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1.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 241-246, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496154

RESUMO

OBJECTIVE: To investigate the effect of emergency medical service (EMS) on the prognosis of ischemic stroke patients treated with intravenous thrombolysis. METHODS: Clinical data of 2123 ischemic stroke patients treated with intravenous thrombolysis in 70 hospitals in Zhejiang province were retrospectively analyzed. There were 808 patients sent to the hospital by ambulance (EMS group) and 1315 patients by other transportations (non-EMS group). Good outcome was defined as modified Rankin Scale (mRS) ≤ 2 at 3-month. The onset to needle time (ONT), onset to door time (ODT), door to needle time (DNT) and outcome were compared between EMS group and non-EMS group. Binary logistic regression was used to explore the influencing factors for the outcome at 3-month. RESULTS: Compared with the non-EMS group, patients in the EMS group were older, with higher baseline National Institute of Health Sroke Scale (NIHSS) score, and had a higher proportion of atrial fibrillation (all P<0.05), but there were no significant differences in ONT, ODT and DNT between two groups (all P>0.05). Binary logistic regression showed that EMS was not independently associated with good outcome (OR=0.856, 95%CI:0.664-1.103, P>0.05). CONCLUSIONS: EMS had not improve the outcome of patients receiving intravenous thrombolysis in Zhejiang province.


Assuntos
Isquemia Encefálica , Serviços Médicos de Emergência , Acidente Vascular Cerebral , Terapia Trombolítica , Administração Intravenosa , Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Humanos , Prognóstico , Estudos Retrospectivos , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/estatística & dados numéricos , Resultado do Tratamento
2.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 260-266, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496157

RESUMO

OBJECTIVE: To compare the time delay between in-hospital stroke and out-of-hospital stroke patients, and to explore the influence factors for the prognosis of in-hospital stroke patients treated by intravenous thrombolysis. METHODS: Clinical data of 3050 patients with ischemic stroke who received intravenous thrombolysis in 71 hospitals in Zhejiang province from June 2017 to September 2018 were analyzed. Differences of time delay including door to imaging time (DIT), imaging to needle time (INT) and door to needle time (DNT) between in-hospital stroke (n=101) and out-of-hospital stroke (n=2949) were observed. The influencing factors for the outcome at 3 month after intravenous thrombolysis in patients with in-hospital stroke were analyzed using binary logistic regression analysis. RESULTS: Patients with in-hospital stroke had longer DIT[53.5 (32.0-79.8) min vs. 20.0 (14.0-28.0) min, P<0.01], longer IDT[47.5(27.3-64.0)min vs. 36.0(24.0-53.0)min, P<0.01], and longer DNT[99.0 (70.5-140.5) min vs. 55.0 (41.0-74.0) min, P<0.01], compared with patients with out-of-hospital stroke; patients in comprehensive stroke center had longer DIT[59.5(44.5-83.3) min vs. 37.5(16.5-63.5) min, P<0.01], longer DNT[110.0(77.0-145.0) min vs. 88.0 (53.8-124.3) min, P<0.05], but shorter INT[36.5(23.8-60.3)min vs. 53.5 (34.3-64.8) min, P<0.05], compared with patients in primary stroke center. Age (OR=0.934, 95%CI: 0.882-0.989, P<0.05) and baseline National Institute of Health Stroke Scale score (OR=0.912, 95%CI: 0.855-0.973, P<0.01) were independent risk factors for prognosis of in-hospital stroke patients. CONCLUSIONS: In-hospital stroke had longer DIT and DNT than out-of-hospital stroke, which suggests that a more smooth thrombolysis process of in-hospital stroke should be established.


Assuntos
Isquemia Encefálica , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica , Administração Intravenosa , Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Hospitais/estatística & dados numéricos , Humanos , Prognóstico , Terapia Trombolítica/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento
3.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 267-274, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496158

RESUMO

OBJECTIVE: To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis. METHODS: Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively. RESULTS: There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all P>0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all P>0.05). CONCLUSIONS: The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.


