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1.
CoDAS ; 36(1): e20220263, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1514029

ABSTRACT

ABSTRACT Purpose The purpose of the study was to develop the Tamil Matrix Sentence Test (TMST) and evaluate the performance of a group of young adults with normal hearing on the developed test. The developed sentences were also administered at varying intensities to obtain a performance-intensity (PI) function. Methods A base matrix with 10 sentences containing 5 words each with a total of 50 words was used to develop the TMST. The sentences had a fixed semantic sentence structure of Tamil language in the order of noun, number, adjective, object and verb. The developed test consisted of 30 lists with 10 sentences in each list. The performance of 60 young adults with normal hearing aged 18 to 24 years across the 30 lists were compared for list equivalency. To obtain the PI function the sentences were administered on 20 young adults with normal hearing at intensities from 20 dB HL to 100 dB HL in 10 dB increments. The performance across the intensity levels were compared. Results The 30 lists of TMST were found to be acoustically equivalent. However, few lists showed significant difference in the scores obtained on them compared to the rest of the lists. The PI function revealed a saturation in performance beyond 40 dB HL. Conclusion From the results it was construed that TMST can be used to evaluate the speech identification abilities of Tamil speaking listeners. Multiple lists offer the advantage of retesting without the influence of practice or listeners memorizing the test material.

2.
Rev. bras. med. esporte ; 30: e2021_0499, 2024. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1515071

ABSTRACT

ABSTRACT Introduction: Traditional intermittent hypoxia training improves sport performance after short periods of exposure, but acute exposure to intermittent hypoxia leads to decreased training intensity and technical quality. The solution to overcome these negative effects may be to perform efforts in normoxia and the intervals between efforts in hypoxia, maintaining the quality of training and the benefits of hypoxia. Objective: This study aimed to evaluate the acute physiological responses to hypoxia exposure during recovery between high intensity efforts. Materials and methods: Randomized, one-blind, placebo-controlled study. Sixteen men performed a graded exercise test to determine their maximal intensity and two sessions of high-intensity interval training. The training intervals could be in hypoxia (HRT), FIO2: 0.136 or normoxia (NRT), FIO2: 0.209. During the two-minute interval between the ten one-minute efforts, peripheral oxygen saturation (SpO2), heart rate (HR), blood lactate ([La]), blood glucose ([Glu]) were constantly measured. Results: There were differences in HR (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p < 0.01) and SpO2 (TRN = 96.9 ± 1.0%; TRH = 86.2 ± 3.5%, p < 0.01). No differences in [La] and [Glu] TRN (4.4 ± 1.7 mmol.l-1; 3.9 ± 0.5 mmol.l-1) and TRH (5.2 ± 2.0 mmol.l-1; 4.0 ± 0.8 mmol.l-1, p = 0.17). Conclusion: The possibility of including hypoxia only in the recovery intervals as an additional stimulus to the training, without decreasing the quality of the training, was evidenced. Level of Evidence II; Randomized Clinical Trial of Minor Quality.


RESUMEN Introducción: El entrenamiento tradicional en hipoxia intermitente mejora el rendimiento deportivo tras cortos periodos de exposición, sin embargo, la exposición aguda a la hipoxia intermitente conduce a una disminución de la intensidad del entrenamiento y de la calidad técnica. La solución para superar estos efectos negativos puede ser realizar los esfuerzos en normoxia y los intervalos entre esfuerzos en hipoxia, manteniendo la calidad del entrenamiento y los beneficios de la hipoxia. Objetivo: Este estudio pretendía evaluar las respuestas fisiológicas agudas a la exposición a la hipoxia durante la recuperación entre esfuerzos de alta intensidad. Materiales y métodos: Estudio aleatorizado, a ciegas y controlado con placebo. Dieciséis hombres realizaron una prueba de ejercicio graduado para determinar su intensidad máxima y dos sesiones de entrenamiento por intervalos de alta intensidad. Los intervalos de entrenamiento podían ser en hipoxia (HRT), FIO2: 0,136 o normoxia (NRT), FIO2: 0,209. Durante el intervalo de dos minutos entre los diez esfuerzos de un minuto, se midieron constantemente la saturación periférica de oxígeno (SpO2), la frecuencia cardiaca (FC), el lactato en sangre ([La]) y la glucemia ([Glu]). Resultados: Hubo diferencias en la FC (TRN = 120 ± 14 lpm; TRH = 129 ± 13 lpm, p < 0,01) y la SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p < 0,01). No hubo diferencias en [La] y [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) y TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusión: Se evidenció la posibilidad de incluir hipoxia sólo en los intervalos de recuperación como estímulo adicional al entrenamiento sin disminuir la calidad del mismo. Nivel de Evidencia II; Ensayo Clínico Aleatorizado de Baja Calidad.


RESUMO Introdução: O treinamento de hipóxia intermitente tradicional melhora o desempenho esportivo após curtos períodos de exposição, porém a exposição aguda à hipóxia intermitente leva à diminuição da intensidade do treinamento e da qualidade técnica. A solução para superar esses efeitos negativos pode ser realizar esforços em normóxia e os intervalos entre os esforços em hipóxia, mantendo a qualidade do treinamento e os benefícios da hipóxia. Objetivo: Este estudo teve como objetivo avaliar as respostas fisiológicas agudas à exposição de hipóxia durante a recuperação entre esforços de alta intensidade. Materiais e métodos: Estudo aleatório e one-blinded, com efeito placebo controlado. Dezesseis homens realizaram um teste de exercício graduado para determinar sua intensidade máxima e duas sessões de treinamento intervalado de alta intensidade. Os intervalos de treinamento podem ser em hipóxia (TRH), FIO2: 0,136 ou normóxia (TRN), FIO2: 0,209. Durante os dois minutos de intervalo entre os dez esforços de um minuto, foram medidos constantemente a saturação periférica de oxigênio (SpO2), frequência cardíaca (FC), lactato sanguíneo ([La]), glicemia ([Glu]). Resultados: Houve diferenças na FC (TRN = 120 ± 14 bpm; TRH = 129 ± 13 bpm, p <0,01) e SpO2 (TRN = 96,9 ± 1,0%; TRH = 86,2 ± 3,5%, p <0,01). Sem diferenças em [La] e [Glu] TRN (4,4 ± 1,7 mmol.l-1; 3,9 ± 0,5 mmol.l-1) e TRH (5,2 ± 2,0 mmol.l-1; 4,0 ± 0,8 mmol.l-1, p = 0,17). Conclusão: Evidenciou-se a possibilidade de incluir a hipóxia apenas nos intervalos de recuperação como um estímulo adicional ao treinamento, sem diminuir a qualidade do treinamento. Nível de Evidência II; Estudo Clínico Randomizado de Menor Qualidade.

3.
Rev. bras. med. esporte ; 30: e2022_0193, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1441311

ABSTRACT

ABSTRACT Objective: Analyze the effects of high-intensity interval training (HIIT) on cardiometabolic parameters, and cardiorespiratory fitness to compile the most used HIIT training types in adults with spinal cord injury (SCI). Methods: This is a systematic review of searches performed in the electronic databases PubMed / Medline, Science Direct, and Google Scholar. Studies included I) needed to apply HIIT training II) adults with SCI to analyze III) cardiometabolic aspects and cardiorespiratory fitness. Two independent reviewers selected the articles for inclusion, extracted their data, and assessed their methodological quality. Results: 654 studies were found. Thus, 12 studies, 11 pre- and post-intervention, and one control group (CG) with 106 participants were analyzed. Pre- and post-HIITT intervention results revealed significant improvement in cardiorespiratory fitness and cardiometabolic aspects (VO2peak, LDH, HDL, insulin resistance). In addition, GC results revealed significant improvement in cardiorespiratory fitness observed in the intervention group (HIIT) compared to the moderate-low intensity (GC) group. Seven studies used the arm ergometer as the primary exercise modality. Two studies described functional electrical stimulation (FES) performed with the arm ergometer plus electrical stimulation in the lower limbs. None reported heart rate dynamics during the study period. Conclusion: High-intensity interval training improves physical fitness and cardiometabolic health in adults with SCI. Evidence level II; Systematic Review of level II studies.


RESUMEN Objetivo: Analizar los efectos del entrenamiento interválico de alta intensidad (HIIT) sobre los parámetros cardiometabólicos, fitness cardiorrespiratorio y recopilar los tipos de HIIT más utilizados en el entrenamiento en adultos con lesión medular (LME). Métodos: Se trata de una revisión sistemática, para lo cual se realizaron búsquedas en bases de datos electrónicas PubMed/Medline, Science Direct y Google Scholar. Se incluyeron estudios que I) necesitaban aplicar entrenamiento HIIT en II) adultos con SCI y analizar III) aspectos cardiometabólicos y aptitud cardiorrespiratoria. Dos revisores independientes seleccionaron los artículos para su inclusión, extrajeron sus datos y evaluaron su calidad metodológica. Resultados: De los 654 estudios encontrados, se analizaron 12 estudios, 11 pre y post intervención y 1 grupo control (GC) con un total de 106 participantes. Los resultados previos y posteriores a la intervención HIIT revelaron una mejora significativa en la aptitud cardiorrespiratoria y los aspectos cardiometabólicos (VO2pico, LDH, HDL, resistencia a la insulina). Los resultados de GC revelaron una mejora significativa en la aptitud cardiorrespiratoria observada del grupo de intervención (HIIT) en comparación con el grupo de intensidad moderada-baja (GC). Siete estudios utilizaron el ergómetro de brazo como la modalidad principal de ejercicio. Dos estudios describieron la estimulación eléctrica funcional (EEF) realizada con el ergómetro de brazo más la estimulación eléctrica en los miembros inferiores. Ninguno informó la dinámica de la frecuencia cardíaca durante el período de estudio. Conclusiones: El entrenamiento intervalos de alta intensidad mejora la condición física y la salud cardiometabólica en adultos con LME. Evidencia de nivel II; Revisión sistemática de estudios de nivel II.


RESUMO Objetivo: Analisar os efeitos do treinamento intervalado de alta intensidade (HIIT) nos parâmetros cardiometabólicos, aptidão cardiorrespiratória e compilar os tipos de HIIT mais utilizados no treinamento em adultos com lesão da medula espinhal (LME). Métodos: Trata-se de revisão sistemática, para a qual foram realizadas pesquisas nas bases de dados eletrônicas PubMed / Medline, Science Direct e Google Scholar. Foram incluídos estudos em que I) o treinamento HIIT era aplicado em II) adultos com LME e analisaram III) os aspectos cardiometabólicos e aptidão cardiorrespiratória. Dois revisores independentes selecionaram os artigos para a inclusão, extraindo seus dados e avaliarando a sua qualidade metodológica. Resultados: 654 estudos foram encontrados. Desses, 12 estudos, 11 pré e pós intervenção e 1 grupo controle (GC) com um total de 106 participantes foram analisados. Resultados pré e pós intervenção de HIIT revelaram significante melhora na aptidão cardiorrespiratória e aspectos cardiometabólicos (VO2pico, LDH, HDL, resistência à insulina). Resultados do GC revelaram uma significativa melhoria na aptidão cardiorrespiratória observada no grupo de intervenção (HIIT) em relação ao grupo de intensidade moderada-baixa (GC). Sete estudos usaram o ergômetro de braço como modalidade de exercício primária. Dois estudos descreveram a estimulação elétrica funcional (EEF) realizada com o ergômetro de braço adicionando estimulação elétrica nos membros inferiores. Nenhum relatou a dinâmica da frequência cardíaca durante o período do estudo. Conclusão: O treinamento intervalado de alta intensidade melhora a aptidão física e a saúde cardiometabólica em adultos com LME. Nível de evidência II; Revisão sistemática de Estudos de Nível II.

4.
BrJP ; 6(4): 353-358, Oct.-Dec. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1527978

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Low back pain is among the most disabling conditions worldwide, and among the epigenetic factors, methylation in CpG islands of gene promoter regions can modulate gene expression, potentially correlating with the development of the disease and providing insights into the choice of treatment. The objective of this study was to assess the efficacy of therapy using modified ILIB related to DNA methylation processes in low back pain. Secondary objectives of this study included investigating pain intensity, gender, sociodemographic data, and physical-functional profile. METHODS: This prospective study was conducted in a municipality in the southern region of Brazil. The sample consisted of 30 participants of both genders, with an average age of 41.77 years. The following aspects were analyzed: anthropometric characteristics, global methylation using the ELISA method, pain level, physical activity level, functional disabilities, and hesitancy level related to work and physical activity-related activities. RESULTS: A statistically significant association was observed between methylation levels before and after treatment application for the experimental and placebo groups (p < 0.005), demonstrating a mean responsiveness between methylation and treatment (d = 0.5). However, there were no other statistically significant associations correlated with the other work variables. CONCLUSION: The results obtained in this study suggest the need for further research related to the identification of specific genes in methylation, as well as the standardization of dosimetry used for transcutaneous ILIB laser application in the radial artery.


RESUMO JUSTIFICATIVA E OBJETIVOS: A lombalgia está entre as condições mais incapacitantes no mundo e; dentre os fatores epigenéticos, a metilação em ilhas CpG de regiões promotoras de genes pode modular a expressão gênica permitindo uma possível correlação ao desenvolvimento da doença, como também pode trazer esclarecimentos a respeito do tratamento a ser escolhido. O objetivo deste estudo foi verificar a eficácia da terapia através do uso do ILIB modificado relacionada ao processo de metilação de DNA na lombalgia. Os objetivos secundários deste estudo foram a investigação da intensidade da dor, sexo, dados sociodemográficos e perfil físico-funcional. MÉTODOS: Este estudo, desenvolvido em um município da região sul do Brasil, caracteriza-se como prospectivo. A amostra deste estudo foi composta por 30 participantes, de ambos os sexos, com idade média de 41,77 anos. Foram analisados os seguintes aspectos: características antropométricas, metilação global através do método ELISA, nível de dor, nível de atividade física, incapacidades funcionais e nível de hesitação para realizar atividades relacionada ao trabalho e atividade física. RESULTADOS: Observou-se associação estatisticamente significativa entre os níveis de metilação antes e a após aplicação do tratamento para grupo experimental e placebo (p<0,005) demostrando uma média responsividade entre as variáveis metilação e tratamento (d=0,5). No entanto, não houve nenhuma outra associação estatística correlacionada as demais variáreis do trabalho. CONCLUSÃO: Os resultados obtidos neste estudo sugerem que há necessidade mais estudos relacionados a identificação de genes específicos na metilação, além da necessidade de padronização de dosimetria utilizadas para aplicação do laser ILIB de forma transcutânea, em artéria radial.

5.
Indian J Cancer ; 2023 Jun; 60(2): 258-265
Article | IMSEAR | ID: sea-221784

ABSTRACT

Background: Currently, recommended heart dose constraints are difficult to meet in whole?breast irradiation (WBI) for left?sided breast cancer patients, who cannot be treated with the deep inspiration breath hold. We performed a radiotherapy planning study to establish if the use of intensity?modulated radiation therapy (IMRT) or volumetric?modulated arc therapy (VMAT) allows for better sparing of the heart and its subvolumes than the three?dimensional conformal radiation therapy (3D?CRT), and how these attempts affect the dose delivered to the other organs. Methods: A total of 17 left?sided and 10 right?sided consecutive patients treated with free?breathing WBI were retrospectively included. The 3D?CRT, IMRT, and VMAT plans were generated. Several dose杤olume parameters and plan quality indices were compared, separately for the left? and right?sided plans. Results: All the techniques fulfilled the planning objectives. In the left?sided plans, there was no heart or left ventricle dose reduction with IMRT, nor with VMAT; the maximum dose in the left anterior descending coronary artery was reduced with VMAT (P = 0.005); V5 for the contralateral breast, contralateral lung, and total?body increased markedly in VMAT, and for the ipsilateral lung (V5IL) also in IMRT, compared with 3D?CRT (P < 0.001). In the right?sided plans, the V5 values, except for V5IL, did not differ between the three techniques. Conclusions: IMRT and VMAT had a limited heart?sparing benefit in the left?sided free?breathing WBI, at the cost of increased low?dose volumes, measured by V5. The low?dose volumes are not increased by IMRT or VMAT in the right?sided WBI, where heart sparing is not a problem, but the attempts to reduce cardiac doses in the left?sided WBI increase them.

6.
BrJP ; 6(2): 160-170, Apr.-June 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1513777

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the most prevalent causes of disability in the world, and the adverse effects promoted by analgesics can limit therapeutic success. In this context, laser appears as a complementary therapy that can enhance analgesia without increasing the incidence of undesirable adverse events. The aim of this study was to carry out a systematic review on the effectiveness and efficiency of high intensity laser (HIL) in the treatment of pain. CONTENTS: A systematic search was carried out in Medline, LILACS, Pubmed and PEDro, from July 2020 to August 2022. The keywords pain, chronic pain, high intensity laser and treatment were considered. The quality of selected studies was assessed using the PEDro scale. Included systematic reviews were assessed for methodological quality using the AMSTAR tool. The main measure studied was pain intensity. 227 studies were found and, based on the inclusion and exclusion criteria, 32 articles were read in full, whit one being excluded for not assessing pain. Musculoskeletal disorders corresponded to 70,96% of the assessed diseases and the visual analogue scale (VAS) was the only pain measurement tool used in 100% of the studies. Approximately 57% of the studies were of high methodological quality (PEDro=7). In 53,84% of the trials, HIL was used as a single intervention, and in 46,16% it was associated whit exercises. In 96.15% of clinical trials and 100% of systematic reviews there were positive effects of HIL on pain. CONCLUSION: HIL is an effective modality for analgesia by promoting significant pain relief, rapid recovery and improvement in patient's quality of life, in a safe way. The diversity in irradiation parameters (dose, duration, interval and number of sessions) used, indicates the need for further randomized studies to establish its long-term efficiency.


RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é uma das causas mais prevalentes de incapacidade no mundo, e os efeitos adversos promovidos pelos analgésicos podem limitar o sucesso terapêutico. Nesse contexto, surge o laser como terapia complementar que pode potencializar a analgesia, sem aumentar incidência de eventos adversos indesejáveis. O objetivo deste estudo foi realizar uma revisão sistemática sobre a eficácia e a eficiência do laser de alta intensidade (LAI) no tratamento da dor. CONTEÚDO: Foi realizada uma busca sistemática nas plataformas Medline, LILACS, Pubmed e PEDro, de julho de 2020 a agosto de 2022. As palavras chaves dor, dor crônica, laser de alta intensidade e tratamento foram consideradas. A qualidade dos estudos clínicos selecionados foi avaliada utilizando a escala PEDro. As revisões sistemáticas incluídas foram avaliadas quanto à qualidade metodológica através da ferramenta AMSTAR. A principal medida estudada foi a intensidade de dor. Foram encontrados 227 estudos e com base nos critérios de inclusão e exclusão, 32 artigos foram lidos na íntegra, tendo sido excluído um por não avaliar a dor. As desordens musculoesqueléticas corresponderam a 70,96% das doenças avaliadas e a escala analógica visual (EAV) foi a única ferramenta de mensuração da dor utilizada em 100% dos estudos. Aproximadamente 57% dos estudos tinham alta qualidade metodológica (PEDro=7). Em 53,84% dos ensaios o LAI foi utilizado como intervenção única, e em 46,16% foi associado a exercícios. Em 96,15% dos ensaios clínicos e 100% das revisões sistemáticas, o LAI promoveu alívio da dor. CONCLUSÃO: O LAI é uma modalidade eficaz para analgesia ao promover significativo alívio da dor, rápida recuperação e melhora na qualidade de vida dos pacientes de forma segura. A diversidade nos parâmetros de irradiação (dose, duração, intervalo e número de sessões) empregados, indica a necessidade de mais estudos randomizados para estabelecer sua eficiência em longo prazo.

