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1.
Georgian Med News ; (343): 38-43, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38096513

RESUMO

Loss of muscle mass is a typical symptom of cancer and it is strongly correlated with poor prognosis. Cancer-related Sarcopenia is unresponsive to conventional dietary changes and exercise, in contrast to age-associated muscle atrophy. This particular type of weakness differs from different kinds of muscle loss in that it is triggered by a number of interrelated mechanisms, notably inflammatory processes, abnormal metabolic processes, proteolysis, and autophagy. This research is to examine evidence supporting the theory that tumors have a causal role in causing muscular atrophy. It seeks to investigate the precise regulators that the tumour generates and how they affect the processes that result in muscle waste. The evaluation looks for new directions for further studies and medical treatments. The analysis is based on a thorough examination of the scientific literature and research that shows how tumor and muscle atrophy are related. It concentrates on studies that clarify the numerous strategies by which malignancies cause the loss of muscle. This article highlights particular mechanisms by which these tumor-derived substances affect the development of muscle loss, including inflammatory processes, metabolic disturbance, proteolysis, and autophagy. The discovery of such targets offers hope for the creation of efficient treatment strategies that can enhance the long-term outlook and quality of life of cancer sufferers who are experiencing muscle loss.


Assuntos
Neoplasias , Sarcopenia , Humanos , Sarcopenia/complicações , Sarcopenia/diagnóstico , Músculo Esquelético/metabolismo , Qualidade de Vida , Atrofia Muscular/metabolismo , Atrofia Muscular/patologia , Neoplasias/patologia
2.
Georgian Med News ; (343): 134-138, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38096530

RESUMO

The term microbiome describes the assortment of microbes that dwell in and on a person's body, particularly in the gut, comprising fungi, bacteria, infectious agents and additional microbes. According to research, numerous elements of human well-being, such as digestion, immunological response and psychological well-being, have been linked to the microbiome. Preserving human wellness requires knowledge of the microbiome's stability and how it reacts to perturbations. According to preliminary research, adults' microbial ecosystems are considered stable with no signs of significant disturbances. This stability is not preserved by inertia and the system's interaction with restorative forces keeps the processes stable. Short antibiotic doses can result in quick and substantial microbiome alterations. However, there is confirmation that the taxonomic structure of the microbiome has at least recovered after such disruptions. The effect of antibiotics is individualized and can be altered by earlier exposure to a similar drug, which is a crucial aspect to remember. These results suggest that the individual's microbiome has adaptable qualities. Examining the microbiome's reactions to perturbations might be helpful in the prediction of potential instabilities and illness by revealing important features of function, microbial connections, and important species in the native microbiota. This information can benefit the management of the individual microbial community and the promotion of better health conditions.


Assuntos
Microbioma Gastrointestinal , Microbiota , Adulto , Humanos , Microbioma Gastrointestinal/fisiologia , Microbiota/fisiologia , Bactérias , Antibacterianos/farmacologia
3.
Georgian Med News ; (343): 165-171, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38096535

RESUMO

Parkinson's Disease in Mild Cognitive Impairment (PD-MCI) is a complex condition characterized by a variety of cognitive problems that coexist with the physical symptoms of Parkinson's disease (PD). This study aims to examine the different medical indicators and associated tendencies among different PD-MCI groups. We investigated 132 people who had been given PD-MCI diagnoses. Utilizing SPSS, statistical evaluations are carried out. In overall PD-MCI variants, this investigation found that visuospatial ability and attentional/executive performance are the most impaired cognitive areas. It was also noticed that distinct PD-MCI groups had variances in their neurological characteristics, in multi domain amnesia (Non-Memory) PD-MCI patients exhibiting especially severe issues with unstable posture and walking. The intricacy of PD- Mild Cognitive Impairment (MCI) is highlighted by those results, which also imply that the interplay between mental and physical signs may be controlled by a number of interrelated factors, such as particular cognitive areas, brain surfaces, and the general level of cognitive impairment.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Doença de Parkinson/diagnóstico , Testes Neuropsicológicos , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/diagnóstico , Atenção , Encéfalo
4.
Georgian Med News ; (343): 199-203, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38096540

