RESUMO
BACKGROUND: Sarcopenia is a prevalent and costly disease associated with serious negative health outcomes, and its prevalence will further grow as the percentage of elderly rises. Healthcare professionals play a crucial role in the prevention, identification and management of sarcopenia and in promoting the well-being of elders. Awareness and knowledge are the prerequisite and basis for these actions. OBJECTIVE: The objective of the review was to summarize available publications to identify the healthcare professionals' awareness and knowledge about sarcopenia, and to identify knowledge gaps that interventions could address. DESIGN: The scoping review will be performed based on the Scoping Review guidelines published by JBI in Australia. METHODS: Six electronic databases, including PubMed, Embase, CINAHL, Web of Science, Cochrane Library and CNKI were searched systematically. Two researchers independently screened the retrieved articles and extracted the information. RESULTS: A total of 6 studies were identified, including 5 quantitative studies and 1 qualitative study. These studies mainly were conducted in Australia, Netherlands and Brazil, and none from Asia. The awareness and knowledge of healthcare professionals about sarcopenia varied in different studies. With exception of one study conducted in oncology clinicians, other studies suggested that awareness and knowledge among healthcare professionals was incomplete and limited. CONCLUSION: The relatively few studies indicated that healthcare professionals had low awareness and limited knowledge of sarcopenia, which could influence and hinder the diagnosis and treatment of sarcopenia in practice. Future researches should develop a rigorously tested and valid sarcopenia knowledge assessment tool and researches conducted in larger samples are needed.
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Sarcopenia , Idoso , Brasil , Atenção à Saúde , Pessoal de Saúde , Humanos , Pesquisa Qualitativa , Sarcopenia/diagnóstico , Sarcopenia/prevenção & controleRESUMO
OBJECTIVE: To delineate the association of postoperative complications with clinicopathologic factors and to identify risk factors for tumor recurrence and mortality after tumor resection in patients with colorectal cancer (CRC). METHODS: The clinical data of 1144 patients with CRC who underwent surgical intervention between 2003 and 2013 were retrieved. Correlations of postoperative complications with clinicopathologic factors were examined using univariate analysis. Risk factors for tumor recurrence and mortality of the patients after tumor resection were identified using multivariate Cox proportional hazards models. Time to relapse and overall survival were analyzed using log-rank test of Kaplan-Meier analysis. RESULTS: Blood carcinoembryonic antigen (CEA) significantly correlated with early symptoms, preoperative manifestations, and tumor pathology. Low differentiation grade of tumor increased the risk of recurrence after surgery in all patients with CRC. In the same cohort of patients, elevated blood CEA, low differentiation grade of tumor, laparotomy, smoking history, and TNM stage IV and III increased the mortality risk after tumor resection. In patients with advanced colon cancer, risk for postoperative mortality was increased by blood CEA, advanced tumor stage, and low tumor differentiation grade; while in those with advanced rectal cancer, blood CEA, pathologic type other than mucinous/adenocarcinoma, and laparotomy were identified as significant risk factors. In both groups of patients, postoperative chemotherapy significantly reduced the risk of mortality. CONCLUSIONS: The present work has identified clinical factors increasing the risk of recurrence as well as mortality after surgery in more than 1,000 patients with CRC. Postoperative chemotherapy is associated with a significant reduction in the risk of mortality. All of these findings should provide insights into the better management of critically ill patients with CRC.
