Base de dados : MEDLINE
Pesquisa : E02.919 [Categoria DeCS]
Referências encontradas : 119 [refinar]
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[PMID]:28668364
[Au] Autor:Bouaziz W; Vogel T; Schmitt E; Kaltenbach G; Geny B; Lang PO
[Ad] Endereço:Pôle de gériatrie, hôpitaux universitaires de Strasbourg, 67091 Strasbourg cedex, France; EA-3072, faculté de médecine, institut de physiologie, université de Strasbourg, 67085 Strasbourg cedex, France; Faculté des sciences du sport, centre d'études des transformations par les activités physiques et
[Ti] Título:[Health benefits of aerobic training programs in adults aged 70 or over: A systematic review].
[Ti] Título:Bénéfices de l'activité physique en endurance chez les seniors âgés de 70 ans ou plus : une revue systématique..
[So] Source:Presse Med;46(9):794-807, 2017 Sep.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:CONTEXT: Seniors represent the population where sedentary is the highest. OBJECTIVE: To evaluate of the exact health benefits of regular aerobic training (AT) in seniors aged 70 years or older. DOCUMENTARY SOURCE: Systematic review in CINAHL Plus, Embase, Medline, PubMed Central, ScienceDirect, Scopus, Sport Discus and Web of Science with a keyword search. SELECTION OF STUDIES: Two independent readers have selected randomized controlled and quasi-controlled studies and observational cohort studies published in English. RESULTS: Of 3515 articles identified, 87 studies were included in the systematic review and categorized according to the analysed outcomes. The benefits of AT are clearly demonstrated on total mortality, coronary and neurovascular disease, glucose metabolism and type 2 diabetes, blood lipid profile, body composition, blood pressure, cardiorespiratory performances, muscle strength and functional capacity, and quality of life among senior aged 70 years or more. More recently, it has shown benefits for primary and tertiary prevention of cancer and primary and secondary prevention of cognitive decline. The benefits on bone health and the risk of falling are yet to confirm. LIMITATION OF THE WORK: The data of benefits result from studies published in English only. CONCLUSION: The AT is an important determinant of health and quality of life in seniors. Its promotion in this population should be part of the continuity of efforts undertaken among younger population. Thus, seniors should be more actively encouraged to engage in training programs.
[Mh] Termos MeSH primário: Doença Crônica/prevenção & controle
Exercício
Resistência Física
Aptidão Física
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Doença Crônica/mortalidade
Ensaios Clínicos como Assunto
Medicina Baseada em Evidências
Feminino
Seres Humanos
Masculino
Estilo de Vida Sedentário
Análise de Sobrevida
Prevenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170703
[St] Status:MEDLINE


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[PMID]:28437708
[Au] Autor:Mirghani H; Jung AC; Fakhry C
[Ad] Endereço:Department of Otolaryngology - Head and Neck Surgery, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. Electronic address: haitham.mirghani@gustaveroussy.fr.
[Ti] Título:Primary, secondary and tertiary prevention of human papillomavirus-driven head and neck cancers.
[So] Source:Eur J Cancer;78:105-115, 2017 Jun.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Human papillomavirus (HPV)-driven oropharyngeal cancers (OPCs) represent an increasing proportion of head and neck cancers that could become, in the next few decades, a public health problem in certain western countries. This significant epidemiological change strongly calls for preventive measures. Prophylactic HPV vaccination and screening programmes for early identification and treatment of premalignant lesions are currently being used to reduce the incidence of uterine cervical cancer, which is the paradigm of HPV-driven malignancy. These strategies have proven to be efficient as the incidence of cervical cancer has dramatically dropped since the 1960s in most countries where they are properly applied. The success of cervical cancer prevention encourages the development of similar approaches to prevent HPV-driven OPCs. However, a number of important limitations impede their application to HPV-driven OPCs, and the development of innovative and specific strategies dedicated to this disease are urgently needed. This article provides an overview on primary, secondary and tertiary prevention of HPV-driven OPC and discusses some directions for future research.
