RESUMO
Acute myeloid leukemia (AML) is a genetically heterogeneous hematologic malignancy, which is initiated and driven by a rare fraction of leukemia stem cells (LSCs). Despite the difficulties of identifying a common LSC phenotype, there is increasing evidence that high expression of stem cell gene signatures is associated with poor clinical outcome. Identification of functionally distinct subpopulations in this disease is therefore crucial to dissecting the molecular machinery underlying LSC self-renewal. Here, we combined next-generation sequencing technology with in vivo assessment of LSC frequencies and identified the adhesion G protein-coupled receptor 56 (GPR56) as a novel and stable marker for human LSCs for the majority of AML samples. High GPR56 expression was significantly associated with high-risk genetic subgroups and poor outcome. Analysis of GPR56 in combination with CD34 expression revealed engraftment potential of GPR56(+)cells in both the CD34(-)and CD34(+)fractions, thus defining a novel LSC compartment independent of the CD34(+)CD38(-)LSC phenotype.
Assuntos
Biomarcadores Tumorais/metabolismo , Proliferação de Células , Leucemia Mieloide Aguda/patologia , Células-Tronco Neoplásicas/patologia , Receptores Acoplados a Proteínas G/metabolismo , Adulto , Animais , Separação Celular , Células Cultivadas , Células HEK293 , Humanos , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidade , Camundongos , Camundongos Endogâmicos NOD , Camundongos Transgênicos , Células-Tronco Neoplásicas/fisiologia , Receptores Acoplados a Proteínas G/fisiologia , Análise de SobrevidaRESUMO
OBJECTIVE: We measured the satisfaction of both patients and healthcare professionals with the technologies and services provided during in-home telerehabilitation as an alternative to conventional rehabilitation after discharge from total knee arthroplasty surgery. METHODS: This study was embedded in a larger controlled trial where 48 community-living older adults who received total knee arthroplasty were recruited prior to discharge from acute care following surgery and randomly assigned to treatment arms (Tele and Comparison). The participants' satisfaction with the services was assessed at the end of the intervention for both groups using the Healthcare Satisfaction Questionnaire. For the Tele group, the patients' perception of in-home telehealth was assessed before treatment and after completion of teletreatments. The satisfaction of the healthcare professionals with the technology during the telerehabilitation services was noted at the end of each treatment session using a technical quality subjective appreciation questionnaire. RESULTS: Both groups of patients (Tele and Comparison) were satisfied with the services received and no significant difference was observed between them. Moreover, the physiotherapists' satisfaction with regard to goal achievement, patient-therapist relationship, overall session satisfaction, and quality and performance of the technological platform was high. CONCLUSIONS: As patient satisfaction is important in maintaining motivation and treatment compliance and the satisfaction of healthcare professionals must be high in order for new treatments to become mainstream in clinics, the results show that in-home telerehabilitation seems to be a promising alternative to traditional face-to-face treatments.
Assuntos
Artroplastia do Joelho/reabilitação , Pessoal de Saúde/psicologia , Satisfação do Paciente , Telemedicina/métodos , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento/normas , Feminino , Serviços de Assistência Domiciliar , Humanos , Internet/tendências , Masculino , Pessoa de Meia-Idade , QuebequeRESUMO
The aim of this study was to identify questions that could estimate grip strength. Twenty-six questions about the degree of perceived difficulty performing manual tasks as well as two questions concerning self-rated grip strength were developed and completed by 123 community-dwelling older adults, followed by grip strength measurements using a Martin vigorimeter. Multiple regression analyses with all of the participants revealed that the question about the difficulty of opening a jar (question 4) was most associated with grip strength. When analyses were done by gender, the same question showed the best correlation for women, whereas the one for men was self-rated grip strength compared with people the same age (question 28). For the women, age and question 4 together explained 54% of the variance in their grip strength and for the men, age and question 28 explained 46%. Further studies are needed to identify other information that could help to better estimate grip strength for use in epidemiological surveys.