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[PMID]:29313371
[Au] Autor:Marquardt M; Anderson C; Ginader T; Parkhurst J; Pagedar N; Bayon R; Clamon G; Hoover A; Buatti J
[Ad] Endereço:1 Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
[Ti] Título:Utility of 3-Month Surveillance F-18 FDG PET/CT in Surgically Resected Oral Squamous Cell Carcinoma.
[So] Source:Ann Otol Rhinol Laryngol;127(3):185-191, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate the performance of surveillance F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) 1 year after imaging in oral squamous cell carcinoma (OSCC) patients treated with definitive surgery and adjuvant (chemo)radiotherapy (RT). METHODS AND MATERIALS: Surveillance PET/CT accuracy was retrospectively evaluated in OSCC patients receiving surgical resection and (chemo)RT. Pathologic risk factors were assessed for influence on accuracy of the post-RT PET/CT. RESULTS: Fifty-four patients with median follow-up of 3.8 years met inclusion criteria. A PET/CT obtained a median of 3.4 months after RT revealed 11 (20.4%) instances of true disease recurrence: 4 locoregional alone, 6 distant alone, and 1 patient with locoregional and distant disease. Locoregional detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 55.6%, 75.0%, 33.3%, and 88.2%, respectively. For distant recurrence, the respective values were 100%, 95.2%, 77.8%, and 100%. Absence of bone invasion, absence of pT4 disease, and disease within the tongue were independently associated with higher sensitivity ( P = .048). Perineural invasion was associated with increased specificity ( P = .027), and tumor location in the tongue was associated with a higher PPV ( P = .007) on surveillance PET/CT. CONCLUSIONS: Post-RT PET/CT accuracy information for surgically managed OSCC patients demonstrates significant associations with pathologic factors.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas
Fluordesoxiglucose F18/farmacologia
Neoplasias de Cabeça e Pescoço
Recidiva Local de Neoplasia/diagnóstico
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/terapia
Quimiorradioterapia Adjuvante/métodos
Precisão da Medição Dimensional
Feminino
Neoplasias de Cabeça e Pescoço/epidemiologia
Neoplasias de Cabeça e Pescoço/patologia
Neoplasias de Cabeça e Pescoço/terapia
Seres Humanos
Iowa/epidemiologia
Masculino
Meia-Idade
Imagem Multimodal
Esvaziamento Cervical/métodos
Invasividade Neoplásica
Compostos Radiofarmacêuticos/farmacologia
Estudos Retrospectivos
Procedimentos Cirúrgicos Operatórios/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 0Z5B2CJX4D (Fluorodeoxyglucose F18)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417751474


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[PMID]:28921575
[Au] Autor:Quist AJL; Inoue-Choi M; Weyer PJ; Anderson KE; Cantor KP; Krasner S; Freeman LEB; Ward MH; Jones RR
[Ad] Endereço:Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.
[Ti] Título:Ingested nitrate and nitrite, disinfection by-products, and pancreatic cancer risk in postmenopausal women.
[So] Source:Int J Cancer;142(2):251-261, 2018 Jan 15.
[Is] ISSN:1097-0215
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nitrate and nitrite are precursors of N-nitroso compounds (NOC), probable human carcinogens that cause pancreatic tumors in animals. Disinfection by-products (DBP) exposures have also been linked with digestive system cancers, but few studies have evaluated relationships with pancreatic cancer. We investigated the association of pancreatic cancer with these drinking water contaminants and dietary nitrate/nitrite in a cohort of postmenopausal women in Iowa (1986-2011). We used historical monitoring and treatment data to estimate levels of long-term average nitrate and total trihalomethanes (TTHM; the sum of the most prevalent DBP class) and the duration exceeding one-half the maximum contaminant level (>½ MCL; 5 mg/L nitrate-nitrogen, 40 µg/L TTHM) among participants on public water supplies (PWS) >10 years. We estimated dietary nitrate and nitrite intakes using a food frequency questionnaire. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression and evaluated nitrate interactions with smoking and vitamin C intake. We identified 313 cases among 34,242 women, including 152 with >10 years PWS use (N = 15,710). Multivariable models of average nitrate showed no association with pancreatic cancer (HR = 1.16, 95% CI: 0.51-2.64). Associations with average TTHM levels were also null (HR = 0.70, 95% CI:0.42-1.18). We observed no trend with increasing years of exposure to either contaminant at levels >½ MCL. Positive associations were suggested in the highest dietary nitrite intake from processed meat (HR = 1.66, 95% CI 1.00-2.75;p = 0.05). We found no interactions of nitrate with known modifiers of endogenous NOC formation. Our results suggest that nitrite intake from processed meat may be a risk factor for pancreatic cancer.
[Mh] Termos MeSH primário: Desinfecção/métodos
Nitratos/efeitos adversos
Nitritos/efeitos adversos
Neoplasias Pancreáticas/etiologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Iowa
Meia-Idade
Estadiamento de Neoplasias
Pós-Menopausa
Prognóstico
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Nitrates); 0 (Nitrites)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170919
[St] Status:MEDLINE
[do] DOI:10.1002/ijc.31055


