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Neural-activity-associated hemodynamic changes have been used to noninvasively measure brain function in the early developmental stages. However, the temporal changes in their hemodynamics are not always consistent with adults. Studies have not evaluated developmental changes for a long period using the same stimuli; therefore, this study examined the normalized relative changes in oxygenated hemoglobin (Δ[oxy-Hb]) in full-term infants and compared them with neonates up to 10 months of age during the administration of tactile vibration stimuli to their limbs using whole-head functional near-infrared spectroscopy. The time to peak of normalized Δ[oxy-Hb] was not affected by age. The amplitude of normalized Δ[oxy-Hb] showed an effect of age in broader areas, including sensorimotor-related but excluding supplementary motor area; the amplitude of normalized Δ[oxy-Hb] decreased the most in the 1-2-month-old group and later increased with development. We hypothesized that these results may reflect developmental changes in neural activity, vasculature, and blood oxygenation.
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Córtex Motor , Espectroscopia de Luz Próxima ao Infravermelho , Adulto , Recém-Nascido , Lactente , Humanos , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Hemodinâmica/fisiologia , Oxiemoglobinas/análise , Oxiemoglobinas/metabolismo , Córtex Motor/metabolismo , Tato , Hemoglobinas/metabolismoRESUMO
Low circulating vitamin D levels are more prevalent in Black than White individuals. We analyzed the Women's Health Initiative (WHI) calcium plus vitamin D (CaD) randomized clinical trial extended follow-up data to evaluate associations between calcium plus vitamin D supplementation and incident cancer, cardiovascular disease (CVD), and cause-specific mortality endpoints among Black women. Intent-to-treat analysis was performed. Among 3325 Black women in the CaD trial who were randomized into either daily calcium (1000 mg of calcium carbonate) plus vitamin D (400 IU D3) or placebos for an average of 7 years, there were 813 deaths, 588 incident cancers, and 837 CVD events during an average of 15.7 years of follow up (52 230 total person-years). Using Cox's proportional hazards models, we calculated hazard ratios and their confidence intervals for outcomes ascertained during the trial period, posttrial follow-up period and overall periods combined. We found that total mortality, cause-specific mortality, and total cancer incidence were almost identical between CaD and placebo groups. These results suggest that calcium plus vitamin D supplementation does not reduce risks of cancer, CVD, or other major causes of death in Black women overall and, thus, other medical, behavioral or social interventions should be considered to narrow health disparities related to these outcomes. However, other finer endpoints, such as colorectal cancer, warrants further investigation.
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Doenças Cardiovasculares , Neoplasias , Feminino , Humanos , Cálcio , Causas de Morte , Incidência , Seguimentos , Suplementos Nutricionais , Vitamina D , Cálcio da Dieta , Saúde da Mulher , Neoplasias/epidemiologia , Neoplasias/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controleRESUMO
Proton pump inhibitors (PPIs) have off-target activity on fatty acid synthase (FASN), a critical enzyme in energy balance and cancer growth. We evaluated risk of common obesity-related cancers: breast, colorectal (CRC), and endometrial, with use of PPI and histamine-2 receptor antagonists (H2RA) in 124,931 postmenopausal women enrolled in the Women's Health Initiative. Incident cancer cases were physician-adjudicated. Cox proportional hazards models were used to estimate multivariable hazard ratios (HR) and 95% confidence intervals (CI) for cancer incidence after year 3. There were 7956 PPI ever users and 9398 H2RA only users. Ever use of either PPI or H2RA was not associated with risk of breast cancer (n = 9186) nor risk of endometrial cancer (n = 1231). The risk of CRC (n = 2280) was significantly lower in PPI users (HR = 0.75, 95% CI = 0.61-0.92), but not in H2RA users (HR = 1.13, 95% CI = 0.97-1.31). The association of PPI use with CRC was apparent regardless of BMI or NSAID use, and was stronger with longer PPI duration (p = 0.006) and potency (p = 0.005). The findings that PPI use, but not H2RA use, demonstrate an inverse dose-response relationship with risk of CRC is consistent with preclinical data showing FASN inhibition prevents colon cancer progression and supports a role of PPI in CRC prevention.
