The impact of polymorphic variations in the 5p15, 6p12, 6p21 and 15q25 loci on the risk and prognosis of Portuguese patients with non-small cell lung cancer

Polymorphic variants in the 5p15, 6p12, 6p21, and 15q25 loci were demonstrated to potentially contribute to lung cancer carcinogenesis. Therefore, this study was performed to assess the role of those variants in non-small cell lung cancer (NSCLC) risk and prognosis in a Portuguese population. MATERIALS AND METHODS: Blood from patients with NSCLC was prospectively collected. To perform an association study, DNA from these patients and healthy controls were genotyped for a panel of 19 SNPs using a Sequenom® MassARRAY platform. Kaplan-Meier curves were used to assess the overall survival (OS) and progression-free survival (PFS). RESULTS: One hundred and forty-four patients with NSCLC were successfully consecutively genotyped for the 19 SNPs. One SNP was associated with NSCLC risk: rs9295740 G/A. Two SNPs were associated with non-squamous histology: rs3024994 (VEGF intron 2) T/C and rs401681 C/T. Three SNPs were associated with response rate: rs3025035 (VEGF intron 7) C/T, rs833061 (VEGF -460) C/T and rs9295740 G/A. One SNP demonstrated an influence on PFS: rs401681 C/T at 5p15, p?=?0.021. Four SNPs demonstrated an influence on OS: rs2010963 (VEGF +405 G/C), p?=?0.042; rs3025010 (VEGF intron 5 C/T), p?=?0.047; rs401681 C/T at 5p15, p?=?0.046; and rs31489 C/A at 5p15, p?=?0.029. CONCLUSIONS: Our study suggests that SNPs in the 6p12, 6p21, and 5p15 loci may serve as risk, predictive and prognostic NSCLC biomarkers. In the future, SNPs identified in the genomes of patients may improve NSCLC screening strategies and therapeutic management as well.This project was supported by Programa Doutoral em Medicina e Oncologia Molecular, University of Porto, Porto, Portugal and University of Minho, Braga, Portugal. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Eficácia da reabilitação pulmonar uma vez na semana em portadores de doença pulmonar obstrutiva Effectiveness of pulmonary rehabilitation once a week for patients with obstructive pulmonary disease

CONTEXTUALIZAÇÃO: As doenças pulmonares obstrutivas podem interferir negativamente na qualidade de vida (QV) dos pacientes, sendo que questionários específicos, como o Chronic Respiratory Questionnaire (CRQ), são aplicados para quantificar o impacto da doença e para mensurar os efeitos de diferentes protocolos de reabilitação. OBJETIVOS: Avaliar a eficácia da reabilitação pulmonar uma vez por semana associada a exercícios domiciliares em pacientes com doença pulmonar obstrutiva por meio das comparações do CRQ, das pressões respiratórias máximas (PImáx e PEmáx) e da distância percorrida no teste de caminhada de seis minutos (TC6) pré e pós-tratamento. MÉTODO: O estudo foi desenvolvido no Ambulatório de Fisioterapia do hospital. Foram avaliados 34 portadores de doença pulmonar obstrutiva de ambos os sexos, sendo incluídos, no estudo, 19 pacientes, com idade média de 60,8 ± 14,2 anos. Todos realizaram avaliação e reavaliação fisioterapêutica contendo medidas de PImáx, PEmáx, TC6, e questionário CRQ. A fisioterapia era composta de exercícios respiratórios, aeróbios e resistidos, com freqüência de uma vez por semana, durante 12 semanas, associados a exercícios domiciliares duas vezes na semana. RESULTADOS: Foram utilizados os testes de Wilcoxon e de correlação de Spearman. Verificou-se diferença estatisticamente significativa nos períodos pré e pós-reabilitação para todos os domínios do CRQ (p< 0,05), na PImáx (p= 0,01) e PEmáx (p= 0,002). CONCLUSÃO: O programa proposto melhorou a qualidade de vida e promoveu incrementos nas pressões respiratórias máximas de pneumopatas obstrutivos, apesar de a literatura atual sugerir maior freqüência de treinamento.<br>BACKGROUND: Obstructive pulmonary diseases may interfere negatively with patients' quality of life (QOL). Specific QOL questionnaires such as the Chronic Respiratory Questionnaire (CRQ) have been used to quantify the impact of the disease and measure the effects of different rehabilitation protocols. OBJECTIVE: To evaluate the effectiveness of pulmonary rehabilitation performed once a week in association with exercises at home among patients with obstructive pulmonary disease, by means of CRQ comparisons, maximum respiratory pressures (MIP and MEP) and six-minute walking distance test (6MWD), before and after treatment. METHODS: This study was developed in the physical therapy outpatient clinic of the hospital. Thirty-four patients of both sexes with obstructive pulmonary disease were evaluated, and nineteen (mean age: 60.8 ± 14.2 years) were included in the study. These subjects all underwent physiotherapeutic evaluation and reevaluation with the CRQ and measurements of MIP, MEP and 6MWD. The physical therapy consisted of respiratory, aerobic and resistance exercises once a week for 12 weeks, together with home exercises twice a week. RESULTS: The Wilcoxon test and Spearman correlation were used. Statistically significant differences between evaluations before and after rehabilitation were found for all CRQ domains (p< 0.05), MIP (p= 0.01) and MEP (p= 0.002). CONCLUSION: The proposed program improved QOL and promoted increases in maximum respiratory pressures among these patients with obstructive pulmonary disease, even though the current literature suggests that higher frequency of training is needed

