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1.
Actas Urol Esp (Engl Ed) ; 48(4): 304-310, 2024 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38373481

RESUMO

INTRODUCTION: Prostatic carcinoma (PC) is a frequent neoplasm in elderly patients. Although androgen deprivation is associated with survival benefits, it is also related to adverse effects such as osteoporosis, frailty, or sarcopenia, which can negatively affect the patient's quality of life. This study aims to quantify and evaluate the prevalence of osteoporosis, frailty, or sarcopenia in elderly PC patients before and after androgen deprivation. We present data from an interim analysis. MATERIALS AND METHODS: PROSARC is a national (Spain) prospective observational study (May-2022-May-2025) still in progress in 2 hospitals. It includes patients with high-risk PC, aged ≥70 years, non-candidates for local treatment and scheduled to start androgen deprivation therapy. The following variables are analyzed: comorbidity, frailty (Fried frailty phenotype criteria), osteoporosis, sarcopenia (EWGSOP2), fat mass and muscle mass, before treatment and after 6 months of follow-up. RESULTS: A 6-month follow-up was completed by 12/25 included patients (mean age, 84 years), with a high baseline prevalence of pre-frailty/frailty (67.7%), sarcopenia (66.7%) and osteoporosis (25%). Treatment did not significantly alter these variables or comorbidity. We observed changes in body mass index (p=0.666), decreased mean value of appendicular muscle mass (p=0.01) and increased percentage of fat mass (p=0.012). CONCLUSION: In patients with high-risk PC, advanced age and a considerable prevalence of osteoporosis, frailty and sarcopenia, androgen deprivation (ADT; 6 months) produces decreased muscle mass without impact on the incidence of the known adverse effects of androgen deprivation.


Assuntos
Antagonistas de Androgênios , Osteoporose , Neoplasias da Próstata , Sarcopenia , Masculino , Humanos , Antagonistas de Androgênios/efeitos adversos , Antagonistas de Androgênios/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Estudos Prospectivos , Idoso de 80 Anos ou mais , Idoso , Sarcopenia/epidemiologia , Sarcopenia/induzido quimicamente , Osteoporose/induzido quimicamente , Osteoporose/epidemiologia , Prevalência , Medição de Risco , Fragilidade/epidemiologia , Fragilidade/induzido quimicamente
2.
Arch. Soc. Esp. Oftalmol ; 98(11): 633-639, nov. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-227202

RESUMO

Objetivo Evaluar el impacto en la calidad de vida (CdV) entre diferentes enfermedades de la retina como el edema macular diabético (EMD), la oclusión venosa retiniana (OVR), la miopía patológica (MP), la degeneración macular asociada a la edad neovascular (DMAEn) y la coriorretinopatía serosa central (CSC). Métodos Se realizó un estudio transversal en 241 pacientes afectados de EMD (n=44), OVR (n=41), MP (n=34) y DMAEn (n=85) que recibieron inyecciones intravítreas por presencia de edema macular o neovascularización. Los pacientes con CSC incluidos (n=37) eran candidatos a tratamiento con láser. Los pacientes completaron el National Eye Visual Functioning Questioning-25 (NEIVFQ-25). Se registró la mejor agudeza visual corregida (MAVC). Resultados Existieron diferencias significativas entre subgrupos para todos los dominios, excepto para la visión general, en la que todas las puntuaciones entre enfermedades oscilaron entre 40,7 y 45,2 sobre 100 (p=0,436), a pesar de la diferencia en MAVC (CSC: 86,3±11,9; OVR: 78,5±15,5; EMD: 73,3±15,2; DMAEn: 72,9±12,6 y MP: 68,5±18,1 letras, respectivamente (p<0,001). La puntuación total más baja se observó en la MP (52,1±20,9), seguida de DMAEn (55,3±20,8), OVR (65,0±22,3), EMD (68,6±21,0) y CSC (70,9±16,2). El grupo con EMD tuvo la peor puntuación para la salud general (38,9±21,4). La salud mental y las dificultades de rol fueron más bajas en la MP (48,2±28,8 y 48,2±31,9, p<0,007). Conclusiones Este estudio revela las diferencias en la CdV entre EMD, OVR, DMAEn, MP y CSC, describiendo las diferentes repercusiones que pueden sufrir, observándose un mayor impacto en la MP y la DMAEn (AU)


