Tag: nevin manimala

Cancer. 2022 Mar 3. doi: 10.1002/cncr.34111. Online ahead of print.

ABSTRACT

BACKGROUND: Alcohol consumption is a risk factor for a number of communicable and non-communicable diseases, including several types of cancer. This article reports the burden of cancers attributable to alcohol consumption by age, sex, location, sociodemographic index (SDI), and cancer type from 1990 to 2019.

METHODS: The Comparative Risk Assessment approach was used in the 2019 Global Burden of Disease study to report the burden of cancers attributable to alcohol consumption between 1990 and 2019.

RESULTS: In 2019, there were globally an estimated 494.7 thousand cancer deaths (95% uncertainty interval [UI], 439.7 to 554.1) and 13.0 million cancer disability-adjusted life-years (DALYs; 95% UI, 11.6 to 14.5) that were attributable to alcohol consumption. The alcohol-attributable DALYs were much higher in men (10.5 million; 95% UI, 9.2 to 11.8) than women (2.5 million; 95% UI, 2.2 to 2.9). The global age-standardized death and DALY rates of cancers attributable to alcohol decreased by 14.7% (95% UI, 6.4% to 23%) and 18.1% (95% UI, 9.2% to 26.5%), respectively, over the study period. Central Europe had the highest age-standardized death rates that were attributable to alcohol consumption(10.3; 95% UI, 8.7 to12.0). Moreover, there was an overall positive association between SDI and the regional age-standardized DALY rate for alcohol-attributable cancers.

CONCLUSIONS: Despite decreases in age-standardized deaths and DALYs, substantial numbers of cancer deaths and DALYs are still attributable to alcohol consumption. Because there is a higher burden in males, the elderly, and developed regions (based on SDI), these groups and regions should be prioritized in any prevention programs.

PMID:35239973 | DOI:10.1002/cncr.34111

Carcinogenesis. 2022 Mar 3:bgac025. doi: 10.1093/carcin/bgac025. Online ahead of print.

ABSTRACT

There is increased incidence of prostate cancer (PC) among World Trade Center (WTC)-exposed responders and community members, with preliminary evidence suggestive of more aggressive disease. While previous research is supportive of differences in DNA methylation and gene expression as a consequence of WTC exposure, as measured in blood of healthy individuals, the epigenetics of WTC PC tissues has yet to be explored. Patients were recruited from the World Trade Center Health Program. Non-WTC PC samples were frequency matched on age, race/ethnicity and Gleason score. Bisulfite-treated DNA was extracted from tumor tissue blocks and used to assess global DNA methylation with the MethylationEPIC BeadChip. Differential and pathway enrichment analysis were conducted. RNA from the same tumor blocks was used for gene expression analysis to further support DNA methylation findings. Methylation data were generated for 28 samples (13 WTC and 15 non-WTC). Statistically significant differences in methylation were observed for 3,586 genes; on average WTC samples were statistically significantly more hypermethylated (p=0.04131). Pathway enrichment analysis revealed hypermethylation in epithelial mesenchymal transition (EMT), hypoxia, mitotic spindle, TNFA signaling via NFKB, WNT signaling, and TGF beta signaling pathways in WTC compared to non-WTC samples. The androgen response, G2M and MYC target pathways were hypomethylated. These results correlated well with RNA gene expression. In conclusion, long-term epigenic changes associated with WTC dust exposure were observed in PC tissues. These occurred in genes of critical pathways, likely increasing prostate tumorigenesis potential. This warrants analysis of larger WTC groups and other cancer types.

PMID:35239955 | DOI:10.1093/carcin/bgac025

Dental Press J Orthod. 2022 Feb 28;27(1):e2219388. doi: 10.1590/2177-6709.27.1.e2219388.oar. eCollection 2022.

ABSTRACT

INTRODUCTION: Currently, no method is considered effective for the evaluation of digital models in the Certification Examination of the Brazilian Board of Orthodontics (BBO), considering the parameters of the currently used manual method.

OBJECTIVE: Thus, the aim of this study is to verify the reliability of an evaluation method for digital models that could be used in the BBO exam, compared to the gold standard.

METHODS: Measurements were performed by five previously calibrated examiners. Samples of ten sets of plaster models of the final phase of orthodontic treatment were measured using a manual method (Objective Grading System, OGS). These models were digitized using a 3D scanner and exported to Geomagic Qualify software, in which the measurements were made with the proposed digital method. These measurements were repeated using five models, after fifteen days. The intra-examiner performance with this method was analyzed with a paired t-test, whereas the inter-examiner analysis was carried out with analysis of variance and Tukey’s test. To compare the manual and digital methods, a paired t-test and Pearson’s correlation analysis were performed.

