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1.
Anticancer Res ; 39(10): 5345-5352, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570428

RESUMO

BACKGROUND/AIM: Accurate and timely assessment of the human epidermal growth factor receptor 2 (HER2/neu) overexpression is pivotal for the identification of breast cancer (BC) patients that could benefit from HER2-targeted therapy. Currently approved tissue-based HER2 assays (tHER2) are limited to testing HER2 status on tumor samples obtained at a few points in time during the course of the disease. Herein, we assessed serum HER2 (sHER2) status longitudinally in 81 serial samples prospectively collected from 43 consenting patients pre- and post-therapy to revisit the idea of serum testing in the follow-up of BC patients. PATIENTS AND METHODS: The cohort included 11 patients with early BC (EBC), 17 with locally advanced BC (LABC), and 15 with metastatic BC (MBC). sHER2 concentrations were measured using a quantitative ELISA-based technique, using 15 ng/ml as the cut-off for positivity. RESULTS: At baseline, sHER2 was negative in all EBC patients while positive in 1 LABC and 5 MBC patients. Sixteen BC patients (10 LABC, 1 EBC, and 5 MBC) were tHER2 positive. sHER2 and tHER2 results were discordant in 14 patients. Among the 16 tHER2 positive patients, 9 LABC, 1 EBC and 2 MBC patients were sHER2 negative. Conversely, 2 MBC patients were sHER2 positive, despite being tHER2 negative. A rise or drop of sHER2 by >20% correlated with disease progression or pathological response to therapy, respectively. CONCLUSION: The study demonstrated the technical validity and feasibility of the sHER2 assay. Findings suggest that post initial tissue diagnosis (tHER2), sHER2 assay may supplement subsequent tissue tests to monitor disease status and response to therapy. Further studies to assess the role of HER2 targeted therapies in sHER-positive/tHER2-negative cases upon disease progression are warranted.


Assuntos
Neoplasias da Mama/sangue , Receptor ErbB-2/sangue , Biomarcadores Tumorais/sangue , Neoplasias da Mama/patologia , Progressão da Doença , Feminino , Humanos , Oncogenes/genética , Projetos Piloto
2.
Anticancer Res ; 39(10): 5551-5557, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570449

RESUMO

BACKGROUND/AIM: Digestive system cancers are the leading cause of cancer mortality and have poor survival particularly in men. The study aimed to assess the association between pre-diagnosis cardiorespiratory fitness (CRF) and cancer mortality in a pilot sample of men who developed digestive system cancers. PATIENTS AND METHODS: Pre-diagnosis CRF (treadmill exercise test) was assessed in 342 men (68.9±21.8 years) who developed digestive system cancers during 6.7±5 years from baseline evaluation. Cox multivariable hazard models were analyzed for total cancer mortality. RESULTS: During 7.2±5 years follow-up from baseline, 120 participants died from cancer. Compared to low CRF, moderate and high CRF levels were associated with 57% [0.43, 95%CI=0.24-0.74] and 73% [0.27, 95%CI=0.12-0.59] reduced risks for cancer mortality, respectively (p trend=0.002). Survival time from baseline was longer among those with moderate [13.5 (range=12.1-14.9) years] and high [16.1 (range=14.0-18.2) years] compared to low CRF [7.9 (range=5.7-10.1) years]. CONCLUSION: Higher pre-diagnosis CRF is independently associated with lower risk of cancer mortality and longer survival in men who later developed digestive system cancers.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Neoplasias do Sistema Digestório/mortalidade , Neoplasias do Sistema Digestório/fisiopatologia , Idoso , Índice de Massa Corporal , Teste de Esforço/métodos , Humanos , Masculino , Projetos Piloto , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
3.
Medicine (Baltimore) ; 98(39): e16997, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574798

