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1.
Mol Biol Rep ; 51(1): 165, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38252369

RESUMO

This comprehensive review delves into cancer's complexity, focusing on adhesion, metastasis, and inhibition. It explores the pivotal role of these factors in disease progression and therapeutic strategies. This review covers cancer cell migration, invasion, and colonization of distant organs, emphasizing the significance of cell adhesion and the intricate metastasis process. Inhibition approaches targeting adhesion molecules, such as integrins and cadherins, are discussed. Overall, this review contributes significantly to advancing cancer research and developing targeted therapies, holding promise for improving patient outcomes worldwide. Exploring different inhibition strategies revealed promising therapeutic targets to alleviate adhesion and metastasis of cancer cells. The effectiveness of integrin-blocking antibodies, small molecule inhibitors targeting Focal adhesion kinase (FAK) and the Transforming Growth Factor ß (TGF-ß) pathway, and combination therapies underscores their potential to disrupt focal adhesions and control epithelial-mesenchymal transition processes. The identification of as FAK, Src, ß-catenin and SMAD4 offers valuable starting points for further research and the development of targeted therapies. The complex interrelationships between adhesion and metastatic signaling networks will be relevant to the development of new treatment approaches.


Assuntos
Caderinas , Neoplasias , Humanos , Aderências Teciduais , Terapia Combinada , Adesão Celular , Movimento Celular , Integrinas
2.
BMC Public Health ; 24(1): 2022, 2024 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-39075378

RESUMO

Tuberculosis (TB) causes major public health problems worldwide. Fighting TB requires sustained efforts in health prevention, diagnosis and treatment. Previous literature has shown that conventional diagnostic methods like X-ray and sputum microscopy often miss early or extrapulmonary TB due to their limited sensitivity. Blood tests, while useful, lack the anatomical detail needed for precise localization of TB lesions. A possible step forward in the fight against TB could be the use of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and Computed Tomography (CT). This meta-analysis discusses the current literature, including the methods, results and implications of using FDG-PET-CT in the early diagnosis of TB. Analysis of the studies showed that the sensitivity of FDG-PET-CT as a potential method for early detection of TB was 82.6%.


Assuntos
Diagnóstico Precoce , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tuberculose , Humanos , Tuberculose/diagnóstico , Tuberculose/diagnóstico por imagem , Sensibilidade e Especificidade
3.
Cancer Control ; 27(3): 1073274820934822, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32869648

RESUMO

BACKGROUND: Denosumab is a human monoclonal antibody that has been used successfully in the treatment of giant cell tumors of bone. These tumors are rare and, in principle, benign, but they are highly aggressive, locally advanced, osteolytic bone tumors that can metastasize to the lungs. Denosumab is an effective treatment when these tumors cannot be surgically removed or when surgical resection is likely to lead to severe morbidity (eg, loss of limbs or joints). The aim of this systematic review and meta-analysis was to investigate patients with giant cell tumors of bone who experienced tumor progression during treatment with denosumab and to compare them with patients who experienced reduction of their giant cell tumors of bone during treatment with denosumab. METHODS: Embase, Cochrane Library, and MEDLINE/PubMed databases were searched for trials submitted by January 7, 2020, that reported the efficacy and safety of denosumab in patients with giant cell tumors of bone. RESULTS: Sixty studies were reviewed, involving a total of 1074 patients who had giant cell tumors of bone and were treated with denosumab. Of the 60 studies, 58% of the patients were from case series studies, 39% from open-label phase II studies, and 3% from case reports. The response rate for denosumab as a treatment for giant cell tumors of bone was 97.5%, with statistical significance (P < .0001). Pain in the limbs was statistically the most common adverse event for denosumab treatment in case series studies (P < .0001). No treatment-related deaths occurred in the reviewed studies. CONCLUSION: Cumulative evidence supports the addition of surgery to optimal medical therapy with denosumab to reduce tumor size, clinical symptoms, and mortality among patients with giant cell tumors of bone.