Purpose To assess the impact on the quality of life (QoL) among different retinal diseases such as diabetic macular edema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC). Methods A cross-sectional study was carried out in 241 patients, affected by DME (n=44), RVO (n=41), PM (n=34) and nAMD (n=85) receiving intravitreal injections due to the presence of macular edema or choroidal neovascularization. The CSC patients included (n=37) were candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning-25 (NEIVFQ-25). Best eye visual acuity (BEVA) was recorded using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Results There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (P=.436), despite the difference in BEVA (CSC: 86.3±11.9; RVO: 78.5±15.5, DME: 73.3±15.2, nAMD: 72.9±12.6 and PM: 68.5±18.1 letters, respectively; P<.001). The lowest VFQ-25 total score was observed in the PM patients (52.1±20.9), followed by nAMD (55.3±20.8), RVO (65.0±22.3), DME (68.6±21.0) and CSC (70.9±16.2). The DME group reported the worst score for general health (38.9±21.4). Mental health and role difficulties were lowest for PM (48.2±28.8 and 48.2±31.9, P<.007). Conclusions This study reveals the differences in the QoL among DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing a higher impact in PM and nAMD (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Doenças Retinianas/classificação , Doenças Retinianas/psicologia , Estudos Transversais , Retinopatia Diabética , Oclusão da Veia Retiniana , Degeneração Macular , Coriorretinopatia Serosa Central
3.
Arch Soc Esp Oftalmol (Engl Ed) ; 98(11): 633-639, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37748684

RESUMO

PURPOSE: To assess the impact on the quality of life (QoL) among different retinal diseases such as diabetic macular edema (DME), retinal vein occlusion (RVO), pathologic myopia (PM), neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC). METHODS: A cross-sectional study was carried out in 241 patients, affected by DME (n=44), RVO (n=41), PM (n=34) and nAMD (n=85) receiving intravitreal injections due to the presence of macular edema or choroidal neovascularization. The CSC patients included (n=37) were candidates for laser treatment. The patients included completed the National Eye Visual Functioning Questioning-25 (NEI VFQ-25). Best eye visual acuity (BEVA) was recorded using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. RESULTS: There were significant differences between subgroups for all the domains, except for the general vision in which all scores among diseases ranged from 40.7 to 45.2 out of 100 (P=.436), despite the difference in BEVA (CSC: 86.3±11.9; RVO: 78.5±15.5, DME: 73.3±15.2, nAMD: 72.9±12.6 and PM: 68.5±18.1 letters respectively; P<.001). The lowest VFQ-25 total score was observed in the PM patients (52.1±20.9), followed by nAMD (55.3±20.8), RVO (65.0±22.3), DME (68.6±21.0) and CSC (70.9±16.2). The DME group reported the worst score for general health (38.9±21.4). Mental health and role difficulties were lowest for PM (48.2±28.8 and 48.2±31.9, P<.007). CONCLUSIONS: This study reveals the differences in the QoL among DME, RVO, nAMD, PM and CSC, describing the different repercussions that they can suffer, observing a higher impact in PM and nAMD.


Assuntos
Retinopatia Diabética , Degeneração Macular , Edema Macular , Doenças Retinianas , Oclusão da Veia Retiniana , Humanos , Edema Macular/etiologia , Qualidade de Vida , Degeneração Macular/psicologia , Estudos Transversais , Transtornos da Visão
4.
Endocr Pathol ; 33(4): 484-493, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36242759