7.
Medisur ; 21(1)feb. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1440616

ABSTRACT

Fundamento entre las urgencias periodontales que requieren atención inmediata está la estomatitis aftosa recurrente, debido a las molestias o complicaciones que ocasiona al paciente. El empleo de la radiación láser de baja potencia puede resultar efectivo en el tratamiento de esta entidad. Objetivo determinar el efecto terapéutico del tratamiento con radiación láser de baja potencia en pacientes con diagnóstico de estomatitis aftosa recurrente. Métodos estudio descriptivo, transversal, realizado en el periodo mayo/2019-mayo/2021, en el servicio estomatológico del policlínico Dr. Enrique Barnet, del municipio de Lajas, provincia de Cienfuegos, que incluyó a 46 pacientes con diagnóstico de estomatitis aftosa recurrente. Se empleó el análisis de documentos, la observación y el cuestionario; además del examen bucal como método diagnóstico. Los pacientes recibieron tratamiento con radiación láser de baja potencia. Se aplicó el programa EPIDAT 3.1 para el procesamiento estadístico de los datos. Resultados predominó el sexo femenino, la edad entre 19-34 años, así como las úlceras aftosas menores. Las lesiones se localizaron principalmente en labio. El 97,83 % de los pacientes refirió remisión de la lesión al quinto día de tratamiento. Todos los pacientes tratados evolucionaron favorablemente hacia la cicatrización. Solo un paciente presentó reacciones adversas. Conclusiones los resultados permitieron constatar los beneficios terapéuticos de la terapia con láser de baja potencia en el tratamiento de la estomatitis aftosa recurrente.


Background among the periodontal emergencies that require immediate attention is the RAS, due to the inconvenience or complications that it causes to the patient. The use of low power laser radiation can be effective in the treatment of this entity. Objective to determine the therapeutic effect of treatment with low-power laser radiation in patients diagnosed with recurrent aphthous stomatitis. Methods descriptive, cross-sectional study, carried out from May/2019 to May/2021, in the Dr. Enrique Barnet polyclinic's dental service, in Lajas municipality, Cienfuegos province, which included 46 patients diagnosed with recurrent aphthous stomatitis. Document analysis, observation and questionnaire were used; in addition to the oral examination as a diagnostic method. Patients received treatment with low-power laser radiation. The EPIDAT 3.1 program was applied for the statistical data processing. Results the female sex predominated, the age between 19-34 years, as well as minor aphthous ulcers. The lesions were located mainly on the lip. 97.83% of the patients reported remission of the lesion on the fifth day of treatment. All treated patients evolved favorably towards healing. Only one patient presented adverse reactions. Conclusions the results allowed us to verify the therapeutic benefits of low power laser therapy in the treatment of recurrent aphthous stomatitis.

8.
Rev. Flum. Odontol. (Online) ; 1(60): 88-100, jan.-abr. 2023. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1411344

ABSTRACT

Introdução: A doença periodontal, de origem infecciosa, constitui diferentes quadros clínicos de caráter multifatorial e inflamatório. A fotobiomodulação é uma técnica não invasiva que tem demonstrado ser capaz de diminuir a inflamação e proporcionar alívio da dor. Estudos também demonstraram que a adoção da fotobiomodulação adjuvante à raspagem e alisamento radicular tem sido capaz de reduzir a carga bacteriana proveniente da periodontite crônica. Objetivos: Analisar os efeitos da fotobiomodulação como terapia adjuvante à raspagem e ao alisamento radicular no tratamento da periodontite crônica publicados nos últimos cinco anos. Métodos: Trata-se de uma revisão integrativa da literatura, realizada no período de setembro a novembro de 2021, mediante a utilização dos seguintes descritores: "Periodontitis", "Photobiomodulation" e "Therapy, selecionando artigos publicados em inglês durante o período entre 2016 a 2021. Resultados: Foram identificados 47 trabalhos. Destes, foram excluídos 39 estudos que se dispersaram do tema e 2 que se encontravam indisponíveis para o acesso, resultando em 6 artigos que foram consultados integralmente. Foi consenso entre os artigos consultados que a prática da fotobiomodulação tornou-se um potencial agente terapêutico no tratamento da periodontite crônica contribuindo para a redução da contagem de periodontopatógenos e que atua de maneira coadjuvante às raspagens radiculares. Conclusão: A fotobiomodulação mostrou-se uma ferramenta promissora na área odontológica. Entretanto, a grande variedade nos parâmetros de tratamentos e protocolos utilizados na fotobiomodulação impossibilita uma comparação e uma análise mais crítica e rigorosa dos resultados obtidos nos trabalhos analisados.


Introduction: Periodontal disease, which has an infectious origin, constitutes a multifactorial and inflammatory different clinical condition of multifactorial, inflammatory, and infectious origin. Photobiomodulation is a non-invasive technique that has been shown to decrease inflammation and provide pain relief. Studies also have shown that the choosing of photobiomodulation as adjuvant therapy to scaling and root planing has been able to reduce the bacterial load from chronic periodontitis. Objectives: To analyze the effects of photobiomodulation as an adjuvant therapy to scaling and root planing in the treatment of chronic periodontitis in the studies published in the last five years. Methods: This is an integrative literature review, carried out from September to November 2021, using the following descriptors: "Periodontitis", "Photobiomodulation" and "Therapy, from selected articles published in English during the period between 2016 to 2021. Results: From the research and selection of studies to compose this integrative literature review, 47 studies were initially identified based on the descriptors. From those, 39 papers that were outside from the topic and 2 papers that were unavailable for access were excluded from the present review. Then remained, 6 articles that were fully consulted. The practice of photobiomodulation has become a potential therapeutic agent in the treatment of chronic periodontitis reducing the count of periodontopathogens and as an adjunct therapy to root scaling. Conclusion: Photobiomodulation therapy has become a promising tool in the dental field, however, the great variety in the treatment parameters and protocols used for photobiomodulation makes impossible to compare and perform a more critical and rigorous analysis of the results collected in the present work.