RESUMO

This study aimed to determine the association between different lymphocyte subsets and cytomegalovirus (CMV) infection status in patients with systemic lupus erythematosus (SLE). We performed a retrospective study among SLE patients with CMV infection and collected patient socio-demographic and clinical characteristics, as well as their recorded circulating lymphocyte subsets. Univariate and multivariable logistic regression analyses examined the relationship between CMV infection status and lymphocyte subset counts. We included 125 hospitalized patients with SLE, consisting of 88 with documented CMV infection and 37 without any evidence of CMV or other infections. Among the 88 CMV-infected patients, 65 (73.8%) patients developed CMV disease and 23 (26.2%) presented as CMV viremia. Compared to uninfected patients (1520 ±â€Š101 cells/µL), lymphocytes remained stable among those with CMV viremia (1305 ±â€Š272 cells/µL, P = .995). However, compared to their uninfected counterparts, there was a marked decrease in lymphocytes among patients with CMV disease (680 ±â€Š513 cells/µL, P < .001). Analysis of lymphocyte subsets via flow cytometry showed that CD4+ T cell, CD8+ T cell, and natural killer cell counts were lower among those with CMV disease compared to those with CMV viremia and those without infection. Further, multivariable analysis showed that total lymphocyte (odds ratio [OR] 0.999, 95% confidence interval [CI] 0.998-1.000, P = .007) and CD4+ T cell counts (OR 0.99, 95% CI 0.992-0.998, P = .003) were negatively associated with CMV disease. Our findings support a potential inverse relationship between lymphopenia, specifically CD4+ T-cell lymphopenia, and CMV disease among hospitalized SLE patients.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Subpopulações de Linfócitos , Viremia/diagnóstico , Adulto , Sedimentação Sanguínea , Estudos de Casos e Controles , Feminino , Humanos , Contagem de Linfócitos , Linfopenia/complicações , Masculino , Projetos Piloto , Estudos Retrospectivos
4.
Bratisl Lek Listy ; 120(9): 630-635, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475544

RESUMO

OBJECTIVES: To test the hypothesis if mitochondrial bioenergetic function analyzed in circulating platelets may represent peripheral signature of mitochondrial dysfunction in nephropathy associated to non-communicable human diseases such as cardiovascular diseases, diabetes and with statins treatment. METHODS: High-resolution respirometry was used for analysis of mitochondrial bioenergetics in human platelets isolated from peripheral blood. This method is less-invasively compared to skeletal muscle biopsy. Patients with nephropathies and in combination with non-communicable diseases were included in the study. RESULTS: This pilot study showed platelet mitochondrial bioenergy dysfunction in patients with nephropathies and non-communicable diseases. Positive effect of treatment with 10 mg atorvastatin on platelet mitochondrial respiratory chain Complex I-linked respiration and ATP production in patients with nephropathies, diabetes and 80 mg atorvastatin in patient with nephropathy and dialysis was found. Positive effect of 80 mg fluvastatin treatment, and negative effect of thrombocytopenia and renal transplantation on platelet mitochondrial bioenergy was determined. CONCLUSION: High-resolution respirometry allowed detection of small changes in platelet mitochondrial function. This method could be used as a sensitive bioenergetic test of mitochondrial function for diagnosis and monitoring the therapy in patients with nephropathy (Tab. 1, Fig. 3, Ref. 39).


Assuntos
Plaquetas/metabolismo , Metabolismo Energético , Nefropatias/metabolismo , Mitocôndrias/metabolismo , Doenças não Transmissíveis , Respiração Celular , Humanos , Projetos Piloto
5.
J Dent Educ ; 83(9): 1057-1064, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31477584

RESUMO

Pipeline programs aim to increase the representation of underrepresented minorities in the dental profession. At New York University College of Dentistry (NYUCD), two dental students initiated the development of a pipeline program for high school students called Saturday Academy. The purpose of the program is twofold: to mentor and coach underrepresented minority and low-income high school students through the college application process, and to expose them to the field of dentistry as a viable career option through both didactic and hands-on learning. The aim of this pilot study was to determine outcomes for the first five years (2013-17) of the Saturday Academy pipeline program at NYUCD with regard to the high school students' experience with the program and their career interests after high school graduation. Across five cohorts, a total of 82 students participated in Saturday Academy. A "where are you now?" survey sent to 72 participants who reported high school graduation years between 2013 and 2018 received a response rate of 76%. The survey results showed that all (100%) of the responding Saturday Academy participants had graduated from high school and were enrolled in college, and 71% were interested in health profession careers. Almost half (47%) of the students self-identified as being pre-dental, and 96% reported that Saturday Academy had increased their interest in the dental profession. These pilot results justified an expansion of Saturday Academy at NYUCD in both size and creation of an alumni outreach initiative. Other dental schools may benefit from the strategies used by this program in establishing or expanding their pipeline programs.