Assuntos
Neoplasias Ósseas/terapia , Denosumab/administração & dosagem , Tumores de Células Gigantes/terapia , Neoplasias Pulmonares/terapia , Recidiva Local de Neoplasia/epidemiologia , Biópsia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/patologia , Osso e Ossos/cirurgia , Quimioterapia Adjuvante/métodos , Curetagem , Intervalo Livre de Doença , Tumores de Células Gigantes/mortalidade , Tumores de Células Gigantes/secundário , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/secundário , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/prevenção & controle , Osteotomia , Carga Tumoral/efeitos dos fármacos
4.
Adv Exp Med Biol ; 1176: 1-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30989587

RESUMO

Giant cell tumors of the bone are rare, usually benign, tumors consisting of large, multinucleated bone cells. Remarkably, these tumors are characterized by aggressive growth. They tend to recur frequently and, in rare cases, metastasize to the lungs. Previous studies tried to identify risk factors for lung metastasis by giant cell bone tumors. Those studies reported different results due to a small number of patients. Therefore, a particularly high risk associated with this type of bone tumor prompted this systematic review and meta-analysis to identify risk factors for the development of lung metastases. The risk factors for lung metastasis by giant cell bone tumors searched for in this study were gender, age, lung metastasis and recurrence period, follow-up time, primary or recurrent tumor, Campanacci grading, tumor localization, disease course, treatment of primary and recurrent tumors, and pulmonary metastases treated by surgery, radiation, and chemotherapy. This meta-analysis identified the features outlined above by comparing the groups of patients with giant cell bone tumors and lung metastases with the control group consisting of patients without lung metastases. The search for suitable studies revealed 63 publications with a total of 4,295 patients with giant cell bone tumors. Of these, 247 (5.8%; 95% confidence interval (95%CI) 5.1-6.5%) patients had lung metastases. Further, the risk factors for lung metastases were the following: recurrence (p < 0.0001), lung metastasis time (p < 0.0001), Campanacci grade II (p = 0.028) and grade III (p = 0.006), localization in the lower limbs (p = 0.0007), curettage (p = 0.0005), and local irradiation of the primary tumor (p = 0.008). All studies showed a high-risk bias due to the absence of blinding of the participants, personnel, and outcome assessment. Special attention should be paid to tumor recurrence in the long follow-up time, since more advanced giant cell bone tumors, particularly in lower extremities, tend to reoccur and metastasize to the lung. Surgical treatment and local irradiation should be performed thoughtfully, with extended follow-up periods.


Assuntos
Neoplasias Ósseas , Tumor de Células Gigantes do Osso , Neoplasias Pulmonares , Neoplasias Ósseas/patologia , Tumor de Células Gigantes do Osso/patologia , Humanos , Neoplasias Pulmonares/secundário , Recidiva Local de Neoplasia , Fatores de Risco
5.
Adv Exp Med Biol ; 944: 35-45, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27826886

RESUMO

Malaria is an acute, life-threatening infectious disease that spreads in tropical and subtropical regions. Malaria is mainly brought over to Germany by travelers, so the disease can be overlooked due to its nonspecific symptoms and a lack of experience of attending physicians. The aim of this study was to analyze, retrospectively, epidemiological and clinical data from patients examined for malaria. Patient data were collected from hospital charts at the Department of Internal Medicine, Saarland University Medical Center, Germany, for the period of 2004-2012. The data of patients with and without malaria were compared in terms of their epidemiological, demographic, clinical, and medical treatment aspects. We identified found 15 patients with malaria (28.3 %, mean age 42.3 ± 16.5 years, three females [20 %]; 95 % confidence interval of 0.2-0.4) out of the 53 patients examined. Mainly locals brought malaria over to Homburg, Germany (p = 0.009). Malaria tropica was the most common species (p < 0.0001). One patient (6.7 %) with malaria, who had recently traveled, had a mixed infection of Plasmodium falciparum and Plasmodium malariae (p = 0.670). Malaria is characterized by thrombocytopenia (p = 0.047) and elevated C-reactive protein (p = 0.019) in serum, and fever is the leading symptom (p = 0.031). In most cases, malaria was brought from Ghana (33.3 %). Further, patients had contracted malaria despite malaria prophylaxis (33.3 %, p = 0.670). In conclusion, malaria test should be used in patients with fever after a journey from Africa. Malaria caused by Plasmodium falciparum is the most common species of brought over malaria. Mixed-species Plasmodium falciparum and Plasmodium malariae are uncommon in travelers with malaria.


