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2.
J Nutr Health Aging ; 19(4): 413-23, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25809805

RESUMO

OBJECTIVES: Epidemiological evidence linking diet, one of the most important modifiable lifestyle factors, and risk of Alzheimer's disease (AD) is rapidly increasing. However, there is little or no evidence for a direct association between dietary nutrients and brain biomarkers of AD. This study identifies nutrient patterns associated with major brain AD biomarkers in a cohort of clinically and cognitively normal (NL) individuals at risk for AD. DESIGN: Cross-sectional study. SETTING: Manhattan (broader area). PARTICIPANTS: Fifty-two NL individuals (age 54+12 y, 70% women, Clinical Dementia Rating=0, MMSE>27, neuropsychological test performance within norms by age and education) with complete dietary information and cross-sectional, 3D T1-weighted Magnetic Resonance Imaging (MRI; gray matter volumes, GMV, a marker of brain atrophy), 11C-Pittsburgh compound-B (PiB; a marker of fibrillar amyloid-ß, Aß) and 18F-fluorodeoxyglucose (FDG; a marker of glucose metabolism, METglc) Positron Emission Tomography (PET) scans were examined. MEASUREMENTS: Dietary intake of 35 nutrients associated with cognitive function and AD was assessed using the Harvard/Willet Food Frequency Questionnaire. Principal component analysis was used to generate nutrient patterns (NP) from the full nutrient panel. Statistical parametric mapping and voxel based morphometry were used to assess the associations of the identified NPs with AD biomarkers. RESULTS: None of the participants were diabetics, smokers, or met criteria for obesity. Five NPs were identified: NP1 was characterized by most B-vitamins and several minerals [VitB and Minerals]; NP2 by monounsaturated and polyunsaturated fats, including ω-3 and ω-6 PUFA, and vitamin E [VitE and PUFA]; NP3 by vitamin A, vitamin C, carotenoids and dietary fibers [Anti-oxidants and Fibers]; NP4 by vitamin B12, vitamin D and zinc [VitB12 and D]; NP5 by saturated, trans-saturated fats, cholesterol and sodium [Fats]. Voxel-based analysis showed that NP4 scores [VitB12 and D] were positively associated with METglc and GMV, and negatively associated with PiB retention in AD-vulnerable regions (p<0.001). In addition, both METglc and GMV were positively associated with NP2 scores [VitE and PUFA], and negatively associated with NP5 scores [Fats] (p<0.001), and METglc was positively associated with higher NP3 scores [Anti-oxidants and Fibers] (p<0.001). Adjusting for age, gender, ethnicity, education, caloric intake, BMI, alcohol consumption, family history and Apolipoprotein E (APOE) status did not attenuate these relationships. The identified 'AD-protective' nutrient combination was associated with higher intake of fresh fruit and vegetables, whole grains, fish and low-fat dairies, and lower intake of sweets, fried potatoes, high-fat dairies, processed meat and butter. CONCLUSION: Specific dietary NPs are associated with brain biomarkers of AD in NL individuals, suggesting that dietary interventions may play a role in the prevention of AD by modulating AD-risk through its effects on Aß and associated neuronal impairment.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/metabolismo , Biomarcadores/análise , Encéfalo/metabolismo , Cognição/fisiologia , Dieta/estatística & dados numéricos , Adulto , Idoso , Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Amiloide/análise , Encéfalo/patologia , Estudos de Coortes , Estudos Transversais , Feminino , Glucose/metabolismo , Substância Cinzenta , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Cidade de Nova Iorque , Tomografia por Emissão de Pósitrons , Análise de Componente Principal , Inquéritos e Questionários
3.
J Prev Alzheimers Dis ; 1(1): 23-32, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25237654

