Agreement in interpersonal perception as a predictor of group performance

The present work deals with quantifying group characteristics. Specifically, dyadic measures of interpersonal perceptions were used to forecast group performance. 46 groups of students, 24 of four and 22 of five people, were studied in a real educational assignment context and marks were gathered as an indicator of group performance. Our results show that dyadic measures of interpersonal perceptions account for final marks. By means of linear regression analysis 85% and 85.6% of group performance was respectively explained for group sizes equal to four and five. Results found in the scientific literature based on the individualistic approach are no larger than 18%. The results of the present study support the utility of dyadic approaches for predicting group performance in social contexts.

Tachycardia is a strong predictor of cardiovascular events in the value trial

Objective: Tachycardia is associated with hypertension and is a predictor of cardiovascular events. The predictive effect of tachycardia might reflect its connection with hypertension. In this analysis of 15,245 VALUE study patients we explore whether tachycardia predicts cardiovascular endpoints in high risk hypertension and whether the in-trial blood pressure lowering modified the tachycardia - related risk. Methods: Heart rate from ECG readings at baseline and annually throughout the trial. Results: In the Cox Regression analysis the primary endpoint hazard ratio for a 10 beats per minute increment of baseline heart rate was 1.16 (1.12-1.2) p < 0.0001, 1.17 (1.13-1.22) p < 0.0001 and 1.22 (1.18-1.27) p < 0.0001 unadjusted, adjusted for baseline blood pressure and for blood pressure plus risk factors, respectively. Primary endpoints strikingly increased in the highest quintile of baseline heart rate (=/>79 beats). Primary endpoints in the highest heart rate quintile were 30 % higher in first, 55 % in second, 55 % in third, 52 % in fourth and 46 % in the fifth year of the study. The in-trial heart rate was also a potent predictor. The primary endpoint hazard ratios of highest heart rate quintile versus pooled lower 4 quintiles was (1.34-1.66) p < 0.0001 unadjusted, 1.52 (1.36-1.69) p <0.0001 adjusted for baseline blood pressure and risk factors and 1.52 (1.36-1.69) p < 0.0001 further adjusted for in trial pressure. The increase of primary events in the upper quintile of in-trial heart rate was 68% in the group with good and 63% in the group with inadequate blood pressure control (both p < 0.0001 by log rank test). Conclusions: 1./ Tachycardia is a short term marker and a long term predictor of adverse event in high risk hypertension. 2./ Tachycardia contributes to the residual cardiovascular risk regardless of the degree of BP control. We hypothesize heart rate lowering with appropriate drugs may further decrease the cardiovascular risk in patients with high risk hypertension and tachycardia.

IFN Stimulated Gene Expression in the Liver is a Better Predictor of Treatment Response in Chronic Hepatitis C than the IL28B (IFN lambda 3) Genotype

BACKGROUND: Therapy of chronic hepatitis C (CHC) with pegIFNα/ribavirin achieves a sustained virologic response (SVR) in ∼55%. Pre-activation of the endogenous interferon system in the liver is associated with non-response (NR). Recently, genome-wide association studies described associations of allelic variants near the IL28B (IFNλ3) gene with treatment response and with spontaneous clearance of the virus. We investigated if the IL28B genotype determines the constitutive expression of IFN stimulated genes (ISGs) in the liver of patients with CHC. METHODS: We genotyped 93 patients with CHC for 3 IL28B single nucleotide polymorphisms (SNPs, rs12979860, rs8099917, rs12980275), extracted RNA from their liver biopsies and quantified the expression of IL28B and of 8 previously identified classifier genes which discriminate between SVR and NR (IFI44L, RSAD2, ISG15, IFI22, LAMP3, OAS3, LGALS3BP and HTATIP2). Decision tree ensembles in the form of a random forest classifier were used to calculate the relative predictive power of these different variables in a multivariate analysis. RESULTS: The minor IL28B allele (bad risk for treatment response) was significantly associated with increased expression of ISGs, and, unexpectedly, with decreased expression of IL28B. Stratification of the patients into SVR and NR revealed that ISG expression was conditionally independent from the IL28B genotype, i.e. there was an increased expression of ISGs in NR compared to SVR irrespective of the IL28B genotype. The random forest feature score (RFFS) identified IFI27 (RFFS = 2.93), RSAD2 (1.88) and HTATIP2 (1.50) expression and the HCV genotype (1.62) as the strongest predictors of treatment response. ROC curves of the IL28B SNPs showed an AUC of 0.66 with an error rate (ERR) of 0.38. A classifier with the 3 best classifying genes showed an excellent test performance with an AUC of 0.94 and ERR of 0.15. The addition of IL28B genotype information did not improve the predictive power of the 3-gene classifier. CONCLUSIONS: IL28B genotype and hepatic ISG expression are conditionally independent predictors of treatment response in CHC. There is no direct link between altered IFNλ3 expression and pre-activation of the endogenous system in the liver. Hepatic ISG expression is by far the better predictor for treatment response than IL28B genotype.