[Mh] Termos MeSH primário: Neoplasias de Cabeça e Pescoço/prevenção & controle
Infecções por Papillomavirus/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Biomarcadores Tumorais/metabolismo
DNA Viral/metabolismo
Detecção Precoce de Câncer/métodos
Feminino
Neoplasias de Cabeça e Pescoço/virologia
Seres Humanos
Masculino
Meia-Idade
Papillomaviridae/genética
Vacinas contra Papillomavirus
Prevenção Primária/métodos
Medição de Risco
Prevenção Secundária/métodos
Prevenção Terciária/métodos
Neoplasias do Colo do Útero/prevenção & controle
Neoplasias do Colo do Útero/virologia
Vacinação/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (DNA, Viral); 0 (Papillomavirus Vaccines)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE


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[PMID]:28189351
[Au] Autor:Espenel S; Garcia MA; Guy JB; Vallard A; Ben Mrad M; Langrand-Escure J; El Meddeb Hamrouni A; Trone JC; Xia Y; Rancoule C; Magné N
[Ad] Endereço:Département de radiothérapie, institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France.
[Ti] Título:[Ototoxicity in head and neck cancers after radiotherapy and chemoradiotherapy: From primary prevention to tertiary prevention].
[Ti] Título:Ototoxicité radio-induite et chimio-induite dans les cancers ORL : de la prévention primaire à la prévention tertiaire..
[So] Source:Cancer Radiother;21(1):77-83, 2017 Feb.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Each year, 15,000 head and neck cancer are treated in France. Prognosis is steadily improving. Consequently, limitation of late toxicities becomes essential. Ototoxicity is common, disabling and undervalued. We aimed to inventory primary, secondary and tertiary prevention measures to reduce ototoxicity induced by radiotherapy and chemotherapy, as well as its impact on quality of life of patients treated for head and neck cancer. External radiation therapy induced 30 to 40% of ototoxicity, including irreversible sensorineural hearing loss. Primary prevention of this risk is based on limiting the dose to the cochlea: 40Gy in case of radiotherapy alone, 10Gy during concomitant chemoradiotherapy with cisplatin. Dose gradients allowed by intensity-modulated radiotherapy help respecting these limits. Concurrent chemotherapy with high dose cisplatin (100mg/m ) also causes hearing loss by cochlear damages. Prescription of carboplatin-5-fluorouracil combination or cetuximab should be preferred in case of high risk of ototoxicity. This risk must be precisely evaluated before treatment. Ototoxicity monitoring during treatment allows early management, and lower long-term impact. Radiosensitivity predictive tests and research of genetic factors predisposing to chemo-induced ototoxicity should enable optimization of therapeutic choices and monitoring.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias de Cabeça e Pescoço/terapia
Perda Auditiva Condutiva/prevenção & controle
Perda Auditiva Neurossensorial/prevenção & controle
Lesões por Radiação/prevenção & controle
Radioterapia de Intensidade Modulada/efeitos adversos
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimiorradioterapia/efeitos adversos
Quimiorradioterapia/métodos
Cisplatino/administração & dosagem
Cisplatino/efeitos adversos
Cóclea/efeitos dos fármacos
Cóclea/efeitos da radiação
Terapia Combinada
Dor de Orelha/induzido quimicamente
Dor de Orelha/etiologia
Neoplasias de Cabeça e Pescoço/radioterapia
Perda Auditiva Condutiva/etiologia
Perda Auditiva Neurossensorial/induzido quimicamente
Perda Auditiva Neurossensorial/etiologia
Seres Humanos
Órgãos em Risco
Otite/induzido quimicamente
Otite/etiologia
Prevenção Primária/métodos
Qualidade de Vida
Lesões por Radiação/etiologia
Tolerância a Radiação
Dosagem Radioterapêutica
Prevenção Secundária/métodos
Prevenção Terciária/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170213
[St] Status:MEDLINE


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[PMID]:27671870
[Au] Autor:Tulek Z; Polat C; Ozkan I; Theofanidis D; Togrol RE
[Ad] Endereço:Istanbul University Florence Nightingale Faculty of Nursing, Istanbul, Turkey. Electronic address: tulekz@yahoo.com.
[Ti] Título:Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument.
[So] Source:J Tissue Viability;25(4):201-208, 2016 Nov.
[Is] ISSN:0965-206X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:STUDY AIM: Sound knowledge of pressure ulcers is important to enable good prevention. There are limited instruments assessing pressure ulcer knowledge. The Pressure Ulcer Prevention Knowledge Assessment Instrument is among the scales of which psychometric properties have been studied rigorously and reflects the latest evidence. This study aimed to evaluate the validity and reliability of the Turkish version of the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI-T), an instrument that assesses knowledge of pressure ulcer prevention by using multiple-choice questions. MATERIALS AND METHODS: Linguistic validity was verified through front-to-back translation. Psychometric properties of the instrument were studied on a sample of 150 nurses working in a tertiary hospital in Istanbul, Turkey. RESULTS: The content validity index of the translated instrument was 0.94, intra-class correlation coefficients were between 0.37 and 0.80, item difficulty indices were between 0.21 and 0.88, discrimination indices were 0.20-0.78, and the Kuder Richardson for the internal consistency was 0.803. CONCLUSIONS: The PUPKAI-T was found to be a valid and reliable tool to evaluate nurses' knowledge on pressure ulcer prevention. The PUPKAI-T may be a useful tool for determining educational needs of nurses on pressure ulcer prevention.
[Mh] Termos MeSH primário: Educação Continuada em Enfermagem
Lesão por Pressão
[Mh] Termos MeSH secundário: Seres Humanos
Lesão por Pressão/enfermagem
Lesão por Pressão/prevenção & controle
Avaliação de Programas e Projetos de Saúde
Higiene da Pele/enfermagem
Inquéritos e Questionários
Centros de Atenção Terciária
Prevenção Terciária
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160928
[St] Status:MEDLINE


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[PMID]:27528431
[Au] Autor:Baker PR; Francis DP; Hairi NN; Othman S; Choo WY
[Ad] Endereço:School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia, 4059.
[Ti] Título:Interventions for preventing abuse in the elderly.
[So] Source:Cochrane Database Syst Rev;(8):CD010321, 2016 Aug 16.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. OBJECTIVES: The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. SEARCH METHODS: We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts , ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. MAIN RESULTS: The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes, although there were few details on the components and analysis of the costing.We are uncertain whether these interventions reduce the occurrence or recurrence of elder abuse due to variation in settings, measures and effects reported in the included studies, some of which were very small and at a high risk of bias (low- and very low-quality evidence).Two studies measured the occurrence of elder abuse. A high risk of bias study found a difference in the post-test scores (P value 0.048 and 0.18). In a low risk of bias study there was no difference found (adjusted odds ratio (OR) =0.48, 95% 0.18 to 1.27) (n = 214). For interventions measuring abuse recurrence, one small study (n = 16) reported no difference in post-test means, whilst another found higher levels of abuse reported for the intervention arms (Cox regression, combined intervention hazard ratio (HR) = 1.78, alpha level = 0.01).It is uncertain whether targeted educational interventions improve the relevant knowledge of health professionals and caregivers (very low-quality evidence), although they may improve detection of resident-to-resident abuse. The concept of measuring improvement in detection or reporting as opposed to measuring the occurrence or recurrence of abuse is complicated. An intervention of public education and support services aimed at victims may also improve rates of reporting, however it is unclear whether this was due to an increase in abuse recurrence or better reporting of abuse.The effectiveness of service planning interventions at improving the assessment and documentation of related domains is uncertain. Unintended outcomes were not reported in the studies. AUTHORS' CONCLUSIONS: There is inadequate trustworthy evidence to assess the effects of elder abuse interventions on occurrence or recurrence of abuse, although there is some evidence to suggest it may change the combined measure of anxiety and depression of caregivers. There is a need for high-quality trials, including from low- or middle-income countries, with adequate statistical power and appropriate study characteristics to determine whether specific intervention programmes, and which components of these programmes, are effective in preventing or reducing abuse episodes among the elderly. It is uncertain whether the use of educational interventions improves knowledge and attitude of caregivers, and whether such programmes also reduce occurrence of abuse, thus future research is warranted. In addition, all future research should include a component of cost-effectiveness analysis, implementation assessment and equity considerations of the specific interventions under review.
[Mh] Termos MeSH primário: Maus-Tratos ao Idoso/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Cuidadores
Maus-Tratos ao Idoso/classificação
Maus-Tratos ao Idoso/diagnóstico
Seres Humanos
Análise de Séries Temporais Interrompida
Casas de Saúde
Recursos Humanos de Enfermagem
Prevenção Primária
Ensaios Clínicos Controlados Aleatórios como Assunto
Prevenção Secundária
Prevenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160817
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010321.pub2


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[PMID]:27356809
[Au] Autor:Brans R; Skudlik C; Weisshaar E; Scheidt R; Ofenloch R; Elsner P; Wulfhorst B; Schönfeld M; John SM; Diepgen TL; ROQ Study Group
[Ad] Endereço:Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, 49090 Osnabrück, Germany. rbrans@uos.de.
[Ti] Título:Multicentre cohort study 'Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ)': results from a 3-year follow-up.
[So] Source:Contact Dermatitis;75(4):205-12, 2016 Oct.
[Is] ISSN:1600-0536
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A tertiary individual prevention programme (TIP) is offered to patients with severe occupational skin disease (OSD) in Germany. Previously, it was shown that the burden of OSDs is considerably reduced in patients up to 1 year after the TIP. OBJECTIVES: To evaluate the long-term effects of the TIP. PATIENTS AND METHODS: In a prospective multicentre cohort study, the clinical and patient-reported outcome data 3 years after the TIP were evaluated. RESULTS: Of the 1788 patients initially included in the study, 1410 were available for the 3-year follow-up analysis. The severity of OSD, the use of topical corticosteroids and days of absence from work were significantly reduced 3 years after the TIP, and the quality of life and skin protective behaviour were significantly improved. Of the patients, 96.9% were able to resume work. One thousand one hundred and sixty-six patients (82.7%) were still working 3 years after the TIP, 874 of them (75.0%) in the same occupational field. Hairdressers had the lowest rate of remaining in their original profession (41.3%). CONCLUSIONS: The follow-up during 3 years of this unique cohort of patients with OSDs shows that the TIP is associated with sustained improvements in terms of disease severity, ability to work, quality of life, and prognosis.
[Mh] Termos MeSH primário: Dermatite Alérgica de Contato/reabilitação
Dermatite Irritante/reabilitação
Dermatite Ocupacional/reabilitação
Dermatoses da Mão/reabilitação
Qualidade de Vida
Retorno ao Trabalho
Prevenção Terciária/métodos
[Mh] Termos MeSH secundário: Administração Cutânea
Corticosteroides/uso terapêutico
Adulto
Estudos de Coortes
Indústria da Construção
Dermatite Alérgica de Contato/tratamento farmacológico
Dermatite Irritante/tratamento farmacológico
Dermatite Ocupacional/tratamento farmacológico
Feminino
Manipulação de Alimentos
Alemanha
Dermatoses da Mão/tratamento farmacológico
Setor de Assistência à Saúde
Hospitalização
Seres Humanos
Estudos Longitudinais
Masculino
Metais
Meia-Idade
Medidas de Resultados Relatados pelo Paciente
Estudos Prospectivos
Garantia da Qualidade dos Cuidados de Saúde
Licença Médica/estatística & dados numéricos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Metals)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160701
[St] Status:MEDLINE
[do] DOI:10.1111/cod.12614


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[PMID]:27343744
[Au] Autor:Scott JM; Adams SC; Koelwyn GJ; Jones LW
[Ad] Endereço:Universities Space Research Association, NASA Johnson Space Center, Houston, Texas, USA.
[Ti] Título:Cardiovascular Late Effects and Exercise Treatment in Breast Cancer: Current Evidence and Future Directions.
[So] Source:Can J Cardiol;32(7):881-90, 2016 Jul.
