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1.
Climacteric ; 27(3): 296-304, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38353251

RESUMO

The aim of this systematic review with meta-analysis was to evaluate the effects of resistance training on physical fitness, physiological variables and body composition of postmenopausal women. The present systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and was registered in PROSPERO. A total of 12 studies were included. The literature search was performed in PubMed, Web of Science and EBSCO. Randomized control trials were included. Two blinded investigators performed the search, study selection and data collection, and assessed the quality and risk of bias. A random-effects model was used for all analyses. Compared to the control group, resistance training produced a significant improvement in maximal oxygen volume (standardized mean difference [SMD] = 2.32, p < 0.001), lower extremity strength (SMD = 4.70, p < 0.001) and upper extremity strength (SMD = 7.42, p < 0.001). The results obtained in the systematic review and meta-analysis confirm the benefits of resistance training on physical fitness in postmenopausal women, although there is more debate regarding its influence on bone mineral density, and anthropometric and derived variables. This work provides a solid starting point for promoting resistance training at a frequency of 3 days per week, in 60-min sessions, with the aim of improving parameters directly related to quality of life, functionality and disease prevention of postmenopausal women.


Assuntos
Composição Corporal , Força Muscular , Aptidão Física , Pós-Menopausa , Treinamento Resistido , Humanos , Feminino , Treinamento Resistido/métodos , Pós-Menopausa/fisiologia , Força Muscular/fisiologia , Aptidão Física/fisiologia , Densidade Óssea , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Ann Oncol ; 33(2): 181-192, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34839016

RESUMO

BACKGROUND: While osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is the standard treatment in patients with advanced non-small-cell lung cancer (NSCLC) with sensitising EGFR and acquired T790M mutations, progression inevitably occurs. The angiogenic pathway is implicated in EGFR TKI resistance. PATIENTS AND METHODS: BOOSTER is an open-label randomised phase II trial investigating the efficacy and safety of combined osimertinib 80 mg daily and bevacizumab 15 mg/kg every 3 weeks, versus osimertinib alone, in patients with EGFR-mutant advanced NSCLC and acquired T790M mutations after failure on previous EGFR TKI therapy. Primary endpoint was investigator-assessed progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR) and adverse events (AEs). RESULTS: Between May 2017 and February 2019, 155 patients were randomised (combination: 78; osimertinib: 77). At data cut-off of 22 February 2021, median follow-up was 33.8 months [interquartile range (IQR): 26.5-37.6 months] and 129 (83.2%) PFS events were reported in the intention-to-treat population. There was no difference in median PFS between the combination [15.4 months; 95% confidence interval (CI) 9.2-18.0 months] and osimertinib arm (12.3 months; 95% CI 6.2-17.2 months; stratified log-rank P = 0.83), [hazard ratio (HR) = 0.96; 95% CI 0.68-1.37]. Median OS was 24.0 months (95% CI 17.8-32.1 months) in the combination arm and 24.3 months (95% CI 16.9-37.0 months) in the osimertinib arm (stratified log-rank P = 0.91), (HR = 1.03; 95% CI 0.67-1.56). Exploratory analysis revealed a significant interaction of smoking history with treatment for PFS (adjusted P = 0.0052) with a HR of 0.52 (95% CI 0.30-0.90) for smokers, and 1.47 (95% CI 0.92-2.33) for never smokers. ORR was 55% in both arms and the median time to treatment failure was significantly shorter in the combination than in the osimertinib arm, 8.2 months versus 10.8 months, respectively (P = 0.0074). Safety of osimertinib and bevacizumab was consistent with previous reports with grade ≥3 treatment-related AEs (TRAEs) reported in 47% and 18% of patients on combination and osimertinib alone, respectively. CONCLUSIONS: No difference in PFS was observed between osimertinib plus bevacizumab and osimertinib alone. Grade ≥3 TRAEs were more common in patients on combination.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Acrilamidas , Compostos de Anilina/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bevacizumab/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Mutação , Inibidores de Proteínas Quinases/efeitos adversos
3.
Ann Oncol ; 30(2): 290-296, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30535340