A new early and automated MRI-based predictor of motor improvement after stroke.

OBJECTIVES: In this study, we investigated the structural plasticity of the contralesional motor network in ischemic stroke patients using diffusion magnetic resonance imaging (MRI) and explored a model that combines a MRI-based metric of contralesional network integrity and clinical data to predict functional outcome at 6 months after stroke. METHODS: MRI and clinical examinations were performed in 12 patients in the acute phase, at 1 and 6 months after stroke. Twelve age- and gender-matched controls underwent 2 MRIs 1 month apart. Structural remodeling after stroke was assessed using diffusion MRI with an automated measurement of generalized fractional anisotropy (GFA), which was calculated along connections between contralesional cortical motor areas. The predictive model of poststroke functional outcome was computed using a linear regression of acute GFA measures and the clinical assessment. RESULTS: GFA changes in the contralesional motor tracts were found in all patients and differed significantly from controls (0.001 ≤ p < 0.05). GFA changes in intrahemispheric and interhemispheric motor tracts correlated with age (p ≤ 0.01); those in intrahemispheric motor tracts correlated strongly with clinical scores and stroke sizes (p ≤ 0.001). GFA measured in the acute phase together with a routine motor score and age were a strong predictor of motor outcome at 6 months (r(2) = 0.96, p = 0.0002). CONCLUSION: These findings represent a proof of principle that contralesional diffusion MRI measures may provide reliable information for personalized rehabilitation planning after ischemic motor stroke. Neurology® 2012;79:39-46.

Success of thrombolysis as a predictor of outcome in acute thrombosis of popliteal aneurysms.

PURPOSE: Acute limb ischemia after thrombosis of a popliteal aneurysm is a distinct and limb-threatening entity. Preoperative intra-arterial thrombolysis may improve the outcome in this challenging situation. This study retrospectively analyzed a consecutive series of patients treated with preoperative thrombolysis and subsequent revascularization. METHODS: Thirteen patients with acute limb ischemia caused by thrombosis of a popliteal aneurysm underwent catheter-directed intra-arterial thrombolysis with urokinase and subsequent vascular reconstruction. The angiographic and clinical outcome was analyzed and compared with that in the literature. RESULTS: Complete aneurysm thrombosis with absence of runoff was documented in 12 cases. Thrombolysis restored perfusion with patency of the popliteal artery and a one- or two-vessel runoff in 77% of cases (10/13). Early cumulative graft patency and limb salvage rates were 68% and 83%, respectively, with an ankle/brachial index of 0.8 +/- 0.2. Lytic failure followed by attempts at bypass grafting was present in three patients (23%) and resulted in above-knee amputation. Severe rhabdomyolysis and fatal pulmonary embolism were responsible for a 15% early mortality rate. CONCLUSION: Preoperative thrombolysis followed by bypass grafting is a valid treatment option for patients who can withstand an additional period of ischemia that does not require immediate revascularization and intraoperative lysis. Lytic failure identifies patients with a highly compromised runoff who are probably best treated by means of subsequent amputation, without any attempts at bypass grafting.