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Neoplasias Colorretais/cirurgia , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Complicações Pós-Operatórias/mortalidade , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
PURPOSE: Locally advanced rectal cancer (LARC) patients achieving ypT3 status following neoadjuvant chemoradiation are considered to have poor response with minimal downstaging. However, residual cancer cell amounts vary in the subserosa/perirectal fat. Tumor regression grading (TRG) is an evaluation method based on the proportion of fibrosis and residual cancer cells. The aim of this study is to assess the influence of TRG in ypT3 rectal cancer patients who received neoadjuvant chemoradiation. METHODS: We retrospectively reviewed 325 LARC patients who received neoadjuvant chemoradiation and surgery. TRG scores were recorded by two independent pathologists. Among these patients, 143 were staged as ypT3. We analyzed TRG and other clinicopathological factors and their relationship with survival outcome including overall survival (OS) and disease-free survival (DFS). RESULTS: Among 143 ypT3 patients, 44 (30.8 %) were TRG1, 84 (58.7 %) were TRG2 and 15 (10.5 %) were TRG3. Seventy-nine (55.3 %) of these patients had metastatic lymph nodes. In univariate analysis, TRG was not associated with DFS (TRG2 vs TRG1, P = 0.852; TRG3 vs TRG1, P = 0.593) or OS (TRG2 vs TRG1, P = 0.977; TRG3 vs TRG1, P = 0.665). Palliative surgery (HR 3.845; 95 % CI 1.670-8.857; P = 0.002) and metastatic lymph nodes after surgery (HR 5.894; 95 % CI 1.142-3.48; P = 0.015) were significantly associated with decreased DFS, while palliative surgery was the only factor associated with worse OS (HR 6.011; 95 % CI 2.150-16.810; P = 0.001). Palliative surgery (HR 3.923; 95 % CI 1.696-9.073; P = 0.001) and metastatic lymph nodes (HR 2.011; 95 % CI 1.152-3.512; P = 0.014) also showed prognostic significance for DFS in multivariate analysis. CONCLUSIONS: Residual cancer cells evaluated by TRG score after neoadjuvant chemoradiation do not influence survival outcome in ypT3 rectal cancer patients. However, lymph node status is a significant prognostic factor in ypT3 patients.
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Adenocarcinoma/patologia , Neoplasias Retais/patologia , Adenocarcinoma/mortalidade , Adenocarcinoma/terapia , Adulto , Idoso , Quimiorradioterapia , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Gradação de Tumores , Neoplasias Retais/mortalidade , Neoplasias Retais/terapia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
We investigated the distribution of endometrial lymphatic vessels and expression of forkhead box C2 (FOXC2) in normal endometrium during menstrual cycle and in endometrial adenocarcinoma. Full-thickness uterine samples and endometrial adenocarcinoma samples were collected for immunohistochemical analysis using D2-40 and FOXC2 mouse monoclonal antibodies. The lymphatic vessel density (LVD) of the endometrium was significantly reduced compared with the myometrium during the cycle. Intra-tumoral LVD was significantly decreased in both stages of endometrioid adenocarcinoma compared with normal endometrium and myometrium. Intra-tumoral LVD significantly decreased from stage IA to stage IIIC. Peri-tumoral LVD for stage IA and stage IIIC tumors was significantly increased compared with normal endometrial LVD, but decreased compared with normal myometrial LVD. Stage IIIC showed increased peri-tumoral LVD when compared with stage IA. The positive rate of FOXC2 was 73.3% in proliferative endometrium and 80% in secretory endometrium. Secretory endometrium showed significantly increased FOXC2 expression compared with proliferative endometrium. Endometrioid adenocarcinoma showed significantly increased FOXC2 expression compared with normal endometrium, both in the epithelium and stroma. FOXC2 expression in the stroma significantly increased when pelvic and/or para-aotic lymph nodes were involved. FOXC2 was immunolocalized in low-risk endometrial carcinoma in endometrioid adenocarcinoma, but not in normal endometrium. Endometrial lymphatic vessels were located in normal endometrium and myometrium across the menstrual cycle and in intra-and peri-endometrioid adenocarcinoma, and increased in endometrial adenocarcinoma. Peri-tumoral lymphatics were associated with increased lymphatic metastasis. FOXC2 may be associated with the genesis of endometrial carcinoma and lymphangiogensis in endometrial adenocarcinoma in intra- and peri-tumoral lymphatics.
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Carcinogênese/genética , Neoplasias do Endométrio/genética , Fatores de Transcrição Forkhead/genética , Linfonodos/metabolismo , Adulto , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Endométrio/metabolismo , Feminino , Fatores de Transcrição Forkhead/biossíntese , Regulação Neoplásica da Expressão Gênica , Humanos , Histerectomia , Linfonodos/patologia , Metástase Linfática , Ciclo Menstrual/genética , Pessoa de Meia-IdadeRESUMO
Two new species of the tetrigid genus Criotettix Bolivar from China, namely Criotettix interruptaoides Deng & Zheng n. sp. and Criotettix shiwanshanensis Deng & Zheng n. sp. are described. An updated key to all known species of the genus from China is given.