[Is] ISSN:1916-7075
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Advances in detection and supportive care strategies have led to improvements in cancer-specific and overall survival after a diagnosis of early-stage breast cancer. These improvements, however, are associated with an increase in competing forms of morbidity and mortality, particularly cardiovascular disease (CVD). Indeed, in certain subpopulations of patients, CVD is the leading cause of mortality after early breast cancer, and these women also have an increased risk of CVD-specific morbidity, including an elevated incidence of coronary artery disease and heart failure compared with their sex- and age-matched counterparts. Exercise treatment is established as the cornerstone of primary and secondary prevention of CVD in multiple clinical populations. The potential benefits of exercise treatment to modulate CVD or CVD risk factors before, immediately after, or in the months/years after adjuvant therapy for early-stage breast cancer have received limited attention. We discuss the risk and extent of CVD in patients with breast cancer, review the pathogenesis of CVD, and highlight existing evidence from select clinical trials investigating the efficacy of structured exercise treatment across the CVD continuum in early breast cancer.
[Mh] Termos MeSH primário: Neoplasias da Mama/complicações
Doenças Cardiovasculares/prevenção & controle
Exercício
[Mh] Termos MeSH secundário: Antineoplásicos/efeitos adversos
Neoplasias da Mama/terapia
Doenças Cardiovasculares/complicações
Doenças Cardiovasculares/etiologia
Ensaios Clínicos como Assunto
Feminino
Seres Humanos
Prevenção Primária
Fatores de Risco
Prevenção Secundária
Prevenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170727
[Lr] Data última revisão:
170727
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160626
[St] Status:MEDLINE


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[PMID]:27245485
[Au] Autor:Mol GC; van de Ree MA; Klok FA; Tegelberg MJ; Sanders FB; Koppen S; de Weerdt O; Koster T; Hovens MM; Kaasjager HA; Brouwer RE; Kragten E; Schaar CG; Spiering W; Arnold WP; Biesma DH; Huisman MV
[Ad] Endereço:Department of Internal Medicine, Diakonessenhuis Hospital, Utrecht, Netherlands Department of Internal Medicine, University Medical Center, Utrecht, Netherlands Department of Vascular Medicine, University Medical Center, 3508 GA Utrecht, Netherlands.
[Ti] Título:One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial.
[So] Source:BMJ;353:i2691, 2016 May 31.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE:  To study whether stopping elastic compression stockings (ECS) after 12 months is non-inferior to continuing them for 24 months after proximal deep venous thrombosis. DESIGN:  Multicentre single blind non-inferiority randomised controlled trial. SETTING:  Outpatient clinics in eight teaching hospitals in the Netherlands, including one university medical centre. PARTICIPANTS:  Patients compliant with compression therapy for 12 months after symptomatic, ultrasound proven proximal deep venous thrombosis of the leg. INTERVENTIONS:  Continuation or cessation of ECS 12 months after deep venous thrombosis. MAIN OUTCOME MEASURES:  The primary outcome was the incidence of post-thrombotic syndrome 24 months after diagnosis of deep venous thrombosis, as assessed by the standardised Villalta scale in an intention to treat analysis. The predefined non-inferiority margin was 10%. The main secondary outcome was quality of life (VEINES-QOL/Sym). RESULTS:  518 patients compliant with ECS and free of post-thrombotic syndrome were randomised one year after diagnosis of deep venous thrombosis to stop or continue ECS therapy for another year. In the stop-ECS group, 51 of 256 patients developed post-thrombotic syndrome, with an incidence of 19.9% (95% confidence interval 16% to 24%). In the continue-ECS group, 34 of 262 patients developed post-thrombotic syndrome (incidence 13.0%, 9.9% to 17%), of whom 85% used ECS six or seven days a week during the study period, for an absolute difference of 6.9% (95% confidence interval upper limit 12.3%). Because the upper limit of the 95% confidence interval exceeds the predefined margin of 10%, non-inferiority was not reached. The number needed to treat to prevent one case of post-thrombotic syndrome by continuing ECS was 14 (95% confidence interval lower limit 8). Quality of life did not differ between the two groups. CONCLUSION:  Stopping ECS after one year in compliant patients with proximal deep venous thrombosis seemed not to be non-inferior to continuing ECS therapy for two years in this non-inferiority trial. TRIAL REGISTRATION:  Netherlands Trial Register NTR1442.