RESUMO

Pendred syndrome (PDS) is an autosomal recessive disorder caused by mutations in the gene that encodes pendrin. Pendred thyroid tissue is supposedly altered by the absence of functional pendrin, but it is still unknown whether other iodide exchangers could compensate for the loss of the protein. Moreover, we have recently described that primary cilium, a conserved structure present at the apical surface of normal follicular cells, suffers different alterations in functional thyroid diseases. We aimed (1) to better understand the histopathological changes experienced by PDS thyroids, (2) to analyze the expression of different thyroid-specific genes and alternative iodide transporters and, finally, (3) to determine whether those changes may alter the morphological pattern of primary cilia in follicular cells. Thyroid samples from a series of four PDS patients were analyzed by immunohistochemistry, double immunofluorescence, and morphometry to evaluate changes in primary cilia frequency and length. We found thyroid follicular nodular disease in all PDS thyroids, frequently in association with follicular adenomas. There were only slight changes in the expression of thyroid-specific markers. Although no positivity for pendrin was found, cytoplasmic immunostaining for ANO-1, CLC-5, and CFTR was stronger in diffuse hyperplastic areas when compared to areas with highly cellular follicular nodules (HCFNs). HCFNs and follicular adenomas always showed diminished ciliary frequency and length. Our results suggest a direct relationship between the absence of functional pendrin and the loss of the normal thyroid architecture in PDS patients, which was also accompanied by differences in the expression of specific immunohistochemical markers and altered ciliogenesis. The present data may help the pathologist in screening for PDS.


Assuntos
Adenoma , Bócio Nodular , Perda Auditiva Neurossensorial , Doenças da Glândula Tireoide , Humanos , Iodetos/metabolismo , Bócio Nodular/genética , Bócio Nodular/metabolismo , Bócio Nodular/patologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/genética , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Transportadores de Sulfato
5.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 48(6): 385-393, sept, 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-211023

RESUMO

Introducción La pandemia COVID-19, que empezó en Wuhan, China, a finales del 2019, y, que hoy amenaza a todos los habitantes del planeta, configura el tema de investigación prioritaria en la actualidad. En este contexto, este artículo enfoca la manera en que este problema de salud afecta directamente al estado psicológico y educativo de 344 estudiantes universitarios y de secundaria, en Córdoba, España. Material y métodos Para el análisis se ha empleado el modelo de ecuaciones estructurales (SEM), a través de la cuantificación de un conjunto de relaciones entre una o más variables independientes, intentando condensar el escenario de pandemia y sus implicaciones sanitarias, psicológicas y educativas. Resultados La primera variable latente «Salud», es causal de la variable latente «Psicología», y de las variables endógenas «efectos relaciones sociales», «efectos tristeza» y «efectos sexualidad», lo cual confirma que la COVID-19 afectó seriamente al comportamiento psicológico de los estudiantes de universidad y de secundaria de Córdoba (AU)


Introduccion The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. Material and methods For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. Results The first latent variable “Health” is causal of the latent variable “Psychology”, and, of the endogenous variables, “social relations effects”, “sadness effects” and “sexuality effects”, which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Pandemias , Estudantes/psicologia , Ensino Fundamental e Médio , 35174 , Espanha
6.
Semergen ; 48(6): 385-393, 2022 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-35753944

RESUMO

INTRODUCCION: The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. MATERIAL AND METHODS: For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. RESULTS: The first latent variable "Health" is causal of the latent variable "Psychology", and, of the endogenous variables, "social relations effects", "sadness effects" and "sexuality effects", which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba.


Assuntos
COVID-19 , Estudantes , COVID-19/epidemiologia , Escolaridade , Humanos , Pandemias , Espanha/epidemiologia , Estudantes/psicologia , Universidades
7.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(9): 470-475, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34479703

RESUMO

PURPOSE: To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). METHODS: A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. RESULTS: Fifty-five patients with nAMD participated with a mean age of 80.9 ± 6.6 years-old (range 67-93) and a mean VA in the best eye of 73.5 ± 12.7 letters (range 44-95). The global VFQ-25 mean score was 57.4 ± 21.9 being 38.9 ± 13.2 for the general vision and 42.0 ± 19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R = 0.608; P < .001), but no correlation was observed with general health (P = .936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R = -0.438). CONCLUSION: This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.


