Complementary and alternative medicine in cancer: a qualitative study on the Internet offer in Spanish-speaking South America

Die Anzahl an Patienten mit Krebs, die Komplementär- und Alternativmedizinische Verfahren nutzen steigt. Diese können jedoch relevante Wechselwirkungen mit der herkömmlichen Krebstherapie haben, sowie zu erheblichen Gesundheitsrisiken führen. Regionale Komplementär- und Alternativmedizinische Methoden verbreiten sich unter anderem auf Grund des Internets auf globaler Ebene. Diese Studie zielt darauf ab Webseiten im spanischsprachigen südamerikanischen Internet, die Komplementär- und Alternativmedizinischen Verfahren bei Krebs anbieten oder erörtern, zu analysieren und sie hinsichtlich der Qualität zu bewerten. Die Internetsuche wurde in neun spanischsprachigen Ländern Südamerikas durchgeführt. Die Anzahl der untersuchten Webseiten beschränkte sich auf die jeweils ersten 10 Suchergebnisse über die Suchmaschine „Google“. Die Webseiten wurden mit einem standardisierten, bereits in anderen Studien verwendeten Instrument durch zwei Untersucher im Vier- Augenprinzip analysiert. Insgesamt wurden 85 Webseiten mit 158 verschiedenen Komplementär- und Alternativmedizinischen Verfahren evaluiert. Die überwiegende Mehrheit der Webseiten wies eine sowohl inhaltlich als auch formal schlechte Qualität auf. Zu den am häufigsten genannten südamerikanischen Methoden gehörten eine Aloe- Mischung namens „Fray Romano“, Annona muricata (Stachelannone), Uncaria tomentosa (Katzenkralle), die „Método HANSI“ und Bestandteile des Lapachobaums. Dass die meisten südamerikanischen Webseiten zum Thema KAM bei Krebserkrankungen eine schlechte Qualität aufzeigen zeigt, dass ein dringender Bedarf an qualitätsgesicherten, leicht zu findenden Webseiten mit hoher Qualität besteht. Dies ist auch für Deutschland relevant, da die Informationen aus Südamerika auch in Deutschland Verbreitung finden, wie man am Beispiel von Annona muricata und Uncaria sieht

From a long‑distance threat to the invasion front : a review of the invasive Aedes mosquito species in Belgium between 2007 and 2020

Author contributions ID drafted the manuscript and revised it after comments of all co-authors. ID, TVL, KDW and AV carried out the mosquito identifications. ID, KDW, AS, AV, IV, JDW, JD, TVL and WVB collected data in the field and sorted the mosquitoes in the laboratory. WVB, ID and KDW managed the data. NS and JDW performed the DNA barcoding. WD and AV produced the morphological reference collection. WVB, ID, MM and RM coordinated the projects. MK performed the statistical analysis. All authors critically reviewed the manuscript. All authors read and approved the final manuscript.Data supporting the conclusions of this article are included within the article and its additional file. The datasets generated and analysed during the current study are available in the GBIF repository [44–50].ADDITIONAL FILE 1: TABLE S1. Overview of the trapping methods used to monitor invasive mosquito species (IMS) in Belgium during the different years (and projects) and in different risk scenarios, indicating the number of traps or larval sampling visits per site and the frequency of trapping or larval sampling. TABLE S2. Aedes albopictus detections in Belgium between 2007 and 2020 at the ten points of entry (PoEs) per year including the sampling perimeter, collection and detection methods, collection (light grey) and detection (dark grey) period, control measures (X), number of individuals (total, females, males, larvae and eggs) and project. TABLE S3. Aedes japonicus detections in Belgium between 2007 and 2020 at the four points of entry (PoEs) per year including the sampling perimeter, collection and detection methods, collection (light grey) and detection (dark grey) period, the control measures (X), number of individuals (total, females, males, larvae and eggs) and project. TABLE S4. Aedes koreicus detections in Belgium between 2007 and 2020 at the two points of entry (PoEs) per year including the sampling perimeter, collection and detection methods, collection (light grey) and detection (dark grey) period, control measures (X), number of individuals (total, females, males, larvae and eggs) and project.Invasive mosquito species (IMS) and their associated mosquito-borne diseases are emerging in Europe. In Belgium, the first detection of Aedes albopictus (Skuse 1894) occurred in 2000 and of Aedes japonicus japonicus (Theobald 1901) in 2002. Early detection and control of these IMS at points of entry (PoEs) are of paramount importance to slow down any possible establishment. This article reviews the introductions and establishments recorded of three IMS in Belgium based on published (2007–2014) and unpublished (2015–2020) data collected during several surveillance projects. In total, 52 PoEs were monitored at least once for the presence of IMS between 2007 and 2020. These included used tyre and lucky bamboo import companies, airports, ports, parking lots along highways, shelters for imported cutting plants, wholesale markets, industrial areas, recycling areas, cemeteries and an allotment garden at the country border with colonised areas. In general, monitoring was performed between April and November. Mosquitoes were captured with adult and oviposition traps as well as by larval sampling. Aedes albopictus was detected at ten PoEs, Ae. japonicus at three PoEs and Aedes koreicus (Edwards 1917) at two PoEs. The latter two species have established overwintering populations. The percentage of PoEs positive for Ae. albopictus increased significantly over years. Aedes albopictus is currently entering Belgium through lucky bamboo and used tyre trade and passive ground transport, while Ae. japonicus through used tyre trade and probably passive ground transport. In Belgium, the import through passive ground transport was first recorded in 2018 and its importance seems to be growing. Belgium is currently at the invasion front of Ae. albopictus and Ae. japonicus. The surveillance and control management actions at well-known PoEs associated to long-distance introductions are more straightforward than at less-defined PoEs associated with short-distance introductions from colonised areas. These latter PoEs represent a new challenge for IMS management in Belgium in the coming years. Aedes albopictus is expected to become established in Belgium in the coming years, hence increasing the likelihood of local arbovirus transmission. The implementation of a sustainable, structured and long-term IMS management programme, integrating active and passive entomological surveillance, vector control and Public Health surveillance is therefore pivotal.The MODIRISK project (2007–2010) was funded by the Belgian Science Policy Programs; the EXOSURV project (2012) by the Federal, Flemish, Walloon and Brussels Capital region governments, the FASFC project (2013–2016) by the Federal Agency for the Safety of the Food Chain (FASFC), the MEMO and MEMO+2020 projects (2017–2020) by the Flemish, Walloon and Brussels regional governments and the Federal Public Service (FPS) Public Health, Food Chain Safety and Environment in the context of the National Environment and Health Action Plan (NEHAP) (Belgium), and the DiMoc project by the 2018–2019 BiodivERsA3 ERA-Net COFUND programme with the funding organisation FWO. The Barcoding Facility for Organisms and Tissues of Policy Concern is financed by the Belgian Science Policy Office (Belspo) as Belgian federal in-kind contribution to the European Research Infrastructure Consortium “LifeWatch”. The Outbreak Research Team of the Institute of Tropical Medicine is financially supported by the Department of Economy, Science and Innovation of the Flemish government.https://parasitesandvectors.biomedcentral.comam2023Veterinary Tropical Disease

