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J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022. ilus
Artigo em Português | LILACS | ID: biblio-1368288


Introdução: Osteogênese Imperfeita (OI) é uma doença genética rara com fragilidade óssea. A classificação inclui muitos tipos. Além do risco de recorrência, o manejo pode variar com o tipo de OI. Relato do caso: Apresentamos um paciente do sexo masculino nascido com 39 semanas, de pais não consanguíneos e saudáveis. A hidrocefalia foi diagnosticada no pré-natal. Com 50 dias de vida, detectamos muitas fraturas e calos ósseos. O teste molecular identificou uma deleção em homozigose do éxon 4 do gene WNT1. Considerações finais: Concluímos que o caso apresentado tinha características clínicas de OI XV, e o teste molecular foi fundamental para o diagnóstico preciso e aconselhamento genético.

Introduction: Osteogenesis Imperfecta (OI) is a rare genetic disease with bone fragility. The classification includes many types. In addition, the risk of a recurrence, the management can vary with the kind of OI. Case report: We report a male patient born at 39 weeks from non-consanguineous healthy parents. The patient was diagnosed with Hydrocephalus at prenatal. At 50 days of life, we detected many fractures and bone calluses. The molecular test identified a homozygous deletion of exon 4 of the WNT1 gene. Final considerations: We conclude this case had clinical features of OI XV, and the molecular test was fundamental for the precise diagnosis and the genetic counseling.

Osteogênese Imperfeita , Osteogênese , Pacientes , Cuidado Pré-Natal , Sexo , Recém-Nascido Prematuro , Fraturas Ósseas , Aconselhamento Genético , Genética , Doenças Genéticas Inatas , Hidrocefalia , Homens
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022.
Artigo em Inglês | LILACS | ID: biblio-1369163


Introduction: One of the challenges of maxillofacial surgery is the rehabilitation of patients with severe bone loss, using implant-supported prostheses. This challenge is based on the small remaining bone structure, and on the need to reconstruct the structure for the rehabilitation with autogenous or exogenous grafts. Case report: We report the case of a patient with severe maxillary atrophy, where a skullcap graft was performed associated with implant placement and prosthetic completion 14 months after the start of treatment. Final considerations: We demonstrate clinical safety for the use of extraoral grafts without complications, representing a good alternative treatment for this group of patients.

Introdução: um dos desafios da cirurgia bucomaxilofacial é a reabilitação de pacientes com perda óssea severa, utilizando próteses implantossuportadas. Este desafio baseia-se na pequena estrutura óssea remanescente e na necessidade de reconstrução da estrutura para a reabilitação com enxertos autógenos ou exógenos. Relato de caso: Relatamos o caso de um paciente com atrofia maxilar grave, onde foi realizado enxerto de calota craniana associado à instalação de implante, com finalização protética 14 meses após o início do tratamento. Consideracoes finais: Demonstramos segurança clínica para o uso de enxertos extrabucais sem complicações, representando uma boa alternativa de tratamento para este grupo de pacientes.

Mandíbula , Pacientes , Próteses e Implantes , Atrofia , Crânio , Cirurgia Bucal , Arcada Edêntula
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022.
Artigo em Inglês | LILACS | ID: biblio-1369172


Introduction: It is reported a case of a 57-year-old woman with multiple psychiatric hospitalizations, during which different diagnostic hypotheses and therapeutic procedures were proposed. Case report: After analyzing the patient's clinical records, the medical team proposed a diagnosis of Schizoaffective Disorder. This disorder presents a high risk of recurrent hospitalizations and high costs associated with therapeutic and follow-up withdrawal, yet there is limited data to assess the post-discharge critical periods. Final considerations: Further research in this area is required to adopt effective therapeutic strategies, reduce the probability of hospital admissions, improve prognosis, and lessen associated financial costs.

Introdução: é relatado o caso de uma mulher de 57 anos com múltiplas hospitalizações psiquiátricas, durante as quais diferentes hipóteses diagnósticas e terapêuticas associadas foram propostas. Relato do caso: Após análise dos registos clínicos, a equipa médica propôs o diagnóstico de Perturbação Esquizoafetiva. Esta Perturbação apresenta um elevado risco de re-internamento, para além do custo associado ao abandono do seguimento clínico e terapêutico. Porém, não existem dados suficientes que avaliem os períodos pós-alta. Consideracoes finais: Portanto, tornam-se necessárias pesquisas mais amplas na área para adotar estratégias terapêuticas eficazes, reduzir a probabilidade de re-internamento, melhorar o prognóstico e minimizar os custos financeiros associados.