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Neoplasias do Colo , Inibidores da Bomba de Prótons , Humanos , Feminino , Inibidores da Bomba de Prótons/efeitos adversos , Antagonistas dos Receptores H2 da Histamina/efeitos adversos , Neoplasias do Colo/tratamento farmacológico , Obesidade/complicações , Obesidade/tratamento farmacológico , Saúde da Mulher , Fatores de RiscoRESUMO
BACKGROUND: Campylobacter jejuni is the leading cause of zoonotic gastroenteritis. The other emerging group of Campylobacters spp. are part of human oral commensal, represented by C. concisus (CC), which has been recently linked to non-oral conditions. Although long-term gastrointestinal (GI) complications from these two groups of Campylobacters have been previously reviewed individually, overall impact of Campylobacter infection on GI carcinogenesis and their inflammatory precursor lesions has not been assessed collectively. AIMS: To evaluate the available evidence concerning the association between Campylobacter infection/colonization and inflammatory bowel disease (IBD), reflux esophagitis/metaplasia colorectal cancer (CRC) and esophageal cancer (EC). METHODS: We performed a comprehensive literature search of PubMed for relevant original publications and systematic reviews/meta-analyses of epidemiological and clinical studies. In addition, we gathered additional information concerning microbiological data, animal models and mechanistic data from in vitro studies. RESULTS: Both retrospective and prospective studies on IBD showed relatively consistent increased risk associated with Campylobacter infection. Despite lack of supporting prospective studies, retrospective studies based on tissue/fecal microbiome revealed consistent enrichment of Campylobacter in CRC samples. Studies on EC precursor lesions (esophagitis and metaplasia) were generally supportive for the association with Campylobacter, while inconsistent observations on EC. Studies on both IBD and EC precursors suggested the predominant role of CC, but studies on CRC were not informative of species. CONCLUSIONS: There is sufficient evidence calling for concerted effort in unveiling direct and indirect connection of this organism to colorectal and esophageal cancer in humans.
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Infecções por Campylobacter , Campylobacter , Neoplasias Esofágicas , Esofagite Péptica , Gastroenteropatias , Doenças Inflamatórias Intestinais , Animais , Humanos , Infecções por Campylobacter/complicações , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Estudos Retrospectivos , Estudos Prospectivos , Doenças Inflamatórias Intestinais/microbiologia , MetaplasiaRESUMO
BACKGROUND: Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI). METHODS: Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in the presence of competing events, combined and separately, for 9301 Black and 4221 Latina postmenopausal women. Additionally, ACS guideline adherence was examined in a subset of less common ORCs and potential effect modification by neighborhood socioeconomic status and smoking. RESULTS: Over a median of 11.1, 12.5, and 3.7 years of follow-up for incidence, nonconditional mortality, and conditional mortality, respectively, 1191 ORCs (Black/Latina women: 841/269), 1970 all-cause deaths (Black/Latina women: 1576/394), and 341 ORC-related deaths (Black/Latina women: 259/82) were observed. Higher ACS guideline adherence was associated with lower ORC incidence for both Black (cause-specific hazard ratio [CSHR]highvs.low : 0.72; 95% CI, 0.55-0.94) and Latina (CSHRhighvs.low : 0.58, 95% CI, 0.36-0.93) women; but not conditional all-cause mortality (Black hazard ratio [HR]highvs.low : 0.86; 95% CI, 0.53-1.39; Latina HRhighvs.low : 0.81; 95% CI, 0.32-2.06). Higher adherence was associated with lower incidence of less common ORC (Ptrend = .025), but conditional mortality events were limited. Adherence and ORC-specific deaths were not associated and there was no evidence of effect modification. CONCLUSIONS: Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality. LAY SUMMARY: Evidence on the association between the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and cancer remains scarce for women of color. Adherence to the guidelines and risk of developing one of 13 obesity-related cancers among Black and Latina women in the Women's Health Initiative was examined. Women who followed the lifestyle guidelines had 28% to 42% lower risk of obesity-related cancer. These findings support public health interventions to reduce growing racial/ethnic disparities in obesity-related cancers.