Fisioterapia respiratória associada à pressão positiva nas vias aéreas na evolução pós-operatória da cirurgia bariátrica Respiratory physiotherapy associated with airway positive pressure in the postoperative bariatric surgery evolution

Analisar volume corrente (VC), volume minuto (VM) e frequência respiratória (FR) de obesas mórbidas no pós-operatório de cirurgia bariátrica (CB), após a fisioterapia respiratória convencional (FRC) associada ou não à pressão positiva contínua nas vias aéreas (CPAP) no pré-operatório. Foram estudadas 36 mulheres, com idade de 40,1±8,41 anos, que seriam submetidas à CB por laparotomia e que realizaram FRC (exercícios respiratórios diafragmáticos, de inspirações profundas, fracionadas e associados a movimentos de membros superiores, 1 série de 10 repetições de cada exercício) por 30 dias antes da cirurgia. Após internação, 18 delas foram submetidas a 20 minutos de CPAP, 1 hora antes da indução anestésica e compuseram o grupo FRC+CPAP. As outras 18 não receberam o CPAP e compuseram o grupo FRC. Foram avaliados VM, VC e FR por meio do ventilômetro, no momento da internação e 24 horas após a realização da cirurgia. Constatou-se que as medidas de VC, VM e FR não apresentaram significância estatística quando comparados os resultados do pré e pós-operatório em ambos os grupos, bem como quando comparados os dois grupos entre si tanto no pré como no pós-operatório. Os resultados sugerem que a tanto a aplicação da FRC como a aplicação da FRC+CPAP no período pré-operatório contribui para a manutenção das variáveis respiratórias no pós-operatório. A aplicação do CPAP antes da indução anestésica não promoveu benefícios adicionais no pós-operatório de CB no que se refere aos volumes pulmonares.<br>To assess the tidal volume (VT), minute volume (MV) and respiratory rate (RR) of morbidly obese women in postoperative bariatric surgery (BS), after the conventional respiratory physiotherapy (CRP) with or without preoperatively continuous positive airway pressure (CPAP). Thirty-six women, aged 40.1±8.41 years, that would be submitted to BS by laparotomy were studied. All of them underwent preoperative outpatient conventional respiratory physiotherapy (CRP) (diaphragmatic breathing exercises, deep breathing, fractionated breathing and breathing associated to movements of the upper limbs, a series of 10 repetitions of each exercise) by 30 days. Once admitted, 18 were subjected to 20 minutes of CPAP, an hour before induction of anesthesia and composed group CRP+CPAP. The other 18 did not receive CPAP and composed group CRP. VT, MV, and RR were performed through the ventilometer, at admission and 24 hours after surgery. It was found that measures of TV, VM and RR were not statistically significant when comparing pre and postoperative in both groups and as well as when the two groups were compared between them in both pre and postoperative. The results suggest that both the application and the implementation of FRC and FRC+CPAP in the preoperative period contribute to the maintenance of respiratory variables in the postoperative period. The use of CPAP before induction of anesthesia, did not provide additional benefits in the post-bariatric surgery with regard to the volumes