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1.
Clin Transl Oncol ; 25(7): 2183-2191, 2023 Jul.
Article in English | MEDLINE | ID: mdl-36792847

ABSTRACT

PURPOSE: Cutaneous melanoma is an aggressive and deadly cancer resulting from malignant transformation of cells involved in skin pigmentation. Glycolysis is widely implicated in cancer progression, but its precise role in melanoma has not been extensively studied. Here, we investigated the role of the glycolysis regulator phosphofructokinase 1 platelet isoform (PFKP) in melanoma progression. METHODS: PFKP expression in human melanoma tissues was analyzed by immunohistochemistry. Knockdown of PFKP by siRNA and overexpression of PFKP were performed to evaluate its functions in vitro. CCK-8 assay was used to assess cell proliferation. Glycolytic activity was determined via measurement of extracellular acidification rate (ECAR), lactic acid level, and ATP content. A tumor xenograft model was used to test the function of PFKP in vivo. RESULTS: PFKP upregulation was observed in human melanoma tissues and correlated with poor patient survival. Knockdown of PFKP in human melanoma cells suppressed cell proliferation and reduced ECAR, ATP levels, and lactic acid levels, while overexpression of PFKP displayed the opposite effects. In vivo, knockdown of PFKP in melanoma cells markedly reduced tumorigenesis. Inhibitory effects on cell proliferation, glycolysis, and tumorigenesis due to PFKP knockdown were further augmented upon treatment with the glycolysis inhibitor 2-deoxy-D-glucose (2-DG). CONCLUSION: Collectively, these results indicate that PFKP expression in melanoma cells increases proliferation and glycolytic activity in vitro and promotes tumorigenesis in vivo, suggesting that suppression of PKFP and inhibition of glycolysis may potently suppress melanoma progression.


Subject(s)
Melanoma , Phosphofructokinase-1, Type C , Skin Neoplasms , Humans , Adenosine Triphosphate/metabolism , Carcinogenesis , Cell Line, Tumor , Cell Proliferation/genetics , Glycolysis/genetics , Lactic Acid/metabolism , Phosphofructokinase-1, Type C/genetics , Phosphofructokinase-1, Type C/metabolism
2.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;38(1): 149-156, Jan.-Feb. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1423074

ABSTRACT

ABSTRACT Introduction: New-onset postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG) surgery. Objective: To explore predictive factors and potential mechanisms of new-onset POAF in isolated off-pump CABG patients. Methods: Retrospective observational case-control study of 233 patients undergoing isolated off-pump CABG surgery between August 2018 and July 2020 at the Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Associations between predictor variables and new-onset POAF were identified. The main outcome was new-onset POAF after CABG surgery. Results: A total of 75 (32.19%) patients developed new-onset POAF after CABG surgery. The new-onset POAF patients had advanced age, higher baseline systolic blood pressure, more preoperative use of diuretic drug, more transfusion of blood products, atrial dilation and postoperative positive inotropic drug treatment. Nineteen variates entered the multivariable logistic regression model with a Hosmer-Lemeshow test score of 7.565 (P=0.477). Postoperative left atrial enlargement, postoperative drainage in the first 24 hours and total length of hospital stay were statistically significant, while postoperative right atrial enlargement (OR and 95% CI, 7.797 [0.200, 304.294], P=0.272) and left atrial enlargement (3.524 [1.141, 10.886], P=0.029) assessed by echocardiography had the largest OR value. Conclusion: Atrial enlargement is strongly associated with new-onset POAF in patients with isolated off-pump CABG, thus it highlights the advantage of echocardiography as a useful tool for predicting new-onset POAF. Careful monitoring and timely intervention should be considered for these patients.

