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1.
J Pediatr Adolesc Gynecol ; 35(6): 659-661, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35760285

RESUMO

STUDY OBJECTIVE: To determine whether differences exist between the acute presentations and post-assault needs of youth presenting to an emergency department (ED) following multiple perpetrator sexual assault (MPSA) compared with those presenting after single perpetrator sexual assault. METHODS: A retrospective cohort study of all female adolescents evaluated in an urban pediatric ED between 2014 and 2021 for acute sexual assault was conducted. Demographic characteristics and assault outcomes were assessed using bivariate analyses. RESULTS: Survivors of MPSA were not more likely than survivors of single perpetrator assaults to be diagnosed with an anal-genital injury or sexually transmitted infection but were more likely to re-present in the subsequent year for an emergent mental health concern (31% vs 11%, P = .001), including suicide attempt (6% vs 1%, P = .022). CONCLUSION: The high rate of subsequent ED visits for mental health concerns among female adolescent survivors of MPSA highlights the need for providing specialized support to this population.


Assuntos
Vítimas de Crime , Delitos Sexuais , Criança , Adolescente , Humanos , Feminino , Estudos Retrospectivos , Vítimas de Crime/psicologia , Serviço Hospitalar de Emergência
3.
JCO Oncol Pract ; 17(12): e1879-e1886, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34133219

RESUMO

PURPOSE: Multiple studies have demonstrated the negative impact of cancer care delays during the COVID-19 pandemic, and transmission mitigation techniques are imperative for continued cancer care delivery. We aimed to gauge the effectiveness of these measures at the University of Pennsylvania. METHODS: We conducted a longitudinal study of SARS-CoV-2 antibody seropositivity and seroconversion in patients presenting to infusion centers for cancer-directed therapy between May 21, 2020, and October 8, 2020. Participants completed questionnaires and had up to five serial blood collections. RESULTS: Of 124 enrolled patients, only two (1.6%) had detectable SARS-CoV-2 antibodies on initial blood draw, and no initially seronegative patients developed newly detectable antibodies on subsequent blood draw(s), corresponding to a seroconversion rate of 0% (95% CI, 0.0 TO 4.1%) over 14.8 person-years of follow up, with a median of 13 health care visits per patient. CONCLUSION: These results suggest that patients with cancer receiving in-person care at a facility with aggressive mitigation efforts have an extremely low likelihood of COVID-19 infection.


Assuntos
COVID-19 , Neoplasias , Humanos , Estudos Longitudinais , Neoplasias/terapia , Pandemias , SARS-CoV-2 , Soroconversão
4.
JNCI Cancer Spectr ; 5(1): Pkaa120, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33554040

RESUMO

Cancer patients are a vulnerable population postulated to be at higher risk for severe coronavirus disease 2019 (COVID-19) infection. Increased COVID-19 morbidity and mortality in cancer patients may be attributable to age, comorbidities, smoking, health care exposure, and cancer treatments, and partially to the cancer itself. Most studies to date have focused on hospitalized patients with severe COVID-19, thereby limiting the generalizability and interpretability of the association between cancer and COVID-19 severity. We compared outcomes of SARS-CoV-2 infection in 323 patients enrolled in a population-based study before the pandemic (n = 67 cancer patients; n = 256 noncancer patients). After adjusting for demographics, smoking status, and comorbidities, a diagnosis of cancer was independently associated with higher odds of hospitalization (odds ratio = 2.16, 95% confidence interval = 1.12 to 4.18) and 30-day mortality (odds ratio = 5.67, 95% confidence interval = 1.49 to 21.59). These associations were primarily driven by patients with active cancer. These results emphasize the critical importance of preventing SARS-CoV-2 exposure and mitigating infection in cancer patients.


Assuntos
COVID-19/complicações , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Neoplasias/complicações , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias/terapia , Razão de Chances , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Fatores de Risco , SARS-CoV-2/fisiologia , Taxa de Sobrevida
5.
medRxiv ; 2021 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-33469597

RESUMO

Multiple studies have demonstrated the negative impact of cancer care delays during the COVID-19 pandemic, and transmission mitigation techniques are imperative for continued cancer care delivery. To gauge the effectiveness of these measures at the University of Pennsylvania, we conducted a longitudinal study of SARS-CoV-2 antibody seropositivity and seroconversion in patients presenting to infusion centers for cancer-directed therapy between 5/21/2020 and 10/8/2020. Participants completed questionnaires and had up to five serial blood collections. Of 124 enrolled patients, only two (1.6%) had detectable SARS-CoV-2 antibodies on initial blood draw, and no initially seronegative patients developed newly detectable antibodies on subsequent blood draw(s), corresponding to a seroconversion rate of 0% (95%CI 0.0-4.1%) over 14.8 person-years of follow up, with a median of 13 healthcare visits per patient. These results suggest that cancer patients receiving in-person care at a facility with aggressive mitigation efforts have an extremely low likelihood of COVID-19 infection.