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[PMID]:28457942
[Au] Autor:Orquera-Tornakian GK; Garrido P; Kronmiller B; Hunger R; Tyler BM; Garzon CD; Marek SM
[Ad] Endereço:Department of Entomology and Plant Pathology, Oklahoma State University, Stillwater, OK 74078, United States. Electronic address: orquera@okstate.edu.
[Ti] Título:Identification and characterization of simple sequence repeats (SSRs) for population studies of Puccinia novopanici.
[So] Source:J Microbiol Methods;139:113-122, 2017 08.
[Is] ISSN:1872-8359
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Switchgrass (Panicum virgatum L.) can be severely affected by rust disease. Recently switchgrass rust caused by P. emaculata (now confirmed to be Puccinia novopanici) has received most of the attention by the research community because this pathogen is responsible for reducing the biomass production and biofuel feedstock quality of switchgrass. Microsatellite markers found in the literature were either not informative (no allele frequency) or showed few polymorphisms in the target populations, therefore additional markers are needed for future studies of the genetic variation and population structure of P. novopanici. This study reports the development and characterization of novel simple sequence repeat (SSR) markers from a Puccinia emaculata s.l. microsatellite-enriched library and expressed sequence tags (ESTs). Microsatellites were evaluated for polymorphisms on P. emaculata s.l. urediniospores collected in Iowa (IA), Mississippi (MS), Oklahoma (OK), South Dakota (SD) and Virginia (VA). Puccinia novopanici single spore whole genome amplifications were used as templates to validate the SSR reactions protocol and to assess a preliminary population genetics statistics of the pathogen. Eighteen microsatellite markers were polymorphic (average PIC=0.72) on individual urediniospores, with an average of 8.3 alleles per locus (range 3 to 17). Of the 49 SSRs loci initially identified in P. emaculata s.l., 18 were transferable to P. striiformis f. sp. tritici, 23 to P. triticina, 20 to P. sorghi and 31 to P. andropogonis. Thus, these markers could be useful for DNA fingerprinting and population structure analysis for population genetics, epidemiology and ecological studies of P. novopanici and potentially other related Puccinia species.
[Mh] Termos MeSH primário: Basidiomycota/genética
Genoma Fúngico
Repetições de Microssatélites
Reação em Cadeia da Polimerase/métodos
[Mh] Termos MeSH secundário: Basidiomycota/classificação
Basidiomycota/crescimento & desenvolvimento
Basidiomycota/patogenicidade
Etiquetas de Sequências Expressas
Biblioteca Gênica
Marcadores Genéticos
Variação Genética
Iowa
Tipagem Molecular
Polimorfismo Genético
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Genetic Markers)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29095802
[Au] Autor:Doney BC; Henneberger PK; Humann MJ; Liang X; Kelly KM; Cox-Ganser JM
[Ad] Endereço:Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia.
[Ti] Título:Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults.
[So] Source:MMWR Surveill Summ;66(21):1-5, 2017 Nov 03.
[Is] ISSN:1545-8636
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PROBLEM/CONDITION: Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. REPORTING PERIOD: 1994-2011. DESCRIPTION OF SYSTEM: This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. RESULTS: The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. INTERPRETATION: Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. PUBLIC HEALTH ACTION: The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.
[Mh] Termos MeSH primário: Poluentes Ocupacionais do Ar/análise
Poeira/análise
Gases/análise
Exposição Ocupacional/estatística & dados numéricos
População Rural/estatística & dados numéricos
População Urbana/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Poluentes Ocupacionais do Ar/efeitos adversos
Estudos de Coortes
Feminino
Gases/efeitos adversos
Seres Humanos
Iowa/epidemiologia
Masculino
Meia-Idade
Doenças Profissionais/epidemiologia
Exposição Ocupacional/efeitos adversos
Ocupações/estatística & dados numéricos
Doença Pulmonar Obstrutiva Crônica/epidemiologia
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Air Pollutants, Occupational); 0 (Dust); 0 (Gases)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171103
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.ss6621a1