Transtornos Psicóticos , Pacientes , Prognóstico , Terapêutica , Mulheres
Perspect Health Inf Manag ; 19(4): 1b, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36348729


Despite the cooperative sharing of health information exchange (HIE), various distinct limitations and barriers are found (i.e., substantial time and resources are being used to achieve health information). This paper investigates the limits of healthcare information sharing policy implementation for patient referral systems in Thailand. Mixed-methods research methodology, both quantitative and qualitative mechanisms, are conducted. The study results present the correlation between the current HIE among the hospitals in patient referral systems and the limitations of implementing the HIE policy, composed of technical, economic, political, and legal barriers. The statistical test reveals that these four main barriers could limit information sharing or impede Thailand's standard healthcare information-sharing policy and practice development. Predominantly, it is further found that there is no standard for data collection and data archiving systems; unclear guidelines, practices, and procedures; and a lack of standard practice due to fragmented administration. Foremost of all, the data ownership of any competent authorities or related regulators could cause any constraints in information sharing (e.g., complexity and processing time). This paper's findings will be beneficial to stakeholders, such as policymakers interested in achieving meaningful use, facilitating the adoption and implementation of HIE at a national level to ensure patients' safety and enhance healthcare quality.

Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Humanos , Atenção à Saúde , Disseminação de Informação/métodos , Encaminhamento e Consulta , Tailândia , Pessoal de Saúde , Pacientes
Artigo em Inglês | MEDLINE | ID: mdl-36361451


The increased aging of populations and rises in immigration have prompted the design of new methodologies and instruments for fostering the invisible care of geriatric patients among health science students in accordance with the 2030 Agenda and the SDGs. A total of 656 psychology, nursing and dentistry students participated in this study, which had a pretest-posttest design and was implemented over the course of three academic years. The intervention groups received training using an active learning methodology based on a case study involving a geriatric patient; specifically, a Maghrebi woman. The control groups were not exposed to the case study. The CCI-U questionnaire was designed ad hoc to evaluate the acquisition of invisible competences for caring for geriatric patients in accordance with their age, sex, emotional situation and ethnic origin. The questionnaire had a reliability of α = 0.63 to 0.72 and its factor solution was found to have a good fit. Students in the intervention groups scored higher than those in the control groups, with the difference being statistically significant for ethnic origin in all three undergraduate courses and all three academic years. The proper application of this active learning methodology fosters the invisible care of geriatric patients among students in accordance with the 2030 Agenda.

Diversidade Cultural , Estudantes de Enfermagem , Feminino , Humanos , Idoso , Aprendizagem Baseada em Problemas , Reprodutibilidade dos Testes , Estudantes , Pacientes , Estudantes de Enfermagem/psicologia
BMC Health Serv Res ; 22(1): 1379, 2022 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-36403029


BACKGROUND: Healthcare organizations made major adjustments to deliver care during the COVID pandemic, yet little is known about how these adjustments shaped ongoing quality and safety improvement efforts. We aimed to understand how COVID affected four U.S. hospitals' prospective implementation efforts in an ongoing quality improvement initiative, the REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) project, which implemented complementary interventions to redesign systems of care for medical patients. METHODS: We conducted individual semi-structured interviews with 40 healthcare professionals to determine how COVID influenced RESET implementation. We used conventional qualitative content analysis to inductively code transcripts and identify themes in MAXQDA 2020. RESULTS: We identified three overarching themes and nine sub-themes. The three themes were (1) COVID exacerbated existing problems and created new ones. (2) RESET and other quality improvement efforts were not the priority during the pandemic. (3) Fidelity of RESET implementation regressed. CONCLUSION: COVID had a profound impact on the implementation of a multifaceted intervention to improve quality and teamwork in four hospitals. Notably, COVID led to a diversion of attention and effort away from quality improvement efforts, like RESET, and sites varied in their ability to renew efforts over time. Our findings help explain how COVID adversely affected hospitals' quality improvement efforts throughout the pandemic and support the need for research to identify elements important for fostering hospital resilience.

COVID-19 , Humanos , COVID-19/epidemiologia , Estudos Prospectivos , Pesquisa Qualitativa , Melhoria de Qualidade , Pacientes
J Wound Ostomy Continence Nurs ; 49(6): 511-517, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417372


PURPOSE: This study aimed to identify predictive risk factors for pressure injury (PI) occurring during surgery. DESIGN: Retrospective case-control study. SUBJECTS AND SETTING: Data on records of 6070 patients hospitalized for surgery at Seoul National University Bundang Hospital located in Seoul Korea. Data were collected between May 2013 and December 2014. METHODS: Anonymized data from patients were accessed via electronic health records, nursing records, direct patient assessment, surgical, clinical laboratory, and anesthesia records, preanesthesia status evaluations, and PI incident reports, and transfusion and extracorporeal circulation reports. Descriptive and logistic regression analyses were conducted. RESULTS: Three hundred eighty-one of the 6070 patients (6.3%) developed within 24 hours a PI that was associated with surgery. The most common locations for the PIs were the coccyx (15.1%; n = 75) and trunk (chest or abdomen; 15.1%; n = 75). All PIs were classified as stage 1 (66.6%; n = 331) or 2 (33.4%; n = 166). Based on logistic regression results, we found that the risk factors that were independently predictive of surgery-related PIs were patient position during surgery, admission to an intensive care unit after surgery, required blood transfusion during surgery, and duration of surgery. CONCLUSIONS: This retrospective study identified several risk factors associated with a higher incidence of perioperative PIs in surgical patients. A PI prevention program accounting for these factors could potentially help prevent PIs and their costly complications.

Lesão por Pressão , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Lesão por Pressão/epidemiologia , Lesão por Pressão/etiologia , Lesão por Pressão/prevenção & controle , Fatores de Risco , Pacientes
Medicina (Kaunas) ; 58(11)2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36363534


Background and Objectives: It has been suggested that intense feelings of fear/anxiety and significant patient concerns may affect the perioperative course. Those findings emphasize the importance of surgical patients' preoperative feelings. Still, current knowledge in this area is based on a limited number of studies. Thus, we think that there is a need to further explore patients' preoperative fears, better characterize risk factors and reasons for their occurrence, and evaluate patients' perspectives associated with anesthesia. Materials and Methods: A total of 385 patients undergoing vascular surgery were preoperatively interviewed using a questionnaire that included demographics and questions related to patients' fears and perceptions of anesthesia. Statistical analyses included descriptive statistics, Pearson's χ2 and McNemar tests, and multivariate ordinal logistic regression. Results: The main causes of patients' preoperative fear were surgery (53.2%), potential complications (46.5%), and anesthesia (40%). Female sex was a predictor of surgery and anesthesia-related fear (OR = 3.07, p = 0.001; OR = 2.4, p = 0.001, respectively). Previous experience lowered the fear of current surgery (OR = 0.65, p = 0.031) and anesthesia (OR = 0.6, p = 0.017). Type of surgery, type of anesthesia, educational and socioeconomic status, and personal knowledge of an anesthesiologist affected specific anesthesia-related fears. Over 25% of patients did not know that an anesthesiologist is a physician, and only 17.7% knew where anesthesiologists work. Level of education and place of residence influenced patients' perceptions of anesthesia. Conclusions: Anesthesia-related fears are affected by the type of surgery/anesthesia, experience with previous surgery, and personal knowledge of an anesthesiologist. Women, patients with lower education levels, and patients with poorer socioeconomic status are at higher risk of developing those fears. The perception of anesthesiologists is inadequate, and knowledge of anesthesia is poor. Promotion of patient education regarding anesthesia is needed to alleviate those fears and increase understanding of anesthesia.

Anestesia , Anestesiologia , Humanos , Feminino , Anestesia/efeitos adversos , Medo , Pacientes , Inquéritos e Questionários
BMC Geriatr ; 22(1): 888, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36418981


BACKGROUND: The Identification of Seniors at Risk (ISAR) screening tool is a widely-used risk stratification tool for older adults in the emergency department (ED). Few studies have investigated the use of ISAR to predict outcomes of hospitalized patients. To improve usability a revised version of ISAR (ISAR-R), was developed in a quality improvement project. The ISAR-R is also widely used, although never formally validated. To address these two gaps in knowledge, we aimed to assess the ability of the ISAR-R to predict readmission in a cohort of older adults who were hospitalized (admitted from the ED) and discharged home. METHODS: This was a secondary analysis of data collected in a pre-post evaluation of a patient discharge education tool. Participants were patients aged 65 and older, admitted to hospital via the ED of two general community hospitals, and discharged home from the medical and geriatric units of these hospitals. Patients (or family caregivers for patients with mental or physical impairment) were recruited during their admission. The ISAR-R was administered as part of a short in-hospital interview. Providers were blinded to ISAR-R scores. Among patients discharged home, 90-day readmissions were extracted from hospital administrative data. The primary metrics of interest were sensitivity and negative predictive value. The Area Under the Curve (AUC) was also computed as an overall measure of performance. RESULTS: Of 711 attempted recruitments, 496 accepted, and ISAR-R was completed for 485. Of these 386 patients were discharged home with a complete ISAR-R, the 90-day readmission rate was 24.9%; the AUC was 0.63 (95% CI 0.57,0.69). Sensitivity and negative predictive value at the recommended cut-point of 2 + were 81% and 87%, respectively. Specificity was low (40%). CONCLUSIONS: The ISAR-R tool is a potentially useful risk stratification tool to predict patients at increased risk of readmission. Its high values of sensitivity and negative predictive value at a cut-point of 2 + make it suitable for rapid screening of patients to identify those suitable for assessment by a clinical geriatric team, who can identify those with geriatric problems requiring further treatment, education, and follow-up to reduce the risk of readmission.

Readmissão do Paciente , Pacientes , Humanos , Idoso , Estudos de Coortes , Pesquisa , Hospitais Comunitários
BMC Psychiatry ; 22(1): 726, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36414961


BACKGROUND: The aim of the study was to explore patients' attitudes towards voluntary and involuntary hospitalization in Norway, and predictors for involuntary patients who wanted admission. METHODS: A multi-centre study of consecutively admitted patients to emergency psychiatric wards over a 3 months period in 2005-06. Data included demographics, admission status (voluntary / involuntary), symptom levels, and whether the patients expressed a wish to be admitted regardless of judicial status. To analyse predictors of wanting admission (binary variable), a generalized linear mixed modelling was conducted, using random intercepts for the site, and fixed effects for all variables, with logit link-function. RESULTS: The sample comprised of 3.051 patients of witch 1.232 (40.4%) were being involuntary hospitalised. As expected 96.5% of the voluntary admitted patients wanted admission, while as many as 29.7% of the involuntary patients stated that they wanted the same. The involuntary patients wanting admission were less likely to be transported by police, had less aggression, hallucinations and delusions, more depressed mood, less use of drugs, less suicidality before admission, better social functioning and were less often referred by general practitioners compared with involuntary patients who did not want admission. In a multivariate analysis, predictors for involuntary hospitalization and wanting admission were, not being transported by police, less aggression and less use of drugs. CONCLUSIONS: Almost a third of the involuntary admitted patients stated that they actually wanted to be hospitalized. It thus seems to be important to thoroughly address patients' preferences, both before and after admission, regarding whether they wish to be hospitalized or not.

Internação Compulsória de Doente Mental , Tratamento Involuntário , Humanos , Hospitalização , Ideação Suicida , Pacientes
Rev. Soc. Esp. Dolor ; 29(supl.1): 10-13, Nov. 2022.
Artigo em Espanhol | IBECS | ID: ibc-211667


El cannabis medicinal ha sido promovido por los medios de comunicación y por la opinión pública en general. La planta del cannabis y los medicamentos a base de cannabis (CbM) han pasado por alto los estudios tradicionales basados en la evidencia, y han sido legalizados en muchos países sin pasar por el camino habitual de aprobación de los medicamentos. La comunidad médica debe conocer la evidencia actual al respecto para poder asesorar de manera competente a los pacientes. Esta revisión explicará brevemente la situación actual de la evidencia, de los obstáculos encontrados y de los posicionamientos de las respectivas sociedades del dolor respecto a la utilización del cannabis medicinal para el tratamiento del dolor.(AU)

Medical cannabis has been promoted by the media and by public opinion. The cannabis herb and cannabis-based medicines have bypassed traditional evidence-based studies, and have been legalized in many countries without going through the usual path of drug approval. The medical community must be aware of the current evidence in this regard in order to appropriately advise patients. This review will explain the current status of the evidence, the obstacles encountered to obtain evidence, and the positions of the respective pain societies regarding the use of medicinal cannabis for the treatment of pain.(AU)

