5,400 research outputs found

    6-thioguanine treatment in inflammatory bowel disease: A critical appraisal by a European 6-TG working party

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    Recently, the suggestion to use 6-thioguanine (6-TG) as an alternative thiopurine in patients with inflammatory bowel disease (IBD) has been discarded due to reports about possible (hepato) toxicity. During meetings arranged in Vienna and Prague in 2004, European experts applying 6-TG further on in IBD patients presented data on safety and efficacy of 6-TG. After thorough evaluation of its risk-benefit ratio, the group consented that 6-TG may still be considered as a rescue drug in stringently defined indications in IBD, albeit restricted to a clinical research setting. As a potential indication for administering 6-TG, we delineated the requirement for maintenance therapy as well as intolerance and/or resistance to aminosalicylates, azathioprine, 6-mercaptopurine, methotrexate and infliximab. Furthermore, indications are preferred in which surgery is thought to be inappropriate. The standard 6-TG dosage should not exceed 25 mg daily. Routine laboratory controls are mandatory in short intervals. Liver biopsies should be performed after 6-12 months, three years and then three-yearly accompanied by gastroduodenoscopy, to monitor for potential hepatotoxicity, including nodular regenerative hyperplasia (NRH) and veno-occlusive disease (VOD). Treatment with 6-TG must be discontinued in case of overt or histologically proven hepatotoxicity. Copyright (c) 2006 S. Karger AG, Basel

    Improved quality of life in patients with refractory or recidivant ascites after insertion of transjugular intrahepatic portosystemic shunts

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    Background. We have recently shown that the transjugular intrahepatic portosystemic shunt (TIPS) is more effective than paracentesis in the treatment of cirrhotic patients with severe ascites and can prolong survival in selected patients. Although an improved quality of life (QOL) has been suggested in these patients after the TIPS procedure, so far there are no data available to substantiate this assumption. Therefore, the aim of this study was to determine the effect of TIPS on the QOL in cