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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1180-1187, out.-dez. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022214

RESUMO

Objetivo: Analisar a trajetória percorrida pelas crianças e adolescentes da suspeição à confirmação diagnóstica de câncer. Métodos: Pesquisa qualitativa, desenvolvida em 2017, com entrevistas semiestruturadas junto a 19 familiares cuidadores de crianças e adolescentes com câncer, cujos dados foram submetidos à análise temática. Resultados: A trajetória de crianças e adolescentes é iniciada a partir de múltiplas e inespecíficas alterações clínicas e de desenvolvimento no âmbito sociofamiliar, posteriormente elas percorrem inúmeros serviços de saúde e são submetidas a diversos procedimentos biomédicos. Nesse caminho, barreiras no acesso aos serviços de saúde na busca pelo diagnóstico do câncer foram evidenciadas. Conclusão: É imprescindível que o sistema de saúde atenda as necessidades da população infantojuvenil em todos os seus níveis, incluindo o acesso adequado ao diagnóstico precoce do câncer, assim como melhor formação dos profissionais para a detecção. Garantindo, assim, o direito à saúde na perspectiva da integralidade do cuidado


Objective: The study's goal has been to analyze the trajectory of children and adolescents from cancer suspicion to its confirmed diagnosis. Methods: It is a descriptive-exploratory research with a qualitative approach, which was performed in 2017 through semi-structured interviews of 19 family caregivers of children and teenagers with cancer diagnosis. The data were subjected to thematic analysis. Results: Both children and adolescents' trajectories start from multiple and unspecific clinical and development alterations in the socialfamily settings, following that they go through countless healthcare services and are subjected to a variety of biomedical procedures. Along this path, there were evidenced barriers of access to healthcare services in the cancer diagnosis pursue. Conclusion: It is crucial that the healthcare system go towards attending the necessities of children and adolescents' population in all levels, including the appropriated access to an earlier diagnosis of cancer, and a better qualification of healthcare professionals for cancer detection. Hence, ensuring the right to health care under the care completeness standpoint


Objetivo: Analizar la trayectoria recorrida por los niños y los adolescentes de sospecha de confirmación diagnóstica del cáncer. Métodos: Pesquisa cualitativa, desarrollada en 2017, con entrevistas semiestructuradas junto a diecinueve familiares cuidadores de niños y adolescentes con cáncer, donde los dados han sido sometidos al analice temática. Resultados: La trayectoria de los niños y adolescentes empieza a partir de varias e inespecíficas alteraciones clínicas y del desarrollo en el ámbito sociofamiliar, posteriormente ellas recogen inúmeros servicios de salud y son sometidas a diversos procedimientos biomédicos. En este camino, barreras en el acceso a los servicios de salud en la busca por el diagnóstico del cáncer fueron evidenciadas. Conclusión: Es imprevisible que el sistema de salud atienda las necesidades de la población infantojuvenil en todos los niveles, incluyendo el acceso adecuado al diagnóstico precoz del cáncer, así como mejor formación de los profesionales para la detección. Garantizando, así, el derecho a la salud en la perspectiva de la integralidad del cuidado


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Saúde da Criança , Saúde do Adolescente , Detecção Precoce de Câncer , Neoplasias/diagnóstico , Brasil , Cuidadores
2.
Adv Exp Med Biol ; 1164: 47-61, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576539

RESUMO

Stem cell antigen-1 (Sca-1) is the first identified member of mouse Ly6 gene family. We discovered that Sca-1 disrupts TGFß signaling and enhances mammary tumorigenesis in a DMBA-induced mammary tumor model. Sca-1 gene is lost during evolution in humans. Human Ly6 genes Ly6D, LyE, LyH, and LyK on human chromosome 8q24.3 genes are syntenic to the mouse chromosome 15 where Sca-1 is located. We found that Ly6D, E, H, and K are upregulated in human cancer compared to normal tissue and that the increased expression of these genes are associated with poor prognosis of multiple types of human cancer. Several other groups have indicated increased expression of Ly6 genes in human cancer. Here we described the relevance of expression of human Ly6D, LyE, LyH, and LyK in functioning of normal tissues and tumor progression.