Assuntos
Coinfecção/epidemiologia , Coinfecção/microbiologia , Malária/epidemiologia , Malária/microbiologia , Plasmodium falciparum/isolamento & purificação , Plasmodium malariae/isolamento & purificação , Adulto , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Coinfecção/metabolismo , Feminino , Febre/microbiologia , Alemanha/epidemiologia , Humanos , Malária/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Viagem
6.
Adv Exp Med Biol ; 1022: 11-18, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28567615

RESUMO

Chronic kidney disease (CKD) often accompanies obstructive sleep apnea (OSA). A causative connection of the two disease entities is uncertain. However, eliminating OSA improves the prognosis of CKD patients. In the present study we examined a possible relationship between OSA and CKD, and whether there would be a mutual enhancing interaction in the severity of the two diseases. The study was of a retrospective nature and encompassed 382 patients over the period of 1 January 2014-30 June 2015. The OSA diagnosis was supported by a polysomnographic examination in 363 (95.0%) patients. Blood samples were taken for the determination of kidney function indices. The influence on OSA and CKD of comorbidities also was examined. We found a high probability of a simultaneous occurrence of OSA and CKD; with the odds ratio of 3.94 (95% CI 1.5-10.3%; p = 0.005). The 363 patients with OSA were stratified into 73 (20.1%) mild, 98 (27.0%) moderate, and 192 (52.9%) severe OSA cases according to the apnea-hypopnea index. CKD was found in 43 (58.9%) patients with mild OSA, 73 (74.5%) with moderate OSA, and 137 (71.4%) with severe OSA. Most OSA patients also suffered from hypertension and obesity. For comparison, CKD was detected in 7 (36.8%) out of the 19 patients without OSA (p < 0.003). We conclude that CKD develops significantly more often in patients with OSA than in those without it, and CKD frequency increases with the severity of OSA.


Assuntos
Hipertensão/complicações , Insuficiência Renal Crônica/complicações , Apneia Obstrutiva do Sono/complicações , Adulto , Idoso , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Polissonografia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia
7.
Adv Exp Med Biol ; 905: 39-56, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26747068