Subject(s)
Periodontal Diseases , Therapeutics , Low-Level Light Therapy , Chronic Periodontitis
9.
Chinese Journal of Postgraduates of Medicine ; (36): 128-131, 2023.
Article in Chinese | WPRIM | ID: wpr-990976

ABSTRACT

Objective:To investigate the effects of intensity modulated radiation therapy (imRT) and risk factors of radiation pneumonia caused by imRT in elderly patients with esophageal cancer.Methods:The clinical data of 80 elderly patients diagnosed with esophageal cancer and performed imRT in Traditional Chinese Medicine Hospital of Kunshan from February 2018 to February 2020 were analyzed, and the therapeutic effect and the incidence of adverse reactions were counted.Results:In the 80 patients, 13 patients occurred radiation pneumonia.The results of univariate analysis showed that the gender, smoking history, pathological stage and age had no correlation with radiation pneumonia ( P> 0.05), while tumor location, diabetes, concurrent chemotherapy, reradiotherapy and chronic obstructive pulmonary disease had correlation with the occurrence of radioactive pneumonia ( P<0.05). The levels of V30, V35, V40 between radioactive pneumonia patients and non-radioactive pneumonia patients had no significant differences ( P>0.05), but the levels of V5, V10, V15, V20 and mean lung dose(MLD) between radioactive pneumonia patients and non-radioactive pneumonia patients had significant differences ( P<0.05). The effect of imRT was no remission in 9 cases (11.25%), partial remission in 59 cases (73.75%) and complete remission in 12 cases (15.00%), and the clinical effective rate was 88.75%(71/80). By comparing the adverse reactions caused by imRT, it was found that the incidence of radiation esophagitis, leukopenia, and acute radiation pneumonia were 93.75%(75/80), 12.50%(10/80) and 22.50%(18/80), respectively, with grade 1 and grade 2 adverse reactions. Conclusions:Risk factors for radiation pneumonia in elderly patients with esophageal cancer after imRT include tumor location, diabetes, V5, V10, V15, V20, MLD, concurrent chemotherapy, reradiotherapy and chronic obstructive pulmonary disease.

10.
Chinese Journal of Practical Nursing ; (36): 1899-1906, 2023.
Article in Chinese | WPRIM | ID: wpr-990425

ABSTRACT

Objective:To construct a comprehensive nutritional index after treatment of nasopharyngeal carcinoma patients with intensity-modulated radiation therapy (IMRT), and to analyze its relationship with quality of life and 3-year survival period, and aimed to provide some reference for the management of nasopharyngeal carcinoma patients.Methods:This was a prospective cohort study. The clinical data of 431 nasopharyngeal carcinoma patients who admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2017 to December 2021 were collected using convenience sampling method. To evaluate the nutritional status of the patients, the BMI, change in body weight, hemoglobin, lymphocyte count, and albumin level and other clinical data of the patients were collected before and after intensity-modulated radiation therapy. The comprehensive nutrition index after IMRT was constructed by principal component analysis. The Chinese version of European Organization for Reasearch and Treatment of Cancer quality of life questionnare-Core 30 (EORTC QLQ-C30) and Quality of life questionnaire head and neck cancer module(QLQ-H&N35) were used to evaluate the patients′ quality of life. The best diagnostic cutoff point for predicting patient death within 3 years using ROC, and based on the determined optimal diagnostic cutoff point, all patients were divided into a low comprehensive nutritional index group and a high comprehensive nutritional index group. And analyzed the Pearson correlation between comprehensive nutritional index and quality of life.Differences in 3-year survival between the two groups were compared using the Kaplan-Meier method and Log-rank test.Results:Using the diagnostic threshold of receiver operating characteristic, all patients were divided into low comprehensive nutrition index group ( n=280) and high comprehensive nutrition index group ( n=151).The BMI, percentage of weight change, albumin, hemoglobin, and lymphocyte count of nasopharyngeal carcinoma patients before intensity-modulated radiation therapy were (23.14 ± 2.87) kg/m 2, (1.08 ± 0.14)%, (44.02 ± 4.52) g/L, (147.28 ± 15.57)g/L, (1.76 ± 0.56)×10 9/L, and higher than after intensity-modulated radiation therapy (21.14 ± 4.07) kg/m 2, (0.97 ± 0.16)%, ( 38.99 ± 5.12) g/L, (113.87 ± 18.24)g/L, (0.50 ± 0.18)×10 9/L, respectively, the difference were statistically significant ( t values were 8.34 to 44.47, all P<0.05).The comprehensive nutritional index constructed using principal component analysis was correlated with multiple dimensions of EORTC QLQ-C30) and QLQ-H&N35, with statistically significant differences ( r values were -0.169 - 0.245, all P<0.05). Kaplan-Meier curves indicated that the 3-year survival rate of the high comprehensive nutritional index group was higher than that of the low comprehensive nutritional index group, with 87.42% and 79.29% respectively, and the difference was statistically significant ( χ2=4.53, P<0.05). Conclusions:The constructed comprehensive nutritional index could reflect the comprehensive nutritional status of nasopharyngeal carcinoma patients. Nasopharyngeal carcinoma patients with a low comprehensive nutritional index score had a worse quality of life and shorter 3-year survival. Active intervention and improvement of malnutrition in nasopharyngeal carcinoma patients should be undertaken to improve patient quality of life and improve survival.

11.
Chinese Journal of Practical Nursing ; (36): 587-592, 2023.
Article in Chinese | WPRIM | ID: wpr-990223

ABSTRACT

Objective:To investigate the effect of high-intensity interval training on cognitive weakness in elderly patients with coronary heart disease.Methods:A randomized controlled study was used. A total of 70 elderly patients with coronary heart disease after discharge from the Cardiology Department, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from June 2020 to June 2021 were selected and divided into the control group (35 cases) and the observation group (35 cases) by random digits table method. The control group received conventional treatment, and the observation group received high-intensity interval training on the basis of conventional treatment. The changes of peak oxygen intake (PeakVO 2), anaerobic threshold oxygen uptake (ATVO 2), Fried phenotype score, Montreal Cognitive Assessment score, and SF-36 quality of life assessment score before and after 12 weeks of intervention were compared between the two groups. Results:During the intervention, 2 cases fell off in the control group and 2 cases in the observation group. After 12 weeks of intervention, PeakVO 2 and ATVO 2 in the observation group were (23.91 ± 5.88), (20.79 ± 5.19) ml·min -1·kg -1, respectively, higher than those in the control group(20.56 ± 5.81), (17.29 ± 5.36) ml·min -1·kg -1, and the differences were statistically significant ( t = 2.38, 2.69, both P<0.05). The scores of SF-36 quality of life assessment and Montreal Cognitive Assessment in the observation group were (85.33 ± 6.43), (22.64 ± 3.81) points, which were significantly higher than those in the control group (78.72 ± 8.14), (20.67 ± 3.04) points, and the differences were statistically significant ( t = 3.66, 2.32, both P<0.05); the Fried phenotype score in the observation group was (1.36 ± 0.99) points, which was significantly lower than that in the control group (3.03 ± 1.08) points, and the difference was statistically significant ( t = 6.54, P<0.05). Conclusions:High-intensity interval training can improve cardiopulmonary function, aerobic exercise ability, cognitive weakness and quality of life in elderly patients with coronary heart disease.