Assuntos
Antígenos Ly , Biomarcadores , Regulação Neoplásica da Expressão Gênica , Neoplasias , Animais , Antígenos Ly/genética , Biomarcadores/metabolismo , Transformação Celular Neoplásica , Humanos , Neoplasias/diagnóstico , Neoplasias/genética , Prognóstico
4.
J Cancer Res Clin Oncol ; 145(10): 2625-2631, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31492984

RESUMO

PURPOSE: Immune checkpoint inhibitors (ICIs) are effective against a wide variety of cancers. However, they also induce a plethora of unique immune-related adverse events (irAEs). Since for many organ systems symptoms can be unspecific, differential diagnosis with progression of disease or infection may be difficult. C-reactive protein (CRP) has been suggested as a marker for infection. The purpose of this study was to evaluate the diagnostic value of CRP in differentiating infectious causes from autoimmune side effects induced by ICIs. METHODS: In order to investigate the role of CRP in irAEs, we screened our patient data base. Only events with full infectious workup were included. In total 88 events of irAEs in 37 melanoma patients were analyzed. CRP levels before and during irAEs were evaluated. Statistical analyses were conducted using the Chi-square test for categorical variables. RESULTS: At the onset of irAE, CRP rose in 93% of cases to a mean of 52.7 mg/L (CI 35.1-70.3) from 8.4 mg/L at baseline (normal < 5 mg/L) (P < 0.0001). Other causes of CRP elevation including infectious diseases were excluded, and procalcitonin (PCT) levels were normal in 92% of events. Importantly, in 42% of cases CRP elevations preceded clinical symptoms. CONCLUSION: CRP elevation can predict the onset of irAEs in patients treated with ICIs in the absence of infectious disease.


Assuntos
Antineoplásicos Imunológicos/farmacologia , Biomarcadores , Proteína C-Reativa , Imunomodulação , Adulto , Antineoplásicos Imunológicos/uso terapêutico , Biomarcadores Tumorais , Feminino , Humanos , Imunomodulação/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Neoplasias/metabolismo , Adulto Jovem
5.
J Registry Manag ; 46(1): 15-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490917

RESUMO

Information on cancer stage at diagnosis is largely missing or poorly documented among population-based cancer registries in sub-Saharan Africa (SSA). In an early field trial of Essential TNM staging, it was observed that some training was needed to enable cancer registrars to abstract the correct TNM from case records. In November 2018, the Addis Ababa City Cancer Registry hosted a training course attended by 17 participants from 16 cancer registries in SSA. The participants were asked to stage 16 cancer cases (from anonymized photocopies of case records obtained from the Global Initiative for Cancer Registry Development) before and after the training. The discrepancy of the stages from before and after were scored and compared. Results showed that there was a substantial improvement in the participants' performance after the training. The application of the Essential TNM staging system, with training in its use, would allow cancer registrars in SSA to abstract cancer stage at diagnosis in a clinically recognized format, which is crucial for cancer control and public health care policy making.


Assuntos
Estadiamento de Neoplasias/normas , Neoplasias/classificação , Neoplasias/patologia , África , Avaliação Educacional , Humanos , Neoplasias/diagnóstico , Avaliação de Programas e Projetos de Saúde , Sistema de Registros
6.
Ther Umsch ; 76(4): 167-172, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498036

RESUMO

Nuclear medicine diagnostics, therapy and theranostics in the context of modern oncology Abstract. Nuclear medicine deals with imaging, therapy and theranostics using radioactive elements bound to targeted carrier molecules, so-called radiotracers. Modern oncology in particular benefits from the increasing diagnostic possibilities, for example in the context of increasingly precise tumour spread diagnostics or the early measurement of tumour response under targeted therapies. Modern nuclear medicine also offers new and innovative methods for the treatment of special types of tumours. For example, new therapies are available to treat metastatic prostate cancer, while other methods, such as breast and lung cancer or pancreatic cancer, are currently being tested in clinical trials. Nuclear medicine is complemented by theranostics, which combines therapeutic and diagnostic methods. Particularly in modern, personalized oncology with all its targeted therapies, these methods benefit from predicting therapy and high response rates.