RESUMO

Older people are often especially susceptible to pneumonia and bacteria may develop resistance to antibiotics quicker in the elderly, whose immune systems gradually diminish. This study analyses, retrospectively, resistance to antibiotics in high-risk elderly patients with fatal pneumonia. Records of all patients aged over 65 who did not survive a bout with pneumonia were gathered from the records of the Department of Pneumology of HELIOS Clinic in Wuppertal, Germany from the period of 2004-2014. Susceptibility testing was executed for the study population, whose pneumonia was triggered by various kinds of bacteria. We detected 936 pneumonia patients of the overall mean age of 68.0 ± 13.6 years, with the following pneumonia types: 461 (49.3 %) community-acquired, 354 (37.8 %) nosocomial-acquired, and 121 (12.9 %) aspiration pneumonia. There were 631 (67.4 %) males and 305 (32.6 %) females there. We identified 672 (71.8 %) patients who had a high risk for pneumonia, especially staphylococcal pneumonia (p < 0.0001). The elderly patients had a higher risk of dying from pneumonia (2.9 odds ratio, 95 % confidence interval 1.8-4.6; p < 0.0001); of the 185 pneumonia-related deaths, 163 (88.1 %) were in the elderly. In those with fatal staphylococcal pneumonia, a high antibiotic resistance rate was found for piperacillin-tazobactam (p = 0.044), cefuroxime (p = 0.026), cefazolin (p = 0.043), levofloxacin (p = 0.018), erythromycin (p = 0.004), and clindamycin (p = 0.025). We conclude that elderly patients with staphylococcal pneumonia show resistance to common antibiotics. However, no significant antibiotic resistance could be ascribed for other types of pneumonia in these patients.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Pneumonia Estafilocócica/mortalidade , Staphylococcus/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Cefazolina/farmacologia , Cefuroxima/farmacologia , Clindamicina/farmacologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/mortalidade , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , Eritromicina/farmacologia , Feminino , Alemanha/epidemiologia , Humanos , Levofloxacino/farmacologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Razão de Chances , Ácido Penicilânico/análogos & derivados , Piperacilina , Combinação Piperacilina e Tazobactam , Pneumonia Estafilocócica/tratamento farmacológico , Pneumonia Estafilocócica/microbiologia , Estudos Retrospectivos
8.
Adv Exp Med Biol ; 905: 79-86, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26747067

RESUMO

Central sleep apnea (CSA) is a sleep-related disorder characterized by pauses in breathing during sleep when the brain respiratory network momentarily interrupts transmission of impulses to the respiratory musculature. CSA presents significant problems being an independent risk factor for cardiovascular events and death. There are several available treatment options according to CSA severity. Currently, adaptive servo-ventilation is considered best for CSA patients. The goal of the present study was to retrospectively investigate different treatment methods employed for CSA, such as different modes of ventilation, oxygen therapy, and drugs to determine the most effective one. Data were obtained from hospital records during 2010-2015. The diagnosis of CSA and the optimal treatment method were supported by polysomnography examinations. Devices used during sleep to support breathing included continuous positive airway pressure, bi-level positive airway pressure, or adaptive servo-ventilation. We classified 71 (2.9 %) patients as having CSA from 2,463 patients with sleep-disordered breathing. Of those 71 patients, 54 (76.1 %, 95 % CI 66.2-86.0 %) were male and 17 (23.9 %, 95 % CI 14.0-33.8 %) were female, and they had a mean age of 67.1 ± 14.1. Four (5.6 %) patients underwent a combination therapy, 39 (54.9 %) received a ventilator in proper ventilation mode, 25 (35.2 %) received oxygen therapy, 7 (9.9 %) received medication, and 4 (5.6 %) received no treatment. We conclude that although the majority of patients needed treatment for central sleep apnea, a clear advantage in using ventilators when compared to oxygen therapy or drug therapy could not be found.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Analgésicos Opioides/uso terapêutico , Pressão Positiva Contínua nas Vias Aéreas/métodos , Dopaminérgicos/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Oxigenoterapia/métodos , Antagonistas da Serotonina/uso terapêutico , Apneia do Sono Tipo Central/terapia , Idoso , Idoso de 80 Anos ou mais , Clozapina/uso terapêutico , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Mianserina/análogos & derivados , Mianserina/uso terapêutico , Pessoa de Meia-Idade , Mirtazapina , Polissonografia , Piridinas/uso terapêutico , Estudos Retrospectivos , Apneia do Sono Tipo Central/diagnóstico , Tiazinas/uso terapêutico , Tilidina/uso terapêutico , Resultado do Tratamento , Zolpidem
9.
Adv Exp Med Biol ; 910: 31-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26820733

RESUMO

Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common chronic lung diseases worldwide. Distinguishing between these different pulmonary diseases can be difficult in practice because of symptomatic similarities. A definitive diagnosis is essential for correct treatment. This review article presents the different symptoms of these two chronic inflammatory lung diseases following a selective search of the PubMed database for relevant literature published between 1996 and 2012. While cough occurs in both diseases, asthmatics often have a dry cough mainly at night, which is often associated with allergies. In contrast, COPD is usually caused by years of smoking. Paroxysmal dyspnea, which occurs in asthma, is characterized by shortness of breath, while in COPD it occurs during physical exertion in early stages and at rest in later stages of the disease. Asthma often begins in childhood or adolescence, whereas COPD occurs mainly in smokers in later life. It is possible to live with asthma into old age, whereas the life expectancy of patients with COPD is significantly limited. Currently, there is no general curative treatment for either disorder.