3.
Int. j. morphol ; 41(1): 104-110, feb. 2023. ilus
Article in English | LILACS | ID: biblio-1430502

ABSTRACT

SUMMARY: The myodural bridge is a dense connective tissue connecting muscles and ligaments to the spinal dura mater in the atlanto-occipital interspace. Some researchers believe that the myodural bridge may play a vital physiological role. It is possible, for instance, that the prevention of spinal dura mater infoldings might be involved in regulated cerebrospinal fluid circulation. For instance, it is possible to prevent spinal dura mater infoldings, regulating cerebrospinal circulation. Bats are nocturnal and the only mammals that can perform a genuine and sustained flight, whereas tree shrews are arboreal mammals that often climb to a high altitude of about 10,000 feet. Both animals have lifestyles that are different from other previously studied mammals. The study of these two animals will shed further light on the existence of the myodural bridge in mammals. Gross anatomical dissection was used to observe the connections between the deep muscles of the neck and the dura mater at the level of the atlanto-occipital interspace. The existing structures were analyzed using conventional and special histological staining techniques. The suboccipital regions in bats and tree shrews contained the rectus capitis dorsal major (RCDma), rectus capitis dorsal minor (RCDmi), oblique capitis anterior (OCA), and oblique capitis posterior (OCP). Dense connective tissue connects the RCDmi to the posterior atlanto-occipital membrane (PAOM) and the latter to the spinal dura mater. The myodural bridge in these mammals shares a similar structure to the myodural bridge in humans. Histological analyses confirmed that the connective fibers of the myodural bridge were primarily type I collagen fibers. In this study, it is supplemented by the existence of the myodural bridge in mammals. This further demonstrates that myodural bridge widely exists in the normal anatomy of mammals. This provides morphological support for a comparative anatomical study of the physiological function of the myodural bridge.


El puente miodural es un tejido conjuntivo denso que conecta los músculos y los ligamentos a la duramadre espinal en el espacio atlanto-occipital. Algunos investigadores creen que el puente miodural puede desempeñar un papel fisiológico vital. Es posible, por ejemplo, que la prevención de los pliegues de la duramadre espinal pueda estar involucrada en la circulación regulada del líquido cefalorraquídeo. En esta instancia, es posible prevenir los pliegues de la duramadre espinal, regulando la circulación cerebro espinal. Los murciélagos son animales nocturnos y los únicos mamíferos que pueden realizar un vuelo real y sostenido, mientras que las musarañas arborícolas son mamíferos arbóreos que a menudo ascienden a una gran altura de unos 10 000 pies. Ambos animales tienen estilos de vida diferentes a los de otros mamíferos previamente estudiados. El estudio de estos dos animales ofrecerá más información sobre la existencia del puente miodural en los mamíferos. Se realizó una disección anatómica macroscópica para observar las conexiones entre los músculos profundos del cuello y la duramadre a nivel del espacio atlanto-occipital. Las estructuras existentes se analizaron mediante técnicas de tinción histológica convencionales y especiales. Las regiones suboccipitales en murciélagos y musarañas arbóreas presentaban el músculo recto dorsal mayor de la cabeza (RCDma), el recto dorsal menor de la cabeza (RCDmi), el oblicuo anterior de la cabeza (OCA) y el oblicuo posterior de la cabeza (OCP). El tejido conjuntivo denso conecta el RCDmi con la membrana atlanto- occipital posterior (PAOM) y esta última con la duramadre espinal. El puente miodural en estos mamíferos comparte una estructura similar al puente miodural en humanos. Los análisis histológicos confirmaron que las fibras conectivas del puente miodural son principalmente fibras de colágeno tipo I. Esto demuestra además que el puente miodural existe ampliamente en la anatomía normal de los mamíferos. Esta investigación proporciona apoyo morfológico para un estudio anatómico comparativo de la función fisiológica del puente miodural.


Subject(s)
Animals , Tupaiidae/anatomy & histology , Chiroptera/anatomy & histology , Dura Mater/anatomy & histology , Anatomy, Comparative
4.
Braz J Cardiovasc Surg ; 38(1): 149-156, 2023 02 10.
Article in English | MEDLINE | ID: mdl-35436075