Assuntos
Escolha da Profissão , Odontologia , Educação em Odontologia , Faculdades de Odontologia , Estudantes de Odontologia/estatística & dados numéricos , Estudantes/psicologia , Feminino , Ocupações em Saúde , Humanos , Masculino , Grupos Minoritários/estatística & dados numéricos , Saúde das Minorias , New York , Projetos Piloto , Pobreza , Instituições Acadêmicas , Inquéritos e Questionários , Universidades
7.
Isr Med Assoc J ; 21(8): 538-541, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474016

RESUMO

BACKGROUND: Travelers' diarrhea (TD) is frequently encountered in people traveling from high-income to low-income countries; however, its epidemiology in those traveling between high-income countries is not known. OBJECTIVES: To evaluate the incidence of diarrhea in North American students relocating to Israel. METHODS: A retrospective cohort study involving medical students from the United States and Canada relocating to Israel was conducted. Students who relocated to Israel during 2010-2016 were contacted by email to participate in an anonymous survey. Data included demographic information as well as occurrence, timing, duration, and outcome of diarrhea after relocation. RESULTS: Ninety-seven students participated in the survey. Most (93.7%) students relocated from the United States or Canada. The period-prevalence of diarrhea was 69.1%. The incidence of diarrhea declined from 34.8 cases per 100 student-months during the first month after relocation to 1.3 cases per 100 student-months after 1 year. The duration of diarrhea was up to 1 week in 72.7%. Students who reported diarrhea were younger than students who did not (mean age 24.0 ± 2.2 and 28.4 ± 1.8 years, respectively, P < 0.001). No other demographic parameter was significantly associated with a higher likelihood of diarrhea. CONCLUSIONS: A high proportion of North American medical students relocating to Israel reported diarrhea with clinical and epidemiological features similar to classic TD. Further studies are needed to elucidate the causative agents of TD in Israel.


Assuntos
Diarreia/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Doença Relacionada a Viagens , Doença Aguda , Adulto , Canadá/etnologia , Estudos de Coortes , Diarreia/etnologia , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Projetos Piloto , Estudos Retrospectivos , Viagem , Estados Unidos/etnologia , Adulto Jovem
8.
Pan Afr Med J ; 33: 132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558931

RESUMO

Introduction: Studies have reported that emergency medical care practitioners (EMCPs) encounter challenges when attending to psychiatric emergencies. The EMC provider's ability to understand, assess and manage psychiatric emergencies has been reported to be poor due to limited knowledge and insufficient training. In South Africa (SA), little is known about the knowledge of EMCPs on pre-hospital management of psychiatric emergencies. The objective of this study was to assess the knowledge of EMCPs working in the Free State province on aspects of pre-hospital management of psychiatric emergencies. Methods: This descriptive study used a questionnaire survey to obtain data on the knowledge of EMCPs on aspects of pre-hospital management of psychiatric emergencies. Results: Only 159 of the initial 192 questionnaires distributed were returned, giving a response rate of 82.8%. The majority (87.4%) of the participants reported inadequate knowledge of pre-hospital management of psychiatric emergencies. More than a third of the participants reported that they are not knowledgeable on how to assess a psychiatric patient (P < 0.01), 64.2% and 73.6% (P < 0.001 in both cases) could not perform mental status examination and lack the knowledge of crisis intervention skills for managing a psychiatric emergencies. The majority (76.7%; P < 0.001) of the participants are not conversant with the Mental Health Care Act 2002 (Act no. 17 of 2002). Finally, participants (94.3% and 86.8%, respectively; P < 0.001) agree that teaching and prior exposure to a psychiatric facility, as in work integrated learning, will empower EMC graduates with skills required to effectively manage psychiatric emergencies. Conclusion: EMC practitioners are often the first healthcare professionals arriving at any scene of medical emergencies including psychiatric emergencies. To avoid malpractices, which could be detrimental to patient's health, it is of utmost importance that EMCPs are well trained and equipped to manage any form of medical emergency including those involving psychiatric patients.