RESULTS: A statistically significant difference was found. The results showed that, when compared to the manual method, the digital method was effective in measuring the OGS in four of the seven variables studied: Marginal Ridge, Overjet, Occlusal Contact, and Interproximal Contact. The variables Alignment, BL inclination, and Occlusal Relationship showed a great amount of dispersion in the findings.

CONCLUSION: Further studies are needed to develop an adequate digital methodology that can be used for all OGS variables.

PMID:35239942 | DOI:10.1590/2177-6709.27.1.e2219388.oar

Rev Assoc Med Bras (1992). 2022 Jan;68(1):31-36. doi: 10.1590/1806-9282.20210341.

ABSTRACT

OBJECTIVE: This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women.

METHODS: A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ2 test, ANOVA, and logistic regression.

RESULTS: The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11-4.90) when considering the whole sample. Women who aged 25-39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08-27.31).

CONCLUSION: Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.

PMID:35239934 | DOI:10.1590/1806-9282.20210341

Rev Assoc Med Bras (1992). 2022 Jan;68(1):19-23. doi: 10.1590/1806-9282.20210199.

ABSTRACT

OBJECTIVE: The objective of this study was to analyze the association between orthostatic changes in blood pressure and mortality in elderly cardiopath patients.

METHODS: A cohort of 455 elderly cardiopath patients, monitored at a referral outpatient cardiology clinic in Pernambuco, Brazil, from October 2015 to July 2018. The exposure groups were formed according to their orthostatic changes in blood pressure following the requirements of the Brazilian Guidelines for Hypertension.

RESULTS: Orthostatic hypotension was present in 46 patients (10.1%), 91 had orthostatic hypertension (20%), and 318 had no orthostatic alterations (69.9%). There were 52 deaths during follow-up. The results demonstrated that there was no statistically significant association between orthostatic hypotension and overall mortality (HR 1.30; 95%CI 0.53-3.14; p=0.567) nor between orthostatic hypertension and overall mortality (HR 0.95; 95%CI 0.65-1.39; p=0.34). Survival in relation to the exposure groups presented no statistically significant difference (p=0.504).

CONCLUSION: There was a low frequency of orthostatic hypotension and a mild high frequency of orthostatic hypertension when compared with previous studies, and no association was observed with overall mortality or with the survival time of elderly patients with heart disease.

PMID:35239932 | DOI:10.1590/1806-9282.20210199

Rev Assoc Med Bras (1992). 2022 Jan;68(1):24-30. doi: 10.1590/1806-9282.20210241.

ABSTRACT

OBJECTIVE: The objective of this study was to determine the frequency of burnout, global, and by dimension, in resident physicians of Federal University of Piauí, and to identify possible factors associated with the presence of the syndrome.

METHOD: This is a cross-sectional, observational, and descriptive study. Population: resident physicians in Federal University of Piauí’s medical residency programs (136 individuals). The frequency of burnout was investigated using the Maslach Burnout Inventory. Sociodemographic variables were evaluated through a questionnaire and their associations with the presence of the syndrome were tested.

RESULTS: A total of 67 (49.26%) residents answered the questionnaires. The burnout syndrome frequencies found were global=73.1%; EE=44.8%; DP=64.2%, and PA=47.8%. Statistically significant association was obtained between current year of residency and EE; between having children and PA; between current work routine and DP; and between the use of antidepressant/hypnotic medication and EE. Compared with residency programs, there was a difference in the EE dimension, which was higher among residents in internal medicine residents (88.9%) and pediatrics (83.3%). In the comparative analysis between global burnout levels and all variables evaluated, no associations were found.

CONCLUSION: Burnout syndrome was found in the majority of participating residents. There was an association between sociodemographic variables and the presence of isolated burnout dimensions, but not between sociodemographic variables and global burnout.

PMID:35239933 | DOI:10.1590/1806-9282.20210241

Rev Assoc Med Bras (1992). 2022 Feb;68(2):227-233. doi: 10.1590/1806-9282.20210979.

ABSTRACT

OBJECTIVE: The stroma surrounding the tumor cells is important in tumor progression and treatment resistance, besides the properties of tumor cells. Studies on the tumor stroma characteristics will contribute to the knowledge for new treatment approaches.