ABSTRACT

INTRODUCTION: New-onset postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG) surgery. OBJECTIVE: To explore predictive factors and potential mechanisms of new-onset POAF in isolated off-pump CABG patients. METHODS: Retrospective observational case-control study of 233 patients undergoing isolated off-pump CABG surgery between August 2018 and July 2020 at the Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Associations between predictor variables and new-onset POAF were identified. The main outcome was new-onset POAF after CABG surgery. RESULTS: A total of 75 (32.19%) patients developed new-onset POAF after CABG surgery. The new-onset POAF patients had advanced age, higher baseline systolic blood pressure, more preoperative use of diuretic drug, more transfusion of blood products, atrial dilation and postoperative positive inotropic drug treatment. Nineteen variates entered the multivariable logistic regression model with a Hosmer-Lemeshow test score of 7.565 (P=0.477). Postoperative left atrial enlargement, postoperative drainage in the first 24 hours and total length of hospital stay were statistically significant, while postoperative right atrial enlargement (OR and 95% CI, 7.797 [0.200, 304.294], P=0.272) and left atrial enlargement (3.524 [1.141, 10.886], P=0.029) assessed by echocardiography had the largest OR value. CONCLUSION: Atrial enlargement is strongly associated with new-onset POAF in patients with isolated off-pump CABG, thus it highlights the advantage of echocardiography as a useful tool for predicting new-onset POAF. Careful monitoring and timely intervention should be considered for these patients.


Subject(s)
Atrial Fibrillation , Humans , Retrospective Studies , Case-Control Studies , Coronary Artery Bypass/adverse effects , Echocardiography , Postoperative Complications/etiology , Risk Factors
5.
Int. j. morphol ; 40(3): 796-800, jun. 2022. ilus
Article in English | LILACS | ID: biblio-1385687

ABSTRACT

SUMMARY: The atlanto-occipital joint is composed of the superior fossa of the lateral masses of the atlas (C1) and the occipital condyles. Congenital Atlanto-occipital fusion (AOF) involves the osseous union of the base of the occiput (C0) and the atlas (C1). AOF or atlas occipitalization/assimilation represents a craniovertebral junction malformation (CVJM) which can be accompanied by other cranial or spinal malformations. AOF may be asymptomatic or patients may experience symptoms from neural compression as well as limited neck movement. The myodural bridge (MDB) complex is a dense fibrous structure that connects the suboccipital muscular and its related facia to the cervical spinal dura mater, passing through both the posterior atlanto-occipital and atlanto-axial interspaces. It is not known if atlas occipitilization can induce structural changes in the MDB complex and its associated suboccipital musculature. The suboccipital region of a cadaveric head and neck specimen from an 87-year-old Chinese male having a congenital AOF malformation with resultant changes to the MDB complex was observed. After being treated with the P45 plastination method, multiple slices obtained from the cadaveric head and neck specimen were examined with special attention paid to the suboccipital region and the CVJM. Congenital atlanto-occipital fusion malformations are defined as partial or complete fusion of the base of the occiput (C0) with the atlas (C1). In the present case of CVJM, unilateral fusion of the left occipital condyle with the left lateral mass of C1 was observed, as well as posterior central fusion of the posterior margin of the foramen magnum with the posterior arch of C1. Also noted was a unilateral variation of the course of the vertebral artery due to the narrowed posterior atlanto-occipital interspace. Surprisingly, complete agenesis of the rectus capitis posterior minor (RCPmi) and the obliques capitis superior (OCS) muscles was also observed in the plastinated slices. Interestingly, the MDB, which normally originates in part from the RCPmi muscle, was observed to originate from a superior bifurcation within an aspect of the nuchal ligament. Therefore, the observed changes involving the MDB complex appear to be an effective compensation to the suboccipital malformations.