Assuntos
Degeneração Macular , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos
8.
Arch. Soc. Esp. Oftalmol ; 96(9): 470-475, sept. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-218029

RESUMO

Propósito Evaluar la calidad de vida relacionada con la visión, así como la presecia de síntomas de depresión y ansiedad en los pacientes con degeneración macular asociada a la edad neovascular (DMAEn). Métodos Se realizó un estudio transversal de pacientes con DMAEn en tratamiento con inyecciones intravítreas de antiangiogénicos. Los pacientes realizaron 2 cuestionarios validados: el cuestionario de función visual (VFQ-25, cuya puntuación varía de 0 a 100) y la Escala hospitalaria de ansiedad y depresión (HADS). Se registraron la edad, el sexo y la agudeza visual (AV) en la escala Early Treatment Diabetic Retinopathy Study. Resultado Se incluyeron 55 pacientes con DMAEn con una edad de 80,9±6,6 años (rango 67 a 93) y una AV en el mejor ojo de 73,5±12,7 letras (rango 44 a 95). La puntuación global media en el VFQ-25 fue de 57,4±21,9, siendo 38,9±13,2 para la visión general y 42,0±19,5 para la salud general. La AV se correlacionó con la puntuación global de la escala VFQ-25 (R=0,608; p<0,001), pero no con la salud general (p=0,936). Mediante la escala HADS se detectó un 27,2% y un 25,5% de pacientes con síntomas de depresión y ansiedad respectivamente. Se observó una correlación negativa entre las puntuaciones del HADS y VFQ-25 para el dominio de visión general (R=–0,438). Conclusiones Este estudio muestra el impacto en la calidad de vida y función visual en los pacientes con DMAE neovascular, presentando en un porcentaje considerable de los casos síntomas de depresión y ansiedad (AU)


Purpose To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). Method A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. Result Fifty-five patients with nAMD participated with a mean age of 80.9±6.6 years-old (range 67 to 93) and a mean VA in the best eye of 73.5±12.7 letters (range 44 to 95). The global VFQ-25 mean score was 57.4±21.9 being 38.9±13.2 for the general vision and 42.0±19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R=.608; P<.001), but no correlation was observed with general health (P=.936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R=–0.438). Conclusions This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida/psicologia , Ansiedade/etiologia , Depressão/etiologia , Degeneração Macular/psicologia , Inquéritos e Questionários , Estudos Transversais
9.
Actas urol. esp ; 45(4): 300-308, mayo 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-216935

RESUMO

Objetivo: Analizamos el perfil de pacientes candidatos a quimioterapia neoadyuvante (QTn) en estadio pT2-4aN0M0, la tolerabilidad y adherencia de nuestro protocolo basado en cisplatino y los resultados oncológicos.Material y métodosEstudio observacional de cohortes retrospectivo que incluye a pacientes con diagnóstico de carcinoma vesical músculo infiltrante tratados con QTn. Se analizaron las características clínicas, histopatológicas, terapéuticas y evolutivas de los pacientes. El uso de la QTn se evaluó mediante la respuesta completa en la pieza quirúrgica (pT0). Este y otros factores anatomopatológicos se relacionaron con la supervivencia global y el tiempo libre de progresión.ResultadosIncluimos a 90 pacientes con carcinoma vesical músculo invasivo (estadio clínico T2a-T4aN0M0) que recibieron algún esquema de QTn basado en cisplatino, entre enero de 2011 y diciembre de 2018, antes del tratamiento quirúrgico radical. El 40% de los pacientes presentaron alguna reacción adversa al tratamiento, con un cumplimiento del protocolo de QTn del 92,2%. No se presentaron muertes relacionadas con el tratamiento sistémico y ninguna reacción adversa al tratamiento imposibilitó la realización de la cistectomía radical. Tras la cistectomía radical, se objetivó la presencia de respuesta completa (pT0) en 20 pacientes (21%), un estadio inferior en pieza quirúrgica ( p = 0,012), en enfermos con afectación ganglionar respecto a pN0 (65,4 vs. 28,2 meses; p=0,014) y en aquellos con bordes quirúrgicos afectos respecto a los que presentaban márgenes libres de tumor (63,5 vs. 8,5 meses; p=0,021).ConclusiónLa selección adecuada de los pacientes con carcinoma vesical músculo infiltrante ha mostrado una buena tolerancia a la QTn, con una alta tasa de cumplimiento previo a la CR. La mejoría en la tasa de respuesta completa implica una mayor supervivencia en este grupo de pacientes. La afectación ganglionar y los bordes quirúrgicos positivos son factores pronósticos importantes. (AU)