Sagittal abdominal diameter is a better predictor than body mass index for duration of laparoscopic left colectomy.

BACKGROUND: Visceral obesity (VO) increases technical difficulty in laparoscopic surgery. The body mass index (BMI) does not always correlate to intra-abdominal fat distribution. Our hypothesis was that simple anthropometric measures that reflect VO, could predict technical difficulty in laparoscopic colorectal surgery, as reflected by the operative time, more accurately than the BMI. METHODS: Charts of all consecutive patients who underwent laparoscopic left colon resection in our institution between 2007 and 2010 were reviewed retrospectively. On a preoperative CT scan, anthropometric measures were taken on an axial plane at the L4-L5 level. Demographic, operative and anthropometric CT measures were correlated with the operative time. Logistic regression analysis was performed to assess the value of anthropometric CT measures or BMI to predict the duration of the colectomy. RESULTS: 121 patients with elective left colon resection for benign (56%) or malignant disease (44%) were included. There were 74 sigmoid resections (61%), 21 left hemicolectomies (17%) and 26 low anterior resections (22%). A longer sagittal abdominal diameter (≥24.8 cm) was significantly associated with longer corrected operative time (248 vs. 228 min, p = 0.043). In multivariate analysis, greater sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter were significantly associated with longer operative time. No significant association was found for the BMI neither in univariate nor in multivariate analysis. CONCLUSIONS: This study suggests that simple linear measures taken on a CT scan, such as sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter, may predict longer operative time in laparoscopic left colonic resections more accurately than BMI.

Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality

OBJECTIVE: To determine the effect of nonadherence to antiretroviral therapy (ART) on virologic failure and mortality in naive individuals starting ART. DESIGN: Prospective observational cohort study. METHODS: Eligible individuals enrolled in the Swiss HIV Cohort Study, started ART between 2003 and 2012, and provided adherence data on at least one biannual clinical visit. Adherence was defined as missed doses (none, one, two, or more than two) and percentage adherence (>95, 90-95, and <90) in the previous 4 weeks. Inverse probability weighting of marginal structural models was used to estimate the effect of nonadherence on viral failure (HIV-1 viral load >500 copies/ml) and mortality. RESULTS: Of 3150 individuals followed for a median 4.7 years, 480 (15.2%) experienced viral failure and 104 (3.3%) died, 1155 (36.6%) reported missing one dose, 414 (13.1%) two doses and, 333 (10.6%) more than two doses of ART. The risk of viral failure increased with each missed dose (one dose: hazard ratio [HR] 1.15, 95% confidence interval 0.79-1.67; two doses: 2.15, 1.31-3.53; more than two doses: 5.21, 2.96-9.18). The risk of death increased with more than two missed doses (HR 4.87, 2.21-10.73). Missing one to two doses of ART increased the risk of viral failure in those starting once-daily (HR 1.67, 1.11-2.50) compared with those starting twice-daily regimens (HR 0.99, 0.64-1.54, interaction P = 0.09). Consistent results were found for percentage adherence. CONCLUSION: Self-report of two or more missed doses of ART is associated with an increased risk of both viral failure and death. A simple adherence question helps identify patients at risk for negative clinical outcomes and offers opportunities for intervention.

The ADO Index as a Predictor of Two-Year Mortality in General Practice-Based Chronic Obstructive Pulmonary Disease Cohorts.