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[PMID]:28886597
[Au] Autor:Montgomery MP; Postel E; Umbach DM; Richards M; Watson M; Blair A; Chen H; Sandler DP; Schmidt S; Kamel F
[Ad] Endereço:Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS) , Research Triangle Park, North Carolina, USA.
[Ti] Título:Pesticide Use and Age-Related Macular Degeneration in the Agricultural Health Study.
[So] Source:Environ Health Perspect;125(7):077013, 2017 07 19.
[Is] ISSN:1552-9924
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Few studies have investigated its relationship to environmental neurotoxicants. In previous cross-sectional studies, we found an association between pesticide use and self-reported retinal degeneration. OBJECTIVE: We evaluated the association of pesticide use with physician-confirmed incident AMD. METHODS: The Agricultural Health Study (AHS) is a prospective cohort of pesticide applicators and their spouses enrolled from 1993-1997 in Iowa and North Carolina. Cohort members reported lifetime use of 50 specific pesticides at enrollment. Self-reports of incident AMD during follow-up through 2007 were confirmed by reports from participants' physicians and by independent evaluation of retinal photographs provided by the physicians. Confirmed cases ( =161) were compared with AHS cohort members without AMD ( =39,108). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by logistic regression with adjustment for age, gender, and smoking. RESULTS: AMD was associated with ever use of organochlorine [OR=2.7 (95% CI: 1.8, 4.0)] and organophosphate [OR=2.0 (95% CI: 1.3, 3.0)] insecticides and phenoxyacetate herbicides [OR=1.9 (95% CI: 1.2, 2.8)]. Specific pesticides consistently associated with AMD included chlordane, dichlorodiphenyltrichloroethane (DDT), malathion, and captan; others with notable but slightly less consistent associations were heptachlor, diazinon, phorate, 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), and 2,4-dichlorophenoxyacetic acid (2,4-D). Results were similar for men and women. Some specific pesticides were associated with both early- and late-stage AMD, but others were associated with only one stage. CONCLUSIONS: Exposures to specific pesticides may be modifiable risk factors for AMD. https://doi.org/10.1289/EHP793.
[Mh] Termos MeSH primário: Doenças dos Trabalhadores Agrícolas/epidemiologia
Degeneração Macular/epidemiologia
Praguicidas/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doenças dos Trabalhadores Agrícolas/induzido quimicamente
Estudos de Casos e Controles
Feminino
Seres Humanos
Incidência
Iowa/epidemiologia
Modelos Logísticos
Degeneração Macular/induzido quimicamente
Masculino
Meia-Idade
North Carolina/epidemiologia
Exposição Ocupacional
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pesticides)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1289/EHP793


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[PMID]:28885427
[Au] Autor:Grossman D; Grindlay K
[Ad] Endereço:Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California; and Ibis Reproductive Health, Cambridge, California.
[Ti] Título:Safety of Medical Abortion Provided Through Telemedicine Compared With In Person.
[So] Source:Obstet Gynecol;130(4):778-782, 2017 Oct.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service. METHODS: We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year. RESULTS: During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion. CONCLUSION: Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events.
[Mh] Termos MeSH primário: Aborto Induzido/efeitos adversos
Assistência Ambulatorial/estatística & dados numéricos
Avaliação de Resultados (Cuidados de Saúde)
Complicações Pós-Operatórias/epidemiologia
Telemedicina/estatística & dados numéricos
[Mh] Termos MeSH secundário: Aborto Induzido/métodos
Adulto
Assistência Ambulatorial/métodos
Feminino
Seres Humanos
Iowa/epidemiologia
Complicações Pós-Operatórias/etiologia
Gravidez
Estudos Retrospectivos
Telemedicina/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002212


