2,127 research outputs found
Pivotal role of families in doctor–patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians
Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives
Insulin-mediated changes in tau hyperphosphorylation and autophagy in a drosophila model of tauopathy and neuroblastoma cells
Almost 50 million people in the world are affected by dementia; the most prevalent form of which is Alzheimer’s disease (AD). Although aging is considered to be the main risk factor for AD, growing evidence from epidemiological studies suggests that type 2 diabetes mellitus (T2DM) increases the risk of dementia including AD. Defective brain insulin signaling has been suggested as an early event in AD and other tauopathies but the mechanisms that link these diseases are largely unknown. Tau hyperphosphorylation is a hallmark of neurofibrillary pathology and insulin resistance increases the number of neuritic plaques particularly in AD. Utilizing a combination of our Drosophila models of tauopathy (expressing the 2N4R-Tau) and neuroblastoma cells, we have attempted to decipher the pathways downstream of the insulin signaling cascade that lead to tau hyperphosphorylation, aggregation and autophagic defects. Using cell-based, genetic, and biochemical approaches we have demonstrated that tau phosphorylation at AT8 and PHF1 residues is enhanced in an insulin-resistant environment. We also show that insulin-induced changes in total and phospho-tau are mediated by the crosstalk of AKT, glycogen synthase kinase-3β, and extracellular regulating kinase located downstream of the insulin receptor pathway. Finally, we demonstrate a significant change in the levels of the key proteins in the mammalian target of rapamycin/autophagy pathway, implying an increased impairment of aggregated protein clearance in our transgenic Drosophila models and cultured neuroblastoma cells
Pentoxifylline Plus Prednisolone versus Pentoxifylline Only for Severe Alcoholic Hepatitis: A Randomized Controlled Clinical Trial
Background: Prednisolone and pentoxifylline (PTX) have been shown to be individually useful in severe alcoholic hepatitis with Maddrey discriminant function (MDF) score .32. Previous report suggests that PTX is probably superior to prednisolone alone. However the efficacy of PTX and prednisolone combination over PTX alone in the management of acute alcoholic hepatitis (MDF score ≥32) is yet unrevealed.Aim: The present study was initiated to find out the efficacy of combined pentoxifylline and prednisolone versus PTX alone in acute alcoholic hepatitis in respect of short and intermediate term outcomes.Subjects and Methods: A total of 124 patients with severe alcoholic hepatitis (MDF score ≥32) initially were evaluated. 62 patients who fulfilled the inclusion and exclusion criteria were randomized and divided into 2 groups. Group 1 received PTX only, whereas Group 2 received PTX plus Prednisolone. The total duration of follow-up was 12 months. Studentfs t-test, Chi-square test, the Kaplan-Meier methods were used forstatistical analysis. Results: A total of 60 patients, 30 in each group were available for finalanalysis. In Group-1, 6 patients expired at the end of 1 year (5 within 3 months and another after 3 months). In Group 2, 10 patients expired at the end of 1 year (9 within 3 months and another after 3 months). Though survival probability is higher among Group 1 patients but the difference is not statistically significant.Conclusion: The combination of PTX plus Prednisolone yields no additional benefit in terms of mortality and morbidity from that of PTX monotherapy.Keywords: Alcoholic hepatitis, Maddrey discriminant function score, Pentoxifylline, Prednisolon
To evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24-hour urine sample in patients with preeclampsia
Objective: This study was done to evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24 hour urine sample in patients with preeclampsia. Methods: A prospective simple random sample study was done on the hypertensive pregnant women attending the antenatal clinic or admitted in Department of Obstetrics and Gynaecology. It included all women being evaluated for preeclampsia, regardless of the alerting sign or symptom, suspected severity or co-morbid conditions. The main measures were the urinary protein to urinary creatinine ratio by random (spot) direct measurement and the 24-h urinary protein excretion by a 24-h urine collection. The data obtained was statistically analyzed. Results: Out of the 78 patients with gestational hypertension included in our study 48 patients had significant proteinuria (e”300mg/day). Only 2 patients had proteinuria of the range of greater than 3500mg. Among the patients, 50 had a positive protein: creatinine ratio (e”0.3) while 28 patients had a negative protein: creatinine ratio (<0.3). The P: C ratio was able to correctly identify 44 out of 48 patients with significant proteinuria (when the comparison is made with the gold-standard test; i.e., 24-hour urine protein). It could also identify 24 out of 30 patients without significant proteinuria as compared to the gold-standard test. In this study, the Protein: Creatinine ratio with a sensitivity of 91.67%, a specificity of 80%, positive predictive values 88% and the negative predictive values 85.71%. Conclusions: Our data suggests that the protein: creatinine ratio in single voided urine is a highly accurate test (p value < 0.0000001) for discriminating between insignificant and significant proteinuria. Based on the above findings we conclude that a random urine protein excretion predicts the amount of 24- hour urine protein excretion with high accuracy. This could be a reasonable alternative to the 24-hour urine collection for detection of significant proteinuria in hospitalised pregnant women with suspected preeclampsia. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 45-53 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9687</p
