The burden of selected digestive diseases in the United States

AbstractBackground & Aims: Gastrointestinal (GI) and liver diseases inflict a heavy economic burden. Although the burden is considerable, current and accessible information on the prevalence, morbidity, and cost is sparse. This study was undertaken to estimate the economic burden of GI and liver disease in the United States for use by policy makers, health care providers, and the public. Methods: Data were extracted from a number of publicly available and proprietary national databases to determine the prevalence, direct costs, and indirect costs for 17 selected GI and liver diseases. Indirect cost calculations were purposefully very conservative. These costs were compared with National Institutes of Health (NIH) research expenditures for selected GI and liver diseases. Results: The most prevalent diseases were non–food-borne gastroenteritis (135 million cases/year), food-borne illness (76 million), gastroesophageal reflux disease (GERD; 19 million), and irritable bowel syndrome (IBS; 15 million). The disease with the highest annual direct costs in the United States was GERD ($9.3 billion), followed by gallbladder disease ($5.8 billion), colorectal cancer ($4.8 billion), and peptic ulcer disease ($3.1 billion). The estimated direct costs for these 17 diseases in 1998 dollars were $36.0 billion, with estimated indirect costs of$22.8 billion. The estimated direct costs for all digestive diseases were $85.5 billion. Total NIH research expenditures were$676 million in 2000. Conclusions: GI and liver diseases exact heavy economic and social costs in the United States. Understanding the prevalence and costs of these diseases is important to help set priorities to reduce the burden of illness.GASTROENTEROLOGY 2002;122:1500-151

Stabilin-1 is expressed in human breast cancer and supports tumor growth in mammary adenocarcinoma mouse model

Stabilin-1 is a multifunctional scavenger receptor expressed on alternatively-activated macrophages. Stabilin-1 mediates phagocytosis of "unwanted-self" components, intracellular sorting, and endocytic clearance of extracellular ligands including SPARC that modulates breast cancer growth. The expression of stabilin-1 was found on tumor-associated macrophages (TAM) in mouse and human cancers including melanoma, lymphoma, glioblastoma, and pancreatic insulinoma. Despite its tumor-promoting role in mouse models of melanoma and lymphoma the expression and functional role of stabilin-1 in breast cancer was unknown. Here, we demonstrate that stabilin-1 is expressed on TAM in human breast cancer, and its expression is most pronounced on stage I disease. Using stabilin-1 knockout (ko) mice we show that stabilin-1 facilitates growth of mouse TS/A mammary adenocarcinoma. Endocytosis assay on stabilin-1 ko TAM demonstrated impaired clearance of stabilin-1 ligands including SPARC that was capable of inducing cell death in TS/A cells. Affymetrix microarray analysis on purified TAM and reporter assays in stabilin-1 expressing cell lines demonstrated no influence of stabilin-1 expression on intracellular signalling. Our results suggest stabilin-1 mediated silent clearance of extracellular tumor growth-inhibiting factors (e.g. SPARC) as a mechanism of stabilin-1 induced tumor growth. Silent clearance function of stabilin-1 makes it an attractive candidate for delivery of immunomodulatory anti-cancer therapeutic drugs to TAM

Terapeuters arbete med krigsrelaterat posttraumatiskt stressyndrom

Posttraumatiskt stressyndrom (PTSD) kännetecknas av tre huvudsymptom: undvikande, förnekande och hyperspändhet. Även koncentrationssvårigheter, ångest, depression, flashbacks och mardrömmar är vanligt förekommande hos individer med PTSD. Flyktingar i Sverige som har varit med om krig kan uppvisa dessa symptom. Syftet med denna studie är att undersöka terapeuters upplevelser av arbete med patienter med krigsrelaterat PTSD. Intervjuer med åtta terapeuter utfördes. Gemensamma mönster i deltagarnas svar var att det är fördelaktigt att skapa en bra relation till patienter. Det är viktigt att prata om krigstrauma och de som får behandling mår bättre. Patienter är präglade av sorg och skuld och det är viktigt för dem att känna tillit och trygghet. Kropp och själ hänger ihop och det är olika och beroende på många faktorer hur individer drabbas av krig. Ofta är det andra svåra upplevelser som förvärrar krigstrauma. Terapeuter upplever sitt arbete som roligt samtidigt som tungt och anser att det är viktigt med teamarbete

