Introducción: La obesidad es una enfermedad que se ha convertido en una preocupación importante de salud pública. El objetivo de esta investigación, fue analizar los cambios en la calidad de vida y ...en parámetros clínicos, fisiológicos y antropométricos en pacientes con obesidad, pertenecientes a un programa multidisciplinario para pérdida de peso.
Materiales y métodos: Estudio observacional de cohorte retrospectivo que incluyó pacientes con obesidad en un programa multidisciplinario. La comparación de variables cuantitativas al ingreso y egreso del programa se realizó con la prueba de rangos con signo de Wilcoxon, mientras que las variables cualitativas fueron comparadas con la prueba de McNemar. El análisis estadístico fue realizado en el programa STATA V.15.
Resultados: Se analizaron 323 pacientes, se observó que la mediana del peso disminuyo 4.4 kg (p<0.001). La adherencia a la actividad física aumentó de 30% (n=97) a 90% (n=289) (p<0.001). De igual modo, la mediana del VO2 max aumentó de 23.6 (RIC 19.7-30.4) al ingreso a 32.9 (RIC 27.8-38) al egreso. En cuanto a calidad de vida, el autocuidado fue una de las dimensiones con mayor impacto durante el programa, con una disminución en el reporte de dificultades extremas de 17.7% a 0.3%. Asimismo, la escala visual análoga (EVA) aumento la mediana de 50 (RIC 50-70) a 80 (RIC 70-90) (p<0.001).
Conclusión: El abordaje multidisciplinario de la obesidad ofrece un enfoque integral al paciente, impactando no solo aspectos físicos, sino psicológicos y emocionales del problema mejorando su calidad de vida.
Introduction: Obesity is a disease that has become a major public health concern. The objective of this research was to analyze the changes in the quality of life and in clinical, physiological, and anthropometric parameters in patients with obesity, belonging to a multidisciplinary program for weight loss.
Materials and methods: Observational retrospective cohort study that included obese patients in a multidisciplinary program. The comparison of quantitative variables at admission and discharge from the program was performed with the Wilcoxon signed rank test, while the qualitative variables were compared with the McNemar test. Statistical analysis was performed in the STATA V.15 program.
Results: 323 patients were analyzed; it was shown that the median weight decreased 4.4 kg (p<0.001). Adherence to physical activity increased from 30% (n=97) to 90% (n=289) (p<0.001). Similarly, the median VO2 max increased from 23.6 (IQR 19.7-30.4) on admission to 32.9 (IQR 27.8-38) on discharge. Regarding quality of life, self-care was one of the dimensions with the greatest impact during the program, with a decrease in the report of extreme difficulties from 17.7% to 0.3%. Likewise, the visual analogue scale (VAS) increased the median from 50 (RIC 50-70) to 80 (RIC 70-90) (p<0.001).
Conclusion: The multidisciplinary approach to obesity offers a comprehensive approach to the patient, impacting not only physical, but also psychological and emotional aspects of the problem, improving her quality of life.