BACKGROUND: Existing prediction models for mortality in chronic obstructive pulmonary disease (COPD) patients have not yet been validated in primary care, which is where the majority of patients receive care. OBJECTIVES: Our aim was to validate the ADO (age, dyspnoea, airflow obstruction) index as a predictor of 2-year mortality in 2 general practice-based COPD cohorts. METHODS: Six hundred and forty-six patients with COPD with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I-IV were enrolled by their general practitioners and followed for 2 years. The ADO regression equation was used to predict a 2-year risk of all-cause mortality in each patient and this risk was compared with the observed 2-year mortality. Discrimination and calibration were assessed as well as the strength of association between the 15-point ADO score and the observed 2-year all-cause mortality. RESULTS: Fifty-two (8.1%) patients died during the 2-year follow-up period. Discrimination with the ADO index was excellent with an area under the curve of 0.78 [95% confidence interval (CI) 0.71-0.84]. Overall, the predicted and observed risks matched well and visual inspection revealed no important differences between them across 10 risk classes (p = 0.68). The odds ratio for death per point increase according to the ADO index was 1.50 (95% CI 1.31-1.71). CONCLUSIONS: The ADO index showed excellent prediction properties in an out-of-population validation carried out in COPD patients from primary care settings. © 2014 S. Karger AG, Basel.

Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs) and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r) was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001), poor (r = 0.380; p = 0.004), and poor (r = 0.277; p = 0.116). The interobserver agreement was considered excellent (0.754) for measurements of cortical thickness and bipolar length (0.833), and satisfactory for parenchymal thickness (0.523). Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

Community-acquired pneumonia in adult patients with special reference to rapid methods for etiological diagnosis

Aikuispotilaan kotisyntyisen keuhkokuumeen etiologinen diagnostiikka mikrobiologisilla pikamenetelmillä Tausta. Keuhkokuume on vakava sairaus, johon sairastuu Suomessa vuosittain n. 60 000 aikuista. Huolimatta siitä, että taudin hoito on kehittynyt, siihen liittyy yhä merkittävä, 6-15%:n kuolleisuus. Alahengitystieinfektion aiheuttajamikrobien tunnistaminen on myös edelleen haasteellista. Tavoitteet. Tämän työn tavoitteena oli tutkia Turun yliopistollisessa keskussairaalassa hoidettujen aikuispotilaiden keuhkokuumeen etiologiaa sekä selvittää uusien mikrobiologisten pikamenetelmi¬en hyödyllisyyttä taudinaiheuttajan toteamisessa. Aineisto. Osatöiden I ja III aineisto koostui 384 Turun yliopistollisen keskussairaalaan infektio-osastolla hoidetusta keuhkokuumepotilaasta. Osatyössä I tutkittiin keuhkokuumeen aiheuttaja¬mikrobeja käyttämällä perinteisten menetelmien lisäksi antigeeniosoitukseen ja PCR-tekniikkaan perustuvia pikamenetelmiä. Osatyö II käsitti 231 potilaasta koostuvan alaryhmän, jossa tutkittiin potilaiden nielun limanäytteestä rinovirusten ja enterovirusten esiintyvyyttä. Osatyössä III potilailta tutkittiin plasman C-reaktiivisen proteiinin (CRP) pitoisuus ensimmäisten viiden sairaalahoitopäi¬vän aikana. Laajoja tilastotieteellisiä analyysejä käyttämällä selvitettiin CRP:n käyttökelpoisuutta sairauden vaikeusasteen arvioinnissa ja komplikaatioiden kehittymisen ennustamisessa. Osatyössä IV 68 keuhkokuumepotilaan sairaalaan tulovaiheessa otetuista näytteistä määritettiin neutrofiilien pintareseptorien ekspressio. Osatyössä V analysoitiin sisätautien vuodeosastoilla vuosina 1996-2000 keuhkokuumepotilaille tehtyjen keuhkohuuhtelunäytteiden laboratoriotutkimustulokset. Tulokset. Keuhkokuumeen aiheuttaja löytyi 209 potilaalta, aiheuttajamikrobeja löydettiin kaikkiaan 230. Näistä aiheuttajista 135 (58.7%) löydettiin antigeenin osoituksella tai PCR-menetelmillä. Suu¬rin osa, 95 (70.4%), todettiin pelkästään kyseisillä pikamenetelmillä. Respiratorinen virus todettiin antigeeniosoituksella 11.1% keuhkokuumepotilaalla. Eniten respiratorisia viruksia löytyi vakavaa keuhkokuumetta sairastavilta potilailta (20.3%). 231 keuhkokuumepotilaan alaryhmässä todettiin PCR-menetelmällä picornavirus 19 (8.2%) potilaalla. Respiratorinen virus löytyi tässä potilasryh¬mässä kaiken kaikkiaan 47 (20%) potilaalta. Näistä 17:llä (36%) löytyi samanaikaisesti bakteerin aiheuttama infektio. CRP-tasot olivat sairaalaan tulovaiheessa merkitsevästi korkeammat vakavaa keuhkokuumetta (PSI-luokat III-V) sairastavilla potilailla kuin lievää keuhkokuumetta (PSI-luokat I-II) sairastavilla potilailla (p <0.001). Yli 100 mg/l oleva CRP-taso neljän päivän kuluttua sairaa¬laan tulosta ennusti keuhkokuumeen komplikaatiota tai huonoa hoitovastetta. Neutrofiilien komple¬menttireseptorin ekspressio oli pneumokokin aiheuttamaa keuhkokuumetta sairastavilla merkitse¬västi korkeampi kuin influenssan aiheuttamaa keuhkokuumetta sairastavilla. BAL-näytteistä vain yhdessä 71:stä (1.3%) todettiin diagnostinen bakteerikasvu kvantitatiivisessa viljelyssä. Uusilla menetelmilläkin keuhkokuumeen aiheuttaja löytyi vain 9.8% BAL-näytteistä. Päätelmät. Uusilla antigeeniosoitus- ja PCR-menetelmillä keuhkokuumeen etiologia voidaan saada selvitettyä nopeasti. Lisäksi näitä menetelmiä käyttämällä taudin aiheuttajamikrobi löytyi huomattavasti suuremmalta osalta potilaista kuin pelkästään tavanomaisia menetelmiä käyttämällä. Pikamenetelmien hyödyllisyys vaihteli taudin vaikeusasteen mukaan. Respiratorinen virus löytyi huomattavan usein keuhkokuumetta sairastavilta potilailta, ja näiden potilaiden taudinkuva oli usein vaikea. Tulovaiheen korkeaa CRP-tasoa voidaan käyttää lisäkeinona arvioitaessa keuhkokuumeen vaikeutta. CRP on erityisen hyödyllinen arvioitaessa hoitovastetta ja riskiä komplikaatioiden ke¬hittymiseen. Neutrofiilien komplementtireseptorin ekspression tutkiminen näyttää lupaavalta pi¬kamenetelmältä erottamaan bakteerien ja virusten aiheuttamat taudit toisistaan. Antimikrobihoitoa saavilla potilailla BAL-tutkimuksen löydökset olivat vähäiset ja vaikuttivat hoitoon vain harvoin.

Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?

PURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.

Glomerular damage as a predictor of renal allograft loss

Interstitial fibrosis and tubular atrophy (IF/TA) are the most common cause of renal graft failure. Chronic transplant glomerulopathy (CTG) is present in approximately 1.5-3.0% of all renal grafts. We retrospectively studied the contribution of CTG and recurrent post-transplant glomerulopathies (RGN) to graft loss. We analyzed 123 patients with chronic renal allograft dysfunction and divided them into three groups: CTG (N = 37), RGN (N = 21), and IF/TA (N = 65). Demographic data were analyzed and the variables related to graft function identified by statistical methods. CTG had a significantly lower allograft survival than IF/TA. In a multivariate analysis, protective factors for allograft outcomes were: use of angiotensin-converting enzyme inhibitor (ACEI; hazard ratio (HR) = 0.12, P = 0.001), mycophenolate mofetil (MMF; HR = 0.17, P = 0.026), hepatitis C virus (HR = 7.29, P = 0.003), delayed graft function (HR = 5.32, P = 0.016), serum creatinine ≥1.5 mg/dL at the 1st year post-transplant (HR = 0.20, P = 0.011), and proteinuria ≥0.5 g/24 h at the 1st year post-transplant (HR = 0.14, P = 0.004). The presence of glomerular damage is a risk factor for allograft loss (HR = 4.55, P = 0.015). The presence of some degree of chronic glomerular damage in addition to the diagnosis of IF/TA was the most important risk factor associated with allograft loss since it could indicate chronic active antibody-mediated rejection. ACEI and MMF were associated with better outcomes, indicating that they might improve graft survival.