Objective: We analyzed the profile of patients who were candidates for neoadjuvant chemotherapy (NACT) in stage pT2-4aN0M0, the tolerability and adherence of our cisplatin-based protocol and oncological outcomes.Material and methodsRetrospective observational cohort study including patients diagnosed with muscle-invasive bladder carcinoma treated with NACT. Clinical, histopathological, therapeutic and evolutionary characteristics of the patients were analyzed. The use of NACT was evaluated by the complete response in the surgical specimen (pT0). This and other pathological factors were related to overall survival and progression-free survival.ResultsWe included 90 patients with muscle-invasive bladder carcinoma (clinical stage T2a-T4aN0M0) who received a cisplatin-based NACT regimen between January 2011 and December 2018, prior to radical surgery. Forty percent of patients presented an adverse reaction, with a compliance with the NACT regimen of 92.2%. There were no deaths related to systemic treatment and no adverse reaction to treatment made radical cystectomy impracticable. After performing radical cystectomy, the presence of complete response (pT0) was observed in 20 patients (21%), lower stage in the surgical specimen ( P=0.012), in patients with lymph node involvement compared to pN0 (65.4 vs. 28, 2 months, P=0.014) and in those with positive surgical margins compared to those with tumor-free margins (63.5 vs. 8.5 months, P=0.021).ConclusionThe adequate selection of patients with muscle-invasive bladder carcinoma has shown a good tolerance to NACT, with a high compliance rate prior to RC. The improvement in the complete response rate implies a greater survival in this group of patients, with lymph node involvement and positive surgical margins being important prognostic factors. (AU)


Assuntos
Humanos , Músculos , Terapia Neoadjuvante , Neoplasias , Neoplasias da Bexiga Urinária/tratamento farmacológico , Tratamento Farmacológico , Estudos Retrospectivos
10.
Actas Urol Esp (Engl Ed) ; 45(4): 300-308, 2021 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33531285

RESUMO

OBJECTIVE: We analyzed the profile of patients who were candidates for neoadjuvant chemotherapy (NACT) in stage pT2-4aN0M0, the tolerability and adherence of our cisplatin-based protocol and oncological outcomes. MATERIAL AND METHODS: Retrospective observational cohort study including patients diagnosed with muscle-invasive bladder carcinoma treated with NACT. Clinical, histopathological, therapeutic and evolutionary characteristics of the patients were analyzed. The use of NACT was evaluated by the complete response in the surgical specimen (pT0). This and other pathological factors were related to overall survival and progression-free survival. RESULTS: We included 90 patients with muscle-invasive bladder carcinoma (clinical stage T2a-T4aN0M0) who received a cisplatin-based NACT regimen between January 2011 and December 2018, prior to radical surgery. Forty percent of patients presented an adverse reaction, with a compliance with the NACT regimen of 92.2%. There were no deaths related to systemic treatment and no adverse reaction to treatment made radical cystectomy impracticable. After performing radical cystectomy, the presence of complete response (pT0) was observed in 20 patients (21%), lower stage in the surgical specimen (

Assuntos
Neoplasias da Bexiga Urinária , Humanos , Músculos , Terapia Neoadjuvante , Invasividade Neoplásica , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/tratamento farmacológico
11.
Eur Psychiatry ; 64(1): e22, 2021 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-33632347

RESUMO

BACKGROUND: This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention. METHOD: A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group-studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)-or to the active control group, who followed the 5 A's intervention. RESULTS: The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group. CONCLUSION: In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A's intervention.


