Porto biomedical journal最新文献

{"title":"Prognostic impact of thrombocytosis in gastric cancer—A retrospective study","authors":"B. Castro, Catarina Costa, Daniel Martins, A. Amado, Mariana Santos, Susana Graça, Amélia Tavares, António Ferreira, F. Viveiros, Sílvio Vale, Manuel Oliveira","doi":"10.1097/j.pbj.0000000000000247","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000247","url":null,"abstract":"Abstract BACKGROUND: Solid tumors are a common cause of secondary thrombocytosis, which has been identified as a prognostic factor in various cancers. However, the impact of thrombocytosis on the prognosis of gastric cancer is not yet well defined. The aim of this study was to assess the prevalence and prognostic value of thrombocytosis in patients with gastric cancer. METHODS: This was a retrospective study of patients with gastric carcinoma treated surgically, with curative intent, in our hospital, Centro Hospitalar Vila Nova de Gaia/Espinho, between January 2009 and December 2019. Clinical files were consulted and clinicopathological characteristics were analyzed. RESULTS: In the present sample (n = 352), the prevalence of pretreatment thrombocytosis was 16.5%. Thrombocytosis was associated with more advanced T stage, greater number of metastatic nodes, and more frequent lymphatic and venous permeation. The presence of thrombocytosis had a negative impact on disease-free survival (hazard ratio [HR] 3.54, 95% confidence interval [CI] 2.35–5.33, P < .001) and overall survival (HR 4.45, 95% CI 2.95–6.71, P < .001). CONCLUSIONS: The presence of pretreatment thrombocytosis had a negative impact on overall survival and disease-free survival and thus could be used as an independent prognostic factor.","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"45 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140076801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressiveness in systemic anticancer therapy at the end of life in an oncology center","authors":"J. Ferraz-Gonçalves, Inês Silva, Patrícia Redondo, M. Luís","doi":"10.1097/j.pbj.0000000000000248","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000248","url":null,"abstract":"Introduction: An increasing aggressiveness in cancer treatment at the end of life (EoL) has been reported in several, but not all, countries. This study aimed to see how aggressive cancer treatment is at the EoL in an oncology center. Methods: Retrospective study of patients 18 years or older with a solid cancer diagnosis who died in 2017. The focus was systemic anticancer therapy (SACT), excluding hormonotherapy. Results: In 2017, 2024 patients with solid tumors died. Of those patients, 1262 (62%) were male, and the median age was 69 (range 19–97) years. The most frequent primary cancer was lung cancer, followed by colorectal and stomach cancers, and 740 (37%) patients had metastatic disease. The median interval between SACT and death was 61 days. Of the patients undergoing SACT, 216 (27%) did it in the last month of life, 174 (22%) between 8 and 30 days from death, and 42 (5%) in the last week. On multivariable analysis, head and neck, colorectal, breast, and melanoma primaries; age group (older than 65 years); and metastatic disease had statistical significance associated with SACT. Of these variables, only metastatic disease is more likely to undergo SACT. Conclusion: This study confirms the relatively frequent aggressiveness in cancer treatment at the EoL. Taking into consideration previously published data, it can be tentatively concluded that the use of SACT increased in the last month and the last week of life.","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"51 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140077113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of syphilitic uveitis in a 61-year-old non-HIV woman","authors":"Rita Oliveira, Lídia Carvalho, Angélica Ramos, Maria João Cardoso, João Tiago Guimarães","doi":"10.1097/j.pbj.0000000000000242","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000242","url":null,"abstract":"","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139525440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with the malnutrition inflammation score (MIS) among hemodialysis patients in Dhaka city: a cross-sectional study in tertiary care hospitals.","authors":"Khanum Un Homaira Bint Harun, Mahbuba Kawser, Mohammad Hayatun Nabi, Dipak Kumar Mitra","doi":"10.1097/j.pbj.0000000000000243","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000243","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a progressive disease that leads to end-stage renal disease (ESRD). Malnutrition increases the risk of mortality among patients with ESRD. This study aimed to determine malnutrition prevalence and associated factors among twice-weekly (n = 94/120) and thrice-weekly (n = 26/120) hemodialysis patients/HDP.</p><p><strong>Method: </strong>A cross-sectional study was conducted at two tertiary-level public hospitals in Dhaka city using a consecutive sampling technique from April to June 2021. Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Multivariable ordinal logistic regression was performed to determine which socioeconomic, clinical, anthropometric, biochemical, and dietary factors are associated with MIS.</p><p><strong>Results: </strong>The prevalence of malnutrition was very high among HDP (severe 15.5%, mild/moderate 56.7%) with an average dialysis vintage of 28.7 months. Comorbidities (80.8%) and gastrointestinal symptoms/GIS (68.3%) were ubiquitous, and \"dialysis frequencies\" were not associated with MIS in bivariate analysis. Multivariable ordinal regression showed that anthropometric factors like mid-upper arm circumference/MUAC (adjusted odds ratio/AOR = 0.978), post-dialysis body mass index/BMI (AOR = 0.957), and biochemical parameters like albumin (AOR = 0.733) and TIBC/total iron binding capacity (AOR = 0.996) negatively (<i>P</i> < .05) associated with MIS. Moreover, having \"no GIS\" (AOR = 0.672, <i>P</i> < .001) was 33.0% less likely to be associated with MIS. Contrarily, as the month of dialysis increases, MIS increases by 22.0% (AOR = 1.22).</p><p><strong>Conclusion: </strong>Significant associations of clinical, anthropometric, and biochemical characteristics with MIS indicate the importance of routine screening of the nutritional status of patients with CKD to improve health status and prevent protein-energy wasting. The MIS could be a simple, noninvasive tool for testing nutritional status in patients with CKD.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 1","pages":"243"},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postlumpectomy imaging: is there a role for the study of the contralateral breast?-a retrospective cohort.","authors":"André M Pires, Jéssica R Rodrigues, Helena G Pereira","doi":"10.1097/j.pbj.0000000000000244","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000244","url":null,"abstract":"<p><strong>Background: </strong>Some patients with breast cancer submitted to breast-conserving surgery might benefit from a postlumpectomy imaging examination previously to radiation therapy. This aims to document the complete removal of cancer and might be accomplished using mammogram with breast and axillary ultrasonography. These modalities study not only the affected side but also the contralateral side. In fact, it is well-documented that women with breast cancer have an increased risk for contralateral breast cancer. Thus, we intended to evaluate the value of postlumpectomy imaging undertaken before adjuvant radiotherapy regarding the evaluation of the contralateral breast and axilla.</p><p><strong>Methods: </strong>In this retrospective study, medical records for patients with breast cancer submitted to breast-conserving surgery and referred to our radiotherapy unit between 2018 and 2019 were reviewed. All patients had to be submitted to bilateral mammogram with breast and axillary ultrasonography previously to radiotherapy. Patients with bilateral disease or with a history of breast cancer were excluded.</p><p><strong>Results: </strong>One thousand two hundred forty patients were analyzed. 19 (1.5%) had suspicious findings for contralateral breast disease, and 8 (0.6%) had a re-excision positive for residual malignancy. Higher age, invasive lobular carcinoma associated or not with lobular carcinoma in situ, and presence of lobular carcinoma in situ were associated with an increased risk for residual disease.</p><p><strong>Conclusion: </strong>Contralateral evaluation as part of postlumpectomy imaging revealed itself useful at detecting contralateral cancer, with some demographic and clinical features being associated with an increased risk for residual disease.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 1","pages":"244"},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From biodiversity to nature deficiency in human health and disease.","authors":"Tari Haahtela, Jean Bousquet, Josep M Antó","doi":"10.1097/j.pbj.0000000000000245","DOIUrl":"10.1097/j.pbj.0000000000000245","url":null,"abstract":"<p><p>Nature (biodiversity) loss is the loss or decline of the state of nature taking place in the wider environment. We present a novel concept, nature deficiency, referring to nature loss in the human body influencing health. Humans are connected with the natural environment and its microbes and biogenic chemicals through eating (drinking), breathing, and touching. The mental and sociocultural links to the environment are also strong. With medical and ecological research and guidelines, the diagnosis, prevention, and treatment of nature deficiency may become part of the clinical practice. Nature prescription is likely to find plausible forms in patient care and inspire preventive actions at the society level. Health professionals are in a key position to integrate public health promotion and environmental care.