RESUMO

OBJECTIVES: Epidemiological evidence linking diet, one of the most important modifiable environmental factors, and risk of Alzheimer's disease (AD) is rapidly increasing. Several studies have shown that higher adherence to a Mediterranean diet (MeDi) is associated with reduced risk of AD. This study examines the associations between high vs. lower adherence to a MeDi and structural MRI-based brain atrophy in key regions for AD in cognitively normal (NL) individuals with and without risk factors for AD. DESIGN: Cross-sectional study. SETTING: Manhattan (broader area). PARTICIPANTS: Fifty-two NL individuals (age 54+12 y, 70% women) with complete dietary information and cross-sectional, 3D T1-weighted MRI scans were examined. MEASUREMENTS: Subjects were dichotomized into those showing higher vs. lower adherences to the MeDi using published protocols. Estimates of cortical thickness for entorhinal cortex (EC), inferior parietal lobe, middle temporal gyrus, orbitofrontal cortex (OFC) and posterior cingulate cortex (PCC) were obtained by use of automated segmentation tools (FreeSurfer). Multivariate general linear models and linear regressions assessed the associations of MeDi with MRI measures. RESULTS: Of the 52 participants, 20 (39%) showed higher MeDi adherence (MeDi+) and 32 (61%) showed lower adherence (MeDi-). Groups were comparable for clinical, neuropsychological measures, presence of a family history of AD (FH), and frequency of Apolipoprotein E (APOE) ε4 genotype. With and without controlling for age and total intracranial volume, MeDi+ subjects showed greater thickness of AD-vulnerable ROIs as compared to MeDi- subjects (Wilk's Lambda p=0.026). Group differences were most pronounced in OFC (p=0.001), EC (p=0.03) and PCC (p=0.04) of the left hemisphere. Adjusting for gender, education, FH, APOE status, BMI, insulin resistance scores and presence of hypertension did not attenuate the relationship. CONCLUSION: NL individuals showing lower adherence to the MeDi had cortical thinning in the same brain regions as clinical AD patients compared to those showing higher adherence. These data indicate that the MeDi may have a protective effect against tissue loss, and suggest that dietary interventions may play a role in the prevention of AD.

4.
Neuroimage ; 100: 684-691, 2014 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-24999038

RESUMO

Interstitial concentration of amyloid beta (Aß) is positively related to synaptic activity in animal experiments. In humans, Aß deposition in Alzheimer's disease overlaps with cortical regions highly active earlier in life. White matter lesions (WML) disrupt connections between gray matter (GM) regions which in turn changes their activation patterns. Here, we tested if WML are related to Aß accumulation (measured with PiB-PET) and glucose uptake (measured with FDG-PET) in connected GM. WML masks from 72 cognitively normal (age 61.7 ± 9.6 years, 71% women) individuals were obtained from T2-FLAIR. MRI and PET images were normalized into common space, segmented and parcellated into gray matter (GM) regions. The effects of WML on connected GM regions were assessed using the Change in Connectivity (ChaCo) score. Defined for each GM region, ChaCo is the percentage of WM tracts connecting to that region that pass through the WML mask. The regional relationship between ChaCo, glucose uptake and Aß was explored via linear regression. Subcortical regions of the bilateral caudate, putamen, calcarine, insula, thalamus and anterior cingulum had WM connections with the most lesions, followed by frontal, occipital, temporal, parietal and cerebellar regions. Regional analysis revealed that GM with more lesions in connecting WM and thus impaired connectivity had lower FDG-PET (r = 0.20, p<0.05 corrected) and lower PiB uptake (r = 0.28, p<0.05 corrected). Regional regression also revealed that both ChaCo (ß = 0.045) and FDG-PET (ß = 0.089) were significant predictors of PiB. In conclusion, brain regions with more lesions in connecting WM had lower glucose metabolism and lower Aß deposition.


Assuntos
Peptídeos beta-Amiloides/metabolismo , Glicemia/metabolismo , Encéfalo/metabolismo , Substância Branca/metabolismo , Idoso , Compostos de Anilina , Encéfalo/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Tiazóis , Substância Branca/patologia
5.
Fam Cancer ; 13(1): 75-82, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24002367