RESUMO

Primary Immunodeficiency Disease (PID) represents a class of diverse illnesses marked by compromised immune system performance. For better patient outcomes, PIDs must be diagnosed and treated quickly. Medical graduates are essential to the detection and treatment of these illnesses. The purpose of this study was to evaluate medical students' knowledge about PIDs in different Indian medical colleges. To perform this analytical investigation, college students from Maharashtra-area universities were enlisted between March and April of 2023. The participants received a questionnaire from mediators from every institution. Of the 500 students in the study, 66% were between the ages of 22 and 24 and 52% were female. Their understanding ratings had an average of 16.3±6.2 and varied between 4 and 32. A set of students classified as below average (86%) and a mean/above average (14%), were separated among the students. The largest percentage of above-average knowledge was demonstrated by VI-year participants (p<0.05). This investigation emphasizes how critical it is to provide focused educational activities to improve medical students' comprehension of PIDs in India.


Assuntos
Doenças da Imunodeficiência Primária , Estudantes de Medicina , Humanos , Feminino , Adulto Jovem , Adulto , Masculino , Índia/epidemiologia , Inquéritos e Questionários , Universidades
5.
Georgian Med News ; (342): 30-35, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37991953

RESUMO

To determine risk factors and the overall incidence of ocular surface disorders in a cohort of long-term glaucoma patients. Utilizing simple clinical tools, cross-sectional observational research were constructed to evaluate ocular surface problems and indicators. Using a four-grade scale, ten queries regarding symptoms and indications on the cornea's surface were used to create an OSD severity score. The patients were divided into three groups: A, B, and C, depending on the result. The variables that increase the incidence of surface sickness were identified using a multinomial logistic regression. Five hundred and twenty patients made up the total population. According to the multivariate analysis, the patient's age, the number of daily eyedrops, any previous changes in topical treatment for ocular intolerance, intraocular pressure, and degree of glaucoma were all connected with the severity of ocular surface illness. Ocular surface disorders are frequently developed by patients getting treatment for primary open-angle glaucoma or ocular hypotension. which are less prevalent and serious in geriatric patients because their use greater drugs and have greater advanced glaucoma.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Hipertensão Ocular , Humanos , Idoso , Glaucoma de Ângulo Aberto/tratamento farmacológico , Endotélio Corneano , Hipertensão Ocular/induzido quimicamente , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/tratamento farmacológico , Estudos Transversais , Anti-Hipertensivos/uso terapêutico , Glaucoma/induzido quimicamente , Glaucoma/diagnóstico , Glaucoma/tratamento farmacológico , Pressão Intraocular
6.
Georgian Med News ; (342): 101-107, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37991963

RESUMO

This article's purpose is to explore how "non-invasive brain stimulation" (NBS) can be used to treat "traumatic brain injury" (TBI) and promote neuroplasticity. Along with the pathophysiological processes that occur after a TBI, "transcranial direct current stimulation" (tDCS) and "transcranial magnetic stimulation" (TMS) are described. These processes are based on a study of the relevant literature. Individualized treatment plans are required because the pathophysiological processes that result from TBI change over time. Given their neurophysiological effects, TMS and tDCS may be used to (a) significant suppression of post-traumatic cerebral hyper excitability; (b) control synaptic plasticity over the long run to prevent unfavorable outcomes; and (c) in addition to other forms of treatment such as physical and behavioral, assist some neural networks to reorganize and consolidate their learning. These treatments have the potential to reduce the disabling symptoms of brain injury.Animal and human research show that NBS may help reduce the severity of injuries and increase plastic changes in lesioned brain tissue, both of which are necessary for the successful acquisition of new knowledge and the restoration of lost functions. However, at present, this evidence is mostly speculative. The relevance of NBS in TBI, further elucidating its therapeutic benefits, and defining appropriate stimulation levels all need investigations in TBI patients due to safety concerns.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Animais , Humanos , Lesões Encefálicas Traumáticas/terapia , Lesões Encefálicas/terapia , Acidente Vascular Cerebral/terapia , Plasticidade Neuronal
7.
Georgian Med News ; (340-341): 17-24, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805868

RESUMO

A gut-brain axis (GBA) has a long history of conceptual development. Intestinal dysbiosis has now been recognized as a key player in the development of adult neurodevelopmental disorders, obesity, and inflammatory bowel disease. Recent developments in metagenomics suggest those nutrition and gut microbiotas (GM) are important regulators of the gut-brain communication pathways that cause neurodevelopmental and psychiatric problems in adulthood. Intestinal dysbiosis and neurodevelopmental disease outcomes in preterm newborns are being linked by recent research. Recent clinical investigations demonstrate that in critical care units, intestinal dysbiosis occurs before late-onset newborn sepsis and necrotizing enterocolitis. Strong epidemiologic data also shows a connection between necrotizing enterocolitis and extremely low birth weight babies' long-term psychomotor impairments and late-onset neonatal sepsis. The GBA theory suggests that intestinal bacteria may indirectly affect preterm newborns' developing brains. In this review, we emphasize the structure and function of the GBA and discuss how immune-microbial dysfunction in the gut affects the transmission of stress signals to the brain. Preterm babies who are exposed to these signals develop neurologic disorders. Understanding neuronal and humoral communication through the GBA may provide insight into therapeutic and nutritional strategies that may enhance the results of very low-birth-weight babies.


Assuntos
Enterocolite Necrosante , Doenças do Recém-Nascido , Sepse Neonatal , Doenças do Sistema Nervoso , Lactente , Adulto , Recém-Nascido , Humanos , Eixo Encéfalo-Intestino , Enterocolite Necrosante/microbiologia , Disbiose , Saúde Mental , Imunidade
8.
Georgian Med News ; (340-341): 93-100, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805881

RESUMO

Fibrosis of the liver, which can be caused by either viral or chemical chronic liver illnesses, is a serious issue for the world's health. Collagen is crucial for the development of the illness and the possibility of developing hepatocellular carcinoma (HCC), which is linked to the progression of liver damage. Although there are various mechanisms for acute liver injury and diseases-specific cells response, almost all of fatty liver aetiologies share similar trends in the development of fibrous liver damage. The scientific community's knowledge of the fundamental causes of fibrosis of the liver has undergone a significant shift during the last ten years. It has been shown that the fundamental trigger, such as the control or management of an infectious disease, can be eradicated or eliminated in order to reverse liver fibrosis. Reversing frequently occurs prematurely or too rarely, particularly in severe fibrosis, to avoid possibly fatal effects. Therefore, there is an urgent need for anti-fibrotic medications to halt the progression of liver damage and the appearance of HCC. Even though various anti-fibrotic medication options have shown strong anti-fibrotic effects in lab animals, research studies have only seen a small amount or none of these advantages. There is not an approved remedy for the condition as a result. In this article, we give a general overview of the physiological and molecular origins of collagen in chronic liver disease and investigate how these causes can impact the quickly developing field of anti-fibrotic treatments.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Animais , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/tratamento farmacológico , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Cirrose Hepática/tratamento farmacológico , Fibrose , Doença Crônica , Colágeno
9.
Georgian Med News ; (340-341): 153-158, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805890

RESUMO

The diverse population of microbes that live in our digestive system, known as the gut microbiota, remains essential for many physiological processes. It plays a role in obtaining energy from food and controls both regional and overall immunity. In addition, changes in the microbiota of the digestive tract are connected to the emergence of an extensive variety of illnesses, such as cancer, gastrointestinal problems, and metabolic disorders. From a metabolic perspective, the gut microbiota can affect processes like lipid accumulation, lipopolysaccharide satisfied, and short-chain fatty acid synthesis, all of which have an effect on food intake, inflammatory reactions, and insulin signaling. Prebiotics, probiotics, specialized anti-diabetic medications, and faecalmicrobiota implantation are a few of the ways that have been discovered to alter the gut microbiota; each has a different influence the human body's metabolism and the emergence of metabolic disorders. These therapies have been reported to be therapeutic strategies for enhancing general wellness and reestablishing a balanced gut flora.