7.
medRxiv ; 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32817956

RESUMO

Cancer patients are a vulnerable population postulated to be at higher risk for severe COVID-19 infection. Increased COVID-19 morbidity and mortality in cancer patients may be attributable to age, comorbidities, smoking, healthcare exposure, and cancer treatments, and partially to the cancer itself. Most studies to date have focused on hospitalized patients with severe COVID-19, thereby limiting the generalizability and interpretability of the association between cancer and COVID-19 severity. We compared outcomes of SARS-CoV-2 infection in 323 patients enrolled prior to the pandemic in a large academic biobank (n=67 cancer patients and n=256 non-cancer patients). After adjusting for demographics, smoking status, and comorbidities, a diagnosis of cancer was independently associated with higher odds of hospitalization (OR 2.16, 95% CI 1.12-4.18) and 30-day mortality (OR 5.67, CI 1.49-21.59). These associations were primarily driven by patients with active cancer. These results emphasize the critical importance of preventing SARS-CoV-2 exposure and mitigating infection in cancer patients.

8.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-20174961

RESUMO

Cancer patients are a vulnerable population postulated to be at higher risk for severe COVID-19 infection. Increased COVID-19 morbidity and mortality in cancer patients may be attributable to age, comorbidities, smoking, healthcare exposure, and cancer treatments, and partially to the cancer itself. Most studies to date have focused on hospitalized patients with severe COVID-19, thereby limiting the generalizability and interpretability of the association between cancer and COVID-19 severity. We compared outcomes of SARS-CoV-2 infection in 323 patients enrolled prior to the pandemic in a large academic biobank (n=67 cancer patients and n=256 non-cancer patients). After adjusting for demographics, smoking status, and comorbidities, a diagnosis of cancer was independently associated with higher odds of hospitalization (OR 2.16, 95% CI 1.12-4.18) and 30-day mortality (OR 5.67, CI 1.49-21.59). These associations were primarily driven by patients with active cancer. These results emphasize the critical importance of preventing SARS-CoV-2 exposure and mitigating infection in cancer patients.

9.
ACS Chem Biol ; 13(7): 1824-1831, 2018 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-29397684

RESUMO

Small heat shock protein (sHSP)-B7 (HSPB7) is a muscle-specific member of the non-ATP-dependent sHSPs. The precise role of HSPB7 is enigmatic. Here, we disclose that zebrafish Hspb7 is a kinetically privileged sensor that is able to react rapidly with native reactive electrophilic species (RES), when only substoichiometric amounts of RES are available in proximity to Hspb7 expressed in living cells. Among the two Hspb7-cysteines, this RES sensing is fulfilled by a single cysteine (C117). Purification and characterizations in vitro reveal that the rate for RES adduction is among the most efficient reported for protein-cysteines with native carbonyl-based RES. Covalent-ligand binding is accompanied by structural changes (increase in ß-sheet-content), based on circular dichroism analysis. Among the two cysteines, only C117 is conserved across vertebrates; we show that the human ortholog is also capable of RES sensing in cells. Furthermore, a cancer-relevant missense mutation reduces this RES-sensing property. This evolutionarily conserved cysteine-biosensor may play a redox-regulatory role in cardioprotection.


Assuntos
Aldeídos/metabolismo , Proteínas de Choque Térmico HSP27/metabolismo , Aldeídos/química , Alquilação , Animais , Linhagem Celular Tumoral , Cisteína/química , Células HEK293 , Proteínas de Choque Térmico HSP27/química , Proteínas de Choque Térmico HSP27/genética , Humanos , Cinética , Mutagênese , Estrutura Secundária de Proteína , Homologia de Sequência de Aminoácidos , Peixe-Zebra
10.
Nat Chem Biol ; 13(3): 333-338, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28114274

RESUMO

Isozyme-specific post-translational regulation fine tunes signaling events. However, redundancy in sequence or activity renders links between isozyme-specific modifications and downstream functions uncertain. Methods to study this phenomenon are underdeveloped. Here we use a redox-targeting screen to reveal that Akt3 is a first-responding isozyme sensing native electrophilic lipids. Electrophile modification of Akt3 modulated downstream pathway responses in cells and Danio rerio (zebrafish) and markedly differed from Akt2-specific oxidative regulation. Digest MS sequencing identified Akt3 C119 as the privileged cysteine that senses 4-hydroxynonenal. A C119S Akt3 mutant was hypomorphic for all downstream phenotypes shown by wild-type Akt3. This study documents isozyme-specific and chemical redox signal-personalized physiological responses.


Assuntos
Proteínas Proto-Oncogênicas c-akt/metabolismo , Células HEK293 , Humanos , Isoenzimas/metabolismo , Lipídeos , Oxirredução , Fenótipo , Proteínas Proto-Oncogênicas c-akt/genética
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