153 research outputs found
Mathematical Models for Estimating the Risk of vCJD Transmission
We present two different simple models for vCJD transmission by blood transfusion. Both models indicate that transfusions alone are unlikely to cause more than a few infections, unless the number of primary cases increases.
To improve our models, future work should pursue data collection, empirical estimation of the model parameters, and examination of the underlying assumptions of our frameworks.
Further improvements could also include examining susceptibility to vCJD infection by age group and iatrogenic infections introduced through surgical instruments. Regarding the latter, it may be worthwhile to conduct experiments to quantify the transmission of prions from an infected surgical instrument after repeated sterilization procedures
Fenton-like oxidation of Orange II solutions using heterogeneous catalysts based on saponite clay
Fe-clay catalysts have been prepared and tested for Orange II oxidation with H2O2 in aqueous solution. Thereaction is carried out in a batch reactor, using different hydrogen peroxide concentrations, and in a wide range oftemperature and pH values. Twelve samples were prepared, with three different iron loads (7.5, 13.0 and 17.0 %,w/w), and using four iron salts as precursors, namely Fe(II) acetate, Fe(II) oxalate, Fe(II) acetylacetonate and Fe(III)acetylacetonate. The samples were characterized using X-ray diffraction, thermal analysis, infrared spectroscopy andadsorption of nitrogen at 77K. The catalytic results show that these solids present good catalytic properties for thedegradation and mineralization of Orange II solutions, allowing to reach, in the best conditions and after 4h ofoxidation, 99% of dye degradation with 91% of TOC (Total Organic Carbon) reduction (at 70ºC), using only ca. 90 mgof clay catalyst per litre of solution. Nevertheless, 96% of dye removal with 82% of mineralization were also reachedat 30ºC. Besides, the amount of iron released into the final solution is lower than 1 ppm, in the worst of the cases,and 0.09 ppm in the best case
Electronic health records and patient registries in medical oncology departments in Spain
We aimed to evaluate the current situation of electronic health records (EHRs) and patient registries in the oncology departments of hospitals in Spain. This was a cross-sectional study conducted from December 2018 to September 2019. The survey was designed ad hoc by the Outcomes Evaluation and Clinical Practice Section of the Spanish Society of Medical Oncology (SEOM) and was distributed to all head of medical oncology department members of SEOM. We invited 148 heads of oncology departments, and 81 (54.7%) questionnaires were completed, with representation from all 17 Spanish autonomous communities. Seventy-seven (95%) of the respondents had EHRs implemented at their hospitals; of them, over 80% considered EHRs to have a positive impact on work organization and clinical practice, and 73% considered that EHRs improve the quality of patient care. In contrast, 27 (35.1%) of these respondents felt that EHRs worsened the physician-patient relationship and conveyed an additional workload (n = 29; 37.6%). Several drawbacks in the implementation of EHRs were identified, including the limited inclusion of information on both outpatients and inpatients, information recorded in free text data fields, and the availability of specific informed consent. Forty-six (56.7%) respondents had patient registries where they recorded information from all patients seen in the department. Our study indicates that EHRs are almost universally implemented in the hospitals surveyed and are considered to have a positive impact on work organization and clinical practice. However, EHRs currently have several drawbacks that limit their use for investigational purposes. Not applicable The online version contains supplementary material available at 10.1007/s12094-021-02614-9
Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study
To obtain an adequate view of the whole small
intestine during capsule endoscopy (CE) a clear liquid diet and overnight fasting
is recommended. However, intestinal content can hamper vision in spite of these
measures. Our aim was to evaluate tolerance and degree of intestinal cleanliness
during CE following three types of bowel preparation. PATIENTS AND METHODS: This
was a prospective, multicenter, randomized, controlled study. Two-hundred
ninety-one patients underwent one of the following preparations: 4 L of clear
liquids (CL) (group A; 92 patients); 90 mL of aqueous sodium phosphate (group B;
89 patients); or 4 L of a polyethylene glycol electrolyte solution (group C; 92
patients). The degree of cleanliness of the small bowel was classified by blinded
examiners according to four categories (excellent, good, fair or poor). The
degree of patient satisfaction, gastric and small bowel transit times, and
diagnostic yield were measured. RESULTS: The degree of cleanliness did not differ
significantly between the groups (P = 0.496). Interobserver concordance was fair
(k = 0.38). No significant differences were detected between the diagnostic
yields of the CE (P = 0.601). Gastric transit time was 35.7 +/- 3.7 min (group
A), 46.1 +/- 8.6 min (group B) and 34.6 +/- 5.0 min (group C) (P = 0.417).