Assuntos
Microbioma Gastrointestinal , Doenças Metabólicas , Síndrome Metabólica , Microbiota , Probióticos , Humanos , Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal , Probióticos/uso terapêutico
10.
Georgian Med News ; (340-341): 205-211, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805899

RESUMO

Complex inflammatory skin disease with autoimmune roots is psoriasis. This disease affects various cell types, and the underlying signaling processes are complicated yet not fully understood. Extensive psoriatic lesions' proteome and transcriptome of several researches were combined to understand disease's underlying biological mechanisms. According to a network-based study, both transcriptomics and proteomics control were comparable. They discovered many pathways of signaling previously undiscovered and possibly involved in overexpression of psoriasis genes. They also found a collection of transcription factors in charge of this process. The functional overlap between the results of transcriptomics and proteomics was also examined. There created a network-based method for combining the analysis of many high-throughput data sources. Proteomic and transcriptome studies of psoriasis data sets demonstrated regulatory flexibility apparatus underpinning disease and complementary relationships within two cellular organizations.


Assuntos
Psoríase , Transcriptoma , Humanos , Proteômica/métodos , Queratinócitos/metabolismo , Perfilação da Expressão Gênica/métodos , Psoríase/genética , Pele/metabolismo
11.
Georgian Med News ; (340-341): 284-289, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37805913

RESUMO

The research we provided look at a number of factors, such as age, unilateral testing, and squinting both during the ictal and interictal periods to define vestibular migraine. One hundred and ten adults with recurrent spontaneous and positional vertigo participated in the study, which the investigators did. Vestibular migraines (VM) or probable vestibular migraine constituted the two diagnoses given to the patients (n = 29 and n = 76, respectively). The findings revealed those surveyed frequently complained of headache (85.3%), spinning vertigo (76.2%), and Mal de Débarquement (60.2%), with movement hypersensitivity (32.6%). After an episode, 75.2% of individuals having vestibular migraine showed spontaneous squinting, whereas 16.5% did so among assaults, although fixing was forbidden. 27.3% of people had clear spatial squinting after an assault, while 57.3% did so after assaults. In 51.2% of instances, the direction of ictal spontaneous Nystagmus was straight, while in 19.5% of cases, it was vertical. Positional and spontaneously ictal squinting was evaluated at speeds between 0.0 and 59.3 degrees per second and 0.0 and 99.9 levels per minute, respectively. In 92.6% and 25.1% of instances, respectively, the interact spontaneous and positional nystagmus velocities were typically less than 3 degrees/second. When contrasted with the time within assaults, squinting speeds were substantially greater after an assault. According to additional tests, 98.6% of those tested exhibited normal lateral video head impulse test gains, indicating that their vestibule-ocular responses were in place. The calorie test findings were symmetrical in 86.4% of the instances, showing normal vestibular function. In 90.4% and 95.2% of cases misogynic potentials displayed symmetrical magnitudes. In 69.8% and 98.1% of instances, misogynic possibilities were identical. In 89.3% of cases, the audiometer data is generally uniform and age-consistent. In outcome, low-velocity squinting that can be horizontal, vertical, or torsional motions occur throughout a sensory migraines event. The investigation also discovered that patients with vestibular migraine often had acceptable audio vestibular test findings.


Assuntos
Transtornos de Enxaqueca , Nistagmo Patológico , Adulto , Humanos , Vertigem/diagnóstico , Vertigem/terapia , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Nistagmo Patológico/diagnóstico , Olho
12.
Georgian Med News ; (345): 166-171, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38325318