Assuntos
Transtornos Mentais , Doença Pulmonar Obstrutiva Crônica , Abandono do Hábito de Fumar , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Motivação , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fumar
12.
Actas Urol Esp (Engl Ed) ; 44(10): 692-700, 2020 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33010988

RESUMO

INTRODUCTION: Inflammatory markers have prognostic value in various tumors due to the role of inflammatory phenomena at different stages of tumor development. The aim of this study is to demonstrate the prognostic value of these markers, as well as other clinical and analytical variables in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIAL AND METHODS: Prospective cohort study carried out on 80 patients diagnosed with mCRPC. Clinical and analytical data were collected, and the following inflammatory markers were estimated: Absolute Neutrophil Count (ANC), Neutrophil-Lymphocyte Ratio (NLR), Total Platelet Count (TPC), Platelet-Lymphocyte Ratio (PLR), Lymphocyte-Monocyte Ratio (LMR) and Systemic Inflammation Index (SII). The values of albumin, hemoglobin (Hb), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were also determined. RESULTS: Patients with ANC>7500, NLR>3, PLR>150, LMR>3 and/or SII>535,000, presented significantly lower median survival time than the remaining patients, and TPC was the only marker which did not show a significant association. Moreover, NLR, PLR and SII were inversely correlated with survival time. Patients with hypoalbuminemia, anemia, and elevated LDH values had significantly lower median survival time. Albumin and hemoglobin were directly correlated to overall survival time. The need for analgesia was also associated with shorter survival. CONCLUSION: The values of certain inflammatory markers are associated with shorter survival time in patients with mCRPC, and their use in clinical practice can be considered to evaluate the prognosis and estimate survival.


Assuntos
Biomarcadores Tumorais/sangue , Plaquetas , Linfócitos , Neutrófilos , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/mortalidade , Idoso , Humanos , Contagem de Leucócitos , Masculino , Metástase Neoplásica , Contagem de Plaquetas , Prognóstico , Estudos Prospectivos , Neoplasias de Próstata Resistentes à Castração/patologia , Taxa de Sobrevida
13.
Poult Sci ; 99(4): 1832-1837, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32241463

RESUMO

Forty broilers maintained under natural hypobaric hypoxia (2,638 m above sea level) and 20 maintained under relative normoxia (460 m above sea level) were selected as pulmonary hypertensive (PHB) and nonpulmonary hypertensive (NPHB), to estimate the degree of the adventitial vascular thickness in lung arterioles and connective tissue growth factor (CTGF) expression in lung. In each group, the adventitial thickness (%AT) of 20 arterioles with 100 to 250 µm of external diameter was measured in lung samples of 24 and 42-day-old broilers. Also, mRNA extraction and real-time reverse transcription-PCR analysis were used to measure lung CTGF expression. The %AT was higher in PHB at 42 D as compared to NPHB at both ages and PHB at 24 D; however, the same differences were not evidenced at 24 D. In the 2 ages evaluated, differences were observed in the %AT between broilers under hypobaric hypoxia (PHB and NPHB) and under relative normoxia (P < 0.01). In broilers subjected to relative normoxia, no significant differences were found at any of the 2 ages. The expression levels of CTGF mRNA were higher in PHB compared to NPHB at the 2 ages. The %AT was higher in PHB with high levels of expression of CTGF mRNA than those NPHB with low expression of CTGF mRNA. This study showed that adventitial thickening is part of the pulmonary hypertension (PH) physiopathology in broilers exposed to hypobaric hypoxia, in which CTGF appears to be a fibrosis enhancer. Although present data suggest that adventitial engrossment could be a time-dependent process, individual susceptibility and the variable time-course of PH pathophysiology have to be considered.


Assuntos
Arteríolas/fisiopatologia , Proteínas Aviárias/genética , Galinhas , Fator de Crescimento do Tecido Conjuntivo/genética , Expressão Gênica , Hipertensão Pulmonar/veterinária , Doenças das Aves Domésticas/fisiopatologia , Animais , Arteríolas/metabolismo , Proteínas Aviárias/metabolismo , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/fisiopatologia , Hipóxia/etiologia , Hipóxia/fisiopatologia , Hipóxia/veterinária , Pulmão/metabolismo , Pulmão/fisiopatologia , Masculino , Doenças das Aves Domésticas/etiologia , Doenças das Aves Domésticas/genética
14.
Actas Urol Esp (Engl Ed) ; 43(6): 284-292, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31085041