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 1","pages":"245"},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence and predictors of delirium in critically ill older patients: a prospective cohort study.","authors":"Rita Martins, Sónia Martins, Raquel Correia, Elika Pinho, Cristiana Paulo, Maria João Silva, Ana Teixeira, Liliana Fontes, Luís Lopes, José Artur Paiva, Luís Filipe Azevedo, Lia Fernandes","doi":"10.1097/j.pbj.0000000000000240","DOIUrl":"10.1097/j.pbj.0000000000000240","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyze the occurrence of delirium in critically ill older patients and to identify predictors of delirium.</p><p><strong>Methods: </strong>This prospective study included critically ill older patients admitted into level II units of Intensive Care Medicine Department of a University Hospital. Patients with Glasgow Coma Scale score ≤11, traumatic brain injury, terminal disease, history of psychosis, blindness/deafness, or inability to understanding/speaking Portuguese were excluded. The Confusion Assessment Method-Short Form (CAM-4) was used to assess the presence of delirium.</p><p><strong>Results: </strong>The final sample (n = 105) had a median age of 80 years, most being female (56.2%), widowed (49.5%), and with complete primary education (53%). Through CAM-4, 36.2% of the patients had delirium. The delirium group was more likely to have previous cognitive decline (48.6% vs 19.6%, <i>P</i> = .04) and severe dependency in instrumental activities of daily living (34.3% vs 14.8%, <i>P</i> = .032), comparing with patients without delirium. The final multiple logistic regression model explained that patients with previous cognitive decline presented a higher risk for delirium (odds ratio: 4.663, 95% confidence Interval: 1.055-20.599, <i>P</i> = .042).</p><p><strong>Conclusions: </strong>These findings corroborate previous studies, showing that cognitive decline is an independent predictor for delirium in older patients. This study is an important contribution for the knowledge regarding the predictors of delirium. The recognition of these factors will help to identify patients who are at high risk for this syndrome and implement early screening and prevention strategies. However, further studies with larger samples, recruited from other clinical settings as well as analyzing other potential factors for delirium, will be needed.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e240"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous gastrostomies in advanced cancer.","authors":"José António Ferraz-Gonçalves, Susana Amaral, Filipa Pereira, Lígia Rodrigues Santos, José Guilherme Assis, Sérgio Alves, Diana Martins","doi":"10.1097/j.pbj.0000000000000238","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000238","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrostomies can be performed percutaneously by interventional radiology (PRG) or endoscopy (PEG).</p><p><strong>Methods: </strong>Retrospective analysis of patients with advanced cancer who underwent a gastrostomy in 2017 in an oncology center.</p><p><strong>Results: </strong>In 2017, 164 patients underwent gastrostomies, and 137 (84%) were male. The median age was 60 years (range: 38-91). The predominant Eastern Cooperative Oncology Group (ECOG) performance status stage was 1, with 73 (45%) patients. Head and neck cancer was the most common diagnosis, with 127 (77%) cases. The most frequent reason for performing a gastrostomy was dysphagia, 132 (81%). Most gastrostomies were PEG, 121 (74%), followed by PRG, 41 (25%), and surgery, 2 (1%). Early complications occurred in 86 (52%) patients, and the most frequent of them were local pain in 69 (80%) patients and minor local bleeding in 13 (15%). Late complications occurred in 90 (55%) patients, and the most frequent was also local pain in 57 (63%) patients, followed by local infection in 8 (9%), tube extrusion in 7 (8%), and stomal leakage in 7 (8%). In the multivariable analysis, the factors associated with survival were lymph node metastases and the ECOG performance status. Until June 30th, 2022, 123 (75%) patients had died, and 41 (25%) were still alive.