Assuntos
Neoplasias/diagnóstico , Neoplasias/terapia , Medicina Nuclear , Nanomedicina Teranóstica , Humanos , Oncologia , Terapia de Alvo Molecular
7.
Ther Umsch ; 76(4): 179-185, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498038

RESUMO

Molecularly-targeted anticancer treatments - a short appraisal Abstract. Molecularly-targeted or personalized systemic treatment has substantially transformed modern oncology, and has improved the prognosis of many tumor entities, in particular advanced solid and hematological malignancies. The bulk of molecularly-targeted anticancer drugs comprise small orally administered molecules, most prominently the tyrosine kinase inhibitors (TKI). The respective tumor entities treated by those drugs typically harbour specific genetic aberrations that we often call 'driver mutations', referring to their transforming and tumorigenic properties. Molecularly-targeted anticancer drugs fit to these genetic aberrations as they are able to specifically inhibit growth-stimulating signals. The success story of modern TKI's started 1999 with the use of the anti-BCR / ABL TKI imatinib in chronic myelogenous leucemia (CML) that enables those patients to achieve a virtually normal life expectancy. Since then, many molecularly-targeted anticancer drugs and TKI's have been approved for a wide range of malignancies. The next level of personalized oncological treatment will have to deal with much less frequent genetic aberrations that are inherently more difficult to spot in the tumor and to study. Newer techniques including next-generation sequencing (NGS) will help cancer specialists to screen their patients for genetic aberrations and get the most benefit from personalized oncology.


Assuntos
Antineoplásicos , Terapia de Alvo Molecular , Neoplasias/diagnóstico , Neoplasias/terapia , Medicina Nuclear , Resistencia a Medicamentos Antineoplásicos , Humanos , Oncologia
9.
Anticancer Res ; 39(9): 4597-4602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519556

RESUMO

Our previous review of the literature assessed the existing knowledge (until 2000) about the possible link between angiotensin-converting enzyme inhibitors (ACEIs) and factors influencing the development of malignancies. We reviewed the literature for reports of statistical associations (or lack thereof) between ACEi treatment and incidence of specific cancers (e.g. breast, gastrointestinal, and skin). We concluded then that results from the epidemiological studies are conflicting, even taking the different methodology and endpoints into consideration, and thus inconclusive. Further investigation is needed beyond the observation period of most of these studies, and additional experimental studies are needed also to study the mechanisms by which agents blocking the renin-angiotensin system may obtain their inhibitory effect on tumor growth and metastasis. The present review elaborates further with more recent evidence from numerous human clinical studies from the past two decades (including large epidemiological studies, and long-term prospective and retrospective studies) on a protective association between ACEi treatment and the prognosis of patients with specific cancer types, malignancy characteristics or stage. Moreover, treatment with ACEI/angiotensin receptor blockers represents an adjuvant therapy with synergistic effects to chemotherapy and may improve patient outcomes (i.e. progression-free survival, and prolonged overall survival) in different types of cancers.


Assuntos
Neoplasias/metabolismo , Neoplasias/mortalidade , Sistema Renina-Angiotensina/efeitos dos fármacos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos Clínicos como Assunto , Modelos Animais de Doenças , Progressão da Doença , Humanos , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Neoplasias/etiologia , Prognóstico , Resultado do Tratamento
10.
Anticancer Res ; 39(9): 4687-4698, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519568