[Mh] Termos MeSH primário: Tratamento Conservador
Extremidade Inferior/irrigação sanguínea
Síndrome Pós-Trombótica
Meias de Compressão
Veias
Trombose Venosa
[Mh] Termos MeSH secundário: Adulto
Idoso
Tratamento Conservador/instrumentação
Tratamento Conservador/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
Avaliação de Processos e Resultados (Cuidados de Saúde)
Síndrome Pós-Trombótica/diagnóstico
Síndrome Pós-Trombótica/etiologia
Síndrome Pós-Trombótica/fisiopatologia
Síndrome Pós-Trombótica/prevenção & controle
Prevenção Terciária/instrumentação
Prevenção Terciária/métodos
Fatores de Tempo
Ultrassonografia/métodos
Veias/diagnóstico por imagem
Veias/fisiopatologia
Trombose Venosa/complicações
Trombose Venosa/diagnóstico
Trombose Venosa/fisiopatologia
Trombose Venosa/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160602
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i2691


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[PMID]:26987530
[Au] Autor:Terry MB; McDonald JA; Wu HC; Eng S; Santella RM
[Ad] Endereço:Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. mt146@columbia.edu.
[Ti] Título:Epigenetic Biomarkers of Breast Cancer Risk: Across the Breast Cancer Prevention Continuum.
[So] Source:Adv Exp Med Biol;882:33-68, 2016.
[Is] ISSN:0065-2598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Epigenetic biomarkers, such as DNA methylation, can increase cancer risk through altering gene expression. The Cancer Genome Atlas (TCGA) Network has demonstrated breast cancer-specific DNA methylation signatures. DNA methylation signatures measured at the time of diagnosis may prove important for treatment options and in predicting disease-free and overall survival (tertiary prevention). DNA methylation measurement in cell free DNA may also be useful in improving early detection by measuring tumor DNA released into the blood (secondary prevention). Most evidence evaluating the use of DNA methylation markers in tertiary and secondary prevention efforts for breast cancer comes from studies that are cross-sectional or retrospective with limited corresponding epidemiologic data, raising concerns about temporality. Few prospective studies exist that are large enough to address whether DNA methylation markers add to the prediction of tertiary and secondary outcomes over and beyond standard clinical measures. Determining the role of epigenetic biomarkers in primary prevention can help in identifying modifiable pathways for targeting interventions and reducing disease incidence. The potential is great for DNA methylation markers to improve cancer outcomes across the prevention continuum. Large, prospective epidemiological studies will provide essential evidence of the overall utility of adding these markers to primary prevention efforts, screening, and clinical care.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/genética
Neoplasias da Mama/genética
Neoplasias da Mama/prevenção & controle
Metilação de DNA
Epigênese Genética
[Mh] Termos MeSH secundário: Animais
Neoplasias da Mama/epidemiologia
Progressão da Doença
Intervalo Livre de Doença
Detecção Precoce de Câncer
Feminino
Regulação Neoplásica da Expressão Gênica
Predisposição Genética para Doença
Testes Genéticos
Seres Humanos
Recidiva Local de Neoplasia
Fenótipo
Valor Preditivo dos Testes
Prevenção Primária
Medição de Risco
Fatores de Risco
Prevenção Secundária
Prevenção Terciária
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160319
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-22909-6_2


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[PMID]:26980125
[Au] Autor:Wilcox HC; Wyman PA
[Ad] Endereço:Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 550 North Broadway, Room 921, Baltimore, MD 21287, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 550 North Broadway, Room 921, Baltimore, MD 21287, USA. Electronic address: hwilcox1@jhmi.edu.
[Ti] Título:Suicide Prevention Strategies for Improving Population Health.
[So] Source:Child Adolesc Psychiatr Clin N Am;25(2):219-33, 2016 Apr.
[Is] ISSN:1558-0490
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means.
[Mh] Termos MeSH primário: Prevenção Primária/métodos
Prevenção Secundária/métodos
Suicídio/prevenção & controle
Prevenção Terciária/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.; REVIEW
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170104
[Lr] Data última revisão:
170104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160317
[St] Status:MEDLINE



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