METHODS: A total of 363 breast cancer patients were evaluated for the tumor-stroma ratio. The percentage of stroma was visually assessed on hematoxylin-eosin stained slides. The cases of tumor-stroma ratio more than 50% were categorized as tumor-stroma ratio high, and those less than 50% and below were categorized as tumor-stroma ratio low.

RESULTS: Tumor-stroma ratio-high tumors had shorter overall survival (p=0.002). Disease-free survival tended to be shorter in tumor-stroma ratio-high tumors (p=0.082) compared with tumor-stroma ratio-low tumors. Tumor-stroma ratio was an independent prognostic parameter for the total group of patients (p=0.003) and also axillary lymph node metastasis and tumor-stroma ratio was statistically associated (p=0.004). Also, tumor-stroma ratio was an independent prognostic parameter in node-positive Luminal A and B subgroups for overall survival (p<0.001).

CONCLUSION: Tumor-stroma ratio is an independent prognostic parameter that can be evaluated quite easily in all molecular subtypes of all breast cancers and does not require extra cost and time to evaluate.

PMID:35239887 | DOI:10.1590/1806-9282.20210979

Rev Assoc Med Bras (1992). 2022 Feb;68(2):245-249. doi: 10.1590/1806-9282.20211040.

ABSTRACT

BACKGROUND: The infection caused by coronavirus disease 2019 can lead to respiratory sequelae in individuals who have experienced severe or mild symptoms.

METHODS: An observational, cross-sectional study was developed, following the STROBE guidelines. Maximal inspiratory and expiratory mouth pressures were assessed in 50 healthy young students (26 women, 24 men; age 22.20±2.41 years). The inclusion criteria were as follows: aged between 18 and 35 years; control group: not diagnosed with coronavirus disease 2019; and coronavirus disease 2019 group: diagnosed with coronavirus disease 2019, at least 6 months ago. The exclusion criteria were as follows: obese/overweight; infected with coronavirus disease 2019 or coronavirus disease 2019 symptoms in the last 6 months; smokers; and asthmatics.

RESULTS: When comparing with groups, the coronavirus disease 2019 group presented statistically significant lower maximal inspiratory pressure values compared with the control group (88.32±16.62 vs. 101.01±17.42 cm H2O; p=0.01). Regarding the maximal expiratory pressure, no significant differences were found. Similar results were found when performing a subgroup analysis by sex and group.

CONCLUSIONS: Young students who suffered from coronavirus disease 2019 asymptomatically or mildly at least 6 months ago presented a significant decrease in the inspiratory muscle strength as a sequel, so we believe that patients affected by this disease should have a brief postinfection assessment of this musculature to detect the indication for cardiorespiratory rehabilitation.

PMID:35239890 | DOI:10.1590/1806-9282.20211040

Rev Assoc Med Bras (1992). 2022 Feb;68(2):217-221. doi: 10.1590/1806-9282.20210833.

ABSTRACT

OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life.

METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention.

RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05).

CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.

PMID:35239885 | DOI:10.1590/1806-9282.20210833

Rev Assoc Med Bras (1992). 2022 Feb;68(2):183-190. doi: 10.1590/1806-9282.20210890.

ABSTRACT

OBJECTIVE: The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months.

METHODS: Our study was conducted between August 1, 2020 and April 30, 2021. At 1 month after discharge, follow-up evaluations, PFTs, and lung imaging were performed on patients aged above 18 years who had been diagnosed with COVID-19 pneumonia. In the 6th month, the PFTs were repeated for those with pulmonary dysfunction.

RESULTS: A total of 219 patients (mean age, 49±11.9 years) were included. Pathological PFT results were noted in the 1st month for 80 patients and in the 6th month for 46 (7 had obstructive disorder, 15 had restrictive disorder, and 28 had small airway obstruction) patients. A significant difference was found between abnormal PFT results and patient-described dyspnea in the 1st month of follow-up. The 6-month PFT values (especially those for forced vital capacity) were statistically significantly lower in the patients for whom imaging did not indicate complete radiological improvement at the 1-month follow-up. No statistically significant difference was found between the severity of the first computed tomography findings or clinical condition on emergency admission and pulmonary dysfunction (Pearson’s chi-square test, P=0.904; Fisher’s exact test, P=0.727).

CONCLUSION: It is important that patients with COVID-19 pneumonia be followed up for at least 1 month after discharge to be monitored for potential long-term lung damage. PFTs should be administered to those in whom ongoing dyspnea, which started with COVID-19, and/or full recovery were not identified in pulmonary imaging.

PMID:35239879 | DOI:10.1590/1806-9282.20210890