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[PMID]:29318276
[Au] Autor:Plevritis SK; Munoz D; Kurian AW; Stout NK; Alagoz O; Near AM; Lee SJ; van den Broek JJ; Huang X; Schechter CB; Sprague BL; Song J; de Koning HJ; Trentham-Dietz A; van Ravesteyn NT; Gangnon R; Chandler Y; Li Y; Xu C; Ergun MA; Huang H; Berry DA; Mandelblatt JS
[Ad] Endereço:Departments of Radiology and Biomedical Data Science, School of Medicine, Stanford University, Stanford, California.
[Ti] Título:Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012.
[So] Source:JAMA;319(2):154-164, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. Objective: To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). Design, Setting, and Participants: Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. Exposures: Screening mammography and treatment. Main Outcomes and Measures: The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. Results: In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49% (model range, 39%-58%) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37% (model range, 26%-51%) of this reduction was associated with screening and 63% (model range, 49%-74%) with treatment. Of the 63% associated with treatment, 31% (model range, 22%-37%) was associated with chemotherapy, 27% (model range, 18%-36%) with hormone therapy, and 4% (model range, 1%-6%) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2-, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER-/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER-/ERBB2-, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%). Conclusions and Relevance: In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.
[Mh] Termos MeSH primário: Neoplasias da Mama/mortalidade
Detecção Precoce de Câncer
Mamografia
Modelos Estatísticos
[Mh] Termos MeSH secundário: Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/terapia
Feminino
Seres Humanos
Mamografia/métodos
Mortalidade/tendências
Receptor ErbB-2
Receptores Estrogênicos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Receptors, Estrogen); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19130


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[PMID]:29342379
[Au] Autor:Trivedi AN; Leyva B; Lee Y; Panagiotou OA; Dahabreh IJ
[Ad] Endereço:From the Departments of Health Services, Policy and Practice (A.N.T., B.L., Y.L., O.A.P., I.J.D.), and Epidemiology (I.J.D.), Brown University School of Public Health, and the Providence Veterans Affairs Medical Center (A.N.T.) - both in Providence, RI.
[Ti] Título:Elimination of Cost Sharing for Screening Mammography in Medicare Advantage Plans.
[So] Source:N Engl J Med;378(3):262-269, 2018 01 18.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography. METHODS: We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage. RESULTS: In plans that eliminated cost sharing, adjusted rates of biennial screening mammography increased from 59.9% (95% confidence interval [CI], 54.9 to 65.0) in the 2-year period before cost-sharing elimination to 65.4% (95% CI, 61.8 to 69.0) in the 2-year period thereafter. In control plans, the rates of biennial mammography were 73.1% (95% CI, 69.2 to 77.0) and 72.8% (95% CI, 69.7 to 76.0) during the same periods, yielding a difference in differences of 5.7 percentage points (95% CI, 3.0 to 8.4). The difference in differences was 9.8 percentage points (95% CI, 4.5 to 15.2) among women living in the areas with the highest quartile of educational attainment versus 4.3 percentage points (95% CI, 0.2 to 8.4) among women in the lowest quartile. As indicated by the difference-in-differences estimates, after the elimination of cost sharing, the rate of biennial mammography increased by 6.5 percentage points (95% CI, 3.7 to 9.4) for white women and 8.4 percentage points (95% CI, 2.5 to 14.4) for black women but was almost unchanged for Hispanic women (0.4 percentage points; 95% CI, -7.3 to 8.1). CONCLUSIONS: The elimination of cost sharing for screening mammography under the ACA was associated with an increase in rates of use of this service among older women for whom screening is recommended. The effect was attenuated among women living in areas with lower educational attainment and was negligible among Hispanic women. (Funded by the National Institute on Aging.).
[Mh] Termos MeSH primário: Custo Compartilhado de Seguro
Mamografia/utilização
Medicare Part C/economia
Patient Protection and Affordable Care Act
[Mh] Termos MeSH secundário: Idoso
Detecção Precoce de Câncer/utilização
Grupos Étnicos
Feminino
Seres Humanos
Mamografia/economia
Medicare
Fatores Socioeconômicos
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMsa1706808


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[PMID]:28453693
[Au] Autor:Mahal BA; Chen YW; Muralidhar V; Mahal AR; Choueiri TK; Hoffman KE; Hu JC; Sweeney CJ; Yu JB; Feng FY; Kim SP; Beard CJ; Martin NE; Trinh QD; Nguyen PL
[Ad] Endereço:Harvard Radiation Oncology Program, Boston, USA.
[Ti] Título:Racial disparities in prostate cancer outcome among prostate-specific antigen screening eligible populations in the United States.
[So] Source:Ann Oncol;28(5):1098-1104, 2017 05 01.
[Is] ISSN:1569-8041
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: In 2012, the United States Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA) screening, despite evidence that Black men are at a higher risk of prostate cancer-specific mortality (PCSM). We evaluated whether Black men of potentially screening-eligible age (55-69 years) are at a disproportionally high risk of poor outcomes. Patients and methods: The SEER database was used to study 390 259 men diagnosed with prostate cancer in the United States between 2004 and 2011. Multivariable logistic regression modeled the association between Black race and stage of presentation, while Fine-Gray competing risks regression modeled the association between Black race and PCSM, both as a function of screening eligibility (age 55-69 years versus not). Results: Black men were more likely to present with metastatic disease (adjusted odds ratio [AOR] 1.65; 1.58-1.72; P < 0.001) and were at a higher risk of PCSM (adjusted hazard ratio [AHR] 1.36; 1.27-1.46; P < 0.001) compared to non-Black men. There were significant interactions between race and PSA-screening eligibility such that Black patients experienced more disproportionate rates of metastatic disease (AOR 1.76; 1.65-1.87 versus 1.55; 1.47-1.65; Pinteraction < 0.001) and PCSM (AHR 1.53; 1.37-1.70 versus 1.25; 1.14-1.37; Pinteraction = 0.01) in the potentially PSA-screening eligible group than in the group not eligible for screening. Conclusions: Racial disparities in prostate cancer outcome among Black men are significantly worse in PSA-screening eligible populations. These results raise the possibility that Black men could be disproportionately impacted by recommendations to end PSA screening in the United States and suggest that Black race should be included in the updated USPSTF PSA screening guidelines.
[Mh] Termos MeSH primário: Neoplasias da Próstata/diagnóstico
[Mh] Termos MeSH secundário: Afroamericanos
Idoso
Detecção Precoce de Câncer
Disparidades em Assistência à Saúde
Seres Humanos
Calicreínas/metabolismo
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Antígeno Prostático Específico/metabolismo
Neoplasias da Próstata/metabolismo
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/terapia
Fatores de Risco
Programa de SEER
Resultado do Tratamento
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/annonc/mdx041


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[PMID]:29397592
[Au] Autor:National Clinical Research Center for Digestive Disease of China; Chinese Society of Digestive Endoscopy; Chinese Association of Endoscopologist, Gastroenterologist & Hepatologist
[Ti] Título:[Clinical guidelines for perioperative management of gastric endoscopic submucosal dissection].
[So] Source:Zhonghua Nei Ke Za Zhi;57(2):84-96, 2018 Feb 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Gastric cancer has become one of the important public health issues endangering people's health in China. Currently, endoscopic submucosal dissection (ESD) has been used as the curative procedure of early gastric cancer without lymph node metastasis. Endoscopic resection has several advantages, including less invasiveness, permitting en bloc, histologically completed resection, accurate pathological diagnosis, lower recurrent rate and rapid recovery. The perioperative period of ESD is the time of a patient's endoscopic operative procedure; more specifically, it includes ward admission, indication, contraindication, preoperative preparation, endoscopic operation, postoperative complications, recovery and the disposal of specimen. The aim of this guideline is to assist endoscopists in providing standardized operation to patients, as well as managing perioperative complications.
[Mh] Termos MeSH primário: Ressecção Endoscópica de Mucosa
Mucosa Gástrica/cirurgia
Guias de Prática Clínica como Assunto
Neoplasias Gástricas/diagnóstico
Neoplasias Gástricas/cirurgia
[Mh] Termos MeSH secundário: China
Detecção Precoce de Câncer
Endoscopia
Seres Humanos
Metástase Linfática
Complicações Pós-Operatórias
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.02.002


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[PMID]:28452044
[Au] Autor:Luckmann R; White MJ; Costanza ME; Frisard CF; Cranos C; Sama S; Yood R
[Ad] Endereço:Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lave Ave. N, Worcester, MA, 01655, USA. LuckmanR@ummhc.org.
[Ti] Título:Implementation and process evaluation of three interventions to promote screening mammograms delivered for 4 years in a large primary care population.
[So] Source:Transl Behav Med;7(3):547-556, 2017 Sep.
[Is] ISSN:1613-9860
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The optimal form of outreach to promote repeated, on time screening mammograms in primary care has not been established. The purpose of this study is to assess the implementation process and process outcomes for three interventions for promoting biannual screening mammography in a randomized trial. In a large urban primary care practice over a 4-year period, we randomized women aged 40-85 and eligible for mammograms to three interventions: reminder letter only (LO), reminder letter + reminder call (RC), and reminder letter + counseling call (CC). We tracked information system development, staff training, patient and provider recruitment, reach, dose delivered and received, fidelity, and context measures. Ninety-three of 95 providers approved participation by 80% (23,999) of age-eligible patients, of whom only 207 (0.9%) opted not to receive any intervention. Of 9161 initial reminder letters mailed to women coming due or overdue for mammograms, 0.8% were undeliverable. Of women in the RC and CC arms unresponsive to the first reminder letter (n = 3982), 71.4% were called and reached, and of those, 49.1% scheduled a mammogram. Only 33.4% of women reached in the CC arm received full counseling, and women in the CC arm were less likely to schedule a mammogram than those in the RC arm. Implementing mail and telephone mammography reminders is feasible and acceptable in a large urban practice and reaches a majority of patients. Many schedule a mammogram when reached. A reminder letter followed by a simple reminder call if needed may be the optimal approach to promoting screening mammograms.
[Mh] Termos MeSH primário: Aconselhamento
Detecção Precoce de Câncer/métodos
Promoção da Saúde/métodos
Mamografia
Atenção Primária à Saúde
Sistemas de Alerta
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/prevenção & controle
Feminino
Implementação de Plano de Saúde
Política de Saúde
Seres Humanos
Meia-Idade
Atenção Primária à Saúde/métodos
Avaliação de Programas e Projetos de Saúde
Software
Telefone
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1007/s13142-017-0497-x


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[PMID]:29480875
[Au] Autor:Leatham H; Schadt C; Chisolm S; Fretwell D; Chung L; Callen JP; Fiorentino D
[Ad] Endereço:Department of Dermatology, Stanford University.
[Ti] Título:Evidence supports blind screening for internal malignancy in dermatomyositis: Data from 2 large US dermatology cohorts.
[So] Source:Medicine (Baltimore);97(2):e9639, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The association between dermatomyositis and internal malignancy is well established, but there is little consensus about the methods of cancer screening that should be utilized.We wished to analyze the prevalence and yield of selected cancer screening modalities in patients with dermatomyositis.We performed a retrospective analysis of 2 large US dermatomyositis cohorts comprising 400 patients.We measured the frequency of selected screening tests used to search for malignancy. Patients with a biopsy-confirmed malignancy were identified. Prespecified clinical and laboratory factors were tested for association with malignancy. For each malignancy we identified the screening test(s) that led to diagnosis and classified these tests as either blind (not guided by suspicious sign/symptom) or triggered (by a suspicious sign or symptom).Forty-eight patients (12.0% of total cohort) with 53 cancers were identified with dermatomyositis-associated malignancy. Twenty-one of these 53 cancers (40%) were diagnosed within 1 year of dermatomyositis symptom onset. In multivariate analysis, older age (P = .0005) was the only significant risk factor for internal malignancy. There was no significant difference in cancer incidence between classic and clinically amyopathic patients. Twenty-seven patients (6.8% of the total cohort) harbored an undiagnosed malignancy at the time of dermatomyositis diagnosis. The majority (59%) of these cancers were asymptomatic and computed tomography (CT) scans were the most common studies to reveal a cancer.This is the largest US cohort studied to examine malignancy prevalence and screening practices in dermatomyositis patients. Our results demonstrate that, while undiagnosed malignancy is present in <10% of US patients at the time of dermatomyositis onset, it is often not associated with a suspicious sign or symptom. Our data suggest that effective malignancy screening of dermatomyositis patients often requires evaluation beyond a history, physical examination, and "age-appropriate" cancer screening-these data may help to inform future guidelines for malignancy screening in this population.