Assuntos
Isquemia Encefálica , Acidente Vascular Cerebral , Terapia Trombolítica , Isquemia Encefálica/tratamento farmacológico , Humanos , Prognóstico , Estudos Retrospectivos , Acidente Vascular Cerebral/tratamento farmacológico , Fatores de Tempo
4.
Zhonghua Yi Xue Za Zhi ; 99(32): 2497-2500, 2019 Aug 27.
Artigo em Chinês | MEDLINE | ID: mdl-31484275

RESUMO

Objective: To investigate the feasibility of surgical treatment of port-site metastasis after laparoscopic radical resection of gastric cancer. Methods: The clinical and follow-up data of five patients with port-site metastases after laparoscopic radical resection of gastric cancer at Zhejiang Provincial People's Hospital between January 2014 and January 2018 were retrospectively analyzed. Results: Port-site metastases occurred within 6 months after gastrointestinal tumor resection in three patients, 10 months after the operation in one patient, and 30 months after the operation in one patient, respectively. Metastasis to the abdominal cavity or distant metastasis was excluded before the surgical treatment of the port-site metastases, and all patients recovered well after the operation. No incisional infection or hernia occurred. By December 2018, two patients died (they survived for 13 and 24 months, respectively) and three patients survived. The follow-up duration ranged from 7 to 19 months. Conclusions: Surgical resection of port-site metastases is not difficult due to their superficial location. Surgical treatment can improve the prognosis of patients without abdominal or distant metastasis/recurrence.


Assuntos
Laparoscopia , Neoplasias Gástricas , Humanos , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia
5.
Zhonghua Yi Xue Za Zhi ; 99(32): 2527-2531, 2019 Aug 27.
Artigo em Chinês | MEDLINE | ID: mdl-31484281

RESUMO

Objective: To investigate the clinicopathological features and prognosis of patients with neuroendocrine tumors (NETs). Methods: The clinicopathologic data of enrolled patients with NETs between October 2012 and October 2017 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Results: Among the 488 NETs patients, the average age was (51.0±15.8) years, and the sex ratio (male/female) was 1∶1.1. Of the NETs, 370 were located in the digestive system (75.8%), 63 were pulmonary (12.9%), 14 were mediastinal (2.9%), 7 were of unknown primary origin (1.4%), and 34 were located in other sites (7.0%). Among the NETs, the pancreas, rectum and stomach were the most common sites. In the digestive system NETs, the most common tumor grade was G1 (190 cases, 51.4%), followed by G2 (143 cases, 38.6%) and NET-G3 (37 cases, 10.0%). In pulmonary NETs, typical and atypical carcinoid tumors was 47.6% and 52.4%, respectively. There were 310 patients at stage Ⅰ/Ⅱ, 53 at stage Ⅲ, 69 at stage Ⅳ and 56 at stage undiagnosed, respectively. The relationships among age, stage, grade, metastasis, treatment and prognosis were analyzed. All these factors could influence the survival rate of NET patients. Multivariate Cox analysis showed that age (>50 years old) (HR=2.831, 95%CI:1.414-7.029, P=0.025) and distant metastasis (HR=10.208, 95%CI:4.110-25.355, P<0.001) were independent risk factors. Conclusions: The most common primary sites of NETs are the pancreas, rectum, and stomach. Age and distant metastasis are independent risk factors for the prognosis of NETs.