The SKA and "High-Resolution" Science
"High-resolution", or "long-baseline", science with the SKA and its
precursors covers a broad range of topics in astrophysics. In several research
areas, the coupling between improved brightness sensitivity of the SKA and a
sub-arcsecond resolution would uncover truly unique avenues and opportunities
for studying extreme states of matter, vicinity of compact relativistic
objects, and complex processes in astrophysical plasmas. At the same time, long
baselines would secure excellent positional and astrometric measurements with
the SKA and critically enhance SKA image fidelity at all scales. The latter
aspect may also have a substantial impact on the survey speed of the SKA, thus
affecting several key science projects of the instrument.Comment: JENAM-2010: Invited talk at JENAM session S7: The Square Kilometre
Array: Paving the way for the new 21st century radio astronomy paradigm; 9
page
The therapeutic effect of the neuropeptide hormone somatostatin on Schistosoma mansoni caused liver fibrosis
BACKGROUND: The neuropeptide somatostatin is one of the major regulatory peptides in the central nervous system and the digestive tract. Our recent work has delineated an association between fibrosis and low levels of endogenous somatostatin plasma levels in Schistosoma mansoni infected subjects. Based on these results this paper explores the therapeutic potential of somatostatin in a mouse model of hepatic fibrosis associated with S. mansoni infections. METHODS: Groups of outbred Swiss mice were infected with 100 S. mansoni cercariae, infection maintained till weeks 10 or 14, and then somatostatin therapy delivered in two regimens – Either a one or a two-day treatment. All animals were sacrificed one week after therapy and controlled for liver, spleen and total body weight. Circulating somatostatin levels in mice plasma were measured at the time of sacrifice by means of a radio-immuno assay. GraphPad Prism(® )was used for statistical calculations. RESULTS: Somatostatin administration showed little toxicity, probably due to its short half-life. Total liver and spleen weights of S. mansoni infected animals increased over time, with no changes observed due to somatostatin therapy. Total body weights were decreased after infection but were not affected by somatostatin therapy. Snap frozen liver sections were stained with haematoxylin-eosin or Masson's trichrome to study parasite count, hepatocyte status, granuloma size and cellularity. After somatostatin treatment mean egg counts per liver section (43.76 ± 3.56) were significantly reduced as compared to the egg counts in untreated mice after 10 weeks of infection (56.01 ± 3.34) (P = 0.03). Similar significant reduction in parasite egg counts were also observed after somatostatin treatment at 14 weeks of infection (56.62 ± 3.02) as compared to untreated animals (69.82 ± 2.77)(P = 0.006). Fibrosis was assessed from the spectrophotometric determination of tissue hydroxyproline. Infection with S. mansoni caused increased hydroxyproline levels (9.37 ± 0.63 μmol at wk10; 9.65 ± 0.96 μmol at wk14) as compared to uninfected animals (1.06 ± 0.10 μmol). This significant increase in collagen content (P = 0.01; 0.007 respectively) marks the fibrosis observed at these time points. Treatment with somatostatin resulted in a significant decrease in hydroxyproline levels both at wk10 (4.76 ± 0.58 μmol) and at wk14 (5.8 ± 1.13 μmol) (P = 0.01; 0.03 respectively). Endogenous somatostatin levels were increased at wk10 (297 ± 37.24 pg/ml) and wk14 (206 ± 13.30 pg/ml) of infection as compared to uninfected mice (119 ± 11.99 pg/ml) (P = 0.01; 0.008 respectively). Circulating somatostatin levels in infected animals were not significantly affected by somatostatin treatment. Hepatocyte status remained unaltered and granulomas were not remarkably changed in size or cellularity. CONCLUSION: Our experiments reveal an antifibrotic effect of somatostatin in schistosomiasis. We have previously shown that the somatostatin receptors SSTR2 and SSTR3 are present on the parasite egg and worms. We therefore hypothesize that somatostatin reduces either the number of parasite eggs or the secretion of fibrosis inducing-mediators. Our data suggest somatostatin may have therapeutic potential in S. mansoni mediated liver pathology
Association between the c.*229C>T polymorphism of the topoisomerase IIb binding protein 1 (TopBP1) gene and breast cancer
Topoisomerase IIb binding protein 1 (TopBP1)
is involved in cell survival, DNA replication, DNA damage
repair and cell cycle checkpoint control. The biological
function of TopBP1 and its close relation with BRCA1
prompted us to investigate whether alterations in the
TopBP1 gene can influence the risk of breast cancer.