Humanos , Pacientes , Dor Crônica , Cannabis , Uso da Maconha/tratamento farmacológico , Canabinoides , Dronabinol , Terapêutica , Dor , Manejo da Dor , Espanha , Bases de Dados Bibliográficas , PubMed
Rev. neurol. (Ed. impr.) ; 75(9): 251-259, Nov 1, 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-211697


Introducción: El 30% de los pacientes con epilepsia no responde al tratamiento farmacológico. La presencia de polimorfismos genéticos de nucleótido único (SNP) en el individuo puede influir en la variabilidad de respuesta al tratamiento farmacológico. La hipótesis de transportadores plantea que la presencia de SNP en los genes que codifican las proteínas ABC repercutiría en la biodisponibilidad de los fármacos anticrisis en el foco epileptógeno, lo que ocasionaría refractariedad. El objetivo del presente estudio fue evaluar la asociación de 13 polimorfismos en los genes ABCB1, ABCC2, ABCC5 y ABCG2 con la epilepsia farmacorresistente (EFR) en población española. Sujetos y métodos: Se realizó un estudio de casos y controles que incluyó a 327 pacientes con epilepsia: 227 farmacorresistentes y 100 farmacocontrolados según los criterios de la Liga Internacional contra la Epilepsia. En el ADN de leucocitos de sangre periférica extraído se estudiaron los polimorfismos en los genes transportadores ABC. Se utilizó la plataforma tecnológica iPlex® Gold y Mass ARRAY. Se compararon las frecuencias alélicas y genotípicas del grupo de casos y del de controles, el valor de p, la odds ratio y los intervalos de confianza al 95%. Resultados: La frecuencia alélica y genotípica del presente estudio fue similar a la comunicada en las bases de datos poblacionales. En los SNP estudiados no se encontraron diferencias significativas (p > 0,05) en todos los modelos de herencia analizados. Conclusiones: Nuestros resultados sugieren que no existe asociación entre los polimorfismos analizados en los genes ABC con la EFR en población española. Sin embargo, otros estudios adicionales confirmarán o descartarán estos resultados.(AU)

Introduction: Almost a third of all patients with epilepsy (30%) fail to respond to pharmacological treatment. The presence of single nucleotide polymorphisms (SNPs) in the individual may influence the variability of the response to drug treatment. The transporter hypothesis posits that the presence of SNPs in the genes encoding ABC proteins would affect the bioavailability of antiseizure drugs at the epileptogenic focus, giving rise to refractoriness. The aim of the present study was to evaluate the association of 13 polymorphisms in the ABCB1, ABCC2, ABCC5 and ABCG2 genes with drug-resistant epilepsy (DRE) in a Spanish population. Subjects and methods: A case-control study was conducted involving 327 patients with epilepsy: 227 resistant to drug therapy and 100 in whom their medication enabled them to control their symptoms, according to International League Against Epilepsy criteria. In the peripheral blood leukocyte DNA that was extracted, polymorphisms in the ABC transporter genes were studied. The iPlex® Gold and Mass ARRAY technology platform was used. The allele and genotypic frequencies of the case and control groups, p-value, odds ratio and 95% confidence intervals were compared. Results: The allele and genotypic frequency of the present study was similar to that reported in population-based databases. For the SNPs studied, no significant differences (p > 0.05) were found in any of the inheritance models analysed. Conclusions: Our results suggest that there is no association between the polymorphisms analysed in the ABC genes and DRE in the Spanish population. Nevertheless, further studies will confirm or refute these results.(AU)

Humanos , Masculino , Feminino , Polimorfismo Genético , Pacientes , Epilepsia , Epilepsia Resistente a Medicamentos , Testes Farmacogenômicos , Transportadores de Cassetes de Ligação de ATP , Espanha , Estudos Prospectivos , Estudos de Casos e Controles , Neurologia , Doenças do Sistema Nervoso
Comunidad (Barc., Internet) ; 24(3): 13-17, noviembre 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-JHG-1135