Global Polio Eradication Initiative : annual report 2015 : eradication within reach\ue2\u20ac\ua6

The GPEI Annual Report 2015 provides a historical record and epidemiological summary of the global polio eradication effort during the calendar year 2015. As referenced in the report, Nigeria was removed from the list of endemic countries in September 2015, following no detection of wild poliovirus cases since July 2014.In August 2016, three new cases due to wild poliovirus type 1 (WPV1) were detected from Borno state, Nigeria. Genetic sequencing of the isolated viruses indicate they are most closely linked to WPV1 last detected in Borno in 2011, indicating the strain has been circulating without detection since that time. The Government of Nigeria immediately launched an aggressive outbreak response and declared the outbreak a national public health emergency. At the same time, additional measures are being implemented to strengthen subnational surveillance sensitivity. The response is part of a broader regional outbreak response within the context of the humanitarian emergency in the region, coordinated with neighbouring countries, in particular the Lake Chad sub-region, including Chad, northern Cameroon, southern Niger and parts of Central African Republic. At the Regional Committee for Africa on 21 August 2016, Health Ministers declared the polio outbreak to be a regional public health emergency for countries in the Lake Chad sub-region. Detection of these cases underscores the risk posed by low-level undetected transmission, and of the urgent need to strengthen subnational surveillance everywhere.Although confirmation of these cases falls outside of the 2015 reporting period of this report, the editors felt its importance warranted an editorial note, placing the epidemiological situation in 2015 in the context of 2016. For more and up-to-date information on the evolving situation, please visit www.polioeradication.org.WHO/POLIO/16.01AR2015.pdfAcronyms -- What we want you to take away from this report -- Executive summary -- Stopping polio transmission -- Oral polio vaccine withdrawal and routine immunization strengthening -- Containment and certification -- Securing the legacy of the GPEI through transitioning its infrastructure -- Financing the Polio Eradication & Endgame Strategic Plan

Stabilin-1 is expressed in human breast cancer and supports tumor growth in mammary adenocarcinoma mouse model

Stabilin-1 is a multifunctional scavenger receptor expressed on alternatively-activated macrophages. Stabilin-1 mediates phagocytosis of "unwanted-self" components, intracellular sorting, and endocytic clearance of extracellular ligands including SPARC that modulates breast cancer growth. The expression of stabilin-1 was found on tumor-associated macrophages (TAM) in mouse and human cancers including melanoma, lymphoma, glioblastoma, and pancreatic insulinoma. Despite its tumor-promoting role in mouse models of melanoma and lymphoma the expression and functional role of stabilin-1 in breast cancer was unknown. Here, we demonstrate that stabilin-1 is expressed on TAM in human breast cancer, and its expression is most pronounced on stage I disease. Using stabilin-1 knockout (ko) mice we show that stabilin-1 facilitates growth of mouse TS/A mammary adenocarcinoma. Endocytosis assay on stabilin-1 ko TAM demonstrated impaired clearance of stabilin-1 ligands including SPARC that was capable of inducing cell death in TS/A cells. Affymetrix microarray analysis on purified TAM and reporter assays in stabilin-1 expressing cell lines demonstrated no influence of stabilin-1 expression on intracellular signalling. Our results suggest stabilin-1 mediated silent clearance of extracellular tumor growth-inhibiting factors (e.g. SPARC) as a mechanism of stabilin-1 induced tumor growth. Silent clearance function of stabilin-1 makes it an attractive candidate for delivery of immunomodulatory anti-cancer therapeutic drugs to TAM