Resumen: Introducción: la obesidad es una enfermedad que se ha convertido en una preocupación importante de salud pública. El objetivo de esta investigación, fue analizar los cambios en la calidad de ...vida y en los parámetros clínicos, fisiológicos y antropométricos en los pacientes con obesidad, pertenecientes a un programa multidisciplinario para pérdida de peso. Materiales y métodos: estudio observacional de cohorte retrospectivo que incluyó pacientes con obesidad en un programa multidisciplinario. La comparación de las variables cuantitativas al ingreso y egreso del programa se realizó con la prueba de rangos con signo de Wilcoxon, mientras que las variables cualitativas fueron comparadas con la prueba de McNemar. El análisis estadístico fue realizado en el programa STATA V.15. Resultados: se analizaron 323 pacientes, se observó que la mediana del peso disminuyó 4,4 kg (p < 0,001). La adherencia a la actividad física aumentó de 30% (n = 97) a 90% (n = 289) (p < 0,001). De igual modo, la mediana del VO2 max aumentó de 23,6 (RIC 19,7-30,4) al ingreso a 32,9 (RIC 27,8–38,0) al egreso. En cuanto a la calidad de vida, el autocuidado fue una de las dimensiones con mayor impacto durante el programa, con una disminución en el reporte de dificultades extremas de 17,7% a 0,3%. Asimismo, la escala visual análoga (EVA) aumento la mediana de 50 (RIC 50-70) a 80 (RIC 70-90) (p < 0,001). Conclusión: el abordaje multidisciplinario de la obesidad ofrece un enfoque integral al paciente, impactando no solo los aspectos físicos, sino psicológicos y emocionales del problema mejorando su calidad de vida. Abstract: Introduction: Obesity is a disease that has become a major public health concern. The objective of this research was to analyze the changes in the quality of life and in clinical, physiological, and anthropometric parameters in patients with obesity, belonging to a multidisciplinary program for weight loss. Materials and methods: Observational retrospective cohort study that included obese patients in a multidisciplinary program. The comparison of quantitative variables at admission and discharge from the program was performed with the Wilcoxon signed rank test, while the qualitative variables were compared with the McNemar test. Statistical analysis was performed in the STATA V.15 program. Results: 323 patients were analyzed; it was shown that the median weight decreased 4.4 kg (p < 0.001). Adherence to physical activity increased from 30% (n = 97) to 90% (n = 289) (p < 0.001). Similarly, the median VO2 max increased from 23.6 (IQR 19.7-30.4) on admission to 32.9 (IQR 27.8-38) on discharge. Regarding quality of life, self-care was one of the dimensions with the greatest impact during the program, with a decrease in the report of extreme difficulties from 17.7% to 0.3%. Likewise, the visual analogue scale (VAS) increased the median from 50 (RIC 50-70) to 80 (RIC 70-90) (p < 0.001). Conclusion: The multidisciplinary approach to obesity offers a comprehensive approach to the patient, impacting not only physical, but also psychological and emotional aspects of the problem, improving her quality of life.
Background and Aims
Extracellular vesicles (EVs) have emerged as a potential source of circulating biomarkers in liver disease. We evaluated circulating AV+ EpCAM+ CD133+ EVs as a potential biomarker ...of the transition from simple steatosis to steatohepatitis.
Methods
EpCAM and CD133 liver proteins and EpCAM+ CD133+ EVs levels were analysed in 31 C57BL/6J mice fed with a chow or high fat, high cholesterol and carbohydrates diet (HFHCC) for 52 weeks. The hepatic origin of MVs was addressed using AlbCrexmT/mG mice fed a Western (WD) or Dual diet for 23 weeks. Besides, we assessed plasma MVs in 130 biopsy‐proven NAFLD patients.
Results
Hepatic expression of EpCAM and CD133 and EpCAM+ CD133+ EVs increased during disease progression in HFHCC mice. GFP+ MVs were higher in AlbCrexmT/mG mice fed a WD (5.2% vs 12.1%) or a Dual diet (0.5% vs 7.3%). Most GFP+ MVs were also positive for EpCAM and CD133 (98.3% and 92.9% respectively), suggesting their hepatic origin. In 71 biopsy‐proven NAFLD patients, EpCAM+ CD133+ EVs were significantly higher in those with steatohepatitis compare to those with simple steatosis (286.4 ± 61.9 vs 758.4 ± 82.3; p < 0.001). Patients with ballooning 367 ± 40.6 vs 532.0 ± 45.1; p = 0.01 and lobular inflammation (321.1 ± 74.1 vs 721.4 ± 80.1; p = 0.001), showed higher levels of these EVs. These findings were replicated in an independent cohort.
Conclusions
Circulating levels of EpCAM+ CD133+ MVs in clinical and experimental NAFLD were increased in the presence of steatohepatitis, showing high potential as a non‐invasive biomarker for the evaluation and management of these patients.
Gls gene expression, Gls activity and protein expression were assessed by qPCR, fluorometric and IHC assays. The length of a microsatellite in the promoter region of GLS was assessed by capillary ...electrophoresis (long allele>14 GCA repeats). Results: Hepatic Gls expression was found to increase along with the progression of NAFLD (NASH fold-4.04±1.33; P=0.019 and P=0.033, respectively), being associated with ballooning (P=0.006) and significant fibrosis (P=0.019).