El malestar emocional es una queja habitual en lasociedad y en las consultas de Atención Primaria.La biblioterapia se ha mostrado eficaz en la mejora de síntomas de depresión y ansiedad leves.El siguiente estudio trata de valorar el impacto dela biblioterapia en la calidad de vida de pacientesdel centro de salud (CAP) El Carmel (Barcelona)con ansiedad y/o depresión leves diagnosticadas,con el objetivo de mejorar la percepción de la propia salud emocional.Se trata de un estudio piloto cuasi-experimentalen colaboración con la biblioteca municipal dondese valora, a lo largo de 1 año, la percepción dela propia salud de los pacientes antes y despuésde una intervención de biblioterapia por medio deescalas validadas, evidenciando una mejoría enla autopercepción de sintomatología ansiosa, nosiendo la mejoría estadísticamente significativaen el caso de la depresión. (AU)

The emotional distress is a habitual complaint in oursociety and in the Primary Care consultations. The bibliotherapy has shown efficient to improve the minordepression symptoms and anxieties.This research consists in assessing the impact of bibliotherapy in the quality of life in the patients of Carmel’s primary health care center (Barcelona). Theywere diagnosed with minor anxiety and depression.The target of this work is to enhance the perception oftheir own mental health.It is a pilot quasi-experimental study in collaborationwith the public library. Over a year, an evaluation takesplace about the perception of their particular mentalhealth before and after an intervention of bibliotherapy. The evidence is an improvement in the self-perception of anxiety symptomatology, not resulting asthe most significant statistic in the case of depressionsymptoms. (AU)

Humanos , Biblioterapia , Saúde Mental , Ansiedade , Depressão , Pacientes
Clin. transl. oncol. (Print) ; 24(11): 2090-2106, noviembre 2022. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-210138


Cancer and cancer therapies are a major factor risk for osteoporosis due to bone loss and deterioration of bone microarchitecture. Both factors contribute to a decrease in bone strength and, consequently, increased bone fragility and risk of fracture. Cancer-associated bone loss is a multifactorial process, and optimal interdisciplinary management of skeletal health, accurate assessment of bone density, and early diagnosis are essential when making decisions aimed at reducing bone loss and fracture risk in patients who have received or are receiving treatment for cancer. In this document, a multidisciplinary group of experts collected the latest evidence on the pathophysiology of osteoporosis and its prevention, diagnosis, and treatment with the support of the Spanish scientific society SEOM. The aim was to provide an up-to-date and in-depth view of osteoporotic risk and its consequences, and to present a series of recommendations aimed at optimizing the management of bone health in the context of cancer. (AU)

Humanos , Densidade Óssea , Mama , Osteoporose/induzido quimicamente , Osteoporose/terapia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/terapia , Pacientes
Clin. transl. oncol. (Print) ; 24(11): 2175-2180, noviembre 2022. graf
Artigo em Inglês | IBECS | ID: ibc-210145


FNDC4 gene encodes the fibronectin type III domain-containing 4 protein. Elevated expression of FNDC4 has been associated with poor prognosis in several types of cancer. There are no studies that have evaluated the prognostic capacity of FNDC4 in patients with head and neck cancer (HNSCC). The aim of our study was to analyze the relationship between the transcriptional expression of FNDC4 and prognosis in HNSCC patients.MethodsWe determined the transcriptional expression of FNDC4 in 67 patients with advanced-stage HNSCC (III–IV) treated with chemoradiotherapy. The FNDC4 expression was categorized according to the disease-specific survival with a recursive partitioning analysis.ResultsThere were significant differences in disease-specific survival as a function of the level of FNDC4 transcriptional expression. The 5-year disease-specific survival for patients with high FNDC4 expression (n = 44, 65.7%) was 32.9% (95% CI: 16.5–49.3%), and for patients with low expression (n = 23, 34.3%) it was 85.4% (95% CI: 70.2–100%) (P = 0.0001). Patients with a high FNDC4 expression had poorer local (P = 0.097), regional (P = 0.008), and distant (0.034) recurrence-free survival. The results of a multivariate analysis showed that patients with a high FNDC4 expression had a 6.15-fold increased risk of death as a consequence of the HNSCC (95% CI: 1.71–22.06).ConclusionFNCF4 transcriptional expression was significantly related to the disease-specific survival of HNSCC patients treated with chemoradiotherapy. Patients with elevated FNDC4 expression had a significant decrease in disease-specific survival. (AU)

Humanos , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia/métodos , Domínio de Fibronectina Tipo III , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Prognóstico , Proteínas , Pacientes