RESUMO

BACKGROUND: Approximately 30% of tumor biopsies from patients with advanced-stage lung adenocarcinomas yield insufficient tissue for successful molecular subtyping. We have analyzed the clinical utility of next-generation sequencing (NGS) of cell-free circulating tumor DNA (ctDNA) in patients with inadequate tumor samples for tissue genotyping. PATIENTS AND METHODS: We conducted the study in a multi-institutional prospective cohort of clinically unselected patients with advanced-stage lung adenocarcinomas with insufficient tissue for EGFR, ALK or ROS1 genotyping across 12 Spanish institutions (n = 93). ctDNA NGS was carried out by Guardant Health (Guardant360, Redwood City, CA), using a hybrid-capture-based 73-gene panel. Variants were deemed actionable if they were part of the OncoKB precision oncology knowledge database and classified in four levels of actionability based on their clinical or preclinical evidence for drug response. RESULTS: Eighty-three out of 93 patients (89%) had detectable levels of ctDNA. Potentially actionable level 1-4 genomic alterations were detected in 53 cases (57%), of which 13 (14%) had level 1-2A alterations (Food and Drug Administration-approved and standard-care biomarkers according to lung cancer guidelines). Frequencies of each genomic alteration in ctDNA were consistent with those observed in unselected pulmonary adenocarcinomas. The majority of the patients (62%), particularly those with actionable alterations (87%), had more than one pathogenic variant in ctDNA. The median turnaround time to genomic results was 13 days. Twelve patients (13%) received genotype-matched therapies based on ctDNA results, deriving the expected clinical benefit. Patients with co-occurring pathogenic alterations had a significantly shorter median overall survival as compared with patients without co-occurring pathogenic alteration (multivariate hazard ratio = 5.35, P = 0.01). CONCLUSION: Digital NGS of ctDNA in lung cancers with insufficient tumor samples for tissue sequencing detects actionable variants that frequently co-occur with other potentially clinically relevant genomic alterations, allowing timely initiation of genotype-matched therapies.


Assuntos
Adenocarcinoma de Pulmão/secundário , Biomarcadores Tumorais/sangue , DNA Tumoral Circulante/sangue , DNA de Neoplasias/sangue , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Neoplasias Pulmonares/patologia , Proteínas Proto-Oncogênicas/genética , Adenocarcinoma de Pulmão/sangue , Adenocarcinoma de Pulmão/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , DNA Tumoral Circulante/genética , DNA de Neoplasias/genética , Feminino , Seguimentos , Genoma Humano , Genômica , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Mutação , Metástase Neoplásica , Medicina de Precisão , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida
4.
Int Nurs Rev ; 66(1): 104-111, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30010194

RESUMO

AIMS: To determine what social support is available in Spain to people over 65 who also dedicate hours of their time to the care of others who are older. BACKGROUND: Demographic and social changes are leading to growth of the population. The social support available to older people in the final stage of life affects their health. METHODS: A cross-sectional study was conducted involving the records of older, non-institutionalized individuals residing in Spain, obtained from the European Health Survey of 2014. The method of collecting information used in the European Survey was personal interviews assisted by a computer. RESULTS: The records of 6520 older people were studied; 40.1% of the participants studied had expressed the possibility of having three to five people available in case of a serious problem, and 83.6% reported that the rest of the people around them were very interested in what happens to them. With respect to care, only 7% of the older people studied mentioned performing care tasks. CONCLUSIONS: Social support is beneficial to older people, regardless of whether they perform care tasks, because it acts as a protective factor against problems such as loneliness, stress and depression. The profile of a primary caregiver in this age range is a married, middle-class woman with primary schooling who is caring for a first-degree relative. IMPLICATIONS FOR NURSING AND HEALTH POLICY: These data suggest that it is necessary for nurses to know about the needs of older people to implement societal measures of health promotion, prevention and education that favour social cohort. In addition, health policymakers should establish programmes that improve the social support of non-institutionalized older people.