Assuntos
Neoplasias Intestinais , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
6.
Rinsho Ketsueki ; 60(8): 932-943, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31484893

RESUMO

Methotrexate-associated lymphoproliferative disorders (MTX-LPD) is categorized into other iatrogenic immunodeficiency-associated lymphoproliferative disorders, developing LPD in patients with autoimmune diseases (AIDs) under low dose MTX administration. Two-thirds of MTX-LPDs regresses after MTX withdrawal with the higher incidence in Japanese patients, MTX-LPDs consist of various subtypes of LPDs, the feature of each LPD such as the regressive rate, relapse/regrowth rate, and prognosis, widely varies. The absolute lymphocyte count (ALC) in peripheral blood is suggested to influence LPD development, regression, and relapse/regrowth events. Because various factors might effect the pathogenesis and clinical features of MTX-LPD, careful attention should be paid to assess MTX-LPD.


Assuntos
Artrite Reumatoide , Transtornos Linfoproliferativos , Metotrexato/efeitos adversos , Antirreumáticos , Humanos , Incidência , Transtornos Linfoproliferativos/induzido quimicamente , Prognóstico
7.
Rinsho Ketsueki ; 60(8): 960-967, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31484896

RESUMO

Myelodysplastic syndromes (MDS) constitute a group of heterogeneous disorders of hematopoietic stem cells, characterized by defective hematopoiesis and multilineage dysplasia. While low-risk subtypes normally exhibit a relatively chronic clinical course, high-risk subtypes harbor unfavorable prognosis in which hematopoietic stem cell transplantation (HCT) is the only curative therapy. Nevertheless, transplantation-related mortality is relatively high and should be weighed against the potential benefits of HCT. Hence, it is vital to precisely stratify the prognostic risks before HCT for predicting and enhancing their prognosis. Recently, our understanding of the genetic basis of MDS has substantially advanced, through which a full spectrum of major mutational targets was delineated. Moreover, its effects in the setting of HCT have also been assessed besides the conventional predictive factors. While clinical factors account for as much as 70% of the total hazard of MDS cases treated with HCT, the remaining 30% is explicated by genetic factors. The integration of genetic test and conventional clinical factors could be useful for precise stratification of the prognostic risks and, therefore, treatment decision in MDS.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Síndromes Mielodisplásicas , Humanos , Mutação , Prognóstico , Transplante de Células-Tronco
8.
Medicina (B Aires) ; 79(4): 280-283, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487248

RESUMO

The purpose of the study was to evaluate the outcome of patients under 18 months diagnosed with neuroblastoma. Between April 2006 and December 2013, 45 consecutive patients followed in Hospital de Pediatría Garrahan, were retrospectively reviewed. With a median age of 9.3 months (1-18 months) N-myc amplification was detected in 5 out of 38 patients, 1p deletion (del1p) in 4 patients, and 11q aberration in one patient. With a median follow-up of 53 (range: 6-109 months), at 24 months the event free survival (EFS) of all patients was 83% (SE 6%) and overall survival (OS) of 88% (SE 5%). Significant difference was found in OS and EFS between patients with stages L1, L2 and Ms vs. stage M (p = 0.01 and p = 0.01 respectively). EFS for each stage: L1 85% (SE 7%), L2 100%, MS 100%, vs. M 55% (SE 16%). OS: L1 90% (SE 6%), L2 100%, MS 100%, vs. M 66% (SE 15%). OS and EFS results are similar to those reported in international studies. However, better identification of biological prognostic factors will warr ant accurate staging and consequently an appropriate treatment.


Assuntos
Antineoplásicos/administração & dosagem , Neuroblastoma/diagnóstico , Neuroblastoma/tratamento farmacológico , Protocolos Antineoplásicos , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estimativa de Kaplan-Meier , Masculino , Estadiamento de Neoplasias , Neuroblastoma/mortalidade , Prognóstico , Estudos Retrospectivos
9.
Zhonghua Bing Li Xue Za Zhi ; 48(9): 710-714, 2019 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-31495092