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Exercício Físico , Neoplasias , American Cancer Society , Feminino , Hispânico ou Latino , Humanos , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia , Saúde da MulherRESUMO
There is evidence to suggest that soy may be beneficial for prostate cancer patients, but few randomized trials have addressed this. We examined the effect of 6-8 mo soy protein supplementation on prostate specific antigen (PSA) serum levels in men who recurred (PSA > 0.1 ng/ml) within three years of prostatectomy. Sixteen men were randomized to 20 g soy protein (â¼24-26/day genistein; â¼40-43/day total isoflavones) or casein placebo. PSA was measured at base line and at 1, 2, 4, and 6-8 mo. Serum genistein levels greatly increased from baseline and cholesterol decreased in the soy group. In both treatment arms PSA increased similarly and PSA doubling times were not different over the 6-8 mo study duration. Two subjects in each group had stable PSA. A literature search for clinical studies of soy, isoflavones, and PSA revealed that supplementation with soy or isoflavones did not affect PSA in virtually all clinical studies identified. Although this study is too small to draw a definitive conclusion on the effect of soy protein on PSA in men with biochemical failure, the null finding in this study is consistent with the results of virtually all reports of soy and soy isoflavones in the literature.
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Isoflavonas , Neoplasias da Próstata , Humanos , Isoflavonas/farmacologia , Masculino , Projetos Piloto , Antígeno Prostático Específico , Prostatectomia , Neoplasias da Próstata/tratamento farmacológico , Proteínas de SojaRESUMO
Many studies have addressed the effects of dietary supplementation with soy protein on cancer risk and mortality, but there are only few randomized studies with soy in males. We used serum samples from a two-year trial of soy protein isolate supplementation in middle-aged to older males at risk of recurrence of prostate cancer after radical prostatectomy to determine soy effects on steroid hormones involved in prostate cancer (testosterone, SHBG, and estradiol) and explore the effects on biomarkers of the growth hormone/IGF-1 axis, apoptosis, and angiogenesis. Compared with a casein-based placebo, 18 mo, of consumption of 19.2 g/day of whole soy protein isolate containing 24 mg genistein-reduced circulating testosterone and SHBG, but not free testosterone, and did not affect serum concentrations of estradiol, VEGF, IGF-1, IGFBP-3, IGF-1/IGFBP-3 ratio, soluble Fas, Fas-ligand, and sFas/Fas-ligand ratio. Thus, soy protein supplementation for 18 mo, affected the androgen axis, but the effects on other cancer biomarkers remain to be more definitively determined. The study was registered at clinicaltrials.gov (NCT00765479).
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Fator de Crescimento Insulin-Like I , Proteínas de Soja , Apoptose , Biomarcadores Tumorais , Suplementos Nutricionais , Hormônio do Crescimento , Humanos , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Pessoa de Meia-Idade , Prostatectomia , Proteínas de Soja/farmacologia , TestosteronaRESUMO
BACKGROUND: The Eyberg Child Behavior Inventory (ECBI) is one of the standardized parent rating scales used to identify disruptive behavior problems in children in Western countries. This study aimed to determine norms for the Japanese version of the ECBI, including clinical cutoff scores among the general population in Japan. METHODS: This study established norms for the Japanese version of the ECBI using a sample of 1,992 parents of children aged 2-7, living in Japan. The research evaluates the validity and the reliability of the ECBI scores for the Intensity Scale and the Problem Scale. After validation, a clinical cutoff value of the ECBI scores was calculated, setting the cutoff to above the +1 standard deviation (SD) level based on the population distribution. RESULTS: The means of the Intensity and Problem Scale scores were 100.07 and 6.57, respectively. Cronbach's α for both the Intensity and the Problem scores was 0.91. At this point, we propose cutoff scores of 125 for the Intensity Scale and 14 for the Problem Scale. CONCLUSIONS: Our results suggest that the Japanese version of the ECBI is highly reliable and may be useful as a tool for assessing behavior problems in children.