RESUMEN: La articulación atlanto-occipital está compuesta por las caras articulares superiores de las masas laterales del atlas (C1) y los cóndilos occipitales. La fusión atlanto-occipital congénita (FAO) implica la unión ósea de la base del occipucio (C0) y el atlas (C1). La FAO u occipitalización/asimilación del atlas representa una malformación de la unión craneovertebral (MUCV) que puede presentar otras malformaciones craneales o espinales. La FAO puede ser asintomática o los pacientes pueden experimentar síntomas de compresión neural así como movimiento limitado del cuello. El complejo del puente miodural (PMD) es una estructura fibrosa densa que conecta el músculo suboccipital y su fascia relacionada con la duramadre espinal cervical, pasando a través de los espacios intermedios atlanto-occipital posterior y atlanto-axial. No se sabe si la occipitilización del atlas puede inducir cambios estructurales en el complejo PMD y en la musculatura suboccipital. Se observó en la región suboccipital de un espécimen cadavérico, cabeza y cuello de un varón chino de 87 años con una malformación congénita de FAO con los cambios resultantes en el complejo PMD. Se examinaron múltiples cortes obtenidos de la muestra de cabeza y cuello después de ser tratados con el método de plastinación P45, con especial atención a la región suboccipital y la MUCV. Las malformaciones congénitas por fusión atlanto-occipital se definen como la fusión parcial o completa de la base del occipucio (C0) con el atlas (C1). En el presente caso de MUCV se observó la fusión unilateral del cóndilo occipital izquierdo con la masa lateral izquierda de C1, así como fusión posterior central del margen posterior del foramen magnum con el arco posterior de C1. También se observó una variación unilateral del curso de la arteria vertebral por el estrechamiento del espacio interatlanto-occipital posterior. Se observó además agenesia completa de los músculos Rectus capitis posterior minor (RCPmi) y oblicuos capitis superior (OCS) en los cortes plastinados. Curiosamente, se observó que el MDB, que normalmente se origina en parte del músculo RCPmi, se origina en una bifurcación superior dentro de un aspecto del ligamento nucal. Por lo tanto, los cambios observados en el complejo PMD parecen ser una compensación de las malformaciones suboccipitales.


Subject(s)
Humans , Male , Aged, 80 and over , Atlanto-Occipital Joint/abnormalities , Skull/abnormalities , Cervical Vertebrae/abnormalities , Plastination/methods , Cadaver
6.
Eur J Med Chem ; 207: 112744, 2020 Dec 01.
Article in English | MEDLINE | ID: mdl-32949955

ABSTRACT

Due to the critical tumorigenic role of fused NTRK genes in multiple cancers, TRK kinases have attracted extensive attention as a drug discovery target. Starting from an indazole based scaffold, through the type II kinase inhibitor fragments hybrid design approach with a ring closure strategy, we discovered a novel potent type II TRK kinase inhibitor compound 34 (IHMT-TRK-284), which exhibited IC50 values of 10.5 nM, 0.7 nM and 2.6 nM to TRKA, B, and C respectively. In addition, it displayed great selectivity profile in the kinome when tested among 468 kinases and mutants (S score (1) = 0.02 at 1 µM). Importantly, 34 could overcome drug resistant mutants including V573M and F589L in the ATP binding pocket as well as G667C/S in the DFG region. In vivo, 34 exhibited good PK profiles in different species including mice, rats, and dogs. It also displayed good in vivo antitumor efficacies in the TRKA/B/C, TRKA mutants, and KM-12-LUC cells mediated mouse models. The potent activity against clinically important TRK mutants combined with the good in vivo PK and efficacy properties of 34 indicated that it might be a new potential therapeutic candidate for TRK kinase fusion or mutants driven cancers.


Subject(s)
Drug Design , Drug Resistance, Neoplasm/drug effects , Mutation , Receptor, trkA/antagonists & inhibitors , Thiazoles/chemistry , Thiazoles/pharmacology , Administration, Oral , Animals , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacokinetics , Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Biological Availability , Cell Line, Tumor , Cell Proliferation/drug effects , Dogs , Drug Resistance, Neoplasm/genetics , Humans , Male , Mice , Protein Kinase Inhibitors/administration & dosage , Protein Kinase Inhibitors/chemistry , Protein Kinase Inhibitors/pharmacokinetics , Protein Kinase Inhibitors/pharmacology , Rats , Receptor, trkA/genetics , Thiazoles/administration & dosage , Thiazoles/pharmacokinetics , Xenograft Model Antitumor Assays
7.
Braz. j. microbiol ; Braz. j. microbiol;49(2): 392-400, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-889230

ABSTRACT

Abstract The study of metabolomics requires extracting as many metabolites as possible from a biological sample. This study aimed to determine the optimal method for the extraction of metabolites from solid-state fermented cottonseed meal (FCSM). The UPLC-Q-TOF-MS global metabolomics technology was used to detect the metabolites in FCSM, and the extraction quantity and extraction efficiency of seven different extraction methods, specifically the WA, 50MeOH, 50MeOHB, 50MeCNB, 80MeOHB, 80MeOH and AMF methods were evaluated. The results showed that the number of VIP metabolites extracted by AMF method are 196 and 184 in ESI+ and ESI- mode respectively, it is the largest number of all exacted methods; and the AMF methods also provided a higher extraction efficiency compared with the other methods, especially in indoleacrylic acid, dl-tryptophan and epicatechin (p < 0.01). As a result, AMF/-4 °C method was identified as the best method for the extraction of metabolites from FCSM by Lactobacillus acidophilus. Our study establishes a technical basis for future metabolomics research of fermented feed.