RESUMO

Aim - determining the prevalence of anxiety disorders and their effect on disease progression and quality of life in adults with organic illnesses and functional disorders of the respiratory system treated in a pulmonology environment. A total of 135 young adults between the ages of 13 and 17 were analyzed. There were a total of 46 adolescents diagnosed with somatoform respiratory disorders (SRD), 45 adolescents diagnosed with bronchial asthma (BA), and 44 adolescents diagnosed with pneumonia. The Spielberger-Khanin anxiety questionnaire and the Nijmegen hyperventilation syndrome (HVS) scale were used for the research and diagnosis, respectively. The quality of life was measured using the asthma quality of life questionnaire (AQLQ). In comparison to adults with asthma (33.2%) and pneumonia (32.3%), adults with SRD (34.5%). There were mild immediate associations between the Spielberger scale and the Nijmegen HVS questionnaire for both trait and state anxiety, and mild inverse correlations between the Spielberger scale and the AQLQ for both state and trait anxiety. Adolescents with anxiety had a higher prevalence of trauma, pain, and social issues than their non-anxious counterparts who were referred to psychiatry. In adolescents, 5.1% had severe trait anxiety, and 19.3% had severe condition anxiety. Adolescents with SRD were twice as likely to suffer from extreme state and trait anxiety as the general population. It is hypothesized that anxiety problems are at the root of HVS and contribute to adults' dissatisfaction with their quality of life due to lung ailments. Although certain adolescents with anxiety disorders were referred for anxiety, this data nevertheless lends credence to the idea that using standardized and structured instruments regularly might help increase accuracy and detection rates in the clinic, regardless of the reason for referral. Complete evaluations are essential for this patient population due to the intricacy of their symptoms.


Assuntos
Asma , Pneumonia , Adulto Jovem , Humanos , Adolescente , Estudos Prospectivos , Qualidade de Vida , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Hiperventilação/diagnóstico , Hiperventilação/epidemiologia , Síndrome , Inquéritos e Questionários
13.
Georgian Med News ; (345): 196-202, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38325323

RESUMO

A major issue among adolescents in recent years has been social isolation, or the sensation cut off and alone from peers and society. The effects of social isolation on youngsters and adolescents are investigated with special attention paying to the possible negative effects on their physical and mental health. Multiple studies have shown a link between adversity in life domains and adolescent social isolation. Firstly, it can have a major effect on mental health, raising the probability of experiencing things like anxiety, sadness and even suicidal thoughts. Second, it prevents the development of vital social abilities, making it harder to make and keep close friends. In addition, social isolation is associated with worse academic performance, which in turn reduces the number of courses a student can take and the number of jobs they can have in the future. After looking over 520 papers, 15 were chosen for the systematic review. Four researches reported the implications on general health, while two investigations reported on ramifications affecting the Hypothalamic-pituitary-adrenal (HPA) axis area along with social and mental growth of children. In conclusion, social isolation affects youth development across a wide spectrum, including psychological well-being, interpersonal skills, and academic success. Children and adolescents who experience isolation are more likely to suffer from anxiety and sadness, according to the review's findings. Cortical levels rise and mental growth slows in socially isolated children. Children and adolescents should be monitored by health professionals during and after the COVID-19 pandemic to ensure that their mental and physical health needs are met.


Assuntos
COVID-19 , Pandemias , Criança , Adolescente , Humanos , COVID-19/epidemiologia , Saúde Mental , Ansiedade , Transtornos de Ansiedade
14.
Georgian Med News ; (345): 32-36, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38325294

RESUMO

The thyroid, a gland with a butterfly-like shape in the base of the human neck, plays an important role in metabolism. Body heat, energy levels, weight, hair, fingernail, and regular menstruation cycles are controlled by three hormones produced by the thyroid. A system of feedback regulates the release of those hormones. Overproduction as well as underproduction of thyroid hormones can result from shifts in the stimulation and regulation of those hormones. These factors can have physiological or pathological origins. Pregnancy is a physiological factor. There is a plethora of physiological and psychological shifts that occur during pregnancy. A thyroid alteration in the mother is one example. Thyroid irregularities result from a failure to adjust to new circumstances. Thyroid hormone levels can drop, or manufacturing could be slowed during pregnancy due to variations in hormone concentration. Hypothyroidism describes this disorder. Hypothyroidism in women who are pregnant is either gestational or could be a disorder that is present before pregnancy. Gestational hypothyroidism cures itself throughout postpartum times, though it can stay as subclinical hyperthyroidism for some time after delivery. They pose a serious risk to development, stunt the growth of the unborn child and lead to defects in subsequent generations. Enhanced thyroid binding globulin levels, enhanced iodine clearance by the kidneys, modified effects of the human reproductive hormone and reduced dietary consumption of iodine lead to these alterations in the gland. Cretinism and mental disorders are among the serious health problems related to an iodine imbalance in maternal hypothyroidism. The growth of the brain, nervous system and Intelligence of an unborn child depends on thyroid hormones. As a result, normal early stages of development suffer due to changes in maternal hormone levels.