Assuntos
Cuidadores/psicologia , Família/psicologia , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Apoio Social , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Espanha , Inquéritos e Questionários
5.
Int Nurs Rev ; 65(3): 441-449, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29480550

RESUMO

AIM: To estimate the prevalence of intimate partner abuse in physicians, nurses and nursing assistants and risk factors in the Spanish Health Service. BACKGROUND: In Spain, the national public health service is the most likely point of primary care access for victims of intimate partner violence. However, health professionals are also victims of violence by their intimate partner. Little research has been undertaken exploring the prevalence and risk factors of this abuse in health professionals. METHODS: A cross-sectional multicenter study in professionals of both sexes who were working in the Spanish Public Health Service was performed. The health professionals completed an online survey of intimate violence abuse: for women, the screening of abuse against women by an intimate partner, and for men, the domestic violence screening tool in a family setting. A descriptive and comparative analysis was performed. RESULTS: The sample consisted of 1071 professionals: 49.9% were physicians, 46.9% were nurses and 3.3% were nursing assistants. Of the participants, 26.6% had experienced some form of abuse, and 73.3% of the abused professionals had not spoken of their experience of abuse with anyone else. CONCLUSION: Men experienced a lower incidence of intimate partner violence than women. In fact, 34% of the female participants were in an abusive relationship, which is a higher percentage than that observed in studies of the general Spanish female population (11.7%). It appears that being female and a nurse are risk factors for abuse. IMPLICATIONS FOR NURSING AND HEALTH POLICY: These data suggest the urgent implementation of action plans for the provision of support for the victims and for interventions aimed at reducing the problem. Better training and awareness-raising programmes that improve the detection of intimate partner violence and the care of its victims are also necessary.


Assuntos
Relações Interpessoais , Assistentes de Enfermagem/psicologia , Recursos Humanos de Enfermagem/psicologia , Médicos/psicologia , Parceiros Sexuais/psicologia , Violência/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistentes de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Médicos/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Espanha , Inquéritos e Questionários , Violência/estatística & dados numéricos
6.
J Virol ; 90(23): 10660-10669, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27654300

RESUMO

Bank vole is a rodent species that shows differential susceptibility to the experimental transmission of different prion strains. In this work, the transmission features of a panel of diverse prions with distinct origins were assayed both in bank vole expressing methionine at codon 109 (Bv109M) and in transgenic mice expressing physiological levels of bank vole PrPC (the BvPrP-Tg407 mouse line). This work is the first systematic comparison of the transmission features of a collection of prion isolates, representing a panel of diverse prion strains, in a transgenic-mouse model and in its natural counterpart. The results showed very similar transmission properties in both the natural species and the transgenic-mouse model, demonstrating the key role of the PrP amino acid sequence in prion transmission susceptibility. However, differences in the PrPSc types propagated by Bv109M and BvPrP-Tg407 suggest that host factors other than PrPC modulate prion strain features. IMPORTANCE: The differential susceptibility of bank voles to prion strains can be modeled in transgenic mice, suggesting that this selective susceptibility is controlled by the vole PrP sequence alone rather than by other species-specific factors. Differences in the phenotypes observed after prion transmissions in bank voles and in the transgenic mice suggest that host factors other than the PrPC sequence may affect the selection of the substrain replicating in the animal model.


Assuntos
Arvicolinae/genética , Arvicolinae/fisiologia , Proteínas PrPC/patogenicidade , Doenças Priônicas/etiologia , Príons/patogenicidade , Animais , Encéfalo/fisiopatologia , Bovinos , Síndrome de Creutzfeldt-Jakob/etiologia , Síndrome de Creutzfeldt-Jakob/genética , Síndrome de Creutzfeldt-Jakob/transmissão , Modelos Animais de Doenças , Suscetibilidade a Doenças , Interações Hospedeiro-Patógeno , Humanos , Camundongos , Camundongos Transgênicos , Proteínas PrPC/genética , Proteínas PrPC/fisiologia , Doenças Priônicas/genética , Doenças Priônicas/transmissão , Príons/genética , Príons/fisiologia , Ovinos , Especificidade da Espécie
7.
Ann Oncol ; 26(3): 497-504, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25395283