RESUMO

BACKGROUND/AIM: Propagermanium (PG) inhibits the CCL2/CCR2 axis, and has been shown to function as an immune modulator. This study investigated its anti-tumor mechanism in patients with refractory cancers. MATERIALS AND METHODS: Five healthy volunteers and 23 patients with refractory oral (n=8) or gastric (n=15) cancer received PG (30 mg/day). We performed flow cytometry (FCM) of peripheral blood mononuclear cells and in vitro killing assays. RESULTS: FCM revealed that CD16+/CD56Dim NK cells (i.e., mature, cytolytic subset) increased, and the apoptosis induction rate of cancer cells increased after PG administration. Among gastric cancer patients, median OS was 172.0 days. Two patients showed complete remission of lung or liver metastasis. Survival of patients with oral cancer also tended to be prolonged. CONCLUSION: PG induces NK cell maturation, and may potentiate anti-tumor activity.


Assuntos
Antineoplásicos/farmacologia , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/imunologia , Células Matadoras Naturais/efeitos dos fármacos , Células Matadoras Naturais/imunologia , Neoplasias/imunologia , Neoplasias/mortalidade , Compostos Organometálicos/farmacologia , Linhagem Celular Tumoral , Resistencia a Medicamentos Antineoplásicos , Humanos , Estimativa de Kaplan-Meier , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/metabolismo , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Tomografia Computadorizada por Raios X
11.
Medicine (Baltimore) ; 98(37): e17019, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517821

RESUMO

The role of cytokines in the systemic inflammatory response (SIR) is now well established. This is in keeping with the role of the SIR in tumorigenesis, malignant spread, and the development of cachexia. However, the relationship between performance status/systemic inflammation frameworks and cytokine profiles is not clear. The aim of the present study was to examine the relationship between the Eastern cooperative oncology group performance status/modified Glasgow prognostic score (ECOG-PS/mGPS) and cooperative oncology group performance status/neutrophil platelet score (ECOG-PS/NPS) frameworks and their cytokine profile in patients with advanced cancer.This was a retrospective interrogation of data already collected as part of a recent clinical trial (NCT00676936). The relationship between the independent variables (ECOG-PS/mGPS and ECOG-PS/NPS frameworks), and dependent variables (cytokine levels) was examined using independent Mann-Whitney U and Kruskal Wallis tests where appropriate.Of the 40 patients included in final analysis the majority had evidence of an SIR assessed by mGPS (78%) or NPS (53%). All patients died on follow-up and the median survival was 91 days (4-933 days). With increasing ECOG-PS there was a higher median value of Interleukin 6 (IL-6, P = .016) and C-reactive protein (CRP, P < .01) and lower albumin (P < .01) and poorer survival (P < .001). With increasing mGPS there was a higher median value of IL-6 (P = .016), Macrophage migration inhibitory factor (MIF, P = .010), erythrocyte sedimentation rate (ESR, P < .01) and poorer survival (P < .01). With increasing NPS there was a higher median value of TGF-ß (P < .001) and C-reactive protein (P = .020) and poor survival (P = .001). When those patients with an ECOG-PS 0/1 and mGPS0 were compared with those patients with an ECOG-PS 2 and mGPS2 there was a higher median value of IL-6 (P = .017) and poorer survival (P < .001). When those patients with an ECOG-PS 0/1 and NPS0 were compared with those patients with an ECOG-PS 2 and NPS1/2 there was a higher median value of IL-6 (P = .002), TGF-ß (P < .001) and poorer survival (P < .01).In patients with advanced cancer IL-6 was associated with the ECOG-PS/mGPS and ECOG-PS/NPS frameworks and survival in patients with advanced cancer. Therefore, the present work provides supporting evidence that agents targeting IL-6 are worthy of further exploration.


Assuntos
Citocinas/imunologia , Inflamação/imunologia , Neoplasias/imunologia , Idoso , Biomarcadores/metabolismo , Feminino , Seguimentos , Humanos , Inflamação/diagnóstico , Inflamação/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/mortalidade , Neoplasias/terapia , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida
12.
Anticancer Res ; 39(8): 4253-4258, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366514

RESUMO

Different entities can be the cause of scalp neoplasia. In a phenotype with multiple cystic scalp lesions, the diagnosis must be made with particular caution because the appearance of apparently benign tumors does not necessarily correspond to the biological behaviour of the lesions. This case report describes diagnosis and therapy of a patient with multiple cystic tumors confined to the scalp. Diagnosis of benign lesions all over the scalp allowed an aesthetically pleasing surgical treatment result. Long-term follow-up control was offered to the patient because the histological diagnosis identified further small tumors of the same type as the large lesions, so further neoplasms are likely to develop.