</p><p><strong>Conclusion: </strong>Gastrostomies were performed predominantly in ECOG performance stage 1 patients with head and neck cancer and symptoms of dysphagia, and PEG was the most common procedure.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e238"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease prevalence in asymptomatic patients with risk factors-usefulness of serum cystatin C: a cross-sectional study.","authors":"Mariela N Avila, María C Luciardi, Ana V Oldano, Mariano N Aleman, Rossana C Pérez Aguilar","doi":"10.1097/j.pbj.0000000000000233","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000233","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease is recognized as a worldwide public health problem, particularly within an increasing prevalence of obesity, diabetes mellitus, and hypertension. This disease affects more than 13% of the world's population and is increasing. Further biochemical assessment with new biomarkers, such as serum cystatin C (CysC), would improve patient care and disease control. The aim of this study was to detect chronic kidney disease (CKD) in asymptomatic subjects with risk factors and evaluate CysC as early biomarker of renal damage and accurate test to estimation glomerular filtration (GF).</p><p><strong>Methods: </strong>This observational analytic and cross-sectional design included 195 patients of both sexes. A full clinical evaluation included height, weight, waist circumference, body mass index (BMI), blood pressure (BP), and family history of disease. Renal function was evaluated through serum creatinine (SCrea), serum CysC, urinary albumin, and urinary creatinine. GF was calculated using CKD-EPI creatinine (CKD-EPI Crea) and CKD-EPI creatinine-cystatin C equations (CKD-EPI Crea-CysC).</p><p><strong>Results: </strong>Renal injury showed 24% of patients with albuminuria; 18% of them were categorized as A2 and 6% as A3. Therefore, 73% had no progression risk (baseline risk), 20% moderate risk, and 7% high risk. Among analyzed groups, significant differences were found in BMI, BP, Screa, CysC, CKD-EPI Crea, and CKD-EPI Crea-CysC. Overweight population was analyzed by assessing CysC and calculating CKD-EPI Crea-CysC, showing an important change with respect to the general population.</p><p><strong>Conclusion: </strong>Combined CysC and Crea measurement provides incremental improvement in predicting measured GF.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e233"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do health care professionals, students, and laypeople in Greece believe about informed consent for research on medical practices? Unleashing Pandora's box.","authors":"Vaitsa Giannouli","doi":"10.1097/j.pbj.0000000000000236","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000236","url":null,"abstract":"<p><strong>Background: </strong>Attitudes toward informed consent for research on medical practices has been little investigated in Greece in the general population as well as in health care students and professionals, and at the same time, undergraduate and postgraduate curricula with focus on informed consent issues are entirely missing.</p><p><strong>Methods: </strong>To explore attitudes toward informed consent for research on medical practices among students, doctors, and laypeople in Greece across several demographic variables. A total of 380 participants (180 first-year healthcare university students from various faculties including medicine, pharmacy, biology, nursing, physiotherapy, midwifery, health care engineers, 100 medical doctors of various specialties working in hospitals and private practice, and 100 laypeople) completed a survey questionnaire along with a detailed demographics questionnaire.</p><p><strong>Results: </strong>The results revealed that between the three groups, there were statistically significant differences in the responses for all aspects of attitudes toward informed consent. Overall, Greek participants reported more negative attitudes when compared with findings from the United States. In addition, most of the participants reported lack of educational experience regarding informed consent.</p><p><strong>Conclusion: </strong>The findings showed that the efforts and relevant initiatives by the Greek State, private institutions, and the Greek Medical Societies should refocus and emphasize on educational programs concerning the dissemination of relevant scientific information on informed consent processes, either as a provider or as a consumer. Future research should further investigate in more depth the complex influence of additional social and/or psychological factors for the reported differences.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e236"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}