RESUMO

BACKGROUND: Figitumumab (CP-751,871) is a fully human IgG2 monoclonal antibody that inhibits the insulin-like growth factor 1 receptor. This multicenter, randomized, phase III study investigated the efficacy of figitumumab plus erlotinib compared with erlotinib alone in patients with pretreated, nonsmall-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients (stage IIIB/IV or recurrent disease with nonadenocarcinoma histology) who had previously received at least one platinum-based regimen were randomized to receive open-label figitumumab (20 mg/kg) plus erlotinib 150 mg/day or erlotinib alone every 3 weeks. The primary end point was overall survival (OS). RESULTS: Of 583 patients randomized, 579 received treatment. The study was closed early by an independent data safety monitoring committee due to results crossing the prespecified futility boundary. At the final analysis, median OS was 5.7 months for figitumumab plus erlotinib and 6.2 months for erlotinib alone [hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.91-1.31; P = 0.35]. Median progression-free survival was 2.1 months for figitumumab plus erlotinib and 2.6 months for erlotinib alone (HR 1.08; 95% CI 0.90-1.29; P = 0.43). Treatment-related nonfatal serious adverse events occurred in 18% and 5% of patients in the figitumumab arm or erlotinib alone arm, respectively. There were nine treatment-related deaths (three related to both drugs, four related to erlotinib alone and two related to figitumumab). CONCLUSIONS: The addition of figitumumab to erlotinib did not improve OS in patients with advanced, pretreated, nonadenocarcinoma NSCLC. Clinical development of figitumumab has been discontinued. CLINICAL TRIAL ID: NCT00673049.


Assuntos
Anticorpos Monoclonais/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Cloridrato de Erlotinib/administração & dosagem , Neoplasias Pulmonares/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
8.
Neurologia ; 30(2): 71-6, 2015 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24332773

RESUMO

INTRODUCTION: Although cognitive and learning disorders have been described in patients with epilepsy, very few studies focus on specific disorders such as absence epilepsy. The aim of this study was to evaluate learning skills and academic performance in children and adolescents with absence epilepsy. METHODS: Observational case-control study. Cases were chosen from the Central League against Epilepsy's clinic in Bogotá, Colombia. Controls were selected from a private school and matched with cases by age, school year, and sex. Medical history, seizure frequency, antiepileptic treatment, and academic performance were assessed. Academic abilities were tested with Batería de Aptitudes Diferenciales y Generales (BADyG) (a Spanish-language test of differential and general aptitudes). Data were analysed using Student t-test. RESULTS: The sample consisted of 19 cases and 19 controls aged between 7 and 16. In 15 patients, seizures were controlled; all patients had received antiepileptic medication at some point and 78.9% were actively being treated. Although cases had higher rates of academic failure, a greater incidence of grade retention, and more therapeutic interventions than controls, these differences were not significant. Similarly, there were no significant differences on the BADyG test, except for the immediate memory subcategory on which cases scored higher than controls (P=.0006). CONCLUSION: Children treated pharmacologically for absence epilepsy, whose seizures are controlled, have normal academic abilities and skills for their age.


Assuntos
Avaliação Educacional , Epilepsia Tipo Ausência/psicologia , Aprendizagem , Adolescente , Estudos de Casos e Controles , Criança , Colômbia , Epilepsia Tipo Ausência/tratamento farmacológico , Feminino , Humanos , Deficiências da Aprendizagem/etiologia , Masculino , Testes Neuropsicológicos
9.
Neuropathol Appl Neurobiol ; 40(3): 311-26, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23741998