Assuntos
Cisto Epidérmico/cirurgia , Neoplasias/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/fisiopatologia , Feminino , Humanos , Neoplasias/diagnóstico , Neoplasias/diagnóstico por imagem , Neoplasias/fisiopatologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/fisiopatologia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/fisiopatologia
13.
Vasc Health Risk Manag ; 15: 175-186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31417269

RESUMO

Venous thromboembolism (VTE) is a common cause of morbidity and mortality in patients with cancer. Compared with the general population, cancer patients with VTE have higher rates of both VTE recurrence and bleeding. While low molecular weight heparin (LMWH) has been the mainstay of treatment for cancer-associated VTE for over a decade, direct oral anticoagulants (DOACs) have recently emerged as a new therapeutic option due to their ease of administration and because they do not require laboratory monitoring. Several large randomized clinical trials have been performed or are ongoing at the time of writing, comparing DOACs with LMWH in this population. Three of these trials have thus far been published and suggest that DOACs are a reasonable alternative to LMWH for management of cancer-associated VTE. Despite the advantages offered by DOACs, these agents may not be appropriate for certain patient groups owing to increased risk of bleeding, organ compromise, extremes of weight, and other issues. Finally, data are emerging suggesting that DOACs may be useful for primary thromboprophylaxis in cancer patients in conjunction with validated risk assessment scores. In this evidence-based review, data for the use of DOACs to treat cancer-associated VTE will be examined, focusing on efficacy, safety, and timing of treatment. Guidance on choosing the optimal anticoagulant for a given patient is also offered.


Assuntos
Anticoagulantes/administração & dosagem , Coagulação Sanguínea/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Tromboembolia Venosa/prevenção & controle , Administração Oral , Anticoagulantes/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Neoplasias/sangue , Neoplasias/diagnóstico , Neoplasias/mortalidade , Recidiva , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Tromboembolia Venosa/sangue , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/mortalidade
14.
Presse Med ; 48(7-8 Pt 2): e219-e231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31447333

RESUMO

Image-guided ablation is performed by percutaneously introducing ablation probes to deliver energy into a tumor to destroy it in a controlled and localized fashion. Ablation modalities can be broadly classified as thermal or non-thermal based on the mechanism of tumor destruction and are performed using different types of image guidance for planning, delivering and follow-up of the treatment. Ablation is performed in a minimally invasive fashion, providing greater residual organ preservation with minimal morbidity to the patient. Image-guided ablation is being used in the clinic for the treatment of primary and metastatic tumors, and this article reviews state of the art for the treatment of malignancies in the liver, lung, kidney and musculoskeletal tissue.


Assuntos
Ablação por Cateter/métodos , Neoplasias/cirurgia , Cirurgia Assistida por Computador/métodos , Ablação por Cateter/efeitos adversos , Tecido Conjuntivo/patologia , Tecido Conjuntivo/cirurgia , Humanos , Rim/patologia , Rim/cirurgia , Fígado/patologia , Fígado/cirurgia , Pulmão/patologia , Pulmão/cirurgia , Sistema Musculoesquelético/patologia , Sistema Musculoesquelético/cirurgia , Neoplasias/diagnóstico , Neoplasias/patologia , Especificidade de Órgãos , Complicações Pós-Operatórias/etiologia , Cirurgia Assistida por Computador/efeitos adversos , Resultado do Tratamento
16.
Cancer Invest ; 37(7): 299-310, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379217

RESUMO

Age-related decreases in Quality of Life (QoL) are often compounded by comorbidities, including cancer. This study aimed to examine QoL changes before and after a new cancer diagnosis using data from the National Health and Aging Trend Study (NHATS), linked to Medicare claims (N = 136). There was a significant increase in the relative odds of fair/poor self-reported health and needing help with Activities of Daily Living. There was also a marginal increase in depression, but no change in anxiety or pain scores. Results underscore importance of considering pre-cancer QoL when making treatment decisions for older adult cancer patients.