Assuntos
Asma/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Idade de Início , Asma/diagnóstico , Asma/imunologia , Asma/terapia , Tosse/etiologia , Dispneia/etiologia , Eosinofilia/imunologia , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulina E/imunologia , Neutrófilos/imunologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/imunologia , Doença Pulmonar Obstrutiva Crônica/terapia , Fumar , Espirometria
10.
Adv Exp Med Biol ; 952: 31-34, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27573646

RESUMO

Cannabis is the most widely smoked illicit substance in the world. It can be smoked alone in its plant form, marijuana, but it can also be mixed with tobacco. The specific effects of smoking cannabis are difficult to assess accurately and to distinguish from the effects of tobacco; however its use may produce severe consequences. Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, and hyperinflation. It can also cause serious lung diseases with increasing years of use. Cannabis can weaken the immune system, leading to pneumonia. Smoking cannabis has been further linked with symptoms of chronic bronchitis. Heavy use of cannabis on its own can cause airway obstruction. Based on immuno-histopathological and epidemiological evidence, smoking cannabis poses a potential risk for developing lung cancer. At present, however, the association between smoking cannabis and the development of lung cancer is not decisive.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Bronquite Crônica/etiologia , Neoplasias Pulmonares/etiologia , Fumar Maconha/efeitos adversos , Pneumonia/etiologia , Doença Pulmonar Obstrutiva Crônica/etiologia , Humanos , Medição de Risco , Fatores de Risco
11.
BMC Infect Dis ; 15: 514, 2015 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-26567094

RESUMO

BACKGROUND: The widespread overuse of antibiotics promotes the development of antibiotic resistance in bacteria, which can cause severe illness and constitutes a major public health concern. Haemophilus species are a common cause of community- and nosocomial-acquired pneumonia. The antibiotic resistance of these Gram-negative bacteria can be prevented through the reduction of unnecessary antibiotic prescriptions, the correct use of antibiotics, and good hygiene and infection control. This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species. METHODS: The demographic, clinical, and laboratory data of all patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within a study period from 2004 to 2014. Antimicrobial susceptibility testing was performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Haemophilus species. RESULTS: During the study period of January 1, 2004, to August 12, 2014, 82 patients were identified with community- and nosocomial-acquired pneumonia affected by Haemophilus species. These patients had a mean age of 63.8 ± 15.5 (60 [73.2%, 95% CI 63.6%-82.8%] males and 22 [26.8%, 95% CI 17.2%-36.4%] females). Haemophilus species had a high resistance rate to erythromycin (38.3%), ampicillin (24.4%), piperacillin (20.8%), cefuroxime (8.5%), ampicillin-sulbactam (7.3%), piperacillin-sulbactam (4.3%), piperacillin-tazobactam (2.5%), cefotaxime (2.5%), and levofloxacin (1.6%). In contrast, they were not resistant to ciprofloxacin in patients with pneumonia (P = 0.016). CONCLUSION: Haemophilus species were resistant to many of the typically used antibiotics. Resistance toward ciprofloxacin was not detected in patients with pneumonia caused by Haemophilus species.