Inhibition of angiogenesis by interleukin-4 gene therapy in rat adjuvant-induced arthritis

Objective Interleukin-4 (IL-4) can modulate neovascularization. In this study, we used a gene therapy approach to investigate the role of IL-4 in angiogenesis in rat adjuvant-induced arthritis (AIA), a model for rheumatoid arthritis. Methods Rats received an adenovirus producing IL-4 (AxCAIL-4), a control virus without insert, or control vehicle (phosphate buffered saline) intraarticularly before arthritis onset. At peak onset of arthritis, rats were killed. Vascularization was determined in the synovial tissue, and correlations with inflammation were assessed. Ankle homogenates were used in angiogenesis assays in vitro and in vivo, and protein levels of cytokines and growth factors were assessed by enzyme-linked immunosorbent assay. Synovial tissue expression of Αv integrins was determined by immunohistochemistry. Results IL-4 induced a reduction in synovial tissue vessel density, which was paralleled by a decrease in inflammation. AxCAIL-4 joint homogenates significantly ( P < 0.05) inhibited both endothelial cell (EC) migration and tube formation in vitro. Similarly, AxCAIL-4 inhibited capillary sprouting in the rat aortic ring assay, and vessel growth in the in vivo Matrigel plug assay. The angiostatic effect occurred despite high levels of vascular endothelial growth factor (VEGF), and was associated with down-regulation of the proangiogenic cytokines IL-18, CXCL16, and CXCL5 and up-regulation of the angiogenesis inhibitor endostatin. Of interest, AxCAIL-4 also resulted in decreased EC expression of the Αv and Β3 integrin chains. Conclusion In rat AIA, IL-4 reduces synovial tissue vascularization via angiostatic effects, mediates inhibition of angiogenesis via an association with altered pro- and antiangiogenic cytokines, and may inhibit VEGF-mediated angiogenesis and exert its angiostatic role in part via ΑvΒ3 integrin. This knowledge of the specific angiostatic effects of IL-4 may help optimize target-oriented treatment of inflammatory arthritis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55808/1/22034_ftp.pd

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites

BACKGROUND: Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction. METHODS AND FINDINGS: Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥ 2 years before and ≥ 1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0.55, 95% CI 0.46-0.65) and remained relatively stable through year 7 (RR 0.49, 95% CI 0.35-0.68). Point estimates for VT IPD decreased annually through year 7 (RR 0.03, 95% CI 0.01-0.10), while NVT IPD increased (year 7 RR 2.81, 95% CI 2.12-3.71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18-49 year-olds [RR 0.52, 95% CI 0.29-0.91], 50-64 year-olds [RR 0.84, 95% CI 0.77-0.93], and ≥ 65 year-olds [RR 0.74, 95% CI 0.58-0.95]). CONCLUSIONS: Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not represent the experience in low-income countries or the effects after introduction of higher valency PCVs. High-quality, population-based surveillance of serotype-specific IPD rates is needed to monitor vaccine impact as more countries, including low-income countries, introduce PCVs and as higher valency PCVs are used. Please see later in the article for the Editors' Summary