Assuntos
Serviços Médicos de Emergência/métodos , Socorristas/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/terapia , Adulto , Competência Clínica , Emergências , Serviços Médicos de Emergência/normas , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Projetos Piloto , África do Sul , Inquéritos e Questionários , Adulto Jovem
9.
Ann Agric Environ Med ; 26(3): 472-478, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559806

RESUMO

INTRODUCTION: Winter pruning is a cultivation practice necessary for maintaining the balance between the vegetative and the productive activity of plants and requires many working days using hand scissors. This operation involves the subjects carrying out a series of gestures that are repeated with considerable frequency, which are all musculo-skeletal disorders risk factors (MSDs) for the hand-wrist area. OBJECTIVE: The aim of this study was to investigate the forces applied to pruning tools. MATERIAL AND METHODS: Using a sensor matrix, peak and average forces were measured which are exerted while cutting branches of 3 different diameters, from 5 wine-grape cultivars. Samples were tested on 8 participants using sensored scissors to record, in 6 hand areas, the forces necessary to cut. RESULTS: Results showed that while cutting, the factors which can impact the force employed (peak and average forces) by the subjects are branch diameter and percentage of branch humidity. Cut duration was inversely related to the size of the subject's hand. The middle finger area of the hand recorded the highest force average and peak levels, while the hand region least affected during the cuts was the farthest from the thumb. CONCLUSIONS: The study enabled the highlighting of which factors influence the forces employed by the operator while cutting grape branches, and to identify the hand regions where muscle activation is at its most. These findings can be relevant in preventing MSDs. Further studies need to be conducted with a larger number of subjects.


Assuntos
Agricultura/instrumentação , Mãos/fisiologia , Adulto , Fenômenos Biomecânicos , Força da Mão , Humanos , Masculino , Músculo Esquelético/química , Músculo Esquelético/fisiologia , Projetos Piloto
10.
Ann Agric Environ Med ; 26(3): 489-495, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559809

RESUMO

INTRODUCTION AND OBJECTIVE: Deficits of vitamin resources constitute a significant public health problem, especially among the elderly population. The aim of the research was to determine the level of vitamin 25 (OH) D and vitamins from group B in the chronically ill elderly in domiciliary care, depending on functional capacity and coexisting diseases. MATERIAL AND METHODS: The pilot study included 137 patients staying in long-term domiciliary care. Samples of the participants' venous blood was obtained for laboratory tests. Centrifuged serum was used to determine the level of the following biochemical parameters: vitamin 25 (OH)D, B12, folic acid and total protein, albumin, triglycerides, total cholesterol and HDL cholesterol. Assessment of the functional status of patients was made by using the Barthel scale. RESULTS: More than ¾ of the patients with functional deficit (according to Barthel's score 0-85 points) were deficient in vitamin 25 (OH)D, while folic acid values were below the reference values in more than half of the patients. Respondents with lower functional efficiency were characterised by a reduced average value of vitamin 25 (OH)D and folic acid. CONCLUSIONS: The studied group of the chronically ill elderly was characterised by a deficiency of vitamin D3 and folic acid. Subjects with a functional impairment deficit show a reduced mean value of vitamin 25 (OH)D and folic acid in the blood serum, compared to the group of patients with higher mobility.


Assuntos
Envelhecimento/sangue , Doença Crônica/terapia , Vitamina B 12/sangue , Vitamina D/sangue , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Feminino , Ácido Fólico/sangue , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Locomoção , Masculino , Atividade Motora , Projetos Piloto , Triglicerídeos/sangue
11.
Am J Occup Ther ; 73(5): 7305205020p1-7305205020p10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484026

RESUMO

IMPORTANCE: There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties. OBJECTIVE: To pilot test the first part of the Let's Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders. DESIGN: One-group pretest-posttest design with 3-mo follow-up. SETTING: Outpatient psychiatric and habilitation settings. PARTICIPANTS: Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life. INTERVENTION: Swedish version of Let's Get Organized (LGO-S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr. OUTCOMES AND MEASURES: Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS-S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure. RESULTS: Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS-S results were sustained at 3-mo follow-up. CONCLUSION AND RELEVANCE: LGO-S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further. WHAT THIS ARTICLE ADDS: This study shows that LGO-S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.