RESUMO

INTRODUCTION: The immune system plays an essential role in the organism's response to cancer. Several haematological markers can influence prognosis and survival of patients. The objective of this study is to determine their prognostic value in testicular germ cell tumours. MATERIAL AND METHODS: Retrospective cohort study on 164 patients with germ cell tumours. Clinical, analytical, histological and evolutionary data were collected. The absolute neutrophil and absolute platelet counts, neutrophil-lymphocyte (NLR), platelet-lymphocyte and lymphocyte-monocyte ratios were estimated at diagnosis. The association that these markers can have with the classic prognostic factors, as well as their effect on prognosis and survival, have been analysed. RESULTS: 17.7% had NLR>4 and 14.6% ANC>8000/µL. These patients presented higher percentages of residual disease and stage II-III tumours. Patients with elevated absolute neutrophil showed also higher percentages of progression and exitus. 7.3% presented absolute platelet >400000/µL. These patients obtained higher rates of residual disease, nonseminomatous and stage III tumours. 28.4% showed platelet-lymphocyte values>150. This data was associated to higher percentages of residual disease, progression, stage II and III tumours and seminomatous tumours. 83.3% had an lymphocyte-monocyte >3. These patients presented: higher tumour markers in normal range, decreased residual disease rates and higher percentages of stage I and II tumours. The mean survival time was shorter in patients with NLR>4 and absolute neutrophil >8,000/µL. The ROC curves showed significance in the prediction of progression and values of lymphocyte-monocyte >3, and prediction of survival and values NLR>4. CONCLUSION: Our results indicate that the analysed haematological markers are associated with poor prognoses at diagnosis. Therefore, their use in daily clinical practice can be a valuable tool in the diagnosis and prognosis of patients with testicular germ cell tumours.


Assuntos
Neoplasias Embrionárias de Células Germinativas/sangue , Neoplasias Embrionárias de Células Germinativas/mortalidade , Contagem de Plaquetas , Neoplasias Testiculares/sangue , Neoplasias Testiculares/mortalidade , Adulto , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/sangue , Progressão da Doença , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Monócitos , Neoplasia Residual , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neutrófilos , Orquiectomia , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia
15.
J Hematol Oncol ; 11(1): 96, 2018 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-30041662

RESUMO

Recurrent deletions of the CDKN2A/ARF/CDKN2B genes encoded at chromosome 9p21 have been described in both pediatric and adult acute lymphoblastic leukemia (ALL), but their prognostic value remains controversial, with limited data on adult T-ALL. Here, we investigated the presence of homozygous and heterozygous deletions of the CDKN2A/ARF and CDKN2B genes in 64 adult T-ALL patients enrolled in two consecutive trials from the Spanish PETHEMA group. Alterations in CDKN2A/ARF/CDKN2B were detected in 35/64 patients (55%). Most of them consisted of 9p21 losses involving homozygous deletions of the CDKNA/ARF gene (26/64), as confirmed by single nucleotide polymorphism (SNP) arrays and interphase fluorescence in situ hybridization (iFISH). Deletions involving the CDKN2A/ARF/CDKN2B locus correlated with a higher frequency of cortical T cell phenotype and a better clearance of minimal residual disease (MRD) after induction therapy. Moreover, the combination of an altered copy-number-value (CNV) involving the CDKN2A/ARF/CDKN2B gene locus and undetectable MRD (≤ 0.01%) values allowed the identification of a subset of T-ALL with better overall survival in the absence of hematopoietic stem cell transplantation.