RESUMO

The aim of this qualitative study was to examine the experience of individuals facing a choice about genetic counselling/testing in the context of newly diagnosed colorectal cancer (CRC). Nineteen individuals with newly diagnosed CRC, including 12 individuals who accepted genetic counselling ("acceptors") and 7 individuals who declined genetic counselling ("refusers"), were interviewed using a standardized questionnaire guide which focused on motivations and barriers experienced in the decision process. Data were analyzed using Karlsson's Empirical Phenomenological method of data analysis (Karlsson in Psychological qualitative research from a phenomenological perspective. Almgvist and Wiksell International, Stockholm, 1993). Three major themes were identified: facing challenges in health literacy; mapping an unknown territory; and adjusting to cancer. The study participants' testimonies provided novel insights into potential reasons for patient non-engagement in pilot studies of reflex testing for Lynch syndrome, and allowed us to formulate several recommendations for enhancing patient engagement. Our study findings suggest that patient engagement in clinical cancer genetics services, including reflex testing for Lynch syndrome, can only be achieved by addressing current health literacy issues, by deconstructing current misconceptions related to potential abuses of genetic information, by emphasizing the clinical utility of genetic assessment, and by adapting genetics practices to the specific context of cancer care.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/genética , Aconselhamento Genético/psicologia , Testes Genéticos , Adulto , Idoso , Canadá , Neoplasias Colorretais Hereditárias sem Polipose/psicologia , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Reflexo/fisiologia
7.
Support Care Cancer ; 21(8): 2153-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23475196

RESUMO

PURPOSE: As the number of survivors of Hodgkin's lymphoma (HL) increases, there has been a growing interest in long-term treatment-related side effects and their impact on the quality of life (QoL). The aim of this study was to assess the association of social network and social support with the QoL and fatigue among long-term HL survivors. METHODS: A total of 200 HL survivors were included. The generic Short Form-12 (SF-12) questionnaire, the QoL cancer survivor's questionnaire (QOL-CS), and the Multidimensional Fatigue Inventory were used to assess QoL and fatigue. Social network and social support were evaluated with the Social Support Survey. RESULTS: Social network and all social support measures were favorably associated with two or more SF-12 scales, mainly with physical functioning and the mental health scales. Social network and social support dimensions were also associated with better QOL-CS scores. Affective support, informational support, positive interaction, and emotional support were associated with less fatigue. CONCLUSIONS: Both social network and social support are associated with better QoL and lower levels of fatigue in HL survivors. This information may be useful to health professionals and community organizations in implementing effective interventions to improve these patients' quality of life.


Assuntos
Fadiga/psicologia , Doença de Hodgkin/psicologia , Qualidade de Vida/psicologia , Apoio Social , Sobreviventes/psicologia , Adolescente , Adulto , Idoso , Coleta de Dados , Fadiga/complicações , Feminino , Nível de Saúde , Doença de Hodgkin/complicações , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Inquéritos e Questionários
8.
Ann Oncol ; 23(3): 736-742, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21602260

RESUMO

BACKGROUND: A recent study demonstrated that an increased number of CD68+ macrophages were correlated with primary treatment failure, shortened progression-free survival (PFS) and disease-specific survival (DSS) in patients with classical Hodgkin's lymphoma (cHL). PATIENTS AND METHODS: The aim of the present study was to verify the relationship between the number of CD68+ and CD163+ macrophages with clinical outcomes in a cohort of 265 well-characterized patients with cHL treated uniformly with the standard doxorubicin, bleomycin, vinblastine and dacarbazine chemotherapy regimen. Two pairs of hematopathologists carried out independent pathological evaluations of tissue microarray slides. RESULTS: There were no associations between clinical characteristics and the expression of CD68 or CD163. However, higher levels of CD68 and CD163 expression were correlated with the presence of Epstein-Barr virus-positive Hodgkin tumor cells (P = 0.01 and 0.037, respectively). The expression of CD68 or CD163 was not associated with either the PFS or the DSS. CONCLUSION: CD68 and CD163 expression require further evaluation before their use can be recommended for prognostic stratification of patients with cHL.