RESUMO

AIMS: Transmissible spongiform encephalopathies, also called prion diseases, are characterized by the cerebral accumulation of misfolded prion protein (PrP(SC) ) and subsequent neurodegeneration. However, despite considerable research effort, the molecular mechanisms underlying prion-induced neurodegeneration are poorly understood. Here, we explore the hypothesis that prions induce dysfunction of the PI3K/Akt/GSK-3 signalling pathway. METHODS: We employed two parallel approaches. Using cell cultures derived from mouse primary neurones and from a human neuronal cell line, we identified common elements that were modified by the neurotoxic fragment of PrP(106-126) . These studies were then complemented by comparative analyses in a mouse model of prion infection. RESULTS: The presence of a polymerized fragment of the prion protein (PrP(106-126) ) or of a prion strain altered PI3K-mediated signalling, as evidenced by Akt inhibition and GSK-3 activation. PI3K activation by the addition of insulin or the expression of a constitutively active Akt mutant restored normal levels of Akt and GSK-3 activity. These changes were correlated with a reduction in caspase activity and an increase in neuronal survival. Moreover, we found that activation of caspase 3, Erk and GSK-3 are common features of PrP(106-126) -mediated neurotoxicity in cellular systems and prion infection in the mouse cerebellum, while activation of caspase 12 and JNK was observed in cellular models. CONCLUSIONS: Our findings in cell culture and in vivo models of prion disease demonstrate marked alterations to the PI3K/Akt/GSK-3 pathway and suggest that two additional pathways contribute to PrP-induced neurotoxicity as responsible of JNK and caspase 12 activation.


Assuntos
Quinase 3 da Glicogênio Sintase/metabolismo , Fosfatidilinositol 3-Quinase/metabolismo , Doenças Priônicas/enzimologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Animais , Linhagem Celular Tumoral , Células Cultivadas , Modelos Animais de Doenças , Humanos , Camundongos , Fragmentos de Peptídeos/metabolismo , Príons/metabolismo
10.
Pharmacogenomics J ; 13(2): 121-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22158329

RESUMO

Glucocorticoids (GCs) are steroid hormones widely used as pharmaceutical interventions, which act mainly by regulating gene expression levels. A large fraction of patients (∼30%), especially those of African descent, show a weak response to treatment. To interrogate the contribution of variable transcriptional response to inter-ethnic differences, we measured in vitro lymphocyte GC sensitivity (LGS) and transcriptome-wide response to GCs in peripheral blood mononuclear cells from African-American (AA) and European-American (EA) healthy donors. We found that transcriptional response after 8 h treatment was significantly correlated with variation in LGS within and between populations. We found that NFKB1, a gene previously found to predict LGS within populations, was more strongly downregulated in EAs on average. NFKB1 could not completely explain population differences, however, and we found an additional 177 genes with population differences in the average log2 fold change (false discovery rate<0.05), most of which also showed a weaker transcriptional response in AAs. These results suggest that inter-ethnic differences in GC sensitivity reflect variation in transcriptional response at many genes, including regulators with large effects (for example, NFKB1) and numerous other genes with smaller effects.


Assuntos
Regulação da Expressão Gênica/efeitos dos fármacos , Glucocorticoides/administração & dosagem , Linfócitos/citologia , Transcriptoma , Negro ou Afro-Americano/genética , Glucocorticoides/metabolismo , Humanos , Linfócitos/efeitos dos fármacos , Subunidade p50 de NF-kappa B/genética , Subunidade p50 de NF-kappa B/metabolismo , Ativação Transcricional/efeitos dos fármacos , População Branca/genética
11.
Neurochem Res ; 38(3): 557-63, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23229791

RESUMO

Testosterone (T) is known to play an important masculinizing role in the developing brain of rat, including the regulation of 5α-reductase (5α-R) isozymes. However, the effects of dihydrotesterone (DHT), a more potent androgen than T, have not been elucidated. In this study, DHT was administered from day 5 through day 20 of postnatal life (period of postnatal sexual differentiation of the central nervous system) at doses of: 12 mg/kg/d on days 5, 6, 7, 8, 19, and 20; 15 mg/kg/d on days 9, 10, 11, 12, 16, 17, and 18; and 18 mg/kg/d on days 13, 14, and 15. In adulthood, quantitative RT-PCR was used to measure mRNA levels of 5α-R1 and 5α-R2 isozymes in the prefrontal cortex (PFC) of male and female rats with varied androgenic status. Under our study conditions, neonatal DHT administration influenced on adult PFC 5α-R isozymes levels and their regulation pattern by androgens, and this pattern was the inverse of that reported in adult neonatally T-treated rats.