Assuntos
Inibidor de Quinase Dependente de Ciclina p15/genética , Deleção de Genes , Genes p16 , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Proteína Supressora de Tumor p14ARF/genética , Inibidor p16 de Quinase Dependente de Ciclina/genética , Humanos , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia , Prognóstico
16.
Psychooncology ; 27(6): 1530-1537, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29498768

RESUMO

OBJECTIVE: Patients' psychological reactions to multigene cancer panel testing might differ compared with the single-gene testing reactions because of the complexity and uncertainty associated with the different possible results. Understanding patients' preferences and psychological impact of multigene panel testing is important to adapt the genetic counselling model. METHODS: One hundred eighty-seven unrelated patients with clinical suspicion of hereditary cancer undergoing a 25-gene panel test completed questionnaires after pretest genetic counselling and at 1 week, 3 months, and 12 months after results to elicit their preferences regarding results disclosure and to measure their cancer worry and testing-specific distress and uncertainty. RESULTS: A pathogenic variant was identified in 38 patients (34 high penetrance and 4 moderate penetrance variants), and 54 patients had at least one variant of uncertain significance. Overall, cancer panel testing was not associated with an increase in cancer worry after results disclosure (P value = .87). Twelve months after results, carriers of a moderate penetrance variant had higher distress and uncertainty scores compared with carriers of high penetrance variants. Cancer worry prior to genetic testing predicted genetic testing specific distress after results, especially at long term (P value <.001). Most of the patients reported the wish to know all genetic results. CONCLUSIONS: Our results suggest that patients can psychologically cope with cancer panel testing, but distress and uncertainty observed in carriers of moderate penetrance cancer variants in this cohort warrant further research.


Assuntos
Aconselhamento Genético/psicologia , Predisposição Genética para Doença/psicologia , Testes Genéticos/métodos , Neoplasias/psicologia , Adulto , Ansiedade/psicologia , Estudos de Coortes , Feminino , Predisposição Genética para Doença/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/genética , Neoplasias/prevenção & controle , Espanha
17.
Food Chem ; 253: 227-235, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29502826

RESUMO

This study evaluates the impact on two varietal white wines from 'Chardonnay' and 'Verdejo' cultivars of different fermentative strategies: inoculation with Saccharomyces cerevisiae yeast (CT), sequential inoculation (Torulaspora delbrueckii/Saccharomyces cerevisiae) (SI), and spontaneous fermentation (SP). The wines' chemical composition was characterized by oenological parameters, organic acids, metals, major volatile compounds, ester compounds and sensory analyses. The fermentative strategy (CT, SI and SP) was found to be a key factor for assessing different styles of white wines. SI wines showed enhanced 'mature fruit' nuances and a chemical profile characterized by higher content of ethyl propanoate, ethyl isobutyrate and ethyl dihydrocinnamate. Meanwhile, the SP wines presented enhanced "stone fruit" nuances possible related to the higher contents of 2-phenyl acetate and isobutyl acetate. After a chemometric approach the above esters were identified as the markers of each fermentative strategy, independently of the variety.


Assuntos
Saccharomyces cerevisiae/metabolismo , Sensação , Vinho/análise , Acetatos/análise , Ésteres/análise , Fermentação , Aromatizantes/análise , Fenóis/análise , Torulaspora/metabolismo , Compostos Orgânicos Voláteis/análise , Fermento Seco/metabolismo
18.
Comput Biol Med ; 90: 116-124, 2017 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-28982035

RESUMO

This work presents a data-driven method to simulate, in real-time, the biomechanical behavior of the breast tissues in some image-guided interventions such as biopsies or radiotherapy dose delivery as well as to speed up multimodal registration algorithms. Ten real breasts were used for this work. Their deformation due to the displacement of two compression plates was simulated off-line using the finite element (FE) method. Three machine learning models were trained with the data from those simulations. Then, they were used to predict in real-time the deformation of the breast tissues during the compression. The models were a decision tree and two tree-based ensemble methods (extremely randomized trees and random forest). Two different experimental setups were designed to validate and study the performance of these models under different conditions. The mean 3D Euclidean distance between nodes predicted by the models and those extracted from the FE simulations was calculated to assess the performance of the models in the validation set. The experiments proved that extremely randomized trees performed better than the other two models. The mean error committed by the three models in the prediction of the nodal displacements was under 2 mm, a threshold usually set for clinical applications. The time needed for breast compression prediction is sufficiently short to allow its use in real-time (<0.2 s).


Assuntos
Mama/diagnóstico por imagem , Imageamento Tridimensional , Aprendizado de Máquina , Modelos Biológicos , Adulto , Feminino , Análise de Elementos Finitos , Humanos
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