The aim of this study was to examine the association
between five polymorphisms (rs185903567, rs116645643,
rs115160714, rs116195487, and rs112843513) located in
the 30UTR region of the TopBP1 gene and breast cancer
risk as well as allele-specific gene expression. Five hundred
thirty-four breast cancer patients and 556 population controls
were genotyped for these SNPs. Allele-specific Top-
BP1 mRNA and protein expressions were determined by
using real time PCR and western blotting methods,
respectively. Only one SNP (rs115160714) showed an
association with breast cancer. Compared to homozygous
common allele carriers, heterozygous and homozygous for
the T variant had significantly increased risk of breast
cancer (adjusted odds ratio = 3.81, 95 % confidence
interval: 1.63–8.34, p = 0.001). Mean TopBP1 mRNA and
protein expression were higher in the individuals with the
CT or TT genotype. There was a significant association
between the rs115160714 and tumor grade and stage. Most
carriers of minor allele had a high grade (G3) tumors
classified as T2-T4N1M0. Our study raises a possibility
that a genetic variation of TopBP1 may be implicated in
the etiology of breast cancer
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Investigating the impact of poverty on colonization and infection with drug-resistant organisms in humans: a systematic review
Background
Poverty increases the risk of contracting infectious diseases and therefore exposure to antibiotics. Yet there is lacking evidence on the relationship between income and non-income dimensions of poverty and antimicrobial resistance. Investigating such relationship would strengthen antimicrobial stewardship interventions.
Methods
A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Ovid, MEDLINE, EMBASE, Scopus, CINAHL, PsychINFO, EBSCO, HMIC, and Web of Science databases were searched in October 2016. Prospective and retrospective studies reporting on income or non-income dimensions of poverty and their influence on colonisation or infection with antimicrobial-resistant organisms were retrieved. Study quality was assessed with the Integrated quality criteria for review of multiple study designs (ICROMS) tool.
Results
Nineteen articles were reviewed. Crowding and homelessness were associated with antimicrobial resistance in community and hospital patients. In high-income countries, low income was associated with Streptococcus pneumoniae and Acinetobacter baumannii resistance and a seven-fold higher infection rate. In low-income countries the findings on this relation were contradictory. Lack of education was linked to resistant S. pneumoniae and Escherichia coli. Two papers explored the relation between water and sanitation and antimicrobial resistance in low-income settings.
Conclusions
Despite methodological limitations, the results suggest that addressing social determinants of poverty worldwide remains a crucial yet neglected step towards preventing antimicrobial resistance
Chiral perturbation theory in a magnetic background - finite-temperature effects
We consider chiral perturbation theory for SU(2) at finite temperature in
a constant magnetic background . We compute the thermal mass of the pions
and the pion decay constant to leading order in chiral perturbation theory in
the presence of the magnetic field. The magnetic field gives rise to a
splitting between and as well as between
and . We also calculate the free energy and the
quark condensate to next-to-leading order in chiral perturbation theory. Both
the pion decay constants and the quark condensate are decreasing slower as a
function of temperature as compared to the case with vanishing magnetic field.
The latter result suggests that the critical temperature for the chiral
transition is larger in the presence of a constant magnetic field. The increase
of as a function of is in agreement with most model calculations but
in disagreement with recent lattice calculations.Comment: 24 pages and 9 fig
Proactive and politically skilled professionals: What is the relationship with affective occupational commitment?
The aim of this study is to extend research on employee affective commitment in three ways: (1) instead of organizational commitment the focus is on occupational commitment; (2) the role of proactive personality on affective occupational commitment is examined; and (3) occupational satisfaction is examined as a mediator and political skills as moderator in the relationship between proactive personality and affective occupational commitment. Two connected studies, one in a hospital located in the private sector and one in a university located in the public sector, are carried out in Pakistan, drawing on a total sample of over 400 employees. The results show that proactive personality is positively related to affective occupational commitment, and that occupational satisfaction partly mediates the relationship between proactive personality and affective occupational commitment. No effect is found for a moderator effect of political skills in the relationship between proactive personality and affective occupational commitment. Political skills however moderate the relationship between proactive personality and affective organizational commitment
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