RESUMO

Objective: To investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of pediatric alveolar rhabdomyosarcoma (ARMS). Methods: The clinical and pathological data of 25 pediatric ARMS from 2008 to 2018 in Children's Hospital of Fudan University were collected. This histomorphology was assessed, and FOXO1 gene rearrangement was detected with FISH. The treatment details and outcome were analyzed. Results: There were 13 males and 12 females, with ages range from 19 days to 14 years (median 6 years, mean 6.2 years). The ARMS were located in the limbs (13 cases), head and neck (4 cases), trunk (3 cases), abdominal cavity (3 cases), scrotum (1 case) and perianal region (1 case). The ARMS were classified histologically as classic group (18 cases), solid group (5 cases) and embryonic-alveolar mixed group (2 cases). The typical pathological characteristics were small dark round cells arranged in solid, glandular and papillary patterns. The tumor cells expressed ALK (D5F3) (21/25, 84.0%), muscle origin DES (23/25, 92.0%), myogenin (22/25, 88.0%), MYOD1 (19/25, 76.0%), and in some cases they also expressed neurogenic marker Syn (6/25, 24.0%). FOXO1 gene rearrangement was detected by FISH in 24/25 cases (96.0%). Conclusion: Pediatric ARMS is rare and has unique clinicopathological characteristics, and needs to be differentiated from other common small round cell malignancies in children. ALK, DES, myogenin, MYOD1 immunohistochemistry and FOXO1 gene rearrangement are valuable aid in the diagnosis of ARMS.


Assuntos
Rabdomiossarcoma Alveolar , Rabdomiossarcoma Embrionário , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica , Lactente , Recém-Nascido , Masculino , Miogenina , Prognóstico
10.
Zhonghua Xue Ye Xue Za Zhi ; 40(8): 633-638, 2019 Aug 14.
Artigo em Chinês | MEDLINE | ID: mdl-31495128

RESUMO

Objective: To analyze the therapeutic effect of a modified LMB89 Group C regimen in the treatment of pediatric high-risk Burkitt lymphoma. Methods: The clinical data of 172 children with newly diagnosed high-risk Burkitt lymphoma from January 2007 to April 2017 were retrospectively analyzed. All the cases were treated with the modified LMB89 Group C regimen. Results: The median age of the patients was 6 (1-14) years. The sex ratio was 5.1∶1, 144 boys (83.7%) and 28 girls (16.3%) . According to St. Jude staging classification, 2 patients (1.2%) were in stage Ⅱ, 54 (31.4%) in stage Ⅲ and 116 (67.4%) in stage Ⅳ. Of them, 46 patients (26.7%) had mature B cell acute lymphoblastic leukemia (B-ALL) , and 52 patients had central nervous system (CNS) involvement. According to risk group, the patients can be divided into group C1 (CNS1, without testicles/ovaries involvement, n=65) , group C2 (CNS2, testicles/ovaries involvement, n=55) and group C3 (CNS3, n=52) . A total of 145 patients received rituximab combined with chemotherapy during the treatment, 10 patients suffered from progressive disease and died, and 5 patients relapsed. Treatment-related mortality was 2.9%. With a median follow-up of 36.0 (0.5-119.0) months, 3-year overall survival (OS) rate was (88.9±2.4) % and event free survival (EFS) rate was (87.9±2.6) % for all patients. 3-year EFS rates were (96.9±2.1) %, (90.9±3.9) % and (73.4±6.5) % for Group C1, C2 and C3 respectively, and that of Group C3 was significantly lower than that of Group C1 (χ(2)=12.939, P=0.001) and Group C2 (χ(2)=6.302, P=0.036) . The 3-year EFS rates were (79.3±6.8) % and (44.4±16.6) % for patients in group C3 treated with chemotherapy combined with rituximab and chemotherapy alone (χ(2)=5.972, P=0.015) . Multivariable Cox regression analysis showed that Stage Ⅳ (including B-ALL) , residual diseases in mid-term evaluation were independent unfavorable prognostic factors[HR=4.241 (95%CI 1.163-27.332) , P=0.026; HR=32.184 (95%CI 11.441-99.996) , P<0.001]. Conclusions: The modified LMB89 Group C regimen has ideal effect for the children with high-risk Burkitt lymphoma.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma de Burkitt , Adolescente , Linfoma de Burkitt/tratamento farmacológico , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos
11.
Zhonghua Xue Ye Xue Za Zhi ; 40(8): 644-649, 2019 Aug 14.
Artigo em Chinês | MEDLINE | ID: mdl-31495130