Assuntos
Hipotireoidismo , Iodo , Complicações na Gravidez , Humanos , Gravidez , Feminino , Mães , Hormônios Tireóideos/metabolismo , Desenvolvimento Fetal , Iodo/metabolismo
15.
Georgian Med News ; (345): 105-111, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38325307

RESUMO

A prevalent psychiatric disorder called Child Separation Anxiety Disorder (SAD) is characterized by extreme discomfort when a child gets separated from their primary carers. While SAD's quick consequences on kids are well-researched, its long-term implications for teenage psychopathology have received less attention. This longitudinal study aims to ascertain the connection between child SAD and future psychopathological consequences in adolescents. 500 adolescents were chosen as part of the adolescent depression project, and at the age of 17, we retrospectively evaluated past and present mental disorders. At ages 25 and 32, they conducted diagnostic evaluations of these people during adolescence while they continued to monitor them. Based on childhood/adolescent assessments, the participants were split into different groups: SAD (n=34), other forms of Anxiety (n=76), a control group with combined psychiatric conditions (n=205), and mentally sound control group (n=185). Statistics were evaluated by hierarchical multiple logistic regression after various illnesses and pertinent demographic variables were considered. It implies that SAD has a high risk (80.2%) of being a significant risk indicator for the emergence of mental illnesses in young adults. This study highlights the importance of early SAD management and therapy and the possible advantages of treating SAD in lowering the likelihood of developing other mental health problems in adolescence. It also emphasizes the value of continuous studies to comprehend these connections and enhance the effects on SAD sufferers' psychological well-being.


Assuntos
Transtornos de Ansiedade , Ansiedade de Separação , Humanos , Adolescente , Criança , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Estudos Longitudinais , Estudos Retrospectivos , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Ansiedade
16.
Georgian Med News ; (344): 43-46, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38236097

RESUMO

Ischemic stroke is a major health issue, especially for the older population and it may have severe effects. Stroke diagnosis and treatment have advanced over the last 20 years, which has resulted in considerable reductions in death, long-term impairment, and the need for institutional care. Younger age groups have seen the majority of trials for acute, interventional, and preventive therapy. The purpose of this research was to identify distinct subgroups of older people who had suffered an ischemic stroke and examine the role that risk factors and previous illnesses played in their development. Ischemic stroke risk factors varied by age, gender and exhibited their own unique features. Smoking, cholesterol, and psychological/emotional stress were shown to have the greatest prevalence (p<0.06) among stroke patients aged 45-60. Smoking is associated with a significant (p<0.07) decline in health in elderly people. Our results imply that there are significant patterns of risk factors and preexisting illnesses among the various subgroups of older people who have had an ischemic stroke. Atherosclerotic (large-artery) and cardio embolic (small-artery) ischemic strokes were shown to be the most prevalent among the elderly. Strong associations were found between these subtypes and other risk factors, including higher cholesterol, diabetes, high blood pressure, and atrial fibrillation. This research emphasizes the need for individualized preventative methods and therapeutic therapy, as well as the need to recognize the variability of ischemic stroke in the elderly.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Humanos , Cobertura de Condição Pré-Existente , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Fatores de Risco , Colesterol
17.
Ann Oncol ; 27(8): 1612-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27217544