[Mh] Termos MeSH primário: Dermatomiosite/complicações
Dermatomiosite/diagnóstico
Detecção Precoce de Câncer
Neoplasias/complicações
Neoplasias/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Dermatomiosite/epidemiologia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Neoplasias/epidemiologia
Prevalência
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009639


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[PMID]:29386192
[Au] Autor:Tu H; Wen CP; Tsai SP; Chow WH; Wen C; Ye Y; Zhao H; Tsai MK; Huang M; Dinney CP; Tsao CK; Wu X
[Ad] Endereço:Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
[Ti] Título:Cancer risk associated with chronic diseases and disease markers: prospective cohort study.
[So] Source:BMJ;360:k134, 2018 01 31.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess the independent and joint associations of major chronic diseases and disease markers with cancer risk and to explore the benefit of physical activity in reducing the cancer risk associated with chronic diseases and disease markers. DESIGN: Prospective cohort study. SETTING: Standard medical screening program in Taiwan. PARTICIPANTS: 405 878 participants, for whom cardiovascular disease markers (blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease markers (proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis marker (uric acid) were measured or diagnosed according to standard methods, were followed for an average of 8.7 years. MAIN OUTCOME MEASURES: Cancer incidence and cancer mortality. RESULTS: A statistically significantly increased risk of incident cancer was observed for the eight diseases and markers individually (except blood pressure and pulmonary disease), with adjusted hazard ratios ranging from 1.07 to 1.44. All eight diseases and markers were statistically significantly associated with risk of cancer death, with adjusted hazard ratios ranging from 1.12 to 1.70. Chronic disease risk scores summarizing the eight diseases and markers were positively associated with cancer risk in a dose-response manner, with the highest scores associated with a 2.21-fold (95% confidence interval 1.77-fold to 2.75-fold) and 4.00-fold (2.84-fold to 5.63-fold) higher cancer incidence and cancer mortality, respectively. High chronic disease risk scores were associated with substantial years of life lost, and the highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. The population attributable fractions of cancer incidence or cancer mortality from the eight chronic diseases and markers together were comparable to those from five major lifestyle factors combined (cancer incidence: 20.5% 24.8%; cancer mortality: 38.9% 39.7%). Among physically active (versus inactive) participants, the increased cancer risk associated with chronic diseases and markers was attenuated by 48% for cancer incidence and 27% for cancer mortality. CONCLUSIONS: Chronic disease is an overlooked risk factor for cancer, as important as five major lifestyle factors combined. In this study, chronic diseases contributed to more than one fifth of the risk for incident cancer and more than one third of the risk for cancer death. Physical activity is associated with a nearly 40% reduction in the cancer risk associated with chronic diseases.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Doença Crônica/epidemiologia
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adulto
Artrite Gotosa/epidemiologia
Artrite Gotosa/metabolismo
Doenças Cardiovasculares/complicações
Doenças Cardiovasculares/epidemiologia
Doença Crônica/mortalidade
Complicações do Diabetes
Diabetes Mellitus/epidemiologia
Detecção Precoce de Câncer/métodos
Exercício/fisiologia
Feminino
Seres Humanos
Incidência
Estilo de Vida
Pneumopatias/epidemiologia
Pneumopatias/metabolismo
Pneumopatias/fisiopatologia
Masculino
Meia-Idade
Neoplasias/epidemiologia
Neoplasias/mortalidade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Prospectivos
Insuficiência Renal Crônica/complicações
Insuficiência Renal Crônica/epidemiologia
Fatores de Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k134


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[PMID]:29351560
[Au] Autor:Vreemann S; Gubern-Mérida A; Borelli C; Bult P; Karssemeijer N; Mann RM
[Ad] Endereço:Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, Nijmegen, the Netherlands.
