic cancers. CONCLUSIONS: Our findings support the hypothesis that high processed meat consumption increases esophageal and pancreatic cancers risk. Residual confounding by socio-demographic factors, tobacco smoking, and alcohol intake may, partly or largely, account for these associations. We found no overall association with other digestive tract and laryngeal cancers.


Assuntos
Dieta/efeitos adversos , Neoplasias do Sistema Digestório/etiologia , Manipulação de Alimentos , Neoplasias Laríngeas/etiologia , Carne/efeitos adversos , Adulto , Estudos de Casos e Controles , Dieta/métodos , Neoplasias do Sistema Digestório/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Neoplasias Laríngeas/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
19.
Neth J Med ; 76(3): 100-108, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29667585

RESUMO

Well-differentiated neuroendocrine tumours (NETs) of the digestive tract are being increasingly detected, which is partly explained by the increased use of endoscopic and cross-sectional imaging as well as improved recognition at histopathological evaluation. After the discovery of this relatively indolent type of epithelial malignancy over 100 years ago, their sporadic occurrence and divergent biological behaviour at multiple primary sites have hampered dedicated studies into NET pathogenesis and testing of drug efficacy in well-designed clinical trials. The last decade, however, has seen significant improvements in the NET field regarding our understanding of their pathophysiology. This has been substantiated by novel and exciting diagnostic and therapeutic options, including superior positron emission tomography imaging, treatment with unlabelled and radiolabelled somatostatin analogues and inhibitors of the mammalian target of rapamycin and vascular endothelial growth factor pathways. This review summarises contemporary studies within NET patients, which have enriched our clinical repertoire for this disease and have been instrumental in securing a remarkable improvement of overall survival within recent years.


Assuntos
Neoplasias do Sistema Digestório/diagnóstico , Neoplasias do Sistema Digestório/terapia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/terapia , Algoritmos , Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/fisiopatologia , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/fisiopatologia , Gradação de Tumores , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/fisiopatologia , Prognóstico
20.
J Cancer Res Ther ; 14(2): 437-440, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29516934

RESUMO

Background: Tobacco use is a major risk factor for increasing the burden of upper aero digestive tract (UADT) cancer in the population of Northeast India. Objective: The objective of this study was to investigate the pattern of tobacco use in different UADT cancer. Materials and Methods: This was a retrospective study of electronically recorded data of the Hospital Cancer Registry for the period of May 2014 to December 2014. The UADT cancers were evaluated for gender and age-group distribution, their relative proportion, and association with tobacco use and tobacco-associated risk in males to develop UADT cancers. The type of tobacco usage was clustered as chewable, smoking, and both. Relative risk (RR) of UADT with tobacco usage was identified for males. Results: A total of 1965 (n) UADT cancer patients were identified, male:female was 2.9, tobacco habits was in 1608 (81.8%) patients, both forms of tobacco use in 705 (43.8%), chewable tobacco use in 588 (36.6%) and smoking in 315 (19.6%) patients, tobacco habits in males ranges from 67.3% to 94.3% and in females range from 5.7% to 32.7%, RR of UADT cancer in males for tongue cancer was 1.5 (confidence interval [CI] =1.2-1.9), oropharynx was 1.4 (CI = 1.0-1.8), hypopharynx 1.4 (CI = 1.1-1.7), esophageal cancer was 1.4 (CI = 1.3-1.7), and for laryngeal cancer RR was 1.7 (CI = 1.0-3.0). Conclusion: Consumption of chewable tobacco is the major form of tobacco use alone or in combination in UADT cancer patients of our population.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Neoplasias do Sistema Digestório/etiologia , Vigilância da População , Uso de Tabaco/efeitos adversos , Neoplasias do Sistema Digestório/diagnóstico , Feminino , Hospitais , Humanos , Índia/epidemiologia , Masculino , Razão de Chances , Prevalência , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...