RESUMO

BACKGROUND: Unintentional weight loss occurs among advanced non-small-cell lung cancer (NSCLC) patients and is associated with worse survival. Small studies have suggested that weight gain during treatment is associated with superior survival. PATIENTS AND METHODS: A retrospective analysis analyzed data from three international phase III studies comprising 2301 advanced, non-squamous NSCLC patients who received a platinum-based, first-line doublet, with or without bevacizumab and maintenance therapy. Body weight was recorded before and after treatment by each study's schedule. The relationship between weight gain and overall survival (OS) and progression-free survival (PFS) was assessed using log-rank test and adjusted Cox modeling. Logistic regression assessed the association between baseline covariates and post-baseline weight gain. RESULTS: Four hundred and twenty-one (18.3%) patients had >5% weight gain after baseline. More than half of the weight gain cohort exhibited initial weight gain by 3 weeks. The median OS was 16.7 months versus 10.7 months for the >5% versus ≤5% weight gain subgroup (n = 1880) (P < 0.001). PFS was 6.9 versus 4.8 months, respectively (P < 0.001). Differences in overall tumor response rate (50.8% versus 25.4%, respectively) and disease control rate (tumor response or stable disease) (91.5% versus 63.6%, respectively) were also significant (P < 0.001). The Cox modeling revealed the >5% subgroup had longer survival [hazard ratio (HR) = 0.54, 95% confidence interval (CI) 0.47-0.62; P < 0.001] than the ≤5% subgroup after adjusting for baseline factors. Similar significant results were found for PFS (HR = 0.59, 95% CI 0.52-0.67; P < 0.001). Unadjusted logistic regression indicated a significant association between weight gain (>5% versus ≤5%) and age, and BMI. CONCLUSIONS: Weight gain during treatment may be an early indicator of clinical benefit. If confirmed in prospective studies, monitoring weight change may provide important information regarding survival outcomes in NSCLC and may provide ideas for new therapeutic strategies.


Assuntos
Bevacizumab/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Pemetrexede/administração & dosagem , Aumento de Peso/efeitos dos fármacos , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bevacizumab/efeitos adversos , Índice de Massa Corporal , Caquexia/complicações , Caquexia/tratamento farmacológico , Caquexia/fisiopatologia , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/fisiopatologia , Ensaios Clínicos Fase III como Assunto , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pemetrexede/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
18.
Eur J Cancer ; 50(2): 302-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24246704

RESUMO

BACKGROUND: The development of a rash has been retrospectively associated with increased response and improved survival when treated with erlotinib at the standard dose of 150 mg per day. The objective of this trial was to evaluate the association of the activity of erlotinib in the first-line setting in patients with advanced non-small-cell lung cancer (NSCLC) with the development of a tolerable rash via dose escalation of erlotinib or tumour characteristics. METHODS: Patients, with advanced NSCLC without prior systemic therapy, were treated with erlotinib 150 mg orally per day. The dose was increased by 25mg every two weeks until the development of grade 2/tolerable rash or other dose limiting toxicity. Tumour biopsy specimens were required for inclusion. RESULTS: The study enrolled 137 patients, 135 were evaluable for safety and 124 were eligible and evaluable for response. Only 73 tumour samples were available for analysis. Erlotinib dose escalation occurred in 69/124 patients. Erlotinib was well tolerated with 70% of patients developing a grade 1/2 rash and 10% developing grade 3 rash. Response rate and disease control rate were 6.5% and 41.1% respectively. Median overall survival was 7.7 months. Toxicity and tumour markers were not associated with response. Grade 2 or greater skin rash and low phosphorylated mitogen-activated protein kinase (pMAPK) were associated with improved survival. CONCLUSIONS: Overall survival was similar in this trial compared to first-line chemotherapy in this unselected patient population. Dose escalation to the development of grade 2 skin rash was associated with improved survival in this patient population.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Quinazolinas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Cloridrato de Erlotinib , Exantema/induzido quimicamente , Fadiga/induzido quimicamente , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/uso terapêutico , Quinazolinas/efeitos adversos , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento
19.
J Oleo Sci ; 59(3): 121-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20124753