Assuntos
Atividades Cotidianas/psicologia , Neoplasias/diagnóstico , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Neoplasias/psicologia , Autorrelato , Estados Unidos
19.
Ther Adv Cardiovasc Dis ; 13: 1753944719860676, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31319783

RESUMO

BACKGROUND: The role of cancer-specific factors for ischemic stroke and mortality in patients with cancer and atrial fibrillation (AF) is unknown. We evaluated the utility of a previously validated risk tool for venous thromboembolism (VTE) in cancer outpatients [Khorana score (KS)] in predicting stroke and mortality in cancer patients with AF. METHODS: We conducted a retrospective cohort study of patients with cancer and AF at the Cleveland Clinic from 2008 to 2014. Outcomes, CHADS2, CHA2DS2-VASc, and KS scores were calculated from date of cancer diagnosis. Prognostic factors were identified with Fine and Gray regression (for stroke) or Cox proportional hazards analysis (for mortality). RESULTS: The study population comprised 1181 patients. Genitourinary (19%), lung (18%), and gastrointestinal (13%) were the most frequent cancers. Overall, 67% had CHADS2 ⩾ 2, 57% had an intermediate KS (1-2), and 7% high KS (⩾3). Median follow up was 26.5 months (range 0.03-76). At a median of 8.2 months (range 0-61), 45 patients (3.8%) developed a stroke and 418 (35%) died. In multivariable analysis a high KS (HR 4.5, 95% CI 3.2-6.3, p < 0.001) was associated with a quadruple risk of death and every point increase in CHADS2 score had a 20% increased risk of death (HR 1.19, 95% CI 1.1-1.2, p < 0.001). The addition of KS did not improve risk stratification for ischemic stroke to CHADS2. CONCLUSION: In patients with cancer and AF, CHADS2 and CHA2DS2-VASc but not KS were predictive of ischemic stroke. A high KS represented a unique predictor of mortality beyond traditional risk scores.


Assuntos
Fibrilação Atrial/complicações , Isquemia Encefálica/etiologia , Técnicas de Apoio para a Decisão , Neoplasias/complicações , Acidente Vascular Cerebral/etiologia , Tromboembolia Venosa/etiologia , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/mortalidade , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/mortalidade , Registros Eletrônicos de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/mortalidade , Ohio , Valor Preditivo dos Testes , Prognóstico , Sistema de Registros , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/mortalidade
20.
Zoo Biol ; 38(4): 371-383, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257640

RESUMO

The longevity of zoo animals is increasing due to continuous improvement in husbandry and veterinary medicine. However, increasing age is correlated to a higher prevalence of neoplasia. Despite tremendous improvement in diagnoses and monitoring capacities, cancers are still a challenge for veterinarians within the global zoo community. The recent use of copper isotopes as biomarkers for neoplasia in both human and veterinary medicine is a promising and cost-effective diagnostic tool. Two hundred and twenty-nine serum samples from 10 different species of wild felids under human care were processed through mass spectrometry to determine the ratio of heavy and light copper isotopes (65 Cu/63 Cu). The results of this preliminary study exhibit an important variability between felid species, with a ratio ranging between -1.71 and 0.63. Additionally, copper isotopes seem to be a promising diagnostic tool in monitoring cancer in wild animals, as in human medicine, where the isotopic ratio decreases significantly with time in the presence of a tumor.


Assuntos
Cobre/sangue , Felidae/sangue , Neoplasias/veterinária , Animais , Biomarcadores Tumorais , Feminino , Masculino , Neoplasias/sangue , Neoplasias/diagnóstico , Especificidade da Espécie
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