Quality of life in diabetes mellitus and the International Classification of Functioning Disability and Health: a study of some aspects

O diabetes mellitus (DM) pode ter um efeito profundo na qualidade de vida dos pacientes e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) é um instrumento válido para verificar a influência dos componentes de saúde na qualidade de vida. O objetivo deste estudo, é apresentar a distribuição de freqüência das categorias das CIF do Core Set resumido para DM, com comprometimento grave em um grupo de pacientes com a qualidade de vida muito afetada pelo diabetes. Métodos: Foram estudados 38 pacientes diabéticos, 76,3 % com DM2 e 23,7 % com DM1, utilizando-se dados clínicos, informação de qualidade de vida associada ao diabetes do questionário AddQoL e incapacidade associada ao diabetes: categorias do Core Set resumido da CIF com comprometimento grave e completo, e categorias cuja informação era insuficiente para especificar a gravidade do comprometimento. Análise estatística: análise descritiva dos dados. Resultados: Categorias de funções corporais mais gravemente afetadas foram b130, b210, b530, b540, de estruturas corporais foram s220, s410, s740, de atividades/participação foram d240, d570 e de fatores ambientais foram e110, e115. As estruturas menos classificadas foram pâncreas (s550), globo ocular (s220) e sistema nervoso parassimpático (s150). Conclusão: No grupo estudado de diabéticos com complicações crônicas, controle metabólico inadequado e qualidade de vida muito afetada pela doença, a presença de incapacidade no cuidado pessoal e de barreiras ambientais, é sugestivo de que estes fatores possam contribuir para uma pior qualidade de vida, embora comprometimentos nas funções e estruturas corporais tenham sido os mais prevalentes.Diabetes mellitus (DM) can have a profound impact on the patients’ quality of life and the International Classification on Functioning, Disability and Health (ICF) is a valid tool to verify the influence of the health components on quality of life. Objective: The aim of this study is to present the frequency distribution of the ICF categories of the summarized Core Set for DM with severe involvement in a group of patients whose quality of life was deeply affected by DM. Methods: A total of 38 patients with DM were studied, of whom 76.3 % had DM2 and 23.7% had DM1, using the clinical data, information on the quality of life associated to DM from the AddQoL questionnaire and the disability associated to diabetes: categories of the summarized Core Set of the ICF with severe and complete involvement and categories of which information was insufficient to specify the severity of the involvement. Statistical analysis: The descriptive analysis of the data was performed. Results: The bodily function categories that were more severely affected were b130, b210, b530, b540; categories of body structures were s220, s410, s740; of activities/participation were d240, d570 and of environmental factors were e110, e115. The least classified structures were the pancreas (s550), ocular globe (s220) and parasympathetic nervous system (s150). Conclusion: In the studied group of patients with DM that presented chronic complications, inadequate metabolic control and quality of life that was deeply affected by the disease, the presence of disability in self-care and environmental barriers suggests that these factors can contribute to a worsening in the quality of life, although bodily function and structure involvements were the most prevalent ones

Influence of the interaction between nodal fibroblast and breast cancer cells on gene expression

Our aim was to evaluate the interaction between breast cancer cells and nodal fibroblasts, by means of their gene expression profile. Fibroblast primary cultures were established from negative and positive lymph nodes from breast cancer patients and a similar gene expression pattern was identified, following cell culture. Fibroblasts and breast cancer cells (MDA-MB231, MDA-MB435, and MCF7) were cultured alone or co-cultured separated by a porous membrane (which allows passage of soluble factors) for comparison. Each breast cancer lineage exerted a particular effect on fibroblasts viability and transcriptional profile. However, fibroblasts from positive and negative nodes had a parallel transcriptional behavior when co-cultured with a specific breast cancer cell line. The effects of nodal fibroblasts on breast cancer cells were also investigated. MDA MB-231 cells viability and migration were enhanced by the presence of fibroblasts and accordingly, MDA-MB435 and MCF7 cells viability followed a similar pattern. MDA-MB231 gene expression profile, as evaluated by cDNA microarray, was influenced by the fibroblasts presence, and HNMT, COMT, FN3K, and SOD2 were confirmed downregulated in MDA-MB231 co-cultured cells with fibroblasts from both negative and positive nodes, in a new series of RT-PCR assays. In summary, transcriptional changes induced in breast cancer cells by fibroblasts from positive as well as negative nodes are very much alike in a specific lineage. However, fibroblasts effects are distinct in each one of the breast cancer lineages, suggesting that the inter-relationships between stromal and malignant cells are dependent on the intrinsic subtype of the tumor

Accurate and homogeneous abundance patterns in solar-type stars of the solar neighbourhood: a chemo-chronological analysis

We report the abundances of C, Na, Mg, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Sr, Y, Zr, Ba, Ce, Nd, and Sm in 25 solar-type stars in the solar neighbourhood, and their correlations with ages, kinematics, and orbital parameters. The spectroscopic analysis, based high resolution and high S/N ratio data, was differential to the Sun and applied to atomic line EWs and to C and C2 spectral synthesis. We performed a statistical study using a tree clustering analysis, searching for groups of stars sharing similar abundance patterns. We derived Teff, log(g), and [Fe/H] with errors of 30 K, 0.13 dex, and 0.05 dex, respectively. The average error in [X/Fe] is 0.06 dex. Ages were derived from theoretical HR diagrams and memberships in kinematical moving groups. We identified four stellar groups: with over-solar abundances ( = +0.26 dex), under-solar abundances ( = -0.24 dex), and intermediate values ( = -0.06 and +0.06 dex) but with distinct chemical patterns. Stars sharing solar metallicity, age, and Galactic orbit possibly have non-solar abundance, an effect either of chemical heterogeneity in their natal clouds or migration. A trend of [Cu/Fe] with [Ba/Fe] seems to exist, in agreement with previous claims in the literature, and maybe also of [Sm/Fe] with [Ba/Fe]. No such correlation involving C, Na, Mn, and Zn is observed. [Mg/Fe], [Sc/Fe], and [Ti/Fe] increase with age. [Mn/Fe] and [Cu/Fe] first increase towards younger stars up to the solar age, and then decrease, a result we interpret as possibly related to time-varying yields of SN Ia and the weak s-process. [Sr/Fe], [Y/Fe], [Sr/Mg], [Y/Mg], [Sr/Zn], and [Y/Zn] linearly increase towards younger stars. [Zr/Fe], [Ce/Fe], [Nd/Fe], [Ba/Mg], [Ba/Zn], and [Sr,Y,Ba/Sm] increase but only for stars younger than the Sun. The steepest negative age relation is due to [Ba/Fe], but only for stars younger than the Sun.Comment: 27 pages, 11 figures, 10 table

Genetic Ancestry, Race, and Severity of Acutely Decompensated Cirrhosis in Latin America

Background & Aims: Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on-chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death. / Methods: This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries. / Results: Three hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03–1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84–3.58) for Native American race vs European American race. / Conclusions: In a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment

PINK DOESN’T MEAN WEAK: UNVEILING THE TRIUMPHS AND CHALLENGES OF WOMEN ENTREPRENEURS IN BALAYAN, BATANGAS

The world of entrepreneurship has historically been linked with taking risks and the potential for significant rewards. However, there persists a notable gender imbalance in the entrepreneurial landscape, wherein women entrepreneurs remain a minority. Women navigating the entrepreneurial path encounter distinct challenges, setting their experiences apart from their male counterparts. In Balayan, Batangas, despite strides towards gender equality, women entrepreneurs continue to face challenges in the entrepreneurial landscape. This qualitative study delves into the experiences of 10 successful female entrepreneurs who met specific criteria. Accordingly, semi-structured interviews are conducted, exploring various aspects of participants' experiences and revealing their motivations, achievements, challenges, and strategies. Thematic analysis reveals the connection between familial, community-driven, and personal motivations that drive these entrepreneurs forward. Despite facing obstacles such as financial constraints and gender biases, they prioritize financial gains and personal growth. With resilience, innovation, and dedication, these women overcome challenges and achieve success, utilizing support networks and online marketing strategies to their advantage. Recommendations include empowering women in entrepreneurship, strengthening support networks, introducing tailored financial literacy programs, and advocating against gender biases. Implement skill development initiatives and provide specialized education in online marketing. Engage in policy advocacy, celebrate success stories, and continuously research challenges and successes. Foster collaborative partnerships between businesses, educational institutions, and communities, and advocate for increased funding opportunities for sustainable growth. This research emphasizes the strength and capabilities of women entrepreneurs in Balayan, Batangas, affirming that "pink doesn't mean weak.

Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort.

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced ≥1 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with ≥1 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not ≥5. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin.This study was sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Support for third-party writing assistance for this manuscript, furnished by Blair Jarvis MSc, ELS, of Health Interactions, was provided by F. Hoffmann-La Roche Ltd, Basel, Switzerland

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. Results: SVR24 rates were 46.1 % (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1,2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. Conclusions: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginter-feron alfa-2a/ribavirin