RESUMO

Objectives: To evaluate the clinical characteristics and prognosis of high risk cytogenetic abnormalities (HRCA) and various combinations of cytogenetic abnormality in patients with newly-diagnosed multiple myeloma (NDMM) . Methods: This retrospective study collected 182 NDMM patients in the First Affiliated Hospital of Jilin University between Nov. 2009 and May 2018. HRCA included 1q+, del (17p) , t (4;14) , and t (14;16) detected by FISH, and non-HRCA included del (13q) , t (11;14) detected by FISH. The clinical characteristics among three groups, including cases who carrying a single HRCA, 1 HRCA in combination with non-HRCA and cases carrying two or more HRCAs (double/triple-hit) were observed. Kaplan-Meier curve was used to analyze both progression-free survival (PFS) and overall survival (OS) for the three groups. Results: The survivals of patients with 1 HRCA in combination with non-HRCA were similar to those with two or more HRCAs (double/triple-hit) , the median PFS (mPFS) was 19.1 m vs 12.1 m (P=0.248) and median OS (mOS) was 29.6 m vs 29.3 m (P=0.774) . Furthermore, the prognosis of these two groups were both inferior to patients with a single HRCA, respectively. (mPFS: 32.2 m, P=0.040, P=0.001; mOS: 42.3 m, P=0.021, P=0.041) . Strikingly, both the mPFS and the mOS of patients with 1 HRCA in combination with non-HRCA (regardless of high risk or not) were significantly shorter than that of cases with a single HRCA (mPFS: 15.1 m vs 32.2 m, HR=2.126, 95%CI 1.176-3.843, P=0.005; mOS: 29.3 m vs 42.3 m, HR=1.442, 95%CI 0.705-2.950, P=0.011) . Conclusion: It is of prognostic significance value for detecting double/triple-hit based on FISH cytogenetics in NDMM.


Assuntos
Transtornos Cromossômicos , Mieloma Múltiplo , Aberrações Cromossômicas , Análise Citogenética , Humanos , Prognóstico , Estudos Retrospectivos
12.
Arq. bras. psicol. (Rio J. 2003) ; 71(2): 114-129, mai.-ago 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1015000

RESUMO

Essa pesquisa teve como objetivo construir um modelo preditor de stress para alunos concluintes do ensino médio de escolas públicas. A amostra foi composta por 620 estudantes, idade média de 18 (σ = 1,98) anos. Utilizou-se metodologia de corte transversal, quantitativo, tipo survey. Principais resultados: indivíduos pertencentes majoritariamente às classes B2 (27,9%) e C1 (25,04%); stress revelado em 55,92% e na fase de resistência 49,43%. Foram preditores de significância estatística: idade, presença de tabagismo, nota de aproveitamento médio e domínio psíquico da qualidade de vida. Conclui-se que o modelo parcimonioso de predição de stress no ambiente escolar foi validado internamente com satisfatória acurácia. Os escores apresentam potencial aplicação e replicação em programas de identificação e prevenção de stress no ambiente escolar


This research aimed to build a predictor of stress for high school graduates of public schools. Sample composed of 620 students, mean age of 18 (SD = 1.98) years. Cross-sectional, quantitative, survey-type methodology. Main results: individuals belonging mainly to class B2 (27.9%) C1 (25.04%); stress revealed in 55.92% and in the resistance stage 49.43%. Predictors of statistical significance were: age, presence of smoking, class average and psychic domain of quality of life. It is concluded that the parsimonious model of prediction of stress in the school environment was validated internally with satisfactory accuracy. The scores present potential application and replication in programs of identification and prevention of stress in the school environment