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[PMID]:28877026
[Au] Autor:Cardemil CV; Dahl RM; James L; Wannemuehler K; Gary HE; Shah M; Marin M; Riley J; Feikin DR; Patel M; Quinlisk P
[Ad] Endereço:From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
[Ti] Título:Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control.
[So] Source:N Engl J Med;377(10):947-956, 2017 09 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity. METHODS: Of 20,496 university students who were enrolled during the 2015-2016 academic year, mumps was diagnosed in 259 students. We used Fisher's exact test to compare unadjusted attack rates according to dose status and years since receipt of the second MMR vaccine dose. We used multivariable time-dependent Cox regression models to evaluate vaccine effectiveness, according to dose status (three vs. two doses and two vs. no doses) after adjustment for the number of years since the second dose. RESULTS: Before the outbreak, 98.1% of the students had received at least two doses of MMR vaccine. During the outbreak, 4783 received a third dose. The attack rate was lower among the students who had received three doses than among those who had received two doses (6.7 vs. 14.5 cases per 1000 population, P<0.001). Students had more than nine times the risk of mumps if they had received the second MMR dose 13 years or more before the outbreak. At 28 days after vaccination, receipt of the third vaccine dose was associated with a 78.1% lower risk of mumps than receipt of a second dose (adjusted hazard ratio, 0.22; 95% confidence interval, 0.12 to 0.39). The vaccine effectiveness of two doses versus no doses was lower among students with more distant receipt of the second vaccine dose. CONCLUSIONS: Students who had received a third dose of MMR vaccine had a lower risk of mumps than did those who had received two doses, after adjustment for the number of years since the second dose. Students who had received a second dose of MMR vaccine 13 years or more before the outbreak had an increased risk of mumps. These findings suggest that the campaign to administer a third dose of MMR vaccine improved mumps outbreak control and that waning immunity probably contributed to propagation of the outbreak. (Funded by the Centers for Disease Control and Prevention.).
[Mh] Termos MeSH primário: Surtos de Doenças/prevenção & controle
Imunização Secundária
Vacina contra Sarampo-Caxumba-Rubéola/imunologia
Caxumba/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Iowa/epidemiologia
Masculino
Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem
Caxumba/epidemiologia
Caxumba/imunologia
Modelos de Riscos Proporcionais
Risco
Estudantes
Universidades
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Measles-Mumps-Rubella Vaccine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1703309


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[PMID]:28864373
[Au] Autor:Schaffner M; Rosenstein L; Ballas Z; Suneja M
[Ad] Endereço:Department of Internal Medicine (MeS, MaS, ZB), Division of Hematology and Oncology (MeS), Division of Allergy and Immunology (ZB), University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address: meredith-schaffner@uiowa.edu.
[Ti] Título:Significance of Hyperferritinemia in Hospitalized Adults.
[So] Source:Am J Med Sci;354(2):152-158, 2017 Aug.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although high ferritin levels are associated with iron overload, it is known that ferritin is also an acute-phase reactant that may be elevated in conditions associated with acute and chronic inflammation. In addition, an elevated ferritin level is a criterion for the diagnosis of hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Therefore, the significance of elevated serum ferritin is often unclear. As HLH/MAS is a medical emergency, prompt diagnosis is important to guide appropriate treatment. MATERIALS AND METHODS: To study the spectrum of diagnoses associated with elevated serum ferritin, we did a retrospective review of adult patients admitted to our academic medical center from 2008-2012 with serum ferritin levels greater than 2,000ng/mL. The degree of hyperferritinemia was compared to different diagnoses and selected laboratory values. RESULTS: A total of 333 patients were identified with a serum ferritin level >2,000ng/mL. Hepatocellular injury was the most prevalent diagnosis with n = 126; infection was next with n = 96. Eleven patients were diagnosed with HLH/MAS. CONCLUSIONS: Elevated ferritin, as an isolated finding, was not a specific marker for the diagnosis of HLH/MAS. However, as a group, HLH/MAS patients had the highest mean and median ferritin values.
[Mh] Termos MeSH primário: Ferritinas/metabolismo
Sobrecarga de Ferro/complicações
Sobrecarga de Ferro/diagnóstico
Linfo-Histiocitose Hemofagocítica/epidemiologia
Síndrome de Ativação Macrofágica/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Iowa/epidemiologia
Linfo-Histiocitose Hemofagocítica/etiologia
Síndrome de Ativação Macrofágica/etiologia
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9007-73-2 (Ferritins)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170903
[St] Status:MEDLINE