Assuntos
Antibacterianos/farmacologia , Ciprofloxacina/farmacologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Haemophilus/efeitos dos fármacos , Pneumonia Bacteriana/microbiologia , Idoso , Antibacterianos/uso terapêutico , Ciprofloxacina/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Alemanha , Haemophilus/patogenicidade , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/tratamento farmacológico , Estudos Retrospectivos
12.
Int J Med Sci ; 12(3): 280-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25798054

RESUMO

BACKGROUND: Past studies have shown that aspirin and statins decrease the rate and severity of exacerbation, the rate of hospitalization, and mortality in chronic obstructive pulmonary disease (COPD). Although these studies are relatively new, there is evidence that new therapeutic strategies could prevent exacerbation of COPD. TRIAL DESIGN: This article examines retrospectively the possibility of using aspirin and statins to prevent exacerbation and infection in patients with COPD. METHODS: All patients with COPD were identified from hospital charts in the Department of Internal Medicine, Saarland University Medical Center, Germany, between 2004 and 2014. RESULTS: The study examined 514 medical reports and secured a study population of 300 with COPD. The mean age was 69 ± 10 years (206 men, 68.7%, 95% CI, 63.4-73.9; 94 women, 31.3%, 95% CI, 26.1-36.6). The study results did not show a causal relationship between aspirin and statins and prevention of exacerbation and infection in patients with COPD. CONCLUSION: In contrast, in this study, the exacerbation and infection rates increased under medication with aspirin and statins (p = 0.008).


Assuntos
Aspirina/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Infecções/tratamento farmacológico , Pneumonia/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Idoso , Proteína C-Reativa/metabolismo , Feminino , Humanos , Infecções/mortalidade , Infecções/patologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Pneumonia/mortalidade , Pneumonia/patologia , Doença Pulmonar Obstrutiva Crônica/mortalidade , Doença Pulmonar Obstrutiva Crônica/patologia
13.
Int J Med Sci ; 12(12): 980-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26664260

RESUMO

OBJECTIVES: Group B Streptococcus is a primary source of pneumonia, which is a leading cause of death worldwide. During the last few decades, there has been news of growing antibiotic resistance in group B streptococci to penicillin and different antibiotic agents. This clinical study retrospectively analyzes antimicrobial resistance in inpatients who were diagnosed with group B streptococcal pneumonia. METHODS: All of the required information from inpatients who were identified to have group B streptococcal pneumonia was sourced from the database at the Department of Internal Medicine of HELIOS Clinic Wuppertal, Witten/Herdecke University, in Germany, from 2004-2014. Antimicrobial susceptibility testing was performed for the different antimicrobial agents that were regularly administered to these inpatients. RESULTS: Sixty-six inpatients with a mean age of 63.3 ± 16.1 years (45 males [68.2%, 95% CI 60.0%-79.4%] and 21 females [31.8%, 95% CI 20.6%-43.0%]) were detected to have group B streptococcal pneumonia within the study period from January 1, 2004, to August 12, 2014. Group B Streptococcus had a high resistance rate to gentamicin (12.1%), erythromycin (12.1%), clindamycin (9.1%), and co-trimoxazole (3.0%), but it was not resistant to penicillin, cefuroxime, cefotaxime, or vancomycin (P < 0.0001). CONCLUSION: No resistance to penicillin, cefuroxime, cefotaxime, or vancomycin was detected among inpatients with pneumonia caused by group B streptococci.


Assuntos
Farmacorresistência Bacteriana , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Pneumocócica/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae , Idoso , Cefotaxima/farmacologia , Cefuroxima/farmacologia , Resistência às Cefalosporinas , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Alemanha , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Resistência às Penicilinas , Pneumonia Bacteriana/microbiologia , Pneumonia Pneumocócica/microbiologia , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/isolamento & purificação , Resistência a Vancomicina
14.
Adv Exp Med Biol ; 873: 15-23, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26269028