Recurrence risk in breast cancer varies throughout the follow-up time. We examined if these changes are related to the level of expression of the proliferation pathway and intrinsic subtypes.
...Expression of estrogen and progesterone receptor, Ki-67, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR) and cytokeratin 5/6 (CK 5/6) was performed on tissue-microarrays constructed from a large and uniformly managed series of early breast cancer patients (N = 1,249). Subtype definitions by four biomarkers were as follows: luminal A (ER + and/or PR+, HER2−, Ki-67 <14), luminal B (ER + and/or PR+, HER2−, Ki-67 ≥14), HER2-enriched (any ER, any PR, HER2+, any Ki-67), triple-negative (ER−, PR−, HER2−, any Ki-67). Subtype definitions by six biomarkers were as follows: luminal A (ER + and/or PR+, HER2−, Ki-67 <14, any CK 5/6, any EGFR), luminal B (ER + and/or PR+, HER2−, Ki-67 ≥14, any CK 5/6, any EGFR), HER2-enriched (ER−, PR−, HER2+, any Ki-67, any CK 5/6, any EGFR), Luminal-HER2 (ER + and/or PR+, HER2+, any Ki-67, any CK 5/6, any EGFR), Basal-like (ER−, PR−, HER2−, any Ki-67, CK5/6+ and/or EGFR+), triple-negative nonbasal (ER−, PR−, HER2−, any Ki-67, CK 5/6−, EGFR−). Each four- or six-marker defined intrinsic subtype was divided in two groups, with Ki-67 <14% or with Ki-67 ≥14%. Recurrence hazard rate function was determined for each intrinsic subtype as a whole and according to Ki-67 value.
Luminal A displayed a slow risk increase, reaching its maximum after three years and then remained steady. Luminal B presented most of its relapses during the first five years. HER2-enriched tumors show a peak of recurrence nearly twenty months post-surgery, with a greater risk in Ki-67 ≥14%. However a second peak occurred at 72 months but the risk magnitude was greater in Ki-67 <14%. Triple negative tumors with low proliferation rate display a smooth risk curve, but with Ki-67 ≥14% show sharp peak at nearly 18 months.
Each intrinsic subtype has a particular pattern of relapses over time which change depending on the level of activation of the proliferation pathway assessed by Ki-67. These findings could have clinical implications both on adjuvant treatment trial design and on the recommendations concerning the surveillance of patients.
Mutational analysis of the KRAS gene has recently been established as a complementary in vitro diagnostic tool for the identification of patients with colorectal cancer who will not benefit from ...anti-epidermal growth factor receptor (EGFR) therapies. Assessment of the mutation status of KRAS might also be of potential relevance in other EGFR-overexpressing tumors, such as those occurring in breast cancer. Although KRAS is mutated in only a minor fraction of breast tumors (5%), about 60% of the basal-like subtype express EGFR and, therefore could be targeted by EGFR inhibitors. We aimed to study the mutation frequency of KRAS in that subtype of breast tumors to provide a molecular basis for the evaluation of anti-EGFR therapies.
Total, genomic DNA was obtained from a group of 35 formalin-fixed paraffin-embedded, triple-negative breast tumor samples. Among these, 77.1% (27/35) were defined as basal-like by immunostaining specific for the established surrogate markers cytokeratin (CK) 5/6 and/or EGFR. KRAS mutational status was determined in the purified DNA samples by Real Time (RT)-PCR using primers specific for the detection of wild-type KRAS or the following seven oncogenic somatic mutations: Gly12Ala, Gly12Asp, Gly12Arg, Gly12Cys, Gly12Ser, Gly12Val and Gly13Asp.
We found no evidence of KRAS oncogenic mutations in all analyzed tumors.
This study indicates that KRAS mutations are very infrequent in triple-negative breast tumors and that EGFR inhibitors may be of potential benefit in the treatment of basal-like breast tumors, which overexpress EGFR in about 60% of all cases.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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