Assuntos
Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Doença de Hodgkin/patologia , Macrófagos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Intervalo Livre de Doença , Infecções por Vírus Epstein-Barr/complicações , Feminino , Doença de Hodgkin/mortalidade , Doença de Hodgkin/virologia , Humanos , Imuno-Histoquímica , Hibridização In Situ , Estimativa de Kaplan-Meier , Macrófagos/metabolismo , Masculino , Pessoa de Meia-Idade , Prognóstico , Receptores de Superfície Celular/metabolismo , Análise Serial de Tecidos , Resultado do Tratamento , Adulto Jovem
9.
Int J Lab Hematol ; 33(2): 117-24, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21118380

RESUMO

INTRODUCTION: Thrombotic complications are a main concern in patients with myeloproliferative neoplasms. Recently, a gain-of-function mutation of the gene encoding the JAK2 tyrosine kinase that results in a valine-to-phenylalanine substitution at position 617 (V617F) has been described. Since the description of the JAK2-V617F mutation and its finding in patients with splanchnic vein thrombosis without an overt myeloproliferative neoplasm, many groups have studied the prevalence of this mutation in patients with unexplained venous and arterial thrombosis. METHODS: A literature search was made using the key words thrombosis, JAK2V617F mutation, myeloproliferative neoplasms, cerebral vein thrombosis and splanchnic vein thrombosis. RESULTS: JAK2V617F is frequent in patients with splanchnic vein thrombosis, but is rare in patients with venous thrombosis at other locations or with arterial thrombosis. CONCLUSION: Routine testing for JAK2V617F is not currently recommended for patients with unexplained thromboses, except for those with splanchnic vein thrombosis. In patients with cerebral vein thrombosis, the value of testing for JAK2V617F mutation is yet to be established.


Assuntos
Testes Genéticos , Janus Quinase 2/genética , Mutação , Trombose/genética , Veias Cerebrais/patologia , Predisposição Genética para Doença , Testes Genéticos/normas , Humanos , Veias Mesentéricas/patologia , Transtornos Mieloproliferativos/complicações , Transtornos Mieloproliferativos/genética , Trombose/etiologia
10.
Int J Neurosci ; 119(9): 1399-418, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19922364

RESUMO

Clinical signs appearance and significant increases of ICAM-1 and MMP-2 expressions with the clusters of VCAM-1(+) immunoreactivity in the choroids plexus epithelium to transferred anti-myelin oligodendroglial antibodies into the third brain ventricle, indicate important role of choroids plexus in the induction of acute experimental autoimmune encephalomyelitis (EAE). Magnetic brain stimulation with AKMA micro-magnet flux density of 60 miliTesla, 5 mm in diameter, implanted upon the pineal gland (PG), immediately after antibody injection, significantly decreases the expression of MMP-2 and ICAM-1 in the choroids plexus of the rat brain and abruptly suppresses the induction of acute EAE.


Assuntos
Adesão Celular/fisiologia , Plexo Corióideo/metabolismo , Estimulação Encefálica Profunda , Encefalomielite Autoimune Experimental/prevenção & controle , Molécula 1 de Adesão Intercelular/biossíntese , Metaloproteinase 2 da Matriz/biossíntese , Molécula 1 de Adesão de Célula Vascular/biossíntese , Animais , Contagem de Células , Plexo Corióideo/efeitos dos fármacos , Eletrodos Implantados , Encefalomielite Autoimune Experimental/patologia , Feminino , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Masculino , Bainha de Mielina/metabolismo , Oligodendroglia/patologia , Ratos , Terceiro Ventrículo/metabolismo , Regulação para Cima
11.
Int J Tuberc Lung Dis ; 13(8): 982-8, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19723378

RESUMO

BACKGROUND: In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil. SETTING: Two public general hospitals with large open emergency rooms in Rio de Janeiro City. OBJECTIVE: To evaluate the contribution of TB death surveillance in detecting gaps in TB control. METHODS: We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases. RESULTS: Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected. CONCLUSION: TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.