Étude pilote des effets du Tandem Forsus Maxillary Corrector sur la croissance des maxillaires

Objectif : Récemment, un nouvel appareil issu de la technologie du Forsus™ et visant à corriger les malocclusions de classe III a été mis sur le marché et se popularise dans la pratique orthodontique : le Tandem Forsus Maxillary Corrector (TFMC). L’objectif de la présente étude est de mesurer les effets squelettiques, l’influence réelle sur la croissance, et les effets dento-alvéolaires du port du TFMC. Matériel et méthodes : 14 patients présentant une malocclusion de classe III (âge moyen de 9 ans 6 mois) traités par le même orthodontiste ont participé à cette étude prospective. Le groupe consiste en 10 garçons et 4 filles. Le Tandem Forsus Maxillary Corrector est porté de 12 à 14 heures par jour jusqu’à l’obtention d’une surcorrection du surplomb horizontal et une relation dentaire de classe I. Le traitement est généralement d’une durée de 8 à 9 mois. Des radiographies céphalométriques latérales prises avant (T1) et après (T2) le traitement ont été analysées afin de déterminer les changements dentaires et squelettiques. Les résultats ont été comparés à un groupe contrôle composé de 42 enfants provenant du Centre de croissance de l’Université de Montréal. Les radiographies ont été tracées et analysées de manière aveugle à l’aide du logiciel Dolphin Imaging (ver 11.0, Patterson Dental, Chatsworth, California). L’erreur sur la méthode a été évaluée avec la formule de Dahlberg, le coefficient de corrélation intra-classe et l’indice de Bland-Altman. L’effet du traitement a été évalué à l’aide du test t pour échantillons appariés. L’effet de la croissance pour le groupe contrôle a été calculé à l’aide d’un test t pour échantillons indépendants. Résultats : L’utilisation du TFMC produit un mouvement antérieur et une rotation antihoraire du maxillaire. De plus, il procline les incisives supérieures et rétrocline les incisives inférieures. Une rotation antihoraire du plan occlusal contribue aussi à la correction de la malocclusion de classe III. Par contre, le TFMC ne semble pas avoir pour effet de restreindre la croissance mandibulaire. Conclusion : La présente étude tend à démontrer que le port de l’appareil TFMC a un effet orthopédique et dento-alvéolaire significatif lors du traitement correctif des malocclusions modérées de classe III.

SA-ß-galactosidasa como predictor de senescencia celular del epitelio superficial ovárico y factores de riesgo de cáncer de ovario

Introducción: la tercera causa de muerte ginecológica es cáncer de ovario (CO), la detección temprana es fundamental para reducir mortalidad. El objetivo es establecer asociación entre senescencia en cultivos de tejido epitelial de ovario (ESO) mediante expresión de enzima ßgalactosidasa/normalizada y factores de riesgo reconocidos para CO. Métodos: estudio descriptivo observacional con fase exploratoria de datos proporcionados por “TRF2” segunda fase; muestra 29 tejidos de mujeres con ooforectomia condiciones benignas, analizadas estadísticamente con confianza del 95%, software SPSS versión 17, datos se presentan con desviación estándar, promedio, mediana (velocidad de crecimiento celular y ßgal/Normalizada) y porcentajes (variables categóricas). Realizo comparación con t-student, test de normalidad con Shapiro Wilks y asociación mediante análisis multivariado. Resultados: encuentra evidencia estadísticamente significativa (p < 0,05) para asociación entre antecedente familiar de otros tipos de cáncer con cáncer gástrico (IC95%: -2,84, -0,23) y cáncer de seno (IC95%: -3,39, -0,38); no tener régimen de afiliación en salud (vinculado) (IC95%: -3,67 -0,014); uso de método anticonceptivo de barrera (IC95%: -3,95, -0,07); consumo de embutidos (IC95%: -3,30, -0,21) y enlatados (IC95%: -3,62, -0,030) 1 a 3 veces/semana y consumo de alcohol (IC95%: -2,33, -0,33) con aumento expresión ßgal/Normalizada. Discusión: senescencia es antitumorigénica a edades tempranas, en avanzadas es protumorigénica, cuando hay mucha acumulación de células senescentes en tejido, éstas cambian su perfil senector produciendo sustancias que afectan a las vecinas, lo que lleva a transformación tumoral. Esta investigación es novedosa.