Esta investigación tuvo como objetivo construir un modelo predictor de estrés para los graduados de escuelas públicas secundarias. La muestra fue compuesta por 620 estudiantes con una edad media de 18 (σ = 1,98) años. Se utilizó metodología de corte transversal, cuantitativo, tipo survey. Principales resultados: individuos pertenecientes mayoritariamente a la clase B2 (27,9%) C1 (25,04%); el estrés revelado en el 55,92% y en la fase de resistencia el 49,43%. Los predictores de significación estadística fueron: edad, presencia de tabaquismo, nota de aprovechamiento medio y dominio psíquico de la calidad de vida. Se concluye que el modelo parsimonioso de predicción del estrés en el ambiente escolar fue validado internamente con una satisfactoria exactitud. Las puntuaciones presentan una posible aplicación y replicación en programas de identificación y prevención del estrés en el ambiente escolar


Assuntos
Humanos , Prognóstico , Estresse Psicológico , Estudantes , Ensino Fundamental e Médio
13.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 374-383, July-Aug. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1012347

RESUMO

Maximal oxygen uptake (VO2max) and both first (VT1) and second (VT2) thresholds have been used as reference points for exercise prescription in different populations. Objective: We aimed to test the hypothesis that exercise prescription, based on VTs determined by treadmill cardiopulmonary exercise testing (CPET), is influenced by the rate of increase in treadmill workload. Methods: Nine healthy individuals underwent two CPETs, followed by two sessions of submaximal exercise, both in randomized order. For the "speed" protocol, there was an increment of 0.1 to 0.3 km.h-1 every 15s. The "grade" incremental protocol increased 1% every 30s and 0.1 km.h-1 every 45s. This was followed by submaximal exercise sessions lasting 40min at an intensity corresponding to heart rate (HR) between the VT1 and VT2. Results: The "speed" protocol resulted in higher VT1 (p = 0.01) and VT2 (p = 0.02) when compared to the "grade" incremental protocol, but there was no effect on VO2max. The target HR for the submaximal exercise sessions was higher in the "speed" protocol compared to the "grade" incremental protocol (p < 0.01) and remained stable during the two steady-state exercise sessions. Blood lactate remained stable during the submaximal exercise sessions, with higher values observed during the "speed" protocol than those "grade" incremental protocol (p < 0.01). Conclusions: Compared to a grade-based protocol, a speed-based protocol resulted in higher VT1 and VT2, which significantly affected cardiorespiratory and metabolic responses to prescribed exercise intensity in healthy young adults


Assuntos
Humanos , Masculino , Feminino , Adulto , Tolerância ao Exercício , Teste de Esforço/métodos , Consumo de Oxigênio , Prognóstico , Doenças Cardiovasculares/diagnóstico , Exercício , Protocolos/métodos , Eletrocardiografia/métodos , /métodos , Frequência Cardíaca
14.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 396-407, July-Aug. 2019. graf, ilus
Artigo em Inglês | LILACS | ID: biblio-1012340

RESUMO

The use of technology has increased tremendously, by means of more reliable, smaller, more accessible and specially more user-friendly devices, which provide a wider range of features, and promote significant benefits for the population and health professionals. It is in this context that monitors and apps for heart rate (HR) measurement have emerged. HR is a clinical vital sign of diagnostic and prognostic importance. In response to body movement, HR tends to increase, in a direct relationship with the intensity of exercise. HR was primarily measured by the count of arterial pulse, and recently, HR can be precisely measured by monitors, bracelets and smartphone apps capable to perform real-time measurements and storage of data. This paper aimed to make a brief and updated review on the theme, providing a broader view of advantages and limitations of these resources for HR measurement in exercise. HR monitors and apps use basically two types of technology, optical sensor (photoplethysmography) and electrical signal from the heart. In general, these devices have shown good accuracy in measuring HR and HR variability at rest, but there are differences between brands and models considering the type, mode and intensity of exercise. HR measurements by monitors and smartphone apps are simple, accessible and may help cardiologists in the monitoring of the intensity of aerobic exercise, focusing on health promotion and on primary and secondary prevention of cardiovascular diseases