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Transtornos do Comportamento Infantil , Comportamento Problema , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Humanos , Japão , Psicometria , Reprodutibilidade dos TestesRESUMO
Recently, our studies revealed that some passenger strands of microRNAs (miRNAs) were closely involved in cancer pathogenesis. Analysis of miRNA expression signatures showed that the expression of miR-30e-3p (the passenger strand of pre-miR-30e) was significantly downregulated in cancer tissues. In this study, we focused on miR-30e-3p (the passenger strand of pre-miR-30e). We addressed target genes controlled by miR-30e-3p that were closely associated with the molecular pathogenesis of head and neck squamous cell carcinoma (HNSCC). Ectopic expression assays demonstrated that the expression of miR-30e-3p attenuated cancer cell malignant phenotypes (e.g., cell proliferation, migration, and invasive abilities). Our analysis of miR-30e-3p targets revealed that 11 genes (ADA, CPNE8, C14orf126, ERGIC2, HMGA2, PLS3, PSMD10, RALB, SERPINE1, SFXN1, and TMEM87B) were expressed at high levels in HNSCC patients. Moreover, they significantly predicted the short survival of HNSCC patients based on 5-year overall survival rates (p < 0.05) in The Cancer Genome Atlas (TCGA). Among these targets, SERPINE1 was found to be an independent prognostic factor for patient survival (multivariate Cox regression; hazard ratio = 1.6078, p < 0.05). Aberrant expression of SERPINE1 was observed in HNSCC clinical samples by immunohistochemical analysis. Functional assays by targeting SERPINE1 expression revealed that the malignant phenotypes (e.g., proliferation, migration, and invasion abilities) of HNSCC cells were suppressed by the silencing of SERPINE1 expression. Our miRNA-based approach will accelerate our understanding of the molecular pathogenesis of HNSCC.
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Neoplasias de Cabeça e Pescoço , MicroRNAs , Proteínas de Transporte/metabolismo , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias de Cabeça e Pescoço/genética , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Inibidor 1 de Ativador de Plasminogênio/genética , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Proteínas Proto-Oncogênicas/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/genéticaRESUMO
In humans, the coronin family is composed of seven proteins containing WD-repeat domains that regulate actin-based cellular processes. Some members of the coronin family are closely associated with cancer cell migration and invasion. The Cancer Genome Atlas (TCGA) analysis revealed that CORO1C, CORO2A, and CORO7 were significantly upregulated in oral squamous cell carcinoma (OSCC) tissues (p < 0.05). Moreover, the high expression of CORO2A was significantly predictive of the 5-year survival rate of patients with OSCC (p = 0.0203). Overexpression of CORO2A was detected in OSCC clinical specimens by immunostaining. siRNA-mediated knockdown of CORO2A suppressed cancer cell migration and invasion abilities. Furthermore, we investigated the involvement of microRNAs (miRNAs) in the molecular mechanism underlying CORO2A overexpression in OSCC cells. TCGA analysis confirmed that tumor-suppressive miR-125b-5p and miR-140-5p were significantly downregulated in OSCC tissues. Notably, these miRNAs bound directly to the 3'-UTR of CORO2A and controlled CORO2A expression in OSCC cells. In summary, we found that aberrant expression of CORO2A facilitates the malignant transformation of OSCC cells, and that downregulation of tumor-suppressive miRNAs is involved in CORO2A overexpression. Elucidation of the interaction between genes and miRNAs will help reveal the molecular pathogenesis of OSCC.
Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/patologia , Movimento Celular , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , Proteínas dos Microfilamentos/metabolismo , Neoplasias Bucais/patologia , Apoptose , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Proliferação de Células , Humanos , Proteínas dos Microfilamentos/genética , Neoplasias Bucais/genética , Neoplasias Bucais/metabolismo , Invasividade Neoplásica , Prognóstico , Taxa de Sobrevida , Células Tumorais CultivadasRESUMO
Helicobacter pylori (Hp) infects the stomach of about half of the human population and is strongly associated with the risk of gastric cancer (GC) and its premalignant precursors. The cag pathogenicity island (cagPAI) is a region of the Hp genome encoding for key molecular machinery involved in the infection process. Following a sequencing study, we selected 50 genetic polymorphisms located in seven cagPAI genes and tested their associations with the risk of advanced gastric premalignant lesions and GC in 1220 subjects from various Latin American populations showing the whole spectrum of phenotypes from gastritis to GC. We found that three polymorphisms of cagA are associated with the risk of advanced gastric premalignant lesions (incomplete intestinal metaplasia [ie, Type 2 and 3] or dysplasia), and that six polymorphisms located in cagA, cagL and cagI were associated with risk of GC. When corrected for multiple testing none of the associations were statistically significant. However, scores built by integrating the individual polymorphisms were significantly associated with the risk of advanced gastric premalignant lesions and GC. These results have the potential of establishing markers for risk stratification in the general population, in view of targeting Hp eradication to high-risk population groups.