[Ti] Título:The correlation of background parenchymal enhancement in the contralateral breast with patient and tumor characteristics of MRI-screen detected breast cancers.
[So] Source:PLoS One;13(1):e0191399, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Higher background parenchymal enhancement (BPE) could be used for stratification of MRI screening programs since it might be related to a higher breast cancer risk. Therefore, the purpose of this study is to correlate BPE to patient and tumor characteristics in women with unilateral MRI-screen detected breast cancer who participated in an intermediate and high risk screening program. As BPE in the affected breast may be difficult to discern from enhancing cancer, we assumed that BPE in the contralateral breast is a representative measure for BPE in women with unilateral breast cancer. MATERIALS AND METHODS: This retrospective study was approved by our local institutional board and a waiver for consent was granted. MR-examinations of women with unilateral breast cancers screen-detected on breast MRI were evaluated by two readers. BPE in the contralateral breast was rated according to BI-RADS. Univariate analyses were performed to study associations. Observer variability was computed. RESULTS: Analysis included 77 breast cancers in 76 patients (age: 48±9.8 years), including 62 invasive and 15 pure ductal carcinoma in-situ cases. A negative association between BPE and tumor grade (p≤0.016) and a positive association with progesterone status (p≤0.021) was found. The correlation was stronger when only considering invasive disease. Inter-reader agreement was substantial. CONCLUSION: Lower BPE in the contralateral breast in women with unilateral breast cancer might be associated to higher tumor grade and progesterone receptor negativity. Great care should be taken using BPE for stratification of patients to tailored screening programs.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Mama/patologia
Neoplasias da Mama/genética
Neoplasias da Mama/patologia
Carcinoma Ductal de Mama/diagnóstico por imagem
Carcinoma Intraductal não Infiltrante/diagnóstico por imagem
Carcinoma Lobular/diagnóstico por imagem
Meios de Contraste
Detecção Precoce de Câncer
Feminino
Seres Humanos
Programas de Rastreamento
Meia-Idade
Mutação
Estudos Retrospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191399


  9 / 16385 MEDLINE  
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[PMID]:29321194
[Au] Autor:Seibert TM; Fan CC; Wang Y; Zuber V; Karunamuni R; Parsons JK; Eeles RA; Easton DF; Kote-Jarai Z; Al Olama AA; Garcia SB; Muir K; Grönberg H; Wiklund F; Aly M; Schleutker J; Sipeky C; Tammela TL; Nordestgaard BG; Nielsen SF; Weischer M; Bisbjerg R; Røder MA; Iversen P; Key TJ; Travis RC; Neal DE; Donovan JL; Hamdy FC; Pharoah P; Pashayan N; Khaw KT; Maier C; Vogel W; Luedeke M; Herkommer K; Kibel AS; Cybulski C; Wokolorczyk D; Kluzniak W; Cannon-Albright L; Brenner H; Cuk K; Saum KU; Park JY; Sellers TA; Slavov C; Kaneva R; Mitev V; Batra J; PRACTICAL Consortium*
[Ad] Endereço:Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA tseibert@ucsd.edu amdale@ucsd.edu.
[Ti] Título:Polygenic hazard score to guide screening for aggressive prostate cancer: development and validation in large scale cohorts.