Assuntos
Terapia Ocupacional , Gerenciamento do Tempo , Função Executiva , Humanos , Terapia Ocupacional/métodos , Projetos Piloto , Suécia , Gerenciamento do Tempo/métodos
12.
Codas ; 31(4): e20180181, 2019 Aug 29.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31482997

RESUMO

PURPOSE: To measure listening effort using of a dual-task paradigm of working memory and analyze the clinical significance of the normal-hearing individuals' performance. METHODS: Participants were 10 young adults with similar socio-cultural level, aged 18-30 years, of both genders, classified as normal-hearing individuals based on the quadritonal average (500, 1000, 2000 and 4000 Hz). The participants were submitted to audiological anamnesis, meatoscopy, and pure tone audiometry. Listening effort was measured using a dual-task paradigm comprising the tasks of speech perception and working memory with logatomes, real words, and meaningless sentences. Prior to measurement, the dual-task paradigm was carried out in audiometric booth in order to train the participants to perform the tasks properly. After the training stage, this paradigm was conducted under two different hearing situations with white noise: signal-to-noise ratios of +5 and -5dB. RESULTS: Performance comparison per ear, right or left, for the two signal-to-noise ratios significantly influenced the speech perception tasks with logatomes and meaningless sentences in both ears; however, significant difference was observed only for the right ear in the tasks of listening effort and working memory. CONCLUSION: Listening effort can be measured using the paradigm proposed, and this instrument was proven sensitive for the quantification of this auditory parameter.


Assuntos
Estimulação Acústica/métodos , Percepção Auditiva/fisiologia , Percepção da Fala/fisiologia , Adolescente , Adulto , Audiometria de Tons Puros , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Projetos Piloto , Valores de Referência , Razão Sinal-Ruído , Análise e Desempenho de Tarefas , Adulto Jovem
13.
Codas ; 31(4): e20180218, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31483043

RESUMO

PURPOSE: To develop a short educational program about aphasia (SEPA) for family caregivers of people with aphasia and verify its effect in their burden and quality of life. METHODS: This is a quantitative experimental study. The participants included in the study were family caregivers of people with aphasia. They completed the Zarit interview scale and WHOQOL-Bref instruments pre- and post-intervention. The intervention was a short educational program about aphasia, administered in a group setting and conducted in two didactic sessions. RESULTS: Four participants were included in the study. In the group analysis, there was no significant difference in any measure. However, looking into the individual performances, all participants presented a trend for improvement in most of the scores. CONCLUSION: Possibly, family caregivers of people with aphasia might benefit from the SEPA. It would be relevant for future studies to include larger samples and consider new strategies to improve inclusion of participants.


Assuntos
Afasia/psicologia , Cuidadores/psicologia , Educação em Saúde/métodos , Qualidade de Vida , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos
14.
Pan Afr Med J ; 33: 103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489081

RESUMO

Introduction: Foot deformities and amputations are parameters that have been studied as risk factors for diabetic foot ulceration (DFU). However, inclusion of "foot deformities" and "amputations" in a single, broad variable and with reference to the severity of these deformities, may better characterize subjects who are prone to develop DFU. Methods: The objective of the study was the examination of amputative and non-amputative foot deformities severity as risk factor for DFU in relation with the other established risk factors. A cross-sectional and case-control study was conducted from October 2005 to November 2016. One hundred and thirty-four subjects with type 1 and 2 diabetes, with and without active foot ulcers, participated. A structured quantitative interview guide was used. Univariate logistic regression analysis for the literature's established risk factors was performed, as well as for two versions of the "amputative and non-amputative foot deformities severity" variable. Subsequently, multivariate logistic regression analysis (MLRA) for three models and receiver operating characteristic (ROC) curve analysis were carried out. Results: From the MLRA, only PAD (peripheral arterial disease) was significant (OR 3.56, 95% CI 1.17-10.82, P=0.025 and OR 3.33, 95% CI 1.02-10.08, P=0.033). Concerning the ROC curve analysis of the models, the one with the three categories amputative and non-amputative foot deformities severity variable, had the greatest area under the ROC curve (0.763, P<0.001). Conclusion: A united variable for lower extremity amputations and other foot deformities with reference to their severity, could be more helpful to the clinicians in identifying patients with diabetes at risk for foot ulceration.