Dinamometría como examen predictor de desordenes musculoesqueléticos (DME) de miembros superiores en tabajadores del sector floricultor

RESUMEN Objetivo: Analizar el comportamiento de la sintomatología de los Desórdenes Músculo-esqueléticos (DME) de miembros superiores y determinar si la dinamometría es predictiva y sirve como soporte para el diagnostico de los mismos. Pacientes y Métodos: Se tomó una cohorte de 400 trabajadores de tres empresas del sector floricultor de la sabana de Bogotá en el año 2006, quienes fueron evaluados clínicamente por un médico especialista en salud ocupacional. Se seleccionaron 105 trabajadores que no presentaban síntomas osteomusculares de miembros superiores, a quienes se realizó seguimiento clínico y dinamometría anual hasta el año 2009. En cada evaluación se realizaron tres mediciones con el dinamómetro Dynatron® midiendo la fuerza de agarre en cada mano, tomando como dato final el promedio obtenido. Los datos fueron digitados en un base de Excel 2003 (Office®) y la depuración y el procesamiento fueron realizados en el programa estadístico de sobrevida. Resultados: El grupo de estudio estaba compuesto por 73 mujeres (69.5%) y 32 hombres (32.5%). La mano dominante fue la derecha en 99 trabajadores (94.3%). El índice de masa corporal (IMC) se encontró alterado revelando sobrepeso en 50 trabajadores (47.6%). Tenían una media de antigüedad en la empresa de 6,48 años y de 14.12 años de exposición en el sector floricultor. El promedio de la fuerza de agarre manual fue mayor para los hombres con respecto a las mujeres. Los primeros presentaron cifras; para la mano derecha de 105 libras y para la izquierda de 102 libras; en las mujeres fue de 62 libras para la mano derecha y de 61 libras para la izquierda. El 38.1% de la población estudiada desarrolló patologías osteomusculares de miembros superiores a lo largo de los 4 años de seguimiento, dentro de las cuales predominó la epicondilitis de miembro superior derecho, presentándose con mayor frecuencia en las mujeres. La probabilidad de supervivencia global para las mujeres fue 46,3% mientras que para los hombres fue de 81,6% a lo largo del tiempo de estudio con una p=0.0107. En el periodo de estudio las mujeres necesitaron aproximadamente de 38 meses para alcanzar el 50% de sobrevida. Para el género femenino el promedio de la fuerza de la mano derecha de 28 libras tiene una sensibilidad del 100% con una especificidad del 1%. En la mano izquierda el promedio de la fuerza de 30,0 libras tiene una sensibilidad del 100% y una especificidad del 1%. En los hombres se encontró que el promedio de fuerza de la mano derecha de 65 libras tiene una sensibilidad del 100% y una especificidad del 1% y de la mano izquierda de 66 libras tiene una sensibilidad del 100% y una especificidad del 1%. Conclusiones: Las lesiones osteomusculares presentaron altas incidencias en la población estudiada que no se relacionan con aspectos como IMC y tiempo de vida en el sector floricultor y las mujeres presentaron una probabilidad de supervivencia significativamente menor con respecto a los hombres. La dinamometría en valores bajos es un estudio que se correlaciona con la presencia de DME pero no tiene valor predictivo.