Assuntos
Atestado de Óbito , Tuberculose/mortalidade , Brasil/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Feminino , Hospitais Públicos , Humanos , Masculino , Vigilância da População , Tuberculose/prevenção & controle
13.
Scand J Clin Lab Invest ; 67(8): 877-84, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17852820

RESUMO

The diagnosis of pleural tuberculosis (pTB) is difficult, and more sensitive and specific techniques are needed. In the period August 1998 to November 2002, we evaluated 132 patients with a pleural effusion submitted to a thoracentesis and pleural biopsy in a tertiary care hospital in Rio de Janeiro, Brazil. Three tests were performed and compared in the pleural fluid: ADA activity measurement, IgA-ELISA for two combined specific Mycobacterium tuberculosis antigens, and polymerase chain reaction (PCR) for detection of M. tuberculosis DNA. Ninety-five patients (72%) were given a final diagnosis of pTB. Overall histopathologic sensitivity was 77%. The sensitivities of pleural fluid culture and AFB smear were 42% and 1%, respectively. Twenty-one (22%) additional patients had a clinical diagnosis of pTB. Median follow-up time of all TB patients after the completion of antituberculous treatment was 13 months. Sensitivities of ADA, IgA-ELISA and PCR were 91%, 78% and 82%, while specificities were 93%, 96% and 85%, respectively. Only ADA sensitivity was significantly higher than the histopathologic examination (McNemar chi2 test; p = 0.002) and also significantly higher than ELISA (p = 0.049), but not higher than PCR (p = 0.143). We conclude that the routine use of ADA activity measurement in pleural fluid can obviate the need for a pleural biopsy in the initial diagnostic approach to pleural effusions, while IgA-ELISA and PCR techniques, potentially more specific tests, need further refinement to improve their accuracy.


Assuntos
Adenosina Desaminase/análise , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina A/análise , Cavidade Pleural/enzimologia , Reação em Cadeia da Polimerase/métodos , Tuberculose Pleural/diagnóstico , Tuberculose Pleural/enzimologia , Adenosina Desaminase/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , DNA Bacteriano/análise , DNA Bacteriano/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Pleural/patologia , Sensibilidade e Especificidade
14.
Histopathology ; 46(3): 328-33, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15720419

RESUMO

AIMS: Diffuse large B-cell lymphoma (DLBCL) is characterized by marked biological heterogeneity. The identification of reproducible parameters that can be combined with the International Prognostic Index (IPI) to better predict outcome could lead to the development of effective risk-adaptive strategies. METHODS AND RESULTS: Bcl-2 and CD10 expression was determined by immunohistochemistry. The impact of the positivity on survival was evaluated in combination with the IPI in 86 patients with a confirmed diagnosis of DLBCL. Patients were divided according to the IPI into low-risk (no to two factors) or high-risk (three to five factors) groups. Positivity rates were 25% for CD10 and 42% for Bcl-2. In a Cox analysis, the high-risk IPI group [hazard ratio (HR) 5.98, P < 0.0001) and Bcl-2 expression (HR 2.43, P = 0.02) were independent poor prognostic factors, and expression of CD10 (HR 0.41, P = 0.052) predicted a favourable outcome. Among patients in the low-risk IPI group, CD10 positivity was associated with an excellent 8-year overall survival (92% versus 45%, P = 0.06). In the high-risk IPI group, Bcl-2 positivity identified a subgroup with invariably fatal disease. CONCLUSIONS: The expression of CD10 in the low-risk IPI group, and the expression of Bcl-2 in the high-risk IPI group can identify two subgroups of patients who might benefit from new risk-adaptive treatment approaches.


Assuntos
Linfoma Difuso de Grandes Células B/patologia , Neprilisina/biossíntese , Proteínas Proto-Oncogênicas c-bcl-2/biossíntese , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Linfoma Difuso de Grandes Células B/classificação , Linfoma Difuso de Grandes Células B/metabolismo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Fatores de Risco , Análise de Sobrevida
15.
Arch Pediatr Adolesc Med ; 155(12): 1369-73, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11732958