Assuntos
Amputação/estatística & dados numéricos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/epidemiologia , Deformidades do Pé/epidemiologia , Idoso , Estudos de Casos e Controles , Estudos Transversais , Pé Diabético/etiologia , Feminino , Humanos , Modelos Logísticos , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Projetos Piloto , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença
15.
Anticancer Res ; 39(9): 4897-4903, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519593

RESUMO

BACKGROUND/AIM: Endometrial hyperplastic polyps (EHP) may progress to endometrial carcinoma (EC) if left untreated. We aimed to prospectively investigate the efficacy of the low-dose levonorgestrel intrauterine system (LNG-IUS) as therapy for EHP with malignant potential. PATIENTS AND METHODS: In total, 37 women with EHP underwent therapy with LNG-IUS containing 13.5 mg levonorgestrel for six months or 4-10 weeks depending on whether the EHP was characterized (by D-score analysis) as low- to medium-risk (n=33) or high-risk (n=4) of coexistent or future EC. Therapy response was defined as complete clearance of hyperplastic glands in post-therapy endometrial biopsy. RESULTS: All women with low- to medium-risk EHP obtained therapy response, whereas only 1 out of 4 with high-risk EHP responded to therapy. None of the women were diagnosed with EC during the study and no serious adverse events occurred. CONCLUSION: Low-dose LNG-IUS represents a promising therapy for selected women with EHP.


Assuntos
Antineoplásicos Hormonais/administração & dosagem , Hiperplasia Endometrial/tratamento farmacológico , Hiperplasia Endometrial/patologia , Pólipos/patologia , Lesões Pré-Cancerosas/tratamento farmacológico , Lesões Pré-Cancerosas/patologia , Progestinas/administração & dosagem , Adulto , Idoso , Biomarcadores , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Progestinas/efeitos adversos , Estudos Prospectivos , Resultado do Tratamento
16.
Gene ; 720: 144081, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31473322

RESUMO

Despite the existing research, the etiology of rheumatoid arthritis (RA), an autoimmune disease remains poorly understood with early and accurate diagnosis difficult to achieve. MicroRNAs (miRNAs) play an important role in biological processes as modulators of transcription and translation. Previous studies have demonstrated a downregulation of several genes in early RA stages and in addition, miRNAs may serve as early biomarkers of subclinical changes in early RA. When comparing the four groups (ANOVA P < 0.01, fold change > 4), we found 253 differentially expressed miRNAs. Of these, 97 miRNAs were identified as overexpressed in early rheumatoid arthritis. The validation of miRNA microarray expression was performed in a set by RT-qPCR and showed strong agreement with microarray expression data. The putative targets of overexpressed microRNAs in early RA were significantly enriched in apoptosis, tolerance loss and Wnt pathways. Moreover, ROC analysis showed values of AUC 0.76 and P < 0.05 for miR 361-5p, identifying this miRNA as a potential biomarker of disease. We identified specific microRNAs associated with early rheumatoid arthritis and proposed them as early biomarkers of disease. Our results provide novel insight into immune disease physiopathology and describe unreported microRNAs in RA with potential for clinical use.