Small-intestinal transit time was 276.9 +/- 10.7 min (group A), 249.7 +/- 13.1
min (group B) and 245.6 +/- 11.6 min (group C) (P = 0.120). CL was the best
tolerated preparation. Compliance with the bowel preparation regimen was lowest
in group C (P = 0.008). CONCLUSIONS: A clear liquid diet and overnight fasting is
sufficient to achieve an adequate level of cleanliness and is better tolerated by
patients than other forms of preparation
Tribbles homolog 3 denotes a poor prognosis in breast cancer and is involved in hypoxia response
Hypoxia in solid tumors is associated with treatment resistance, resulting in poor prognosis. Tribbles homolog 3 (TRIB3) is induced during hypoxia and is involved in multiple cellular pathways involved in cell survival. Here, we investigated the role of TRIB3 in breast cancer. TRIB3 mRNA expression was measured in breast tumor tissue from 247 patients and correlated with clinicopathological parameters and clinical outcome. Furthermore, we studied TRIB3 expression regulation in cell lines, xenografts tissues and human breast cancer material using Reverse transcriptase, quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical staining. Finally, the effect of small interfering RNA (siRNA) mediated TRIB3 knockdown on hypoxia tolerance was assessed. Breast cancer patients with low, intermediate or high TRIB3 expression exhibited a mean disease free survival (DFS) of 80 (95% confidence interval [CI] = 74 to 86), 74 (CI = 67 to 81), and 63 (CI = 55 to 71) months respectively (P = .002, Mantel-Cox log-rank). The prognostic value of TRIB3 was limited to those patients that had received radiotherapy as part of their primary treatment (n = 179, P = .005) and remained statistically significant after correction for other clinicopathological parameters (DFS, Hazard Ratio = 1.90, CI = 1.17 to 3.08, P = .009). In breast cell lines TRIB3 expression was induced by hypoxia, nutrient starvation, and endoplasmic reticulum stress in an hypoxia inducible factor 1 (HIF-1) independent manner. TRIB3 induction after hypoxia did not increase with decreasing oxygen levels. In breast tumor xenografts and human breast cancer tissues TRIB3 co-localized with the hypoxic cell marker pimonidazole. The induction of TRIB3 by hypoxia was shown to be regulated via the PERK/ATF4/CHOP pathway of the unfolded protein response and knockdown of TRIB3 resulted in a dose-dependent increase in hypoxia sensitivity. TRIB3 is independently associated with poor prognosis of breast cancer patients, possibly through its association with tumor cell hypoxi
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LRRK2 at the interface of autophagosomes, endosomes and lysosomes
Over the past 20 years, substantial progress has been made in identifying the underlying genetics of Parkinson’s disease (PD). Of the known genes, LRRK2 is a major genetic contributor to PD. However, the exact function of LRRK2 remains to be elucidated. In this review, we discuss how familial forms of PD have led us to hypothesize that alterations in endomembrane trafficking play a role in the pathobiology of PD. We will discuss the major observations that have been made to elucidate the role of LRRK2 in particular, including LRRK2 animal models and high-throughput proteomics approaches. Taken together, these studies strongly support a role of LRRK2 in vesicular dynamics. We also propose that targeting these pathways may not only be beneficial for developing therapeutics for LRRK2-driven PD, but also for other familial and sporadic cases
Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers
Background: Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U. S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities
Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study
Background Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8–13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05–6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50–75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron
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