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1.
Lima; Instituto Nacional de Salud; jun. 2020.
Não convencional em Espanhol | LILACS (Américas), BRISA | ID: biblio-1116148

RESUMO

ANTECEDENTES: Los coronavirus son una familia de virus causantes de enfermedades respiratorias, digestivas y del sistema nervioso en humanos y animales. A fines de 2019, se identificó en la provincia de Wuhan, China una cepa de coronavirus nunca antes encontrada en humanos, la cual recibió el nombre de SARS-CoV-2. La infección por SARS-CoV-2 se ha extendido a más de 212 países y fue declarada como pandemia por la Organización Mundial de la Salud. En nuestro país, se ha reportado 251 338 casos y un total de 7 861 fallecidos. Un número creciente de investigaciones ha relacionado la obesidad con una mayor probabilidad de enfermar y morir por COVID-19. En nuestro país, un 60% de personas mayores de 15 años presentan sobrepeso u obesidad, por lo cual resulta necesario investigar el rol del exceso de peso como un factor pronóstico de riesgo independiente en pacientes con COVID-19. OBJETIVO: Describir la evidencia científica publicada respecto al exceso de peso como factor pronóstico en pacientes con COVID-19. MÉTODO: Búsqueda electrónica de estudios publicados en idioma español o inglés en Medline (vía PubMed), The Cochrane Library, medRxiv y Google Scholar entre el 01 de diciembre de 2019 (mes donde se reportó los primeros casos de COVID-19 en China) y el 19 de junio de 2020. RESULTADOS: Se incluyeron 18 estudios desarrollados en diferentes países de América (Brasil, Estados Unidos y México), Europa (Francia, Italia y Reino Unido) y Asia (China y Kuwait). La mayoría de estudios fueron desarrollados en contextos hospitalarios. Cuatro estudios sub-analizaron registros nacionales de pacientes hospitalizados y no hospitalizados. La cantidad de sujetos incluidos en los estudios varió grandemente entre 103 y 285 817 pacientes. CONCLUSIONES : La revisión incluyó 18 estudios procedentes de diferentes países de América, Asia y Europa. La población de los estudios fue heterogénea en cuanto al promedio de edad, personas del sexo masculino, comorbilidades y proporción de personas con sobrepeso y obesidad. Los hallazgos muestran un incremento significativo del riesgo de contraer COVID-19 y requerir hospitalización en personas con sobrepeso u obesidad, en comparación con personas con peso normal. En personas con sobrepeso, no se observó un incremento del riesgo para otros desenlaces relacionados con la progresión de la enfermedad, como progresión a enfermedad severa, necesidad de ventilación mecánica o admisión a UCI. En personas con obesidad, solo se observó una tendencia a un incremento del riesgo en aquellas ubicadas en las categorías de mayor severidad de la obesidad. La mortalidad por COVID-19 fue similar entre personas con sobrepeso y personas con peso normal. Los resultados en personas con obesidad no fueron consistentes, dos estudios observaron un riesgo significativamente más alto, mientras que en otros tres estudios no se observaron diferencias significativas. Cabe mencionar que aunque solo se incluyó estudios que evaluaran el riesgo del sobrepeso y obesidad sobre diferentes desenlaces pronósticos de COVID-19 utilizando modelos multivariados ajustados por factores de confusión, los ajustes del modelo variaron grandemente y en la mayoría de estudios no se tuvo en cuenta el tipo de tratamiento recibido por los pacientes.(AU)


Assuntos
Humanos , Pneumonia Viral/etiologia , Infecções por Coronavirus/etiologia , Obesidade/complicações , Prognóstico , Avaliação da Tecnologia Biomédica , Avaliação em Saúde
2.
Lima; Instituto Nacional de Salud; jun. 2020.
Não convencional em Espanhol | LILACS (Américas), BRISA | ID: biblio-1116150

RESUMO

ANTECEDENTES: Los coronavirus son una familia de virus causantes de enfermedades respiratorias, digestivas y del sistema nervioso en humanos y animales. A fines de 2019, se identificó en la provincia de Wuhan, China una cepa de coronavirus nunca antes encontrada en humanos, la cual recibió el nombre de SARS-CoV-2. La infección por SARS-CoV-2 se ha extendido a más de 212 países y fue declarada como pandemia por la Organización Mundial de la Salud. En nuestro país, se ha reportado 251 338 casos y un total de 7 861 fallecidos. Un número creciente de investigaciones muestran una alta prevalencia de hipertensión arterial entre los pacientes con COVID-19, lo que plantea interrogantes sobre la mayor susceptibilidad de estos pacientes, así como del papel de la hipertensión en la progresión y pronóstico de pacientes con COVID-19. OBJETIVO: Describir la evidencia científica publicada respecto a la hipertensión arterial como factor pronóstico en pacientes con COVID-19. MÉTODO: Búsqueda electrónica de estudios publicados en idioma español o inglés en Medline (vía PubMed), The Cochrane Library, medRxiv y Google Scholar entre el 01 de diciembre de 2019 (mes donde se reportó los primeros casos de COVID-19 en China) y el 21 de junio de 2020. RESULTADOS: Se incluyó una revisión sistemática con meta-análisis, cuyo objetivo fue investigar la asociación entre la hipertensión arterial y desenlaces pronósticos en pacientes con COVID-19. La revisión incluyó un total de 30 estudios con 6560 participantes. CONCLUSIONES: • Se identificó una revisión sistemática que evaluó diferentes desenlaces de pronóstico en pacientes con hipertensión y diagnóstico confirmado de COVID-19 con evidencia procedente de treinta estudios. Los hallazgos fueron consistentes en mostrar que los pacientes con hipertensión arterial tuvieron un riesgo entre dos a tres veces mayor de morir, desarrollar formas severas de COVID-19, observar una progresión de la enfermedad o ser admitidos en una Unidad de Cuidados Intensivos, en comparación con pacientes con presión arterial normal. La revisión sistemática fue considerada como nivel de confianza críticamente bajo. Asimismo, algunas limitaciones observadas en los estudios primarios incluidos en la revisión sistemática fueron: la utilización de un diseño retrospectivo en la mayoría de estudios, la utilización de diferentes definiciones de hipertensión arterial y la presencia de factores de confusión no ajustados, como el porcentaje de personas con hipertensión no controlada o los diferentes tipos de medicación antihipertensiva empleados. Asimismo, la mayoría de estudios fueron publicados en servidores de preimpresión, no siendo revisados por pares.


Assuntos
Pneumonia Viral/etiologia , Infecções por Coronavirus/etiologia , Hipertensão/complicações , Prognóstico , Avaliação da Tecnologia Biomédica , Avaliação em Saúde
3.
Rev. Asoc. Odontol. Argent ; 108(1): 25-28, ene.-abr. 2020. ilus
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1096717

RESUMO

Objetivo: Describir el diagnóstico y la resolución de un caso clínico de schwannoma maligno mandibular, una neopla- sia extremadamente rara en la región maxilofacial y con alto porcentaje de mortalidad. Caso clínico: Un paciente masculino de 56 años de edad acudió a la consulta por trismus, dolor y no cierre de la herida posextracción en maxilar inferior, con una evolución de tres meses. Se le solicitó una tomografía computada que evidenció lesión osteolítica y pieza dentaria retenida en la zona afectada. Se realizó la biopsia excisional. El diagnósti- co fue schwannoma maligno mandibular. Nueve meses des- pués del tratamiento quirúrgico y coadyuvante, el paciente falleció. Conclusiones: La derivación a un especialista y el análisis histopatológico tempranos permiten diagnosticar a tiempo este tipo de neoplasias. El schwannoma maligno es una enfermedad agresiva, con una tasa de supervivencia baja, pero la intervención oportuna y el diagnóstico precoz mejoran el pronóstico y la sobrevida del paciente (AU)


Aim: Describe the diagnosis and resolution of a clini- cal case of malignant mandibular schwannoma. An extremely rare neoplasm in the maxillary facial region, and with a high percentage of mortality. Clinical case: A 56-year-old male patient attended the consultation due to trismus, pain and non-closure of the post-extraction wound in the lower jaw, with an evolution of three months. He was asked for a computed tomography scan, that showed an osteolytic lesion and retained tooth in the af- fected area. Excisional biopsy is performed. The diagnosis was malignant mandibular schwannoma. After surgical and adjuvant treatment, the patient dies nine months later. Conclusion: Early referral to a specialist and histo- pathological analysis will allow to diagnose this type of neoplasms early. Malignant schwannoma is recorded as an aggressive disease with a low survival rate, but timely inter- vention and early diagnosis improves the prognosis and pa- tient survival (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Mandibulares , Neurofibrossarcoma/cirurgia , Neurofibrossarcoma/diagnóstico , Argentina , Prognóstico , Biópsia , Neurofibrossarcoma/mortalidade , Neurofibrossarcoma/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais , Unidade Hospitalar de Odontologia
4.
Int. j. morphol ; 38(2): 382-388, abr. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1056451

RESUMO

The purpose of this research is to examine stature in both Albanian sexes as well as its association with arm span, as an alternative to estimating stature. A total of 445 individuals (266 boys and 179 girls) participated in this research. The anthropometric measurements were taken according to the protocol of ISAK. The relationships between stature and arm span were determined using simple correlation coefficients at a 95 % confidence interval. Then a linear regression analysis was carried out to examine extent to which arm span can reliably predict stature. Results displayed that Albanian boys are 176.57±7.36 cm tall and have an arm span of 179.98±9.41 cm, while Albanian girls are 166.84±9.28 cm tall and have an arm span of 167.53±10.34 cm. The results have shown that both sexes made Albanians a tall nation but not even close to their male compatriots from Kosovo that are almost 3 centimeters taller, while the results in female population are opposite. Moreover, the arm span reliably predicts stature in both sexes, which confirms a high R-square (%) for the boys (73.4) as well as for the girls (78.8).


El objetivo de esta investigación fue examinar la estatura en individuos de ambos sexos albaneses, además de su asociación con la extensión del brazo, como una alternativa a la estimación de la estatura. Un total de 445 individuos (266 niños y 179 niñas) participaron en esta investigación. Las medidas antropométricas se tomaron de acuerdo con el protocolo de ISAK. Las relaciones entre la estatura y el brazo se determinaron utilizando coeficientes de correlación simples en un intervalo de confianza del 95 %. Luego se realizó un análisis de regresión lineal para examinar en qué medida el brazo puede predecir de manera confiable la estatura. Los resultados muestran que los niños albaneses miden 176,57 ± 7,36 cm de alto y tienen una medida del brazo de 179,98 ± 9,41 cm, mientras que las niñas albanesas miden 166,84 ± 9,28 cm de alto y tienen una medida del brazo de 167,53 ± 10,34 cm. Los resultados han demostrado una altura importante en ambos sexos de la población albanesa. Sin embargo, se observó que respecto de la altura los varones de Kosovo miden casi 3 centímetros más, mientras que en la población femenina se observó lo contrario. Además, la extensión del brazo predice de manera confiable la estatura en ambos sexos, lo que confirma un alto Rcuadrado (%) para los varones (73,4) y para las mujeres (78,8).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Braço/anatomia & histologia , Estatura , Prognóstico , Modelos Lineares , Antropometria , Albânia
5.
J. health med. sci. (Print) ; 6(1): 57-63, ene.-mar. 2020. tab, ilus
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1096722