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Ortópteros/classificação , Animais , ChinaRESUMO
Numerous studies have evaluated the association between estrogen receptor alpha (ESR1) gene PvuII polymorphism and fracture risk in postmenopausal women. However, the results have been inconsistent. We performed a meta-analysis to examine the association between the ESR1 gene PvuII polymorphism and fracture risk in postmenopausal women. Studies published from PubMed, Google Scholar, and China National Knowledge Infrastructure data were retrieved. Pooled odds ratios with 95% confidence intervals were calculated using fixed- or random-effects models. A total of 6 case-control studies containing 592 patients and 705 controls were included in this meta-analysis. We found no association between the PvuII polymorphism in the ESR1 gene and fracture in postmenopausal women. Taking into account the effect of ethnicity, further stratified analyses were performed. In the subgroup analysis, no significant association was found in Caucasians and in Asians. No publication bias was found in the present study (all P > 0.05). In conclusion, the ESR1 gene PvuII polymorphism may not be associated with fracture risk in postmenopausal women. Additional larger studies are needed to confirm this conclusion.
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Desoxirribonucleases de Sítio Específico do Tipo II/genética , Receptor alfa de Estrogênio/genética , Fraturas Ósseas/genética , Predisposição Genética para Doença/genética , Fraturas por Osteoporose/genética , Polimorfismo Genético , Idoso , Povo Asiático , Estudos de Casos e Controles , Feminino , Fraturas Ósseas/etnologia , Genótipo , Humanos , Íntrons , Razão de Chances , Osteoporose Pós-Menopausa/etnologia , Osteoporose Pós-Menopausa/genética , Fraturas por Osteoporose/etnologia , Pós-Menopausa , Fatores de Risco , População BrancaRESUMO
The effects of high glucose on the expression of monocyte chemoattractant protein-1 (MCP-1) and the main component of the extracellular matrix, fibronectin (FN), were explored in human mesangial cells (HMCs), along with the intervention effects of mycophenolate mofetil (MMF) on these indicators. Cultured HMCs were divided into five groups: 1) normal control group (5 mM glucose); 2) high glucose group (30 mM glucose); 3) mannitol osmotic pressure control group (5 mM glucose + 25 mM mannitol); 4) high glucose + MMF-10 group (30 mM glucose + 10 µg/mL MMF); 5) high glucose + MMF-100 group (30 mM glucose + 100 µg/mL MMF). At 24, 48, and 72 h, reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay methods were used to detect the effects of MMF on MCP-1 mRNA and protein and FN expression in HMCs under high glucose conditions. MCP-1 mRNA and protein expressions and FN secretion significantly increased in HMCs of the high glucose group compared with the normal control group (P < 0.01), with the highest expression observed at 48 h. MMF could reduce the MCP-1 mRNA and protein and FN expression levels (P < 0.01), and the inhibition occurred in a dose- and time-dependent manner (P < 0.05). In conclusion, MMF could inhibit MCP-1 expression and the secretion of FN, indicating that it may delay the progression of glomerulosclerosis and interstitial fibrosis in diabetic nephropathy to ultimately achieve protective effects on the kidney.
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Quimiocina CCL2/biossíntese , Fibronectinas/biossíntese , Regulação da Expressão Gênica/efeitos dos fármacos , Células Mesangiais/metabolismo , Células Cultivadas , Meios de Cultura , Nefropatias Diabéticas/tratamento farmacológico , Nefropatias Diabéticas/patologia , Glucose/farmacologia , Humanos , Rim/metabolismo , Rim/patologia , Ácido Micofenólico/administração & dosagem , Ácido Micofenólico/análogos & derivadosRESUMO
Two new species of the tetrigid genus Xistra Bolivar from China, namely Xistra oculata Li, Deng et Zheng n. sp. and Xistra brachynota Li, Deng et Zheng n. sp. are described. An updated key to all known species of the genus is given.
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Ortópteros/classificação , Animais , ChinaRESUMO
Characters of the tetrigid genus Alulatettix Liang are redescribed. Three new species, Alulatettix nigromarginalis n. sp., Alulatettix flavotibialis n. sp., and Alulatettix tianzhushanensis n. sp., are described. An updated key to the species of this genus is provided.
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Ortópteros/classificação , Animais , ChinaRESUMO
Four new species of Tetrigidae (Orthoptera) from Anhui province, China, are described, namely Paragavialidium anhuiensis n. sp. of Scelimeninae, Bolivaritettix jinzhaiensis n. sp. of Metrodorinae, Bannatettix anhuiensis n. sp., and Formosatettix albomaculatus n. sp. of Tetriginae.