Subject(s)
Seeds/metabolism , Plant Extracts/chemistry , Gossypium/metabolism , Metabolome , Lactobacillus acidophilus/metabolism , Lactobacillus acidophilus/chemistry , Mass Spectrometry , Chromatography , Metabolomics
8.
Braz. J. Microbiol. ; 49(2): 392-400, Apr.-June 2018. ilus, tab, graf
Article in English | VETINDEX | ID: vti-738150

ABSTRACT

The study of metabolomics requires extracting as many metabolites as possible from a biological sample. This study aimed to determine the optimal method for the extraction of metabolites from solid-state fermented cottonseed meal (FCSM). The UPLC-Q-TOF-MS global metabolomics technology was used to detect the metabolites in FCSM, and the extraction quantity and extraction efficiency of seven different extraction methods, specifically the WA, 50MeOH, 50MeOHB, 50MeCNB, 80MeOHB, 80MeOH and AMF methods were evaluated. The results showed that the number of VIP metabolites extracted by AMF method are 196 and 184 in ESI+ and ESI- mode respectively, it is the largest number of all exacted methods; and the AMF methods also provided a higher extraction efficiency compared with the other methods, especially in indoleacrylic acid, dl-tryptophan and epicatechin (p < 0.01). As a result, AMF/-4 °C method was identified as the best method for the extraction of metabolites from FCSM by Lactobacillus acidophilus. Our study establishes a technical basis for future metabolomics research of fermented feed.(AU)

9.
Braz J Microbiol ; 49(2): 392-400, 2018.
Article in English | MEDLINE | ID: mdl-29154014

ABSTRACT

The study of metabolomics requires extracting as many metabolites as possible from a biological sample. This study aimed to determine the optimal method for the extraction of metabolites from solid-state fermented cottonseed meal (FCSM). The UPLC-Q-TOF-MS global metabolomics technology was used to detect the metabolites in FCSM, and the extraction quantity and extraction efficiency of seven different extraction methods, specifically the WA, 50MeOH, 50MeOHB, 50MeCNB, 80MeOHB, 80MeOH and AMF methods were evaluated. The results showed that the number of VIP metabolites extracted by AMF method are 196 and 184 in ESI+ and ESI- mode respectively, it is the largest number of all exacted methods; and the AMF methods also provided a higher extraction efficiency compared with the other methods, especially in indoleacrylic acid, dl-tryptophan and epicatechin (p<0.01). As a result, AMF/-4°C method was identified as the best method for the extraction of metabolites from FCSM by Lactobacillus acidophilus. Our study establishes a technical basis for future metabolomics research of fermented feed.


Subject(s)
Gossypium/metabolism , Lactobacillus acidophilus/chemistry , Lactobacillus acidophilus/metabolism , Metabolome , Plant Extracts/chemistry , Seeds/metabolism , Chromatography , Mass Spectrometry , Metabolomics
10.
Braz. J. Pharm. Sci. (Online) ; 54(2): e17604, 2018. tab, graf
Article in English | LILACS | ID: biblio-951948

ABSTRACT

ABSTRACT Altered metabolites level in the biosystems, is the potential cause of cancer, the primary reason of alteration of metabolism is change in nutrient consumption and waste excretion, as a result genetic mutation leads to cancer initiation and progression. Aberration of specific metabolites such as fumarate, succinate, 2-hydroxyglutarate may alter cell signaling. We collected liver and kidney samples and prepared for 1H NMR analysis, then executed NMR spectroscopy. We used a set of domestic R scripts to perform an unsupervised principal component analysis (PCA) and a supervised orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA). It signifies class discrimination for getting a clear separation, whereas PCA scores plot signifies the model group kept further away from the control group than drug group on the horizontal axis. In another PCA scores plots, most parts of the control group was overlapping with the drug group but was distant from the model group. Marsdenia tenacissima extract (MTE) (Chines name: Xiao-Ai-Ping, XAP) modulates level of crucial metabolites such as fumarate, lactate, succinate, determined by 1H NMR spectroscopy and their altered level contributes major role in cancer