RESUMO

El objetivo de este trabajo fue determinar la relación entre el pronóstico visual según el Ocular Trauma Score (OTS) y la agudeza visual (AV) a los 6 meses de ocurrido el trauma ocular, en pacientes atendidos en la Unidad de Trauma Ocular del Hospital del Salvador, Santiago de Chile. Se hizo uso de un estudio descriptivo, longitudinal, retrospectivo. Se accedió a los registros clínicos de pacientes atendidos por trauma ocular grave entre el 1 de enero de 2014 al 15 de marzo 2015. 145 pacientes conformaron una muestra de 153 ojos. Se estableció la relación entre OTS obtenido y la AV a 6 meses del trauma mediante el coeficiente de correlación de Spearman. De los ojos estudiados, el grupo mayor N=68 (44,4%) calificó para OTS 3 y el menor N=16 (10,5%) para OTS 1. Se presentaron cinco categorías de visión, en un tiempo inicial la mayoría de los casos presentaron AV de luz, mala proyección-cuenta dedos (n=89). Tras seis meses dicha distribución se desplazó hacia la categoría 20/40 - 20/20 (n=68). Se encontró una fuerte asociación (r=0,711 p=0,000) entre el OTS calculado y la AV luego de seis meses de seguimiento. El OTS demostró poseer un gran valor predictivo y es una herramienta aplicable en nuestro medio, los datos obtenidos indican que existe un mejor pronóstico visual que los obtenidos en otro estudio. Cabe destacar que es la primera instancia en que se evalúa la aplicación del OTS en Chile.


This work aimed to determine the relationship between the visual prognosis according to the Ocular Trauma Score (OTS) and visual acuity (AV) 6 months after the ocular trauma in patients treated at the Eye Trauma Unit from the Hospital del Salvador, in Santiago, Chile. A descriptive, longitudinal and retrospective study was performed. We accessed registers of clinical patients attended for severe eye trauma from 1 January 2014 to 15 March 2015. 145 patients constitute a sample of 153 eyes. A connection was established between the OTS obtained and the AV 6 months after the trauma via the Spearman correlation coefficient. From the eyes studied, the greatest group N=68 (44.4%) qualified for OTS 3 and the smallest N=16 (10.5%) for OTS 1. Five eye categories were presented, in the beginning, most of the cases presented visual acuity with bad projection ­ hand motion (n=89). After six months of distribution, it moved to the category 20/40 ­ 20/20 (n=68). A strong relation (r=0,711 p=0,000) was found between the estimated OTS and the AV after six months of tracking. The OTS proved to have great predictive valor and is an applicable tool in our area, the data obtained showed that there is a better visual prognosis than the obtained in other studies. It is worth noting that this is the first stage where the application of OTS is assessed in Chile.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Acuidade Visual/fisiologia , Índices de Gravidade do Trauma , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/fisiopatologia , Prognóstico , Chile , Traumatismos Oculares/terapia , Valor Preditivo dos Testes , Estudos Retrospectivos , Seguimentos , Estudos Longitudinais , Emergências , Serviços de Saúde Ocular
6.
Rev. argent. coloproctología ; 31(1): 2-7, mar. 2020. tab, ilus
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1100300

RESUMO

Introducción: El budding tumor (BT) es la presencia de células tumorales aisladas o en pequeños grupos situadas en el frente de invasión del tumor. Su hallazgo en alto grado es un factor de mal pronóstico independiente del cáncer colorrectal. El objetivo de este trabajo es determinar si el grado de BT está asociado con otros factores pronósticos del cáncer rectal. Material y métodos: Se incluyen las resecciones oncológicas de recto en el período 2013-2017. Los casos se agruparon según la densidad en la formación de los BT en 3 grupos, los de grado bajo, intermedio y alto. Se utilizó como valor estadístico el cálculo del odds ratio (OR). Resultados: Se analizaron las piezas de resección de 27 pacientes (15 mujeres y 12 hombres) con una media de edad de 68,4 años (40-86). Se calculó el OR para invasión ganglionar, vascular y recidiva en función del grado de budding tumoral. Discusión: Se observó una tendencia a la presencia de factores histológicos de mal pronóstico en relación al budding de alto grado, si bien el bajo número de casos no permitió demostrarlo en este estudio. Conclusiones: El análisis del grado de tumor budding es reproducible y podría ayudar a identificar pacientes con cáncer rectal de peor pronóstico. (AU)