Assuntos
Humanos , Masculino , Feminino , Palpação/métodos , Exercício , Monitores de Aptidão Física , Frequência Cardíaca , Arritmias Cardíacas , Prognóstico , Esportes , Débito Cardíaco , Doenças Cardiovasculares/diagnóstico , Tecnologia Biomédica , Teste de Esforço/métodos
16.
Anticancer Res ; 39(8): 4019-4022, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366483

RESUMO

Historically, analysis of intragastric exfoliative cytology (IEC) of gastric cancer (GC) was used with a diagnostic intent only. With the successful advent of endoscopic biopsy, the rate of detection of GC has improved worldwide and, as a consequence, IEC has been progressively abandoned. Today, however, there is a renewed interest in this field of research, as witnessed by several pertinent publications. As discussed in this review, in fact, currently the importance of analyzing IEC in patients with early and advanced GC seems to reside in its clinicopathological and prognostic significance. In fact, compared to non-sloughing tumors, GC exhibiting intragastric exfoliation was recently associated with an aggressive tumor phenotype (characterized by deeper infiltration of the gastric wall, lymph nodal or distant metastases, angiolymphatic and perineural invasion) and poorer prognosis. Adoption of IEC examination in routine practice might help identify patients at higher risk of developing local recurrence and peritoneal metastasis from early and advanced GC, optimizing their treatment and improving quality of life and life expectancy.


Assuntos
Citodiagnóstico/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Estômago/diagnóstico por imagem , Endoscopia , Humanos , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Peritônio/diagnóstico por imagem , Peritônio/patologia , Prognóstico , Estômago/patologia , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia
17.
Anticancer Res ; 39(8): 4085-4093, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366492

RESUMO

BACKGROUND/AIM: The identification of novel prognostic biomarkers for melanoma metastasis is essential to improve patient outcomes. To this aim, we characterized miRNA expression profiles in relation to metastasis in melanoma and correlated miRNAs expression with clinical-pathological factors. MATERIALS AND METHODS: MiR-145-5p, miR-150-5p, miR-182-5p, miR-203-3p, miR-205-5p and miR-211-5p expression levels were analyzed in primary cutaneous melanomas, including thin and thick melanomas, and in melanoma metastases by quantitative Real-Time PCR. RESULTS: A significantly lower miR-205-5p expression was found in metastases compared to primary melanomas. Furthermore, a progressive down-regulation of miR-205-5p expression was observed from loco-regional to distant metastasis. Significantly lower miR-145-5p and miR-203-3p expression levels were found in cases with Breslow thickness >1 mm, high Clark level, ulceration and mitotic rate ≥1/mm2 Conclusion: Our findings point to miR-205-5p as potential biomarker of distant metastases and to miR-145-5p and miR-203-3p as markers of aggressiveness in melanoma.


Assuntos
Melanoma/genética , MicroRNAs/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Neoplasias Cutâneas/patologia
18.
Anticancer Res ; 39(8): 4143-4147, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366499