Subject(s)
Animals , Male , Female , Rats , Marsdenia/adverse effects , Metabolomics/classification , Neoplasms , Magnetic Resonance Spectroscopy/methods
11.
Article in English | VETINDEX | ID: vti-739178

ABSTRACT

Abstract The study of metabolomics requires extracting as many metabolites as possible from a biological sample. This study aimed to determine the optimal method for the extraction of metabolites from solid-state fermented cottonseed meal (FCSM). The UPLC-Q-TOF-MS global metabolomics technology was used to detect the metabolites in FCSM, and the extraction quantity and extraction efficiency of seven different extraction methods, specifically the WA, 50MeOH, 50MeOHB, 50MeCNB, 80MeOHB, 80MeOH and AMF methods were evaluated. The results showed that the number of VIP metabolites extracted by AMF method are 196 and 184 in ESI+ and ESI- mode respectively, it is the largest number of all exacted methods; and the AMF methods also provided a higher extraction efficiency compared with the other methods, especially in indoleacrylic acid, dl-tryptophan and epicatechin (p 0.01). As a result, AMF/-4 °C method was identified as the best method for the extraction of metabolites from FCSM by Lactobacillus acidophilus. Our study establishes a technical basis for future metabolomics research of fermented feed.

12.
Braz. arch. biol. technol ; Braz. arch. biol. technol;60: e16160240, 2017. tab, graf
Article in English | LILACS | ID: biblio-839086

ABSTRACT

ABSTRACT Background: Alternative splicing (AS), which plays an important role in gene expression and functional regulation, has been analyzed on genome-scale by various bioinformatic approaches based on RNA-seq data. Compared with the huge number of studies on mouse, the AS researches approaching the rat, whose genome is intermedia between mouse and human, were still limited. To enrich the knowledge on AS events in rodents' brain, we perfomed a comprehensive analysis on four transcriptome libraries (mouse cerebrum, mouse cerebellum, rat cerebrum, and rat cerebellum), recruiting high-throughput sequencing technology. An optimized exon-exon junction library approach was introduced to adapt the longer RNA-seq reads and to improve mapping efficiency. Results: In total, 7,106 mouse genes and 2,734 rat genes were differentially expressed between cerebrum and cerebellum, while 7,125 mouse genes and 1,795 rat genes exhibited varieties on transcript variant level. Only half of the differentially expressed exon-exon junctions could be reflected at gene expression level. Functional cluster analysis showed that 32 pathways in mouse and 9 pathways in rat were significantly enriched, and 6 of them were in both. Interestingly, some differentially expressed transcript variants did not show difference on gene expression level, such as PLCβ1 and Kcnma1. Conclusion: Our work provided a case study of a novel exon-exon junction strategy to analyze the expression of genes and isoforms, helping us understand which transcript contributes to the overall expression and further functional change.

13.
Med Care ; 54(11): 1017-1023, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27213544

ABSTRACT

BACKGROUND: Transitional care interventions can be utilized to reduce post-hospital discharge adverse events (AEs). However, no methodology exists to effectively identify high-risk patients of any disease across multiple hospital sites and patient populations for short-term postdischarge AEs. OBJECTIVES: To develop and validate a 3-day (72 h) AEs prediction model using electronic health records data available at the time of an indexed discharge. RESEARCH DESIGN: Retrospective cohort study of admissions between June 2012 and June 2014. SUBJECTS: All adult inpatient admissions (excluding in-hospital deaths) from a large multicenter hospital system. MEASURES: All-cause 3-day unplanned readmissions, emergency department (ED) visits, and deaths (REDD). The REDD model was developed using clinical, administrative, and socioeconomic data, with data preprocessing steps and stacked classification. Patients were divided randomly into training (66.7%), and testing (33.3%) cohorts to avoid overfitting. RESULTS: The derivation cohort comprised of 64,252 admissions, of which 2782 (4.3%) admissions resulted in 3-day AEs and 13,372 (20.8%) in 30-day AEs. The c-statistic (also known as area under the receiver operating characteristic curve) of 3-day REDD model was 0.671 and 0.664 for the derivation and validation cohort, respectively. The c-statistic of 30-day REDD model was 0.713 and 0.711 for the derivation and validation cohort, respectively. CONCLUSIONS: The 3-day REDD model predicts high-risk patients with fair discriminative power. The discriminative power of the 30-day REDD model is also better than the previously reported models under similar settings. The 3-day REDD model has been implemented and is being used to identify patients at risk for AEs.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Mortality , Patient Readmission/statistics & numerical data , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Models, Statistical , Patient Discharge/statistics & numerical data , Pennsylvania/epidemiology , Retrospective Studies , Risk Factors , Socioeconomic Factors
14.
Braz. j. otorhinolaryngol. (Impr.) ; Braz. j. otorhinolaryngol. (Impr.);82(2): 177-183, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-780974