RESUMO

Sleep apnea is characterized by pauses in breathing during sleep. There are three forms: central, obstructive, and complex, or mixed sleep apnea. Central sleep apnea, a manifestation of respiratory instability in many clinical conditions and with a variety of causes, is the result of a temporary cessation of breathing in which the inhibitory influences favoring the instability predominate over excitatory influences favoring stable breathing. In contrast to central sleep apnea, according to the published data from previous studies, an association exists between obstructive sleep apnea and various comorbidities, especially chronic obstructive pulmonary disease. This article examines retrospectively the possible association of central sleep apnea with special sleep-related symptoms and various co-morbidities. Data of all patients with different types of central sleep apnea were collected from our hospital charts within the Department of Pneumology, HELIOS Clinic, University of Witten/Herdecke, Wuppertal, Germany, within the study period of January 1, 2011 to September 19, 2014. After clinical examination, all patients underwent polysomnography in our sleep laboratory. We identified a total of 60 (3.5 %) patients with central sleep apnea from 1722 patients with assumed sleep disordered breathing of the mean age of 68.2 ± 13.7 years (44 males - 73.3 %, 95 % CI 0.6-0.9 and 16 females - 26.7 %, 95 % CI 0.2-0.4). Typical symptoms of sleep-disordered breathing were not observed. A relation to co-morbidities was not found. Central sleep apnea was often diagnosed in the elderly. A direct association between central sleep apnea and symptoms of sleep-disordered breathing and various co-morbidities was not detected. This is in direct contrast to the obstructive sleep apnea syndrome.


Assuntos
Apneia do Sono Tipo Central/complicações , Apneia do Sono Tipo Central/fisiopatologia , Idoso , Analgésicos Opioides/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Comorbidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Polissonografia , Respiração , Estudos Retrospectivos , Fatores de Risco , Apneia do Sono Tipo Central/diagnóstico , Fases do Sono , Análise de Sobrevida
15.
Prev Med Rep ; 42: 102750, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38741931

RESUMO

Background: Sleep apnea, a prevalent global health issue, is characterized by repeated interruptions in breathing during sleep. This systematic review aggregates global data to outline a comprehensive analysis of its associated risk factors. Purpose: The systematic review underscores the global prevalence of sleep apnea and the universal importance of its early detection and management by delineating key risk factors contributing to its development. Material and Methods: We conducted a thorough systematic review of international medical databases up to July 31, 2023, including PubMed, Medline, and Cochrane Library, to ensure a wide-ranging collection of data reflective of various populations. Results: The systematic review identifies several risk factors such as obesity, age, gender, neck circumference, family history, smoking, alcohol use, underlying medical conditions, and nasal congestion, highlighting their prevalence across diverse demographics globally. Conclusion: Emphasizing lifestyle modifications and proactive interventions, our findings advocate for global health strategies to mitigate the risk of sleep apnea and enhance sleep health worldwide.

16.
J Infect Public Health ; 17(7): 102458, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38823085

RESUMO

BACKGROUND: The COVID-19 pandemic has significantly impacted global health and prompted studies on its effects across various diseases. Recent data suggest a potential correlation between COVID-19 and a decrease in lung cancer incidence. This study examines the association between COVID-19 infection and changes in lung cancer cases. MATERIAL AND METHODS: We conducted a retrospective analysis of medical records from Clinic Lüdenscheid, Germany, from January 1, 2018, to December 31, 2021, comparing lung cancer cases before and during the pandemic. Demographic characteristics and cancer stages were also assessed. RESULTS: We evaluated 523 patients; 269 pre-COVID and 254 during COVID. While the overall number of cases declined, a significant increase in advanced stage cancers was noted during COVID (P = 0.04). The adjusted incidence rates showed a nuanced decrease from approximately 33 cases per 100,000 pre-COVID to 31 during COVID. CONCLUSION: This retrospective study suggests a modest decline in lung cancer incidence and an increase in advanced stages during COVID. Further comparisons with national data indicate a similar trend across Germany, with a decrease of about 3 % in lung cancer diagnoses post-2020, highlighting potential pandemic impacts on cancer detection.