Introduction: Tumor budding (BT) is defined as isolated or small groups of neoplastic cells located at the invasive front of the tumor. High-grade BT is a poor prognostic factor in colorectal cancer. Objective: To determine if the degree of BT is associated with other prognostic factors in rectal cancer. Materials and methods: Rectal oncological resections during the 2013-2017 period were included. Cases were stratified according to the density in the formation of BT in 3 groups: low, intermediate and high. The calculation of the odds ratio (OR) was used as a statistical value. Results: The resection specimens of 27 patients (15 women and 12 men) with a mean age of 68.4 years (40-86) were analyzed. OR for node metastases, vascular invasion and relapse was calculated according to tumor budding grade. Discussion: High-grade tumor budding seems to associate with the presence of poor prognostic factors. However, it was not possible to demonstrate it because of the small sample size. Conclusions: Tumor budding is a reproducible marker and could help to identify rectal cancer patients with a worse prognosis. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Retais/patologia , Adenocarcinoma/patologia , Invasividade Neoplásica/patologia , Invasividade Neoplásica/diagnóstico por imagem , Prognóstico , Neoplasias Retais/cirurgia , Adenocarcinoma/cirurgia , Análise Estatística , Estudos Retrospectivos , Seguimentos , Estadiamento de Neoplasias
8.
Coluna/Columna ; 19(1): 58-66, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-1089645

RESUMO

ABSTRACT Care of the patient with spinal metastasis is challenging. The topic of this article is the treatment and prognosis of spinal metastases, aiming to enumerate and analyze literature that addresses this treatment and prognosis. The methodology used was an integrative review in the Virtual Health Library. Nineteen articles were identified demonstrating that there is research and scientific production in this area. The thematic units and their categories are: treatment decision - prognostic scales or clinical neurological evaluation; types of treatment - minimally invasive and/or traditional; and effectiveness of prognostic scales higher or lower probability of success, which provide insight into the different possibilities of patient evaluation and their applicability in practice. When making the diagnosis, planning the treatment, and establishing a prognosis, the professional must be in sync with current precepts and act based on the objective and subjective characteristics of the patients, such as beliefs and values, which although immeasurable, influence the survival and the effectiveness of treatment. Level of evidence I; Integrative Review.


RESUMO Já que o atendimento ao paciente com metástases na coluna vertebral é desafiador, o presente artigo tem como propósito o tratamento e o prognóstico das metástases espinhais, visando enumerar e analisar literaturas que abordam o tratamento e o prognóstico. A metodologia utilizada consistia em uma revisão integrativa na Biblioteca Virtual de Saúde. Foram identificadas 19 literaturas demonstrando que há pesquisas e produções científicas nessa área, sendo que as unidades temáticas e suas categorias são: decisão quanto ao tratamento - escalas prognósticas ou avaliação clínica neurológica; tipos de tratamento - minimamente invasivos e ou tradicionais; efetividade das escalas de prognóstico - maior ou menor probabilidade de acerto; o que propicia vislumbrar as diferentes possibilidades de avaliação do paciente e sua aplicabilidade na prática. O profissional, ao realizar o diagnóstico, planejar o tratamento e estabelecer um prognóstico, deve estar em sincronia com os preceitos atuais e agir baseado nas características objetivas e nas subjetivas dos pacientes que, apesar de imensuráveis, como crenças e valores, influenciam na sobrevivência e na eficácia do tratamento. Nível de evidência I; Revisão Integrativa.


RESUMEN Ya que la atención al paciente con metástasis en la columna vertebral es desafiante, el presente artículo tiene como propósito el tratamiento y el pronóstico de las metástasis espinales, con el objetivo de enumerar y analizar literaturas que abordan el tratamiento y el pronóstico. La metodología utilizada consistía en una revisión integrativa en la Biblioteca Virtual de Salud. Se identificaron 19 literaturas demostrando que hay investigaciones y producciones científicas en esta área, siendo que las unidades temáticas y sus categorías son: decisión cuanto al tratamiento - escalas pronósticas o evaluación clínica neurológica; tipos de tratamiento - mínimamente invasivos y/o tradicionales; efectividad de las escalas de pronóstico - mayor o menor probabilidad de acierto; lo que propicia vislumbrar las diferentes posibilidades de evaluación del paciente y su aplicabilidad en la práctica. El profesional, al realizar el diagnóstico, planificar el tratamiento y establecer un pronóstico, debe estar en sincronía con los preceptos actuales y actuar basado en las características objetivas y en las subjetivas de los pacientes que, a pesar de inmensurables, como creencias y valores, influencian en la supervivencia y en la eficacia del tratamiento. Nivel de evidencia I; Revisión Integrativa


Assuntos
Humanos , Prognóstico , Coluna Vertebral , Terapêutica , Metástase Neoplásica
9.
Rev. habanera cienc. méd ; 19(1): 63-75, ene.-feb. 2020. tab, graf
Artigo em Espanhol | LILACS (Américas), CUMED | ID: biblio-1099146

RESUMO

Introducción: La sepsis fue definida como una disfunción orgánica potencialmente mortal causada por una respuesta desregulada del huésped a la infección. Objetivo: Identificar factores pronósticos de mortalidad en pacientes con 65 años o más ingresados con sepsis en la Unidad de Cuidados Intensivos del Hospital Aleida Fernández Chardiet entre 2012-2017. Material y Métodos: Se realizó un estudio observacional, analítico y retrospectivo. La población objeto de estudio fue de 129 pacientes con 65 años o más que ingresaron con sepsis. Resultados: Ingresaron 316 pacientes con sepsis; 187 con ˂ 65 años y 129 tenían ≥65 años. Los valores de media del APACHE II fue muy superior en los pacientes que no lograron sobrevivir (16,1; p˂0,01); al igual que el SOFA (6,3±2,4; IC 95 por cvi 5,8-6,8; p˂0,01). La curva ROC mostró un área bajo la curva para el APACHE II es de 0,834 (IC 95 por ciento 0,761-0,907) y para el SOFA es de 0,941 (IC 95 por ciento 0,903-0,980). El 77,6% de los pacientes que murieron presentaban un shock séptico (OR=47,5; IC 95 por ciento 13,2-170,5; p˂0,01); y un síndrome de disfunción múltiple de órganos, 67,1 por ciento (OR=47,8; IC 95 por ciento 9,6-189,5; p˂0,01). Las variables significativamente asociadas a la mortalidad fueron el APACHE II≥15 puntos (OR ajustado 10,7; IC 95 por ciento 2,8-40,4) y el SOFA ≥5 puntos (OR ajustado 43,9; IC 95 por ciento 2,3-826,8). La calibración del modelo fue adecuada (X2=5,7; p=0,336). Conclusiones: Los factores pronósticos que se relacionaron con la mortalidad en los ancianos fueron el APACHE II≥ 15 puntos y el SOFA ≥5 puntos(AU)


Introduction: Sepsis is defined as a life-threatening organ dysfunction caused by an unregulated host response to infection. Objective: To identify prognostic factors for mortality in patients 65 years old or older admitted with sepsis to the Intensive Care Unit of Aleida Fernandez Chardiet Teaching General Hospital between 2012 and 2017. Material and Methods: An observational analytical retrospective study was conducted. The study population was 129 elderly patients who were diagnosed with sepsis. Results: A total of 316 patients were admitted with sepsis; 187 of them were under 65 years old and 129 were 65 years old or older. The average APACHE II scores were much higher in those patients who could not survive (161; p˂0, 01); SOFA scores were (6, 3±2,4; 95 percent CI 5,8-6,8; p˂0,01). The ROC curve showed an area under the curve for APACHE II which was found to be 0,834 (95 percent CI 0,761-0,907) and for SOFA it was 0,941 (95 percent CI 0,903-0,980). On the other hand, 77,6 percent of patients died with septic shock (OR=47,5; 95 percent CI 13,2-170,5; p˂0,01) and a multiple-organ dysfunction syndrome, which was observed in 67,1 percent of them (OR=47,8; 95 percent CI 9,6-189,5; p˂0,01). According to multivariate logistic regression model, the variables significantly associated to mortality were APACHE II score ≥15 points (adjusted OR 10, 7; 95 percent CI 2, 8-40, 4) and SOFA ≥5 points (adjusted OR 43, 9; 95 percent CI 2, 3-826, 8). The model calibration was adequate (X2=5,7; p=0,336). Conclusions: The prognostic factors for mortality in elderly patients admitted with sepsis in the service were as follows: APACHE II score ≥ 15 points and SOFA score ≥5 points (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Sepse/complicações , Unidades de Terapia Intensiva , Prognóstico , Saúde do Idoso , Estudos Retrospectivos , Sepse/mortalidade
10.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 68-71, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1055368

RESUMO

Objective: Circadian dysregulation plays an important role in the etiology of mood disorders. Evening chronotype is frequent in these patients. However, prospective studies about the influence of chronotype on mood symptoms have reached unclear conclusions in patients with bipolar disorder (BD). The objective of this study was to investigate relationship between chronotype and prognostic factors for BD. Methods: At the baseline, 80 euthymic BD patients answered a demographic questionnaire and clinical scales to evaluate anxiety, functioning and chronotype. Circadian preference was measured using the Morningness-Eveningness Questionnaire, in which lower scores indicate eveningness. Mood episodes and hospitalizations were evaluated monthly for 18 months. Results: Among the BD patients, 14 (17.5%) were definitely morning type, 35 (43.8%), moderately morning, 27 (33.7%) intermediate (neither) and 4 (5%) moderately evening. Eveningness was associated with obesity or overweight (p = 0.03), greater anxiety (p = 0.002) and better functioning (p = 0.01), as well as with mood episodes (p = 0.04), but not with psychiatric hospitalizations (p = 0.82). This group tended toward depressive episodes (p = 0.06), but not (hypo)mania (p = 0.56). Conclusion: This study indicated that evening chronotype predicts a poor prognostic for BD. It reinforces the relevance of treating rhythm disruptions even during euthymia to improve patient quality of life and prevent mood episodes.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Ansiedade/fisiopatologia , Transtorno Bipolar/fisiopatologia , Ritmo Circadiano/fisiologia , Prognóstico , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Fatores de Tempo , Modelos Logísticos , Estudos Prospectivos , Inquéritos e Questionários , Estatísticas não Paramétricas , Transtornos Cronobiológicos/fisiopatologia , Hospitalização/estatística & dados numéricos , Pessoa de Meia-Idade
11.
J. Health Biol. Sci. (Online) ; 8(1): 1-8, 01/01/2020. ilus
Artigo em Português | LILACS (Américas) | ID: biblio-1102796

RESUMO

Objetivo: Analisar fatores associados ao óbito por hantavirose no Brasil. Método: trata-se de um estudo epidemiológico analítico do tipo caso-controle aninhado em uma coorte de casos contidos no Sistema de Informação de Agravos de Notificação. Para a análise bruta univariada, foi realizada regressão logística considerada p<0,20 e, para análise multivariada, foi realizada regressão logística do tipo stepwise-backwards, adotando p<0,05. Resultados: foram identificadas associações significativas com maior letalidade por hantavirose para os seguintes grupos: mulheres (Odds Ratio (OR): 1,43 - IC95% 1,02 a 2,00) para indivíduos com escolaridade não informada (OR: 3,86 ­ IC95% 1,71a 8,66) e ensino fundamental completo (OR: 3,88 - IC95% 1,51 a 9,96). Moradores da zona urbana (OR: 1,56 ­ IC95%. 1,15 a 2,12), indivíduos com choque e/ou hipotensão (OR: 3,37 - IC95% 2,51 a 4,51), sintomas respiratórios, e indivíduos cujo primeiro atendimento foi realizado com até três dias do início de sintoma (OR: 3,76 ­ IC95%: 2,51 a 4,51). Conclusão: algumas características do paciente podem aumentar as chances de óbito principalmente devido à baixa suspeição clínica e a possível demora na adoção do manejo adequado dos casos. A busca precoce de atenção, além da presença choque, hipotensão e/ou sinais respiratórios podem indicar evolução rápida da doença e maior gravidade.


Objetive: to analyze factors associated with death from hantavirus in Brazil. Method: This is an analytical case-control type epidemiological study nested in a cohort of cases contained in the Notifiable Diseases Information System. For the univariate crude analysis, a logistic regression was performed considering p <0.20 and for the multivariate analysis, a stepwise-backwards logistic regression was performed, adopting p <0.05. Results: Significant associations with higher lethality due to hantavirosis were identified for the following groups: women (Odds Ratio (OR): 1.43 - 95% CI 1.02 to 2.00) for individuals with uninformed schooling (OR: 3.86 - IC95% 1.71a 8.66) and complete elementary education (OR: 3.88 - 95% CI 1.51 to 9.96). Urban residents (OR: 1.56 - 95% CI 1.15 to 2.12), individuals with shock and / or hypotension (OR: 3.37 - 95% CI 2.51 to 4.51), respiratory symptoms (OR: 3.76 - 95% CI: 2.51 to 4.51), and individuals whose first care was performed within 3 days from the onset of symptoms. Conclusion: some characteristics of the patient may increase the chances of death mainly due to the low clinical suspicion and possible delay in adopting appropriate management of cases. The early search for attention, in addition to the presence of shock, hypotension and / or respiratory signs may indicate rapid disease progression and greater severity.


Assuntos
Infecções por Hantavirus , Prognóstico , Mortalidade , Hantavirus , Morte
12.
Electron. j. biotechnol ; 43: 32-40, Jan. 2020. ilus, tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1087567

RESUMO

Background: TP73 antisense RNA 1 (TP73-AS1), a newly discovered long non-coding RNA (lncRNA), has been reported to be upregulated in various kinds of tumors, and shows a variable influence on living quality and prognosis of patients. Thus, we conducted a meta-analysis to evaluate the overall prognostic value of the lncRNA TP73-AS1 in cancer patients. Results: A systematic literature retrieval was carried out using the PubMed, Cochrane Library, EMBASE, and Web of Science databases. We calculated the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the association of TP73-AS1 expression with prognostic and clinicopathological parameters. A total of 15 studies including 1057 cancer patients were finally selected for the meta-analysis. The results demonstrated that high TP73-AS1 expression was significantly associated with shorter overall survival (OS) (HR = 1.97, 95% CI: 1.68­2.31, P b 0.001). According to a fixed-effects or random-effects model, elevated TP73-AS1 expression markedly predicted advanced clinical stage (OR = 3.30, 95% CI: 2.35­4.64, P b 0.001), larger tumor size (OR = 2.37, 95% CI: 1.75­3.22, P b 0.001), earlier lymph node metastasis (OR = 3.28, 95% CI: 1.59­6.76, P = 0.001), and distant metastasis (OR = 4.94, 95% CI: 2.61­9.37, P b 0.001). Conclusions: High lncRNA TP73-AS1 expression appears to be predictive of a worse OS and clinicopathologic features for patients with various types of malignant tumors. These results provide a basis for utilizing TP73- AS1 expression as an unfavorable indicator to predict survival outcomes.


Assuntos
Carcinoma/genética , Biomarcadores Tumorais/genética , Neoplasias/genética , Prognóstico , Intervalo Livre de Doença , RNA Longo não Codificante/genética
13.
Artigo em Português | LILACS (Américas) | ID: biblio-1097242

RESUMO

Objetivo: iinvestigar a potencial associação entre a hipertensão arterial sistêmica (HAS) e a gravidade da COVID-19. Métodos: realizou-se uma pesquisa eletrônica no Medline, Scopus e Web of Science acerca da relação entre HAS e COVID-19. Resultados: as primeiras hipóteses levantadas revelaram que a associação entre as doenças estava no tratamento com inibidores da enzima de conversão da angiotensina e bloqueadores dos receptores da angiotensina. Contudo, em um estudo experimental, observou-se que os pacientes hipertensos tratados com esses medicamentos apresentaram menor taxa de gravidade da doença. Conclusão: até o momento, a relação de HAS e COVID-19 é conflitante.(AU)


Objective: to investigate the potential association between systemic arterial hypertension (SAH) and the severity of COVID-19. Methods: An electronic research on Medline, Scopus and Web of Science was conducted about the relationship between SAH and COVID-19. Results: The first hypotheses raised revealed that the association between the diseases was in the treatment with angiotensin conversion enzyme inhibitors and angiotensin receptor blockers. However, in an experimental study it was observed that hypertensive patients treated with these drugs had a lower rate of disease severity. Conclusion: So far, the relationship between SAH and COVID-19 is conflicting.(AU)


Assuntos
Humanos , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Infecções por Coronavirus/diagnóstico , Hipertensão/etiologia , Prognóstico
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811221

RESUMO

OBJECTIVE: With the emerging significance of genetic profiles in the management of endometrial cancer, the identification of tumor-driving genes with prognostic value is a pressing need. The LAMC1 gene, encoding the laminin subunit gamma 1 (LAMC1) protein, has been reported to be involved in the progression of various malignant tumors. In this study, we aimed to investigate the role of LAMC1 in endometrial cancer and elucidate the underlying mechanism.METHODS: We evaluated the immunohistochemical expression of LAMC1 in atypical endometrial hyperplasia and endometrial cancer. Within the endometrial cancer cases, we analyzed the association of LAMC1 overexpression with clinicopathological factors and prognosis. Furthermore, to indentify genes influenced by LAMC1 overexpression, we transfected HEC50B and SPAC-S cells with siRNA targeting LAMC1 and conducted microarray gene expression assays.RESULTS: While none of the atypical endometrial hyperplasia specimens exhibited LAMC1 overexpression, endometrial cancer possessed a significantly higher LAMC1 overexpression rate. LAMC1 overexpression was strongly associated with histological type, lymphovascular space invasion, lymph node metastasis, advanced International Federation of Gynecology and Obstetrics stage, and poor overall survival in endometrial cancer. Gene expression microarray analysis identified 8 genes correlated with tumor progression (LZTFL1, TAPT1, SEL1L, PAQR6, NME7, TMEM109, CCDC58, and ANKRD40) that were commonly influenced in HEC50B and SPAC-S by LAMC1 silencing.CONCLUSION: LAMC1 overexpression is a potent biomarker for identifying endometrial cancer patients needing aggressive adjuvant therapy. We elucidated 8 candidate genes that may mediate progression of LAMC1 overexpressing cancer. Further investigation of the underlying mechanism should lead to the discovery of new therapeutic targets.


Assuntos
Hiperplasia Endometrial , Neoplasias do Endométrio , Feminino , Expressão Gênica , Perfilação da Expressão Gênica , Ginecologia , Humanos , Laminina , Linfonodos , Análise em Microsséries , Metástase Neoplásica , Obstetrícia , Prognóstico , RNA Interferente Pequeno
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811217

RESUMO

OBJECTIVE: To evaluate the effectiveness and safety of the combination of pegylated liposomal doxorubicin with carboplatin (CD) compared with those of carboplatin and paclitaxel (CP) for platinum-sensitive recurrent ovarian, fallopian, or primary peritoneal cancer in a real-world setting in Korea.METHODS: We enrolled relevant patients from 9 institutions. All patients received CD or CP as the second- or third-line chemotherapy in routine clinical practice during 2013–2018. The primary endpoints were progression-free survival (PFS) and toxicity. The secondary endpoint included the objective response rate (ORR).RESULTS: Overall, 432 patients (224 and 208 in the CD and CP groups, respectively) were included. With a median follow-up of 18.9 months, the median PFS was not different between the groups (12.7 vs. 13.6 months; hazard ratio, 1.161; 95% confidence interval, 0.923–1.460; p=0.202). The ORR was 74.6% and 80.1% in the CD and CP group, respectively (p=0.556). Age and surgery at relapse were independent prognostic factors. More patients in the CD group significantly experienced a grade 3 to 4 hematologic toxicity and hand-foot syndrome (13.8% vs. 6.3%), whereas grade 2 or more alopecia (6.2% vs. 36.1%), peripheral neuropathy (4.4% vs. 11.4%), and allergic/hypersensitivity reaction (0.4% vs. 8.5%) developed more often in the CP group.CONCLUSIONS: The safety and effectiveness of chemotherapy with CD in a real-world setting were consistent with the results from a randomized controlled study. The different toxicity profiles between the 2 chemotherapy (CD and CP) regimens should be considered in the clinical practice.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03562533


Assuntos
Alopecia , Carboplatina , Estudos de Coortes , Intervalo Livre de Doença , Doxorrubicina , Tratamento Farmacológico , Seguimentos , Síndrome Mão-Pé , Humanos , Coreia (Geográfico) , Neoplasias Ovarianas , Paclitaxel , Doenças do Sistema Nervoso Periférico , Platina , Prognóstico , Recidiva , Estudos Retrospectivos
16.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811213

RESUMO

OBJECTIVE: To evaluate survival and recurrence in stage II endometrial cancer in relation to uterine risk stratification. Outcome for stage II was compared before and after the introduction of lymph node (LN) resection and omission of all postoperative radiotherapy.METHODS: The cohort consisted of 4,380 endometrial carcinoma patients radically operated (no visual tumor, all distant metastasis removed) (2005–2012) including 461 stage II. Adjusted Cox regression was used to compare survival and actuarial recurrence rates.RESULTS: Uterine risk factors (low-, intermediate-, and high-) were the strongest predictors of survival and recurrence in stage II. Stage II low-risk having a prognosis comparable to low-risk stage I (grade 1–2, <50% myometrial invasion), whereas cervical invasion significantly increased the risk of recurrence and decreased cancer-specific survival in intermediate- and high-risk compared to the corresponding stage I risk groups. In 355 cases of 708 with cervical stromal invasion, LN-resection showed 27.9% with LN metastasis and upstaged 18.1% from stage II to IIIC resulting in longer survival and lower recurrence in LN-resected compared to non-LN resected stage II. Radical as compared to simple hysterectomy did not alter survival. Treatment with external beam radiotherapy decreased local recurrence without affecting survival.CONCLUSION: Uterine risk groups are the strongest predictors for survival and recurrence in stage II patients and should be considered when advising adjuvant therapy. LN-resected stage II had increased survival and decreased recurrence. Omitting radiotherapy increase vaginal recurrence without affecting survival.


Assuntos
Estudos de Coortes , Neoplasias do Endométrio , Feminino , Humanos , Histerectomia , Excisão de Linfonodo , Linfonodos , Metástase Neoplásica , Prognóstico , Radioterapia , Recidiva , Fatores de Risco
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811201

RESUMO

Matrix metallopeptidase 3 or MMP3, is a zinc-dependent proteolytic enzyme that is involved in various physiological processes via modification of the extracellular matrix. In particular, its over-expression has been associated with cancer metastasis and tumor growth in various cancers including breast cancer. MMP3 gene expression is regulated by several factors such as DNA polymorphisms which also serve as risk factors for breast cancer. As such, DNA polymorphisms of MMP3 have the potential to be utilized as genetic biomarkers for prediction and prognosis of metastatic breast cancer. Presently, genome-wide association studies of MMP3 gene polymorphisms which are associated with breast cancer risk and patient survival in a variety of populations are reviewed. In order to understand the potential role of MMP3 polymorphisms as genetic markers for breast cancer metastasis, the domain structure of MMP3, the regulation of its expression and its role in breast cancer metastasis are also briefly discussed in this review. The emergence of MMP3 gene polymorphisms as prognostic biomarker candidates for breast cancer metastasis may contribute towards improving targeted therapies and categorization of breast cancer cases in order to provide a better and more accurate prognosis.


Assuntos
Biomarcadores , Neoplasias da Mama , Mama , DNA , Matriz Extracelular , Expressão Gênica , Marcadores Genéticos , Estudo de Associação Genômica Ampla , Humanos , Metaloproteinase 3 da Matriz , Metástase Neoplásica , Fenômenos Fisiológicos , Prognóstico , Fatores de Risco
18.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811198

RESUMO

PURPOSE: We investigated the expression of the N-myc and STAT interactor (NMI) protein in invasive ductal carcinoma tissue and estimated its clinicopathologic significance as a prognostic factor. The expression levels and prognostic significance of NMI were also analyzed according to the molecular subgroup of breast cancers.METHODS: Human NMI detection by immunohistochemistry was performed using tissue microarrays of 382 invasive ductal carcinomas. The correlation of NMI expression with patient clinicopathological parameters and prognostic significance was analyzed and further assessed according to the molecular subgroup of breast cancers. Moreover, in vitro experiments with 13 breast cancer cell lines were carried out. We also validated NMI expression significance in The Cancer Genome Atlas cohort using the Human Protein Atlas (HPA) database.RESULTS: Low NMI expression was observed in 190 cases (49.7%). Low NMI expression was significantly associated with the “triple-negative” molecular subtype (p < 0.001), high nuclear grade (p < 0.001), high histologic grade (p < 0.001), and advanced anatomic stage (p = 0.041). Patients with low NMI expression had poorer progression-free survival (p = 0.038) than patients with high NMI expression. Low NMI expression was not significantly associated with patient prognosis in the molecular subgroup analysis. In vitro, a reduction of NMI expression was observed in 8 breast cancer cell lines, especially in the estrogen receptor-positive and basal B type of triple-negative breast cancer molecular subgroups. The HPA database showed that low NMI expression levels were associated with a lower survival probability compared with that associated with high NMI expression (p = 0.053).CONCLUSION: NMI expression could be a useful prognostic biomarker and a potential novel therapeutic target in invasive ductal carcinoma.


Assuntos
Biomarcadores Tumorais , Mama , Neoplasias da Mama , Carcinoma Ductal , Linhagem Celular , Estudos de Coortes , Bases de Dados Genéticas , Intervalo Livre de Doença , Regulação para Baixo , Estrogênios , Genoma , Humanos , Imuno-Histoquímica , Técnicas In Vitro , Prognóstico , Neoplasias de Mama Triplo Negativas
19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811196

RESUMO

PURPOSE: The 8th edition of the American Joint Committee on Cancer (AJCC) staging manual introduced a new prognostic staging system for breast cancer. This study aimed to evaluate the changes in staging distribution and predictive power of the new staging system.METHODS: Of the 12,275 patients with breast cancer identified from the Severance Breast Cancer Registry who underwent surgery between 1978 and 2016, 12,125 patients met the inclusion criteria.RESULTS: In both the 7th and 8th staging systems, stage I patients constituted the largest proportion (38.2% and 48.4%). Migration from the 7th to 8th edition of the AJCC manual resulted in a decrease in stage II population and an increase in stage I and III populations. A total of 1,293 (15.4%) patients were upstaged, and 1,201 (14.3%) were downstaged. Downstaged patients had better recurrence-free and overall survival (p < 0.001). Pathologic complete response after neoadjuvant therapy showed good prognosis as p stage 0, and yp stages I and III showed poorer outcomes than the same p stage (p < 0.001).CONCLUSIONS: Staging migrations are common in early breast cancer under the prognostic staging system. The prognostic staging system of the 8th edition of the AJCC manual discriminates survival outcomes better than the anatomical staging system of the 7th edition of the AJCC manual.


Assuntos
Neoplasias da Mama , Mama , Humanos , Articulações , Terapia Neoadjuvante , Prognóstico
20.
Immune Network ; : 8-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811174

RESUMO

Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anti-cancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.


Assuntos
Aceleração , Antígeno B7-H1 , Biomarcadores , Biópsia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Evolução Fatal , Humanos , Prognóstico , Receptor de Morte Celular Programada 1
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