[So] Source:BMJ;360:j5757, 2018 01 10.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age. DESIGN: Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis). The resulting polygenic hazard score is an assessment of individual genetic risk. The final model was applied to an independent dataset containing genotype and PSA screening data. The hazard score was calculated for these men to test prediction of survival free from PCa. SETTING: Multiple institutions that were members of international PRACTICAL consortium. PARTICIPANTS: All consortium participants of European ancestry with known age, PCa status, and quality assured custom (iCOGS) array genotype data. The development dataset comprised 31 747 men; the validation dataset comprised 6411 men. MAIN OUTCOME MEASURES: Prediction with hazard score of age of onset of aggressive cancer in validation set. RESULTS: In the independent validation set, the hazard score calculated from 54 single nucleotide polymorphisms was a highly significant predictor of age at diagnosis of aggressive cancer (z=11.2, P<10 ). When men in the validation set with high scores (>98th centile) were compared with those with average scores (30th-70th centile), the hazard ratio for aggressive cancer was 2.9 (95% confidence interval 2.4 to 3.4). Inclusion of family history in a combined model did not improve prediction of onset of aggressive PCa (P=0.59), and polygenic hazard score performance remained high when family history was accounted for. Additionally, the positive predictive value of PSA screening for aggressive PCa was increased with increasing polygenic hazard score. CONCLUSIONS: Polygenic hazard scores can be used for personalised genetic risk estimates that can predict for age at onset of aggressive PCa.
[Mh] Termos MeSH primário: Detecção Precoce de Câncer/métodos
Calicreínas/análise
Polimorfismo de Nucleotídeo Único/genética
Antígeno Prostático Específico/análise
Neoplasias da Próstata/sangue
Neoplasias da Próstata/genética
[Mh] Termos MeSH secundário: Idade de Início
Idoso
Estudos de Coortes
Intervalo Livre de Doença
Grupo com Ancestrais do Continente Europeu/genética
Genótipo
Seres Humanos
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Valor Preditivo dos Testes
Neoplasias da Próstata/diagnóstico
Medição de Risco
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nome de substância:
EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5757


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[PMID]:28460452
[Au] Autor:Lin Z; Neiswender J; Fang B; Ma X; Zhang J; Hu X
[Ad] Endereço:State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, China.
[Ti] Título:Value of circulating cell-free DNA analysis as a diagnostic tool for breast cancer: a meta-analysis.
[So] Source:Oncotarget;8(16):26625-26636, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of this study was to systematically evaluate the diagnostic value of cell free DNA (cfDNA) for breast cancer. RESULTS: Among 308 candidate articles, 25 with relevant diagnostic screening qualified for final analysis. The mean sensitivity, specificity and area under the curve (AUC) of SROC plots for 24 studies that distinguished breast cancer patients from healthy controls were 0.70, 0.87, and 0.9314, yielding a DOR of 32.31. When analyzed in subgroups, the 14 quantitative studies produced sensitivity, specificity, AUC, and a DOR of 0.78, 0.83, 0.9116, and 24.40. The 10 qualitative studies produced 0.50, 0.98, 0.9919, and 68.45. For 8 studies that distinguished malignant breast cancer from benign diseases, the specificity, sensitivity, AUC and DOR were 0.75, 0.79, 0.8213, and 9.49. No covariate factors had a significant correlation with relative DOR. Deek's funnel plots indicated an absence of publication bias. MATERIALS AND METHODS: Databases were searched for studies involving the use of cfDNA to diagnose breast cancer. The studies were analyzed to determine sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and the summary receiver operating characteristic (SROC). Covariates were evaluated for effect on relative DOR. Deek's Funnel plots were generated to measure publication bias. CONCLUSIONS: Our analysis suggests a promising diagnostic potential of using cfDNA for breast cancer screening, but this diagnostic method is not yet independently sufficient. Further work refining qualitative cfDNA assays will improve the correct diagnosis of breast cancers.
[Mh] Termos MeSH primário: Biomarcadores Tumorais
Neoplasias da Mama/diagnóstico
Neoplasias da Mama/genética
Ácidos Nucleicos Livres
DNA de Neoplasias
[Mh] Termos MeSH secundário: Área Sob a Curva
Neoplasias da Mama/sangue
Bases de Dados Genéticas
Detecção Precoce de Câncer/métodos
Feminino
Seres Humanos
Biópsia Líquida
Viés de Publicação
Curva ROC
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Cell-Free Nucleic Acids); 0 (DNA, Neoplasm)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15775



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