Assuntos
COVID-19 , Neoplasias Pulmonares , Humanos , COVID-19/epidemiologia , Estudos Retrospectivos , Incidência , Masculino , Feminino , Neoplasias Pulmonares/epidemiologia , Alemanha/epidemiologia , Pessoa de Meia-Idade , Idoso , SARS-CoV-2 , Idoso de 80 Anos ou mais , Adulto
17.
Food Chem Toxicol ; 185: 114507, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38331086

RESUMO

BACKGROUND: This systematic review evaluated the health risks of electronic cigarettes (e-cigarettes) compared to traditional cigarettes. It examines various studies and research on the subject to provide a comprehensive analysis of potential health risks associated with both smoking methods. METHODS: The systematic review, incorporating searches in PubMed, Scopus, Web of Science, and the Cochrane Library up to July 2023, examines the results obtained in relevant studies, and provides a critical discussion of the results. RESULTS: E-cigarettes exhibit reduced exposure to harmful toxins compared to traditional cigarettes. CONCLUSION: However, concerns persist regarding respiratory irritation and potential health risks, especially among youth, emphasizing the need for comprehensive, long-term research and protective legislation.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Adolescente , Humanos , Nicotina/efeitos adversos , Produtos do Tabaco/efeitos adversos , Fumar
18.
Pneumonia (Nathan) ; 16(1): 11, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38965640

RESUMO

Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.

19.
Respir Physiol Neurobiol ; 315: 104110, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37393968

RESUMO

Depression, anxiety, and panic disorders are common in chronic obstructive pulmonary disease (COPD) and important for the further course of the disease, as they are associated with increased hospital admissions, longer hospital stays, more frequent doctor visits, and a worsened quality of life. There are also indications of premature death in affected patients. Therefore, knowledge of the risk factors for depression in COPD patients is all the more important for early detection and treatment. Hence, Embase, the Cochrane Library, and the MEDLINE/PubMed databases were analyzed for studies on these risk factors. The main factors are as follows: female gender; older/younger age; living alone; higher education; unemployment; retirement; a low quality of life; social isolation; high/low income; high cigarette and alcohol consumption; poor physical fitness; severe respiratory symptoms; high/low body mass index, airway obstruction, dyspnea, exercise capacity index scores; and comorbidities (mainly heart disease, cancer, diabetes, and stroke). This article presents the analyzed medical literature.


Assuntos
Depressão , Doença Pulmonar Obstrutiva Crônica , Feminino , Humanos , Comorbidade , Depressão/epidemiologia , Depressão/etiologia , Dispneia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida , Fatores de Risco
20.
Int J Gen Med ; 14: 2883-2892, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34234518

RESUMO

PURPOSE: Some previously published primarily retrospective studies have shown that statins could reduce the rate and severity of exacerbations, the length of hospital stays, and mortality in patients with chronic obstructive pulmonary disease (COPD), but retrospective data needs to be reviewed regarding this connection since statins are cholesterol-lowering drugs. Therefore, the aim of this study was to investigate the independent influence of statins on the exacerbation rate in COPD patients. METHODS: An observational retrospective study was conducted to assess the independent influence of statins on the COPD exacerbation rate at the Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Witten/Herdecke University from January 1, 2010 to December 31, 2020. This study enrolled patients with COPD in 2010 and documented their exacerbation rate over a further 10 years. The number of exacerbations in COPD patients was compared between statin users and non-users. RESULTS: Of the total of 295 [176 male (59.7%)] COPD patients, 105 (35.6%, CI 30.3-41.2%) patients with COPD were treated with statins, and 190 (64.4%, CI 58.8-69.7%) were treated without statins. The mean exacerbation rate in the COPD patients who received statin did not differ from that in the COPD patients who did not receive statin (p = 0.175). Also, the mortality rates did not differ between the statin-treated and non-statin-treated COPD patients (p = 0.271). CONCLUSION: Statins have no effect on the exacerbation rate or mortality in COPD patients.

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