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Mucosa Gástrica/patologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Lesões Pré-Cancerosas/microbiologia , Neoplasias Gástricas/epidemiologia , Adulto , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Biópsia , Colômbia/epidemiologia , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Feminino , Mucosa Gástrica/microbiologia , Gastrite/microbiologia , Gastrite/patologia , Marcadores Genéticos , Genoma Bacteriano/genética , Ilhas Genômicas , Infecções por Helicobacter/patologia , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/patogenicidade , Humanos , Masculino , Metaplasia/microbiologia , Metaplasia/patologia , México/epidemiologia , Pessoa de Meia-Idade , Polimorfismo Genético , Lesões Pré-Cancerosas/patologia , Medição de Risco/métodos , Fatores de Risco , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Sequenciamento Completo do GenomaRESUMO
The peak alignment is a vital preprocessing step before downstream analysis, such as biomarker discovery and pathway analysis, for two-dimensional gas chromatography mass spectrometry (2DGCMS)-based metabolomics data. Due to uncontrollable experimental conditions, e.g., the differences in temperature or pressure, matrix effects on samples, and stationary phase degradation, a shift of retention times among samples inevitably occurs during 2DGCMS experiments, making it difficult to align peaks. Various peak alignment algorithms have been developed to correct retention time shifts for homogeneous, heterogeneous or both type of mass spectrometry data. However, almost all existing algorithms have been focused on a local alignment and are suffering from low accuracy especially when aligning dense biological data with many peaks. We have developed four global peak alignment (GPA) algorithms using coherent point drift (CPD) point matching algorithms: retention time-based CPD-GPA (RT), prior CPD-GPA (P), mixture CPD-GPA (M), and prior mixture CPD-GPA (P+M). The method RT performs the peak alignment based only on the retention time distance, while the methods P, M, and P+M carry out the peak alignment using both the retention time distance and mass spectral similarity. The method P incorporates the mass spectral similarity through prior information and the methods M and P+M use the mixture distance measure. Four developed algorithms are applied to homogeneous and heterogeneous spiked-in data as well as two real biological data and compared with three existing algorithms, mSPA, SWPA, and BiPACE-2D. The results show that our CPD-GPA algorithms perform better than all existing algorithms in terms of F1 score.
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For the last 500 years, the Americas have been a melting pot both for genetically diverse humans and for the pathogenic and commensal organisms associated with them. One such organism is the stomach-dwelling bacterium Helicobacter pylori, which is highly prevalent in Latin America where it is a major current public health challenge because of its strong association with gastric cancer. By analyzing the genome sequence of H. pylori isolated in North, Central and South America, we found evidence for admixture between H. pylori of European and African origin throughout the Americas, without substantial input from pre-Columbian (hspAmerind) bacteria. In the US, strains of African and European origin have remained genetically distinct, while in Colombia and Nicaragua, bottlenecks and rampant genetic exchange amongst isolates have led to the formation of national gene pools. We found three outer membrane proteins with atypical levels of Asian ancestry in American strains, as well as alleles that were nearly fixed specifically in South American isolates, suggesting a role for the ethnic makeup of hosts in the colonization of incoming strains. Our results show that new H. pylori subpopulations can rapidly arise, spread and adapt during times of demographic flux, and suggest that differences in transmission ecology between high and low prevalence areas may substantially affect the composition of bacterial populations.
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Infecções por Helicobacter/genética , Helicobacter pylori/genética , Filogenia , Neoplasias Gástricas/genética , Alelos , DNA Mitocondrial/genética , Evolução Molecular , Genoma Bacteriano , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/patogenicidade , Humanos , Indígenas Norte-Americanos , América Latina , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia , População BrancaRESUMO
[This corrects the article DOI: 10.1371/journal.pgen.1006546.].