RESUMO

OBJECTIVE: To compare tuberculosis skin test (TST) reading rates between children whose tests were read by school nurses following specific requests by physicians and those who relied on their parents to get their tests read, either at school or at the physician's office. DESIGN: A randomized controlled trial. SETTING: An urban hospital-based pediatric practice. PARTICIPANTS: Healthy low-income Hispanic and African American children aged 5 to 17 years whose physicians ordered TSTs at their routine physical examinations. Subjects attended 1 of 68 public schools. Nurses at these schools were willing to read student TSTs, and received instructions about how to read and report the results back to the physician's office. INTERVENTION: Subjects were randomized to a control group (routine TST placement, with no physician-to-school nurse communication) or to an intervention group (routine TST placement, with physician-to-school nurse communication). MAIN OUTCOME MEASURES: Tuberculosis skin test reading rates between the 2 groups were compared. Impediments to TST reading and reporting were investigated. RESULTS: One hundred thirty-four children were enrolled, 54 (40%) in the control group and 80 (60%) in the intervention group. More patients in the intervention group had their TSTs read by 72 hours compared with those in the control group (74 [92%] vs 30 [56%]; P<.001). The low reading rate in the control group was best attributed to communication failures. CONCLUSION: Systematic collaboration with school nurses can increase TST reading rates.


Assuntos
Comportamento Cooperativo , Serviços de Enfermagem Escolar , Teste Tuberculínico , Tuberculose/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Hospitais Urbanos , Humanos , Masculino , Satisfação do Paciente , Fatores Socioeconômicos , Fatores de Tempo
16.
Ann Otol Rhinol Laryngol ; 110(11): 1007-10, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11713909

RESUMO

To develop a model for recurrent anterior glottic stenosis and to test the efficacy of topical mitomycin-C in preventing restenosis, we induced anterior glottic stenosis with a CO2 laser in 5 dogs. In 3 dogs, recurrence was established after surgical lysis. Subsequently, the 3 dogs received a single topical 3-minute treatment with a 1% solution of mitomycin-C after a second surgical lysis. In a parallel experiment, the other 2 dogs received a single topical 3-minute treatment with a 1% solution of mitomycin-C after the initial surgical lysis. An anterior glottic web was induced in all 5 dogs with the CO2 laser. The 3 dogs experienced restenosis at the anterior glottis after surgical lysis alone. Mitomycin-C prevented anterior glottic restenosis in 2 of the 3 dogs treated twice and in both of the dogs treated once (p = .02). We conclude that a recurrent stenosis of the anterior glottis may be induced reproducibly in the canine model with the CO2 laser. Application of topical mitomycin-C after lysis of an anterior glottic stenosis produces a statistically significant reduction in the rate of restenosis as compared to surgical lysis alone.


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Glote , Laringoestenose/prevenção & controle , Mitomicina/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Administração Tópica , Animais , Modelos Animais de Doenças , Cães , Laringoestenose/cirurgia , Recidiva
17.
J Adv Nurs ; 36(2): 266-9, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11580801

RESUMO

Obesity/overweight in adults and children is a worldwide health problem associated with substantial economic burden as measured by paid sick leave, life and disability insurance rates, and obesity-related physician visits and hospital stays. Overweight/obese people experience hypertension, elevated cholesterol, and type 2 diabetes and suffer more joint and mobility problems than people within the normal weight for height range. While there is need to understand individual behaviors that can be modified to promote weight loss and weight maintenance, there is as great a need to consider contextual factors at the societal level that can impede or even sabotage weight control efforts. In every country with improved living standards people will continue to eat too much and engage in too little physical activity. The call for action is for all modernized societies to alter environments and attitudes to support, rather than hinder, healthy dietary intake and being physically active.


Assuntos
Saúde Global , Promoção da Saúde/organização & administração , Avaliação das Necessidades/organização & administração , Obesidade/epidemiologia , Obesidade/prevenção & controle , Absenteísmo , Adulto , Criança , Efeitos Psicossociais da Doença , Diabetes Mellitus Tipo 2/etiologia , Exercício Físico , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hiperlipidemias/etiologia , Hipertensão/etiologia , Artropatias/etiologia , Estilo de Vida , Obesidade/complicações , Fatores de Risco , Apoio Social , Valores Sociais
18.
Plast Reconstr Surg ; 108(5): 1268-75, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11604630