RESUMO

BACKGROUND/AIM: Vitamin D analogs have a protective effect on carcinogenesis in humans. Since vitamin D receptor (VDR) is detected in many histotypes of cancer, this study evaluated the role of VDR expression in endometrioid carcinoma. MATERIALS AND METHODS: Tumor samples were collected from 60 patients who had undergone surgery, and the pattern of VDR expression assessed in tissue microarray (TMA) blocks of tumor samples. When VDR expression in the cytoplasm was higher than that in the nucleus, this was noted as 'displacement'. Using statistical analysis, the relationship between VDR expression and clinicopathological factors was evaluated. RESULTS: Immunohistochemical staining of nuclear VDR was as follows: Negative: 32 (53.3%); mild: 13 (21.7%); moderate: 14 (23.3%); strong: 1 (1.7%). For cytoplasmic VDR expression: Negative: 2 (3.3%); mild: 19 (31.7%); moderate: 31 (51.7%); strong: 7 (11.7%). VDR displacement was found in 42 (70%) cores. VDR displacement was significantly positively correlated with endometrioid carcinoma having lower histological grade (1, p=0.03). CONCLUSION: Displacement of VDR was significantly correlated with lower histological grade. Clinicians might be able to predict prognosis and decide therapies related to vitamin D analogs using this remarkable biomarker for endometrial carcinoma.


Assuntos
Carcinogênese/genética , Carcinoma Endometrioide/genética , Prognóstico , Receptores de Calcitriol/genética , Adulto , Idoso , Carcinoma Endometrioide/patologia , Citoplasma/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Análise Serial de Tecidos , Vitamina D/genética
19.
Anticancer Res ; 39(8): 4185-4190, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366504

RESUMO

BACKGROUND/AIM: Insulin-like growth factor 1 (IGF-1)-mediated molecular pathway has been implicated in non-small cell lung cancer (NSCLC) pathogenesis and progression. We aimed to evaluate serum levels of IGF-1, IGF-2 and IGF-binding protein 3 (IGF-BP3) before and after standard treatment in patients with advanced NSCLC and their prognostic and predictive correlations. PATIENTS AND METHODS: Seventy-three patients were prospectively included. Analysis and quantification of circulating levels of IGF1, IGF2, IGFBP3 were performed by total ELISA in peripheral blood samples at baseline and 3 months post-treatment. RESULTS: The median values of IGF-1 and IGF-1/IGF-BP3 ratios (125.82 vs. 133.4 ng/ml, p=0.087 and 0.01006 vs. 0.01252, p=0.011) were both decreased after treatment. Importantly, the post-treatment value of the ratio was significantly reduced only among responders to treatment (0.01044 from 0.01255, p=0.02). CONCLUSION: Reduction of IGF-1/IGF-BP3 ratio was statistically significant only among patients with NSCLC who responded to first-line treatment. If validated in larger cohorts, IGF-1/IGFBP3 might be a useful predictive tool for response to chemotherapy in NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/sangue , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Fator de Crescimento Insulin-Like II/genética , Fator de Crescimento Insulin-Like I/genética , Idoso , Biomarcadores Tumorais/sangue , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pemetrexede/administração & dosagem , Prognóstico , Proteínas Recombinantes , Transdução de Sinais/efeitos dos fármacos
20.
Anticancer Res ; 39(8): 4273-4277, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366517

RESUMO

BACKGROUND/AIM: For treatment of brain metastases, a patient's survival prognosis should be considered. Existing survival scores appear complex and require complete tumor staging. For many patients, a faster and simpler tool would be helpful. PATIENTS AND METHODS: This retrospective study investigated the prognostic value of the number of pre-treatment symptoms plus eight other factors on survival of patients irradiated for brain metastases. Other factors included whole-brain radiotherapy (WBRT) regimen, age, gender, performance score, primary tumor type, number of brain metastases, extracranial metastases, and interval between cancer diagnosis and WBRT. RESULTS: The number of symptoms (p=0.002) and all other factors were significantly associated with survival on univariate analyses. On multivariate analysis, all factors but the number of symptoms (p=0.47) and primary tumor type (p=0.48) were significant. CONCLUSION: Since the number of symptoms was not an independent predictor of survival, it cannot replace existing scoring tools and may only serve for orientation.


Assuntos
Neoplasias Encefálicas/radioterapia , Neoplasias/radioterapia , Prognóstico , Idoso , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/secundário , Irradiação Craniana/efeitos adversos , Feminino , Humanos , Avaliação de Estado de Karnofsky , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/classificação , Neoplasias/patologia
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