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Historically, adolescents and young adults (AYA) diagnosed with cancer have been an understudied population, and their unique care experiences, needs, and outcomes were not well understood. Thus, 10 years ago, the National Cancer Institute supported the fielding of the Adolescent and Young Adult Health Outcomes and Patient Experiences (AYA HOPE) study to address this gap. We recruited individuals diagnosed at ages 15 to 39 with germ cell, Hodgkin and non-Hodgkin lymphoma, acute lymphoblastic leukemia, and sarcoma from Surveillance, Epidemiology, and End Results cancer registries into the first multicenter population-based study of medical care, physical, and mental health outcomes for AYAs with cancer in the United States. This review of the 17 published manuscripts showed low awareness of clinical trials and substantial impact of cancer on financial burden, education and work, relationships and family planning, and physical and mental health. It highlights the feasibility of a longitudinal population-based study and key lessons learned for research on AYAs with cancer in and beyond the United States.
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Avaliação das Necessidades , Neoplasias/psicologia , Neoplasias/terapia , Psicoterapia , Qualidade de Vida , Sobreviventes/psicologia , Adaptação Psicológica , Adolescente , Adulto , Necessidades e Demandas de Serviços de Saúde , Humanos , Cobertura do Seguro , Masculino , Sistema de Registros , Programa de SEER , Resultado do Tratamento , Adulto JovemRESUMO
AIM: To assess the effect of psychotropic drugs on fetal behavior using four-dimensional (4D) ultrasound in the third trimester of pregnancy. METHODS: Fetal behavior was assessed using Kurjak's antenatal neurodevelopmental test (KANET) using 4D ultrasound between 28 and 36 weeks of gestation. Thirty healthy (control group) and 10 psychotropic-drug-administered pregnant (case group) women were studied. The total value of the KANET score and values of each parameter (eight parameters) were compared between the two groups. RESULTS: The total KANET score was normal (except for one fetus in the case group: total score of 9) in both groups, and there was no significant difference in the total KANET score. When individual KANET parameters were compared, no significant differences were noted in any of the eight parameters. CONCLUSION: Our results showed that there is no difference in fetal behavior between fetuses of normal pregnant women and those of psychotropic-drug-administered pregnant women in the third trimester of pregnancy. These results suggest that psychotropic drugs may not affect fetal behavioral development in utero. However, the data and their interpretation in the present study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size are needed to assess the effect of psychotropic drugs on fetal neurobehavior during pregnancy.
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Desenvolvimento Fetal/efeitos dos fármacos , Movimento Fetal/efeitos dos fármacos , Psicotrópicos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Japão , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Terceiro Trimestre da Gravidez , Gravidez de Alto Risco , Cuidado Pré-Natal/métodos , Psicotrópicos/administração & dosagem , Psicotrópicos/efeitos adversos , Psicotrópicos/classificação , Projetos de Pesquisa , Ultrassonografia Pré-Natal/métodosRESUMO
PURPOSE: This study aimed to describe the experiences of nurses who were employed in a psychiatric hospital in Fukushima prefecture during the Great East Japan Earthquake and to explore what sustained the nurses while they worked in the damaged hospital. DESIGN AND METHODS: The research design was a qualitative descriptive study. The setting for the study was one of the Fukushima psychiatric hospitals where functions were disrupted by the earthquake and tsunami. Data were collected through a dialogic interview and Katarai (a form of group interview). Nine psychiatric nurses from the hospital participated. The interview and Katarai were transcribed and the narratives were analyzed using a phenomenological approach. FINDINGS: Themes identified from the transcripts were: (a) the nurses' internalized perception of their duties, (b) responsibility toward their patients, (c) conflicts among nurses and dilemmas nurses faced during this period, and (d) what sustained the nurses to continue working. CONCLUSIONS: Through the earthquake experience, the nurses in this study reconsidered their own ways of living and ways of nursing that they had not thought about before the disaster. The findings also revealed that the state of hospital management and nursing care under normal conditions are reflected during the crisis situation in a disaster. CLINICAL RELEVANCE: Clearly, whether it is natural disaster or conflict caused by man, healthcare infrastructures are challenged when unexpected disruptions occur. The findings of this study are applicable not only because they provide guidance about infrastructure development for disaster preparedness, but also because they provide practical methods to support nurses who are placed in strongly stressful situations and have to protect patients.