RESUMO

Laser scar revision was studied to measure the effects of targeting extracellular matrix protein versus tissue water on scar revision. We compared the free electron laser used at 7.7 microm (the amide III protein absorption band) to the carbon dioxide (CO2) laser and dermabrasion.Nude mice (n = 40) that had rejected skin grafts on their dorsal surface and developed mature scars were used as a model for scar revision. One-half of each scar was revised with either the free electron laser at 7.7 microm (32 to 38 mJ, nonoverlapping pulses delivered with a computerized adjustable pattern generator at 30 Hz, and two to three passes), a 100-microsec CO2 resurfacing laser (500 mJ, 5.0 Hz, and two to five passes), or dermabrasion. The untreated portion of each scar served as an internal control. Evaluation was by measurement of the clinical size of the scar using photography with quantitative computer image analysis to compare the data and histology to evaluate the quality and depth of the scars. The free electron laser at 7.7 microm was significantly better than the CO2 laser and dermabrasion for scar size reduction (p < 0.046 and p < 0.018). The CO2 laser and a highly skilled dermabrader were not statistically significantly different (p < 0.44). The result seen with less skilled dermabraders was significantly worse than all other methods (p < 0.009). The free electron laser at 7.7 microm, which is preferentially absorbed by the proteins of the extracellular matrix, provided better scar reduction than the CO2 resurfacing laser and dermabrasion. Dermabrasion by a skilled operator resulted in improvement similar to the results obtained with the CO2 resurfacing laser, but less skilled operators had significantly poorer results.


Assuntos
Cicatriz/cirurgia , Terapia a Laser , Animais , Dermabrasão , Terapia a Laser/métodos , Camundongos , Camundongos Nus
19.
Oncol Rep ; 8(3): 693-6, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11295104

RESUMO

We investigated the presence of free mRNA in the plasma of patients with chronic myeloid leukemia (CML), through RT-PCR analysis of G3PDH, a metabolism gene. We also analysed the presence of mRNA for HLM, a human oxysterol-binding protein homologue recently described as a potential marker for blood dissemination of solid tumors. Our results showed the presence of metabolism G3PDH mRNA in the plasma of 5/11 (45%) CML patients studied but HLM mRNA was not detected in any of the plasma studied. HLM mRNA was detected in the leukocytes of 4/5 (80%) CML patients. This work reports for the first time free mRNA in the plasma of CML patients. Our results also suggest that the detection of HLM could be a potential molecular marker for the follow-up in hematological malignancies.


Assuntos
Gliceraldeído-3-Fosfato Desidrogenases/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , RNA Mensageiro/análise , RNA Neoplásico/genética , Receptores de Esteroides/genética , Primers do DNA/química , Eletroforese em Gel de Poliacrilamida , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucócitos/metabolismo , RNA Mensageiro/sangue , RNA Neoplásico/sangue , Receptores de Esteroides/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa
20.
Oncol Rep ; 8(2): 441-4, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11182071

RESUMO

Institutions that treat patients with lymphoma must know their local therapy results and adapt their treatment strategies accordingly. To allow the application of the international prognostic factor index (IPI) in institutions where some of the data necessary are not available, we devised an approach by which the missing data would not impair the applicability of the index. We also collapsed the four categories of the IPI into two categories, and applied this adapted IPI to patients with aggressive non-Hodgkin's lymphoma treated in a public university hospital. Among the 72 patients treated with combination chemotherapy regimens containing doxorubicin, the following outcomes were observed for low and high risk groups, respectively: complete remission rates were 62% and 45% (p=0.2), overall survival rates were 48% and 14% (p=0.0098) and failure-free survival rates were 44% and 17% (p=0.03). This adapted IPI was very effective in predicting the outcome in the patients studied. The survival rates observed in our population were substantially lower than the rates reported in the IPI study. Patient selection might have played an important role in this difference, although other factors related to the social and general health status of the patients treated need to be prospectively studied.


Assuntos
Linfoma não Hodgkin/mortalidade , Linfoma não Hodgkin/terapia , Adolescente , Adulto , Idoso , Algoritmos , Medula Óssea/patologia , Brasil , Criança , Intervalo Livre de Doença , Feminino , Hospitais Públicos , Hospitais Universitários , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Medição de Risco , Neoplasias Esplênicas/mortalidade , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/terapia , Taxa de Sobrevida , População Urbana
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