12.
Journal of Southern Medical University ; (12): 597-603, 2023.
Article in Chinese | WPRIM | ID: wpr-986967

ABSTRACT

OBJECTIVE@#To evaluate the correlation of magnetic resonance (MR) T2-weighted image (T2WI) signal characteristics of adenomyosis and the efficacy of high-intensity focused ultrasound (HIFU) ablation.@*METHODS@#Based on the presence or absence of patchy hyperintense foci on preoperative MR T2WI, the patients with adenomyosis undergoing HIFU treatment were divided into homogeneous signal group and heterogeneous signal group, and the heterogeneous group was further divided into heterogeneous hypointense group and heterogeneous isointense group according to signal intensity of the lesions. The patients in heterogeneous signal group were matched with the patients in the homogeneous group at a 1:1 ratio using the propensity score matching, and similarly, the patients in the heterogeneous hypointense group were matched with those in the heterogeneous isointense group at a 1:1 ratio. The non-perfused volume ratio (NPVR) and relief of dysmenorrhea were used to assess the therapeutic efficacy in the 4 groups.@*RESULTS@#A total of 299 patients were enrolled, who had a median preoperative dysmenorrhea score of 7.0 (6.0, 8.0) and a median NPVR of 53.5% (35.4, 70.1)%. After propensity score matching, the NPVR in homogeneous signal group was significantly higher than that in heterogeneous signal group [(60.3 ± 21.8)% vs (44.6±21.6)%, P < 0.05]. At 3, 6 and 12 months after HIFU, dysmenorrhea relief rates were higher in homogeneous signal group than in heterogeneous signal group, and the difference was statistically significant at 12 months (91.1% vs 76.8%, P < 0.05). The NPVR of heterogeneous hypointense group was higher than that of heterogeneous isointense group [(54.0±22.0) % vs (47.3± 22.9) %, P < 0.05]. At 6 months after HIFU, dysmenorrhea relief rate was significantly higher in heterogeneous hypointense group than in heterogeneous isointense group (91.5% vs 80.9%, P < 0.05).@*CONCLUSION@#The signal characteristics of adenomyosis on T2WI are closely related with the outcome of HIFU ablation, and its efficacy is better for homogeneous than for heterogeneous adenomyosis, and better for heterogeneous hypointense adenomyosis than for heterogeneous isointense adenomyosis.


Subject(s)
Female , Humans , Adenomyosis/pathology , Dysmenorrhea , Cohort Studies , Propensity Score , High-Intensity Focused Ultrasound Ablation/methods , Treatment Outcome
13.
Journal of Prevention and Treatment for Stomatological Diseases ; (12): 408-413, 2023.
Article in Chinese | WPRIM | ID: wpr-964441

ABSTRACT

Objective @# To investigate the application of indocyanine green in near-infrared fluorescence imaging to determine the scope of necrotic bone resection in osteoradionecrosis of the jaw and to provide a reference for clinicians@*Methods @#Eight patients with osteoradionecrosis of the jaws were enrolled. Indocyanine green was intravenously injected through the elbow vein 10 minutes before osteotomy. After conservative resection of necrotic bone lesions based on imaging results, the scope of potential dead bone resection in the area of low fluorescence intensity was gradually expanded at an initial distance of 0.3 cm. Near-infrared fluorescence imaging and fluorescence intensity determination of bone cross-section were performed before and after extended resection. Statistical differences were analyzed. All patients with osteonecrosis underwent regular follow-up to evaluate the postoperative efficacy@*Results@#Indocyanine green was injected into all 8 patients with osteoradionecrosis for near-infrared fluorescence imaging and the scans were clear; the fluorescence intensity of fresh bone wounds with an expanded mandibular resection range of (0.95 ± 0.14) cm was (226.2 ± 15.8) au, which was higher than that based on intraoperative macroscopic observation and radiological results (108.8 ± 3.4) au, (t = 20.718, P<0.001). The postoperative follow-up improvement rate of 8 patients was 87.5%.@* Conclusion @#Near-infrared fluorescence imaging with indocyanine green can assist in the successful removal of necrotic bone until fresh bleeding of the jaw wound occurs, which has important clinical value in defining the resection range of osteoradionecrosis of the jaw.

14.
China Journal of Chinese Materia Medica ; (24): 3715-3721, 2023.
Article in Chinese | WPRIM | ID: wpr-981503

ABSTRACT

The purpose of this study was to analyze the effects of shading intensity on the growth, yield, and quality of Artemisia stolonifera so as to provide references for the artificial cultivation of A. stolonifera. The seedlings of A. stolonifera with consistent growth underwent shading treatment at four shading intensity levels(0, 55%, 85%, and 95%) with different layers of black shading nets. The agronomic indexes, yield, moxa yield, total ash, quality characteristics of moxa during combustion and pyrolysis, main volatile components, flavonoids, and phenolic acids were measured. The results showed that under shading conditions, the stem diameter, leaf width, 5-leaf spacing, branch number, and yield of A. stolonifera decreased significantly, while the plant height, leaf length, leaf number, chlorophyll content, and moxa yield increased first and then decreased with the increase in shading intensity. The burning performance of moxa under natural light was better than that under moderate and severe shading conditions. The content of eucalyptol first increased and then decreased with the increase in shading intensity. The humulene content was negatively correlated with shading intensity. Other major volatile components showed no significant difference under various shading conditions. The content of neochlorogenic acid, cryptochlorogenic acid, isoschaftoside, and isochlorogenic acid B was positively correlated with shading intensity, while the content of chlorogenic acid, isochlorogenic acid A, and isochlorogenic acid C decreased first and then increased with the increase in shading intensity. To sum up, A. stolonifera is a light-loving plant, and shading can greatly reduce the yield, the content of internal components, and the burning performance of moxa. It is the main reason why A. stolonifera is mainly distributed in the forest edge, open forest, roadside, and wasteland grass in the middle and high mountains in the wild. For artificial domestication and cultivation of A. stolonifera, it is better to select plots with sufficient light.

15.
Chinese Journal of Medical Instrumentation ; (6): 110-114, 2023.
Article in Chinese | WPRIM | ID: wpr-971314

ABSTRACT

The purpose of this study is to establish and apply a correction method for titanium alloy implant in spinal IMRT plan, a corrected CT-density table was revised from normal CT-density table to include the density of titanium alloy implant. Dose distribution after and before correction were calculated and compared to evaluate the dose deviation. Plans were also copied to a spinal cancer simulation phantom. A titanium alloy fixation system for spine was implanted in this phantom. Plans were recalculated and compared with the measurement result. The result of this study shows that the max dose of spinal cord showed significant difference after correction, and the deviation between calculation results and measurement results was reduced after correction. The method for expanding the range CT-density table, which means that the density of titanium alloy was included, can reduce the error in calculation.


Subject(s)
Radiotherapy, Intensity-Modulated/methods , Titanium , Radiotherapy Dosage , Alloys , Radiometry/methods , Radiotherapy Planning, Computer-Assisted/methods
16.
Acta Academiae Medicinae Sinicae ; (6): 149-154, 2023.
Article in Chinese | WPRIM | ID: wpr-970460

ABSTRACT

Acute coronary syndrome (ACS),with increasing mortality year by year,has become a major public health problem in China.Exercise rehabilitation as an important part of the out-of-hospital rehabilitation for the patients with heart diseases can further reduce the mortality of patients on the basis of drug treatment.The available studies have proved that high-intensity interval training (HIIT) is more effective and efficient than moderate-intensity continuous training (MICT) such as walking and jogging on chronic cardiovascular diseases such as heart failure,stable coronary heart disease,and hypertension and has high security.According to the latest research,HIIT can reduce the platelet response,mitigate myocardial ischemia-reperfusion injury,and increase the exercise compliance of ACS patients more significantly than MICT.Moreover,it does not increase the risk of thrombotic adverse events or malignant arrhythmia.Therefore,HIIT is expected to become an important part of exercise prescription in out-of-hospital cardiac rehabilitation strategy for the patients with ACS.


Subject(s)
Humans , Cardiac Rehabilitation , High-Intensity Interval Training , Acute Coronary Syndrome , Heart Failure , Blood Platelets
17.
Acta Academiae Medicinae Sinicae ; (6): 50-56, 2023.
Article in Chinese | WPRIM | ID: wpr-970446

ABSTRACT

Objective To compare the image quality of three high-resolution dynamic MRI methods for evaluating the motion of temporomandibular joint disc and condyle. Methods Twenty-five patients with suspected temporomandibular joint disorders were examined by single-shot fast spin-echo (SSFSE),fast imaging employing steady-state acquisition (FIESTA),and spoiled gradient echo (SPGR) on the oblique sagittal position.Two radiologists performed subjective and objective evaluation on the images with double-blind method.The subjective evaluation included the signal intensity of mandibular condyle,articular disc,soft tissue around articular disc,and lateral pterygoid muscle,the contrast between articular disc and condyle,the contrast between articular disc and surrounding soft tissue,condylar motion,and disc movement.The objective evaluation indexes included image signal intensity,signal-to-noise ratio (SNR),and contrast-to-noise ratio (CNR).The subjective and objective indexes of the image quality were compared between the three sequences. Results The SSFSE sequence had lower signal intensity of articular disc and higher signal intensity of condyle and surrounding soft tissue than FIESTA and SPGR sequences (all P<0.001).The SPGR sequence showed higher signal intensity of lateral pterygoid muscle than the SSFSE and FIESTA sequences (P=0.017,P<0.001).Among the three sequences,SSFSE sequence showed the clearest articular disc structure (χ2=41.952,P<0.001),the strongest contrast between articular disc and condyle (χ2=35.379,P<0.001),the strongest contrast between articular disc and surrounding soft tissue (χ2=27.324,P<0.001),and the clearest movement of articular disc (χ2=44.655,P<0.001).SSFSE and FIESTA sequences showed higher proportion of disc displacement and reduction than SPGR sequence (all P<0.001).The CNR (χ2=21.400,P<0.001),SNR (χ2=34.880,P<0.001),and condyle signal intensity (F=337.151,P<0.001) demonstrated differences among SSFSE,FIESTA,and SPGR sequences.The CNR of SSFSE sequence was higher than that of FIESTA sequence (P<0.001),while it had no significant difference between SSFSE and SPGR sequences (P=0.472).In addition,the SSFSE sequence had higher SNR and signal intensity than FIESTA and SPGR sequences (all P<0.001). Conclusion The best image quality can be observed from SSFSE sequence where both the structure and movement of temporomandibular joint are well displayed.Therefore,SSFSE is preferred for the examination of temporomandibular joint movement.


Subject(s)
Humans , Temporomandibular Joint/diagnostic imaging , Motion , Plastic Surgery Procedures
18.
Journal of Environmental and Occupational Medicine ; (12): 317-322, 2023.
Article in Chinese | WPRIM | ID: wpr-969637

ABSTRACT

Background Tinnitus is a common symptom in workers exposed to noise, and no specific treatment is available yet. Paying attention to the influencing factors of tinnitus is very important to prevent tinnitus. Objective To investigate the situation of tinnitus among noise-exposed workers and its influencing factors. Methods Using a cross-sectional study design, 1011 noise-exposed male workers in Hangzhou were studied. Tinnitus status, age, education, personal protection, smoking history, drinking history, and family history of the participants were surveyed by questionnaires. Binaural pure tone hearing threshold test was performed on all study subjects. The environmental noise in the workplace was measured. The relationships of tinnitus with noise exposure intensity, noise exposure time, noise exposure category, cumulative noise exposure, and wearing hearing protectors among the noise-exposed workers were analyzed by logistic regression. Results The prevalence of tinnitus among the noise-exposed workers was 36.1%. The mean hearing thresholds at 500, 3000, 4000, and 6000 Hz in the right and left ears were higher in the tinnitus group than in the non-tinnitus group (P<0.05); the hearing threshold at 2000 Hz in the right ear was higher in the tinnitus group than in the non-tinnitus group (P<0.05). There was no statistically significant difference between the two groups in the prevalence of monaural speech-frequency hearing loss or monaural high-frequency hearing loss (P>0.05). The on-site noise intensity was divided into three groups: <85, 85-<95, and ≥95 dB(A); the prevalence of tinnitus in the three groups was 19.6%, 40.5%, and 66.7% respectively. The years of noise exposure was divided into three groups: <1, 1-<5, and ≥5 years; the prevalence of tinnitus in the three groups was 17.9%, 34.0%, and 45.4% respectively. The cumulative noise exposure was divided into six groups: <80, 80-<85, 85-<90, 90-<95, 95-<100, and ≥100 dB(A)·year; the prevalence of tinnitus in the six groups was 6.8%, 25.0%, 31.0%, 39.6%, 43.1%, and 46.7% respectively. The prevalence of tinnitus was higher in the non-stationary noise group (42.5%) than in the stationary noise group (26.8%) (χ2=26.18, P<0.01), and the prevalence in the group without or with hearing protection was 39.7% and 35.5% respectively. The results of logistic regression showed that workers exposed to higher intensity, longer noise exposure, higher cumulative noise exposure, and non-stationary noise (reference: stationary noise) resulted in a higher risk of tinnitus (Ptrend<0.01 or P<0.01); workers wearing of hearing protection device versus those not showed a lower risk of tinnitus (P<0.05). Conclusion Higher intensity, longer exposure to noise, and more cumulative noise exposure associate with a higher risk of tinnitus. Wearing hearing protective device can reduce the risk of tinnitus. Tinnitus in noise-exposed workers can precede the presentation of abnormal hearing loss.

19.
Chinese Journal of Oncology ; (12): 627-633, 2023.
Article in Chinese | WPRIM | ID: wpr-984759

ABSTRACT

Objective: To compare the incidence of radiation-related toxicities between conventional and hypofractionated intensity-modulated radiation therapy (IMRT) for limited-stage small cell lung cancer (SCLC), and to explore the risk factors of hypofractionated radiotherapy-induced toxicities. Methods: Data were retrospectively collected from consecutive limited-stage SCLC patients treated with definitive concurrent chemoradiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from March 2016 to April 2022. The enrolled patients were divided into two groups according to radiation fractionated regimens. Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) was used to evaluate the grade of radiation esophagus injuries and lung injuries. Logistic regression analyses were used to identify factors associated with radiation-related toxicities in the hypofractionated radiotherapy group. Results: Among 211 enrolled patients, 108 cases underwent conventional IMRT and 103 patients received hypofractionated IMRT. The cumulative incidences of acute esophagitis grade ≥2 [38.9% (42/108) vs 35.0% (36/103), P=0.895] and grade ≥ 3 [1.9% (2/108) vs 5.8% (6/103), P=0.132] were similar between conventional and hypofractionated IMRT group. Late esophagus injuries grade ≥2 occurred in one patient in either group. No differences in the cumulative incidence of acute pneumonitis grade ≥2[12.0% (13/108) vs 5.8% (6/103), P=0.172] and late lung injuries grade ≥2[5.6% (6/108) vs 10.7% (11/103), P=0.277] were observed. There was no grade ≥3 lung injuries occurred in either group. Using multiple regression analysis, mean esophageal dose ≥13 Gy (OR=3.33, 95% CI: 1.23-9.01, P=0.018) and the overlapping volume between planning target volume (PTV) and esophageal ≥8 cm(3)(OR=3.99, 95% CI: 1.24-12.79, P=0.020) were identified as the independent risk factors associated with acute esophagitis grade ≥2 in the hypofractionated radiotherapy group. Acute pneumonitis grade ≥2 was correlated with presence of chronic obstructive pulmonary disease (COPD, P=0.025). Late lung injuries grade ≥2 was correlated with tumor location(P=0.036). Conclusions: Hypofractionated IMRT are tolerated with manageable toxicities for limited-stage SCLC patients treated with IMRT. Mean esophageal dose and the overlapping volume between PTV and esophageal are independently predictive factors of acute esophagitis grade ≥2, and COPD and tumor location are valuable factors of lung injuries for limited-stage SCLC patients receiving hyofractionated radiotherapy. Prospective studies are needed to confirm these results.


Subject(s)
Humans , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Radiotherapy, Intensity-Modulated/methods , Retrospective Studies , Lung Injury , Radiotherapy Dosage , Radiation Injuries/epidemiology , Esophagitis/epidemiology , Risk Factors , Pulmonary Disease, Chronic Obstructive/complications
20.
Chinese Journal of Hematology ; (12): 465-471, 2023.
Article in Chinese | WPRIM | ID: wpr-984645

ABSTRACT

Objective: The purpose of this study was to assess the safety and efficacy of a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced-intensity conditioning (RIC) in patients with hematological malignancies who had relapsed after the first allo-HSCT. Methods: Between April 2018 and June 2021, 44 patients with hematological malignancies (B-ALL 23, T-ALL/T-LBL 4, AML15, and MDS 2) were enrolled and retrospectively examined. Unrelated donors (n=12) or haploidentical donors (n=32) were used. Donors were replaced in all patients for the second allo-HSCT. Hematological and immunological germline predisposition genes and hematopoietic and immune function tests were used to select the best-related donor. Total body irradiation (TBI) /fludarabine (FLU) -based (n=38), busulfan (BU) /FLU-based (n=4), total marrow irradiation (TMI) /FLU-based (n=1), and BU/cladribine-based (n=1) were the RIC regimens used. For graft versus host disease (GVHD) prevention, cyclosporine, mycophenolate mofetil, short-term methotrexate, and ATG were used. Eighteen (40.9%) of 44 patients with gene variations for which targeted medications are available underwent post-transplant maintenance therapy. Results: The median age was 25 years old (range: 7-55). The median interval between the first and second HSCT was 19.5 months (range: 6-77). Before the second allo-HSCT, 33 (75%) of the patients were in complete remission (CR), whereas 11 (25%) were not. All patients had long-term engraftment. The grade Ⅱ-Ⅳ GVHD and severe acute GVHD rates were 20.5% and 9.1%, respectively. Chronic GVHD was found in 20.5% of limited patterns and 22.7% of severe patterns. CMV and EBV reactivation rates were 29.5% and 6.8%, respectively. Hemorrhage cystitis occurred in 15.9% of cases, grade Ⅰ or Ⅱ. The 1-yr disease-free survival (DFS), overall survival (OS), and cumulative recurrence incidence (RI) rates of all patients were 72.5% (95% CI, 54.5%-84.3%), 80.6% (95% CI, 63.4%-90.3%), and 25.1% (95% CI, 13.7%-43.2%), respectively, with a median follow-up of 14 (2-39) months. There were eight deaths (seven relapses and one infection). The rate of non-relapse mortality (NRM) was only 2.3%. The CR patients' 1-yr RI rate was significantly lower than the NR patients (16.8% vs 48.1%, P=0.026). The DFS rate in CR patients was greater than in NR patients, although there was no statistical difference (79.9% vs 51.9%, P=0.072). Univariate analysis revealed that CR before the second allo-HSCT was an important prognostic factor. Conclusion: With our RIC regimens, donor change, and post-transplant maintenance therapy, the second allo-HSCT in relapsed hematological malignancies after the first allo-HSCT is a safe and effective treatment with high OS and DFS and low NRM and relapse rate. The most important factor influencing the prognosis of the second allo-HSCT is the patient's illness condition before the transplant.


Subject(s)
Humans , Adult , Retrospective Studies , Neoplasm Recurrence, Local , Hematologic Neoplasms/therapy , Busulfan/therapeutic use , Graft vs Host Disease/prevention & control , Chronic Disease , Unrelated Donors , Hematopoietic Stem Cell Transplantation , Transplantation, Homologous , Transplantation Conditioning
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