6 research outputs found
Quality of life and intrinsic capacity in patients with post-acute COVID-19 syndrome is in relation to frailty and resilience phenotypes.
Background- The objective of this study was to characterize frailty and resilience in people evaluated for Post-Acute COVID-19 Syndrome (PACS), in relation to quality of life (QoL) and Intrinsic Capacity (IC).
Methods- This cross-sectional, observational, study included consecutive people previously hospitalized for severe COVID-19 pneumonia attending Modena (Italy) PACS Clinic from July 2020 to April 2021. Four frailty-resilience phenotypes were built: “fit/resilient”, “fit/non-resilient”, “frail/resilient” and “frail/non-resilient”. Frailty and resilience were defined according to frailty phenotype and Connor Davidson resilience scale (CD-RISC-25) respectively. Study outcomes were: QoL assessed by means of Symptoms Short form health survey (SF-36) and health-related quality of life (EQ-5D-5L) and IC by means of a dedicated questionnaire. Their predictors including frailty-resilience phenotypes were explored in logistic regressions.
Results- 232 patients were evaluated, median age was 58.0 years. PACS was diagnosed in 173 (74.6%) patients. Scarce resilience was documented in 114 (49.1%) and frailty in 72 (31.0%) individuals. Predictors for SF-36 score <61.60 were the phenotypes “frail/non-resilient” (OR=4.69, CI:2.08-10.55), “fit/non-resilient” (OR=2.79, CI:1.00-7.73). Predictors for EQ-5D-5L <89.7% were the phenotypes “frail/non-resilient” (OR=5.93, CI: 2.64-13.33) and “frail/resilient” (OR=5.66, CI:1.93-16.54). Predictors of impaired IC (below the mean score value) were “frail/non-resilient” (OR=7.39, CI:3.20-17.07), and “fit/non-resilient” (OR=4.34, CI:2.16-8.71) phenotypes.
Conclusions- Resilience is complementary to frailty in the identification of clinical phenotypes with different impact on wellness and QoL. Frailty and resilience should be evaluated in hospitalized COVID-19 patients to identify vulnerable individuals to prioritize urgent health interventions in people with PACS
Decreased ghrelin and des-acyl ghrelin plasma levels in patients affected by pharmacoresistant epilepsy and maintained on the ketogenic diet
Background & aims. The gastric hormones ghrelin and des-acyl
ghrelin have been found to be altered in patients treated with
antiepileptic drugs. However, it is unknown if these hormones could be
modified by other antiepileptic treatments, such as the ketogenic diet.
Especially, a reduction in ghrelin levels could be relevant in view of
the growth retardation observed under ketogenic diet treatment. For this
reason we aimed to determine the changes in ghrelin and des-acyl ghrelin
plasma levels in children affected by refractory epilepsy and treated
with the ketogenic diet up to 90 days.
Methods. Both peptides were measured by immunoassays in plasma obtained
from 16 children.
Results. Ghrelin plasma levels were progressively reduced by the
ketogenic diet, reaching a minimum corresponding to 42% of basal levels
after 90 days of ketogenic diet (P < 0.05, Duncan's test). Des-acyl
ghrelin plasma levels were similarly affected, reaching minimal levels at
30 days (65% of basal levels), and maintaining a significant reduction
until 90 days after the onset of ketogenic diet (P < 0.01 for both time
intervals). No significant changes in growth were observed during the
monitored period of ketogenic diet administration.
Conclusions. Ghrelin and des-acyl ghrelin are downregulated by the
ketogenic diet in children affected by refractory epilepsy. Although no
significant changes in growth were observed during the short time period
of our investigation, the reduction in ghrelin availability may explain
the reported growth retardation found in children treated with the
ketogenic diet in the long-term
Biological and clinical features of triple negative Invasive Lobular Carcinomas of the breast. Clinical outcome and actionable molecular alterations.
We report here for the first time, a comprehensive characterization of biological and clinical features of early-stage triple negative Invasive Lobular Carcinomas(TN-ILCs) METHODS: We analyzed all consecutive patients with early-stage TN-ILC operated at two reference cancer-centers between 1994 and 2012. Primary objective was to assess the invasive disease-free survival(iDFS). Co-primary objective was to assess biological features of TN-ILCs, including molecular intrinsic subtypes based on PAM-50 assay, expression of androgen receptor (AR) and mutational status of ERBB2-gene. Additionally, DNA mutational status of an independent cohort of 45Â TN-ILCs from three databases were analyzed, to confirm mutations in ERBB2-gene and to identify other recurrently mutated genes.info:eu-repo/semantics/publishe