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[PMID]:28841521
[Au] Autor:Roh T; Lynch CF; Weyer P; Wang K; Kelly KM; Ludewig G
[Ad] Endereço:Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA 52242, United States.
[Ti] Título:Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa.
[So] Source:Environ Res;159:338-343, 2017 11.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Inorganic arsenic is a toxic naturally occurring element in soil and water in many regions of the US including the Midwest. Prostate cancer is the second most common type of cancer in men in Iowa, surpassed only by non-melanotic skin cancer. Epidemiology studies have evaluated arsenic exposure from drinking water and prostate cancer, but most have focused on high-level exposures outside the US. As drinking water from groundwater sources is a major source of arsenic exposure, we conducted an ecologic study to evaluate prostate cancer and arsenic in drinking water from public water sources and private wells in Iowa, where exposure levels are low, but duration of exposure can be long. Arsenic data from public water systems were obtained from the Iowa Safe Drinking Water Information System for the years 1994-2003 and for private wells from two Iowa Well Water Studies, the Iowa Community Private Well Study (ICPWS, 2002-2003) and Iowa Statewide Rural Well Water Survey Phase 2 (SWIRL2, 2006-2008) that provided data for 87 Iowa counties. Prostate cancer incidence data from 2009 to 2013 for Iowa were obtained from Surveillance, Epidemiology and End Results' SEER*Stat software. County averages of water arsenic levels varied from 1.08 to 18.6 ppb, with three counties above the current 10 ppb limit. Based on the tertiles of arsenic levels, counties were divided into three groups: low (1.08-2.06 ppb), medium (2.07-2.98 ppb), and high (2.99-18.6 ppb). Spatial Poisson regression modeling was conducted to estimate the risk ratios (RR) of prostate cancer by tertiles of arsenic level at a county level, adjusted for demographic and risk factors. The RR of prostate cancer were 1.23 (95% CI, 1.16-1.30) and 1.28 (95% CI, 1.21-1.35) in the medium and high groups, respectively, compared to the low group after adjusting for risk factors. The RR increased to 1.36 (95% CI, 1.28-1.45) in the high group when analyses were restricted to aggressive prostate cancers (Gleason score ≥ 7). This study shows a significant dose-dependent association between low-level arsenic exposure and prostate cancer, and if this result is replicated in future individual-level studies, may suggest that 10 ppb is not protective for human health.
[Mh] Termos MeSH primário: Arsênico/análise
Água Potável/análise
Exposição Ambiental
Neoplasias da Próstata/epidemiologia
Poluentes Químicos da Água/análise
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Incidência
Iowa/epidemiologia
Masculino
Meia-Idade
Neoplasias da Próstata/induzido quimicamente
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Drinking Water); 0 (Water Pollutants, Chemical); N712M78A8G (Arsenic)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE


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[PMID]:28834807
[Au] Autor:Lofgren MA; Berends SK; Reyes J; Wycoff C; Kinnetz M; Frohling A; Baker L; Whitty S; Dirks M; OʼBrien M
[Ad] Endereço:Authors Affiliations: Director of Advanced Practice Providers (Dr Lofgren) and Nurse Practitioner (Dr Berends), University of Iowa Hospitals and Clinics, Iowa City; Associate Director of Practice and Education, Iowa Board of Nursing, Des Moines (Dr Reyes); Assistant Professor of Nursing, Clarke University, Dubuque (Dr Wycoff); Advanced Practice Registered Nurse, Mercy Medical Center, Des Moines (Ms Kinnetz); Vascular Nurse Practitioner/Care Coordinator, Mercy Heart and Vascular, Mason City (Ms Frohling); Director, Advanced Practice Nursing, Unity Point Health-Des Moines (Ms Baker); Advanced Practice Registered Nurse and Therapist, Hillcrest Mental Health Center, and Counselor and Coordinator, School Based Youth Services Program, Dubuque (Ms Whitty); and Professor and Assistant Dean for Graduate Practice Programs, The University of Iowa College of Nursing (Dr Dirks); and Certified Registered Nurse Anesthetist, University of Iowa Hospitals and Clinics (Dr O'Brien), Iowa.
[Ti] Título:Scope of Practice Barriers for Advanced Practice Registered Nurses: A State Task Force to Minimize Barriers.
[So] Source:J Nurs Adm;47(9):465-469, 2017 Sep.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Collegial relationships, administrative champions, and persistence are key components to breaking down barriers to advanced practice RN (APRN) practice. This article addresses how Iowa APRNs in a state-sanctioned task force identified barriers for practicing at the top of their licensure in a full practice authority state including defending the right to control the scope of nursing practice in court.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem/organização & administração
Licenciamento em Enfermagem/normas
Profissionais de Enfermagem/organização & administração
[Mh] Termos MeSH secundário: Prática Avançada de Enfermagem/normas
Seres Humanos
Iowa
Profissionais de Enfermagem/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000515



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