Assuntos
3-Oxo-5-alfa-Esteroide 4-Desidrogenase/metabolismo , Encéfalo/enzimologia , Di-Hidrotestosterona/farmacologia , Animais , Animais Recém-Nascidos , Feminino , Isoenzimas/biossíntese , Masculino , Ratos , Ratos Wistar , Diferenciação Sexual/efeitos dos fármacos
12.
Pediatr Diabetes ; 14(2): 90-6, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23350725

RESUMO

Recent results of genome wide association study (GWAS) for diabetes genes, while reaching impressive technical milestones and implicating new findings for research, have been uniformly disappointing in terms of immediate clinical utility. The relative risk associated with any of the newly reported genetic loci, or even considering all of them together, is far less than simply that which can be obtained by taking a history and a physical exam. For type 2 diabetes (T2D), GWAS have implicated novel pathways, supported previously known associations, and highlighted the importance of the beta cell and insulin secretion. Monogenic forms of diabetes, on the other hand, continue to yield interesting insights into genes controlling human beta cell function but most cases of monogenic diabetes are simply not diagnosed. Here, we briefly review recent results related to type 1, type 2 and maturity onset diabetes of youth (MODY) diabetes and suggest that future studies emphasizing quantitative traits are likely to yield even more insights.


Assuntos
Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 2/genética , Estudo de Associação Genômica Ampla , Humanos , Desequilíbrio de Ligação , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas
13.
Semergen ; 49(8): 102063, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37619267

RESUMO

INTRODUCTION: Chronic venous disease (CVD) is classified as the most prevalent vascular disease in humans. It has been associated with an increased incidence of cardiovascular diseases and is a strong predictor of all-cause mortality, representing a public health problem of the first magnitude. The objective of this study was to analyze the actions in the management of CVD in the daily clinical practice of health professionals in Spain. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study with data collection through an opinion survey of 22 questions completed electronically through a Google® form for professionals involved in chronic venous disease care. Three hundred surveys were analyzed. The quantitative variables were represented with means and standard deviation and the qualitative ones with percentages and confidence intervals. RESULTS: Three hundred surveys analyzed. 65.3% were women. The most participatory age group was over 55 years of age. 85% of those surveyed considered that CVD is an underdiagnosed and undertreated disease, with an added negative impact in terms of follow-up during the Covid-19 pandemic, since 91.7% considered that it had not been adequate. 47% of the participants did not know the CEAP classification and 56.3% did not know the venous clinical severity scale (VCSS). 92.7% of physicians prescribed compression stockings and 74.7% phlebotonic drugs. Hidrosmine was the best known and most prescribed venoactive drug (51.7%). 73% of the doctors recognized that they did not use any algorithm or protocol for the diagnosis, treatment and monitoring of CVD in their usual clinical practice and 91% stated that they were not trained in their workplaces. 54.3% of the physicians believed that one of the main limitations that made follow-up of the disease difficult was the lack of coordination with the vascular surgeons. CONCLUSIONS: Updating and responding to the training needs of professionals regarding CVD is essential to guarantee quality care continuity in the care of our patients.


Assuntos
Pandemias , Doenças Vasculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Crônica , Estudos Transversais , Atenção à Saúde , Espanha/epidemiologia , Doenças Vasculares/diagnóstico , Doenças Vasculares/epidemiologia , Doenças Vasculares/terapia
14.
Semergen ; 48(5): 344-355, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35618620

RESUMO

Chronic venous disease (CVD) is the most common vascular disease in humans and continues to be underdiagnosed and undertreated at all levels of care. The new times we live in have led to an increase in uncertainty among chronic patients about their diagnosis, treatment and follow-up by family doctors and especially in CVD. In order to analyze these new times, the Semergen Vasculopathies Group has created the Venocheck questionnaire, which assesses aetiological, clinical (CEAP classification), severity and quality of life, therapeutic aspects, presence of complications and referral criteria.