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Atitude do Pessoal de Saúde , Terremotos , Hospitais Psiquiátricos , Enfermeiras e Enfermeiros/psicologia , Estresse Psicológico/etiologia , Adulto , Feminino , Hospitais Psiquiátricos/organização & administração , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , TsunamisAssuntos
Cálcio , Neoplasias , Feminino , Humanos , Seguimentos , Causas de Morte , Incidência , Vitamina D , Cálcio da Dieta , Saúde da Mulher , Neoplasias/epidemiologia , Suplementos NutricionaisRESUMO
BACKGROUND: Surveillance, Epidemiology, and End Results (SEER) public research database does not include chemotherapy data due to concerns for incomplete ascertainment. To compensate for perceived lack of data quality many researchers use SEER-Medicare linked data, limiting studies to persons over age 65. We sought to determine current SEER ascertainment of chemotherapy receipt in two relatively large SEER registries compared to patient-reported receipt and to assess patterns of under-ascertainment. METHODS: In 2011-14, we surveyed patients with Stage III colorectal cancer reported to the Georgia and Metropolitan Detroit SEER registries. 1301/1909 eligible patients responded (68% response rate). Survey responses regarding treatment and sociodemographic factors were merged with SEER data. We compared patient-reported chemotherapy receipt with SEER recorded chemotherapy receipt. We estimated multivariable regression models to assess associations of under-ascertainment in SEER. RESULTS: Eighty-five percent of patients reported chemotherapy receipt. Among those, 10% (n = 104) were under-ascertained in SEER (coded as not receiving chemotherapy). In unadjusted analyses, under-ascertainment was more common for older patients (11.8% age 76+ vs. < 9% for all other ages, p = 0.01) and varied with SEER registries (10.2% Detroit vs. 6.8% Georgia; p = 0.04). On multivariable analyses, chemotherapy under-ascertainment did not vary significantly by any patient attributes. CONCLUSION: We found a 10% rate of under-ascertainment of adjuvant chemotherapy for resected, stage III colorectal cancer in two SEER registries. Chemotherapy under-ascertainment did not disproportionately affect any patient subgroups. Use of SEER data from select registries is an important resource for researchers investigating contemporary chemotherapy receipt and outcomes.
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Neoplasias Colorretais/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/tratamento farmacológico , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Razão de Chances , Medidas de Resultados Relatados pelo Paciente , Reprodutibilidade dos Testes , Programa de SEER , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
Objective To assess the usefulness of the antenatal fetal neurodevelopmental test for the prediction of postnatal developmental disabilities. Methods Fetal behavior was assessed with Kurjak's antenatal neurodevelopmental test (KANET) using four-dimensional ultrasound between 28 and 38 weeks of gestation. A score range of 0-5 was characterized as abnormal, from 6 to 9 was considered borderline, and 10-16 was normal. After birth, follow-up was conducted for at least 2 years in all fetuses. Results There were 337 normal (95.47%) and 16 borderline (4.53%) cases among the 353 cases studied, whereas there was no abnormal case. Five cases with postnatal developmental disabilities (one case of Werdig-Hoffmann disease diagnosed just after delivery, one case of autism spectrum disorder diagnosed at 24 months, one case of Ullrich congenital muscular dystrophy diagnosed at 9 months and two cases of developmental disorders diagnosed at age 3 and 18 months) were noted among the 337 normal cases (1.48%), whereas three cases with developmental disabilities (one case of motor development delay diagnosed at 6 months, one case of Duchenne muscular dystrophy diagnosed at 18 months and one case of autism spectrum disorder diagnosed at age 30 months) were found among the 16 borderline cases (18.75%). There was a significant difference in the prevalence of postnatal developmental disabilities between the normal and borderline KANET groups (P<0.001). Conclusion Our results suggest that the KANET assessment may be a useful diagnostic modality for the prediction of postnatal developmental disabilities.