RESUMO

The present investigation aimed at finding out the effect of different degumming processes and on the use of some nontraditional alkaline material for refining of rice bran oil. Attempt was made to treat crude rice bran oil with H(2)O, and H(3)PO(4) for degumming followed by with alum or H(2)O for dewaxing. After removal of the gums and waxes the oil was neutralized with commonly used NaOH, and some nontraditional neutralizing agents like Na(2)CO(3) and NaHCO(3). Finally the oil was bleached traditionally using earth and charcoal and deodorized. The RBD oil was characterized by determining their color, peroxide value, content of unsaponifiable matter, and free fatty acids. Among the different processes tried degumming with 0.2 %, w/w, H(3)PO(4) followed by dewaxing with 2.0 %, w/w, H(2)O; bleaching with tonsil earth (1.5 %, w/w) and charcoal (0.5 %, w/w) and finally deodorization at 220 degrees C temperature and 2-4 mm Hg pressure resulted best quality oil in terms of the measured parameters. The characteristics of refined rice bran oil could be as content of FFA and UM 0.2 (%, w/w), 2.6 (%, w/w) respectively; color 10.9Y, 2.0R (in 2.54 cm Lovibond Tintometer cell); PV 3.3 (meq/kg). The oil yield is 78-85 % (by weight).


Assuntos
Tecnologia de Alimentos/métodos , Óleos de Plantas/química , Óleos de Plantas/isolamento & purificação , Ácidos Graxos não Esterificados/análise , Odorantes , Óleo de Farelo de Arroz , Ceras/isolamento & purificação
20.
J Natl Cancer Inst ; 102(1): 47-53, 2010 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-20007525

RESUMO

BACKGROUND: Patients treated with epidermal growth factor receptor inhibitors (EGFRIs) frequently experience dermatologic toxic effects. Whereas the impact of these effects on quality of life and EGFRI dosing has been described, their impact on physical health has not been ascertained. We examined the prevalence of infections that complicate dermatologic toxic effects of EGFRIs. METHODS: We used retrospective chart review methods to analyze 221 patients who were treated in the Skin and Eye Reactions to Inhibitors of EGFR and Kinases clinic, a referral clinic for dermatologic toxic effects of cancer therapies. We reviewed results of bacterial cultures, histopathologic assessment of biopsy samples, and immunohistochemical staining of skin specimens for viral pathogens that were recorded in the patients' medical records. Associations between patient demographic and treatment characteristics and the development of infections were examined using the Fisher exact test. All statistical tests were two-sided. RESULTS: Eighty-four (38%) of the 221 patients showed evidence of infection at sites of dermatologic toxic effect. Fifty (22.6%) of the 221 patients had cultures positive for Staphylococcus aureus, and 12 (5.4%) of the 221 patients cultured positive for methicillin-resistant S aureus. Less frequent infections included herpes simplex (3.2%), herpes zoster (1.8%), and dermatophytes (10.4%). The seborrheic region was the most prevalent site of infection, and patients with leukopenia had higher risk for infection than patients who did not have leukopenia (P = .005). Demographic factors and associated treatments were not associated with the occurrence of a dermatologic infection (P > or = .05). CONCLUSIONS: Patients with dermatologic toxic effects following treatment with EGFRIs have a high prevalence of cutaneous infections. Most notably, bacterial infections developed at sites previously affected by dermatologic toxic effects, with leukopenic patients being at greater risk.


Assuntos
Antineoplásicos/efeitos adversos , Receptores ErbB/antagonistas & inibidores , Dermatopatias Infecciosas/etiologia , Pele/microbiologia , Pele/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Biópsia , Dermatomicoses/etiologia , Feminino , Humanos , Imuno-Histoquímica , Leucopenia/induzido quimicamente , Leucopenia/complicações , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Prevalência , Estudos Retrospectivos , Pele/patologia , Dermatopatias Bacterianas/etiologia , Dermatopatias Infecciosas/microbiologia , Dermatopatias Infecciosas/virologia , Dermatopatias Virais/etiologia , Adulto Jovem
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