Assuntos
Doenças Vasculares , Insuficiência Venosa , Doença Crônica , Humanos , Qualidade de Vida , Doenças Vasculares/diagnóstico , Doenças Vasculares/epidemiologia , Doenças Vasculares/etiologia , Veias , Insuficiência Venosa/diagnóstico , Insuficiência Venosa/epidemiologia , Insuficiência Venosa/terapia
15.
Eur Respir J ; 37(3): 624-31, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20595147

RESUMO

Median survival of patients with brain metastases from nonsmall cell lung cancer (NSCLC) is poor and more effective treatments are urgently needed. We have evaluated the efficacy of erlotinib in this setting and its association with activating mutations in the epidermal growth factor receptor (EGFR) gene. We retrospectively identified patients with NSCLC and brain metastases treated with erlotinib. EGFR mutations in exons 19 and 21 were analysed by direct sequencing. Efficacy and tolerability were compared according to EGFR mutational status. 69 NSCLC patients with brain metastases were identified, 17 of whom harboured EGFR mutations. Objective response rate in patients with EGFR mutations was 82.4%; no responses were observed in unselected patients (p<0.001). Median (95% CI) time to progression within the brain for patients harbouring EGFR mutations was 11.7 (7.9-15.5) months, compared to 5.8 (5.2-6.4) months for control patients whose EGFR mutational status had not been assessed (p<0.05). Overall survival was 12.9 (6.2-19.7) months and 3.1 (2.5-3.9) months (p<0.001), respectively. The toxicity of erlotinib was as expected and no differences between cohorts were observed. Erlotinib is active in brain metastases from NSCLC; this clinical benefit is related to the presence of activating mutations in exons 19 or 21 of the EGFR gene.


Assuntos
Neoplasias Encefálicas/secundário , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Receptores ErbB/genética , Neoplasias Pulmonares/patologia , Mutação , Quinazolinas/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Neoplasias Encefálicas/metabolismo , Estudos de Coortes , Receptores ErbB/metabolismo , Cloridrato de Erlotinib , Éxons , Feminino , Humanos , Neoplasias Pulmonares/metabolismo , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Inibidores de Proteínas Quinases/farmacologia , Estudos Retrospectivos , Resultado do Tratamento
16.
Mol Cell Biochem ; 353(1-2): 59-63, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21547454

RESUMO

To study atherogenesis markers in patients with stage 5D chronic kidney disease (CKD-5D) on hemodialysis to determine which parameters are modified and whether their behavior differ between male and female patients of similar age. Total cholesterol, triglycerides, glucose, total proteins, HDL-cholesterol, LDL-cholesterol, oxidative modification of low-density lipoprotein-cholesterol, autoantibodies against oxidized low-density lipoproteins-cholesterol, homocysteine (Hcy), folate, and vitamin B12 were measured in male and female controls and CKD-5D patients on hemodialysis for >6 months. The CKD-5D patients had significantly lower cholesterol, LDL-c and ox-LDL levels and significantly higher ox-LDL-AB and Hcy levels versus their respective controls. The reduction in ox-LDL in CKD patients does not imply a lower risk of atherosclerosis. In fact, the risk may be higher due to a greater capture of ox-LDL by macrophage scavenger receptors, which are increased in these patients. Elevated Hcy levels may also be a risk factor for atherosclerosis in male and female CKD-5D patients.


Assuntos
Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Lipídeos/sangue , Estresse Oxidativo , Diálise Renal , Idoso , Aterosclerose/sangue , Aterosclerose/diagnóstico , Glicemia/metabolismo , Colesterol/sangue , HDL-Colesterol , LDL-Colesterol , Feminino , Ácido Fólico/sangue , Homocisteína/sangue , Humanos , Lipoproteínas LDL , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Triglicerídeos/sangue , Vitamina B 12/sangue
17.
Opt Express ; 18(6): 5413-9, 2010 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-20389557

RESUMO

Tetragonal single crystals of NaT(WO(4))(2) (T = Y or Lu) co-doped with Tm(3+) and Ho(3+) ions have been employed for broadly tunable and efficient room-temperature laser operation at around 2 mum. With Ti:sapphire laser pumping at 795 nm, a slope efficiency and a maximum output power as high as 48% and 265 mW, respectively, have been achieved at 2050 nm from a Tm,Ho:NaY(WO(4))(2) crystal. Tuning from 1830 nm to 2080 nm has also been obtained using an intracavity Lyot filter.