Assuntos
Artrite Reumatoide/genética , Biomarcadores/análise , Genoma Humano , MicroRNAs/genética , Adulto , Artrite Reumatoide/patologia , Estudos de Casos e Controles , Feminino , Perfilação da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Curva ROC
17.
Medicine (Baltimore) ; 98(37): e17039, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517823

RESUMO

BACKGROUND: Climacteric women experience various disorders, including hot flush, depression, insomnia, arthralgia, and hand and foot numbness. Dangguijakyaksan is among the most common treatments for climacteric syndrome, and its effect on depression, insomnia, hot flush and quality of life (QOL) in climacteric women has been reported multiple times. A recent animal study found dangguijakyaksan decreased serum lipid factors and improved blood circulation in a menopausal rat model; however, these effects have not been assessed in clinical trials. This study aims to assess the clinical effects and safety of dangguijakyaksan for lower-extremity blood circulation disturbances in climacteric women. METHODS: This is a single-center, randomized, double-blinded, placebo-controlled pilot study that will be conducted at Dunsan Korean Medicine Hospital at Daejeon University. Forty-six climacteric women with lower-extremity blood circulation disturbances will be recruited and randomized (1:1) into either the dangguijakyaksan or placebo group. After 8 weeks of administration, the effects and safety of dangguijakyaksan will be assessed.The primary outcome is the visual analogue scale for lower-extremity blood circulation disturbances, and it will be assessed on visits 1, 2, and 3. The secondary outcomes, Kupperman's index and blood deficiency scoring system, will be assessed on visits 1, 2, and 3, and accelerated photoplethysmography and digital infrared thermal imaging will be performed on visits 1 and 3. Moreover, blood lipid profile, follicle-stimulating hormone, and estradiol levels will be measured at the screening visit and visit 3. Blood tests will be performed at the screening visit and visit 3 to assess the safety of dangguijakyaksan. Statistical analysis will be performed using R-3.3.3 (Another Canoe), and within-group study variable differences after drug administration will be analyzed using paired t-test or Wilcoxon signed-rank test. DISCUSSION: We expect to confirm the effects and safety of dangguijakyaksan on lower-extremity blood circulation disturbances in menopause, which would provide foundational data for planning subsequent studies.


Assuntos
Circulação Sanguínea/efeitos dos fármacos , Fármacos Cardiovasculares/uso terapêutico , Climatério , Medicamentos de Ervas Chinesas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Duplo-Cego , Feminino , Humanos , Extremidade Inferior , Pessoa de Meia-Idade , Projetos Piloto
18.
Stud Health Technol Inform ; 264: 1891-1892, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438393

RESUMO

We piloted a Spanish and English survey on data privacy. Thirty-one Latino behavioral health patients completed the survey in person with a preference for paper (78%) over electronic questionnaire. Dialect variations across Latino countries and the lack of tools to assess reading level in Spanish affected comprehension. Our experience will help others address similar tasks more effectively and encourage inclusion of Latino populations in future research.


Assuntos
Inquéritos Epidemiológicos , Hispano-Americanos , Privacidade , Humanos , Linguagem , Projetos Piloto
19.
Stud Health Technol Inform ; 264: 1929-1930, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438412

RESUMO

Over 3 million hospitalizations and 17 million ER visits occur in Canada each year. A substantial proportion of these encounters are preventable and attributable to medication non- adherence. Non-adherence to medication changes during discharge increases the risk of adverse events post-discharge. A mobile application was developed to improve medication management of post-discharge patients. A pilot randomized controlled trial was conducted to assess the application's usability and efficacy in decreasing non-adherence to medication changes made at discharge.


Assuntos
Aplicativos Móveis , Alta do Paciente , Canadá , Humanos , Adesão à Medicação , Projetos Piloto
20.
Stud Health Technol Inform ; 264: 1935-1936, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438415

RESUMO

This pilot study aimed to provide students with a learning activity to develop a global perspective of health care. Senior nursing students from New Zealand and the United Kingdom (n=15) were allocated to eNetwork small-groups. Students met weekly for one month via audio/video-conferencing for discussions. Students reported that this collaborative activity enabled them to engage purposefully with other students. While cultural differences were noted, similarities were also found and multiplestudents expressed interest in working overseas.


Assuntos
Pessoal de Saúde , Humanos , Nova Zelândia , Projetos Piloto , Estudantes de Enfermagem , Reino Unido
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