ABSTRACT

ABSTRACT INTRODUCTION: Maxillary defects are usually rehabilitated by a prosthetic obturator. OBJECTIVE: This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. METHODS: Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS). RESULTS: From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP), 11 (39%) with an enhanced retentive obturator prosthesis with stud attachment (POP) and 8 (28%) with an enhanced retentive obturator prosthesis with magnetic attachment (POM). The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p < 0.05) among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p < 0.05) both in MOP and AOP groups. CONCLUSION: Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function.


RESUMO INTRODUÇÃO: Em geral, os defeitos da maxila são reabilitados por uma prótese obturadora. OBJETIVO: O estudo avaliou o funcionamento da prótese obturadora em pacientes com defeitos unilaterais após maxilectomia. MÉTODO: De 49 pacientes, 28 foram submetidos a maxilectomia como cirurgia de ablação tumoral e tiveram como sequela defeitos maxilares unilaterais. A avaliação do funcionamento foi efetuada pela aplicação da Escala Funcional do Obturador (EFO). RESULTADOS: De um total de 49 pacientes, 28 foram tratados da seguinte forma: nove com prótese obturadora retentiva convencional (POC), 11 (39%) com prótese obturadora retentiva com fixação por pino (POP) e oito (28%) com prótese obturadora retentiva com fixação magnética (POM). O escore médio na EFO foi de 80. Os escores para funções da fala, deglutição e mastigação alcançaram significância estatística (p < 0,05) entre os três subgrupos. Na comparação entre os grupos POC e POM, os escores da EFO nos domínios da "Fala-capacidade de discursar em público" e "Deglutição-vazamento de líquidos" foram significativamente mais altos no grupo POP. Na comparação com o grupo POC, os escores da EFO nos domínios de "Deglutição-vazamento com sólido" e "Mastigação/ingestão" estavam significativamente aumentados (p < 0,05) nos grupos POM e POP. CONCLUSÃO: A prótese obturadora melhorou o funcionamento oral de pacientes com defeitos maxilares; a retenção da prótese obturadora reforçada pela adição de dispositivos de fixação demonstrou maiores benefícios na função oral.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Maxillary Neoplasms/surgery , Prosthesis Implantation/rehabilitation , Cohort Studies , Maxillofacial Prosthesis , Maxillary Neoplasms/rehabilitation , Palatal Obturators , Treatment Outcome
15.
Braz J Otorhinolaryngol ; 82(2): 177-83, 2016.
Article in English | MEDLINE | ID: mdl-26671022

ABSTRACT

INTRODUCTION: Maxillary defects are usually rehabilitated by a prosthetic obturator. OBJECTIVE: This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. METHODS: Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS). RESULTS: From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP), 11 (39%) with an enhanced retentive obturator prosthesis with stud attachment (POP) and 8 (28%) with an enhanced retentive obturator prosthesis with magnetic attachment (POM). The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p<0.05) among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p<0.05) both in MOP and AOP groups. CONCLUSION: Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function.


Subject(s)
Maxillary Neoplasms/surgery , Prosthesis Implantation/rehabilitation , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Male , Maxillary Neoplasms/rehabilitation , Maxillofacial Prosthesis , Middle Aged , Palatal Obturators , Treatment Outcome
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