Assuntos
Lasers de Estado Sólido , Desenho de Equipamento , Análise de Falha de Equipamento
18.
Nanotechnology ; 21(7): 75703, 2010 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-20081293

RESUMO

Elastic constants and cross-sectional dimensions of imprinted nanolines of poly(methyl methacrylate) (PMMA) on silicon substrates are determined nondestructively from finite-element inversion analysis of dispersion curves of hypersonic acoustic modes of these nanolines measured with Brillouin light scattering. The results for the cross-sectional dimensions, under the simplifying assumption of vertical sides and a semicircular top, are found to be consistent with dimensions determined from critical-dimension small-angle x-ray scattering measurements. The elastic constants C(11) and C(44) are found to be, respectively, 11.6% and 3.1% lower than their corresponding values for bulk PMMA. This result is consistent with the dimensional dependence of the quasi-static Young's modulus determined from buckling measurements on PMMA films with lower molecular weights. This study provides the first evidence of size-dependent effects on hypersonic elastic properties of polymers.

19.
Actas Dermosifiliogr ; 101(4): 336-40, 2010 May.
Artigo em Espanhol | MEDLINE | ID: mdl-20487689

RESUMO

INTRODUCTION: Acrylates are widely used low-molecular-weight substances, initially introduced in industry in the 1930s and subsequently applied also in medicine and the home. One of their main features is the ability to undergo polymerization. The most commonly used acrylic compounds are cyanoacrylates, methacrylates, and acrylates. OBJECTIVE: To confirm suspicion of occupational disease in a group of workers in an elevator factory. MATERIAL AND METHODS: We studied 8 patients with dermatitis of the hands and finger pads. In their work, the patients came into contact with acrylates. Patch testing was applied with an acrylate panel (BIAL-Aristegui, Bilbao, Spain). RESULTS: Seven of the patients (87. 5%) had a positive result with 1% ethylene glycol dimethacrylate. Positive RESULTS: were also observed for 2% hydroxyethyl methacrylate (5 patients, 62. 5%), 1% triethylene glycol dimethacrylate (4 patients, 50%), 10% ethyl methacrylate monomer (3 patients, 37. 5%), 10% methyl methacrylate monomer (2 patients, 25%), 1% ethyl acrylate (1 patient, 12. 5%), and 0. 1% acrylic acid (1 patient, 12. 5%). CONCLUSIONS: We highlight the strong sensitizing capacity of acrylates and the importance of taking all necessary preventive measures in industries where these substances are used. Such measures should include avoidance of contact with the product in cases where sensitization has been confirmed.


Assuntos
Acrilatos/toxicidade , Dermatite de Contato/diagnóstico , Dermatite de Contato/etiologia , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/diagnóstico , Adulto , Humanos , Masculino , Pessoa de Meia-Idade
20.
Orphanet J Rare Dis ; 15(1): 16, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941528

RESUMO

The low prevalence of European paediatric transplanted patients and scarcity of resources and expertise led to the need for a multidisciplinary network able to improve the quality of life of paediatric patients and families requiring a solid organ or haematopoietic stem cell transplantation. The European Reference Network (ERN) TransplantChild is one of the 24 ERNs established in a European legal framework to improve the care of patients with rare diseases. ERN TransplantChild is the only ERN focused on both solid organ and haematopoietic stem cell paediatric transplantation, based on the understanding of paediatric transplantation as a complex and highly specialised process where specific complications appear regardless the organ involved, thus linking the skills and knowledge of different organ disciplines. Gathering European centres of expertise in paediatric transplantation will give access to a correct and timely diagnosis, share expertise and knowledge and collect a critical mass of patients and data that increases the speed and value of clinical research outcomes. Therefore, the ERN TransplantChild aims for a paediatric Pan-European, Pan-transplant approach.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Órgãos/métodos , Europa (Continente) , Geografia , Humanos , Modelos Teóricos , Qualidade de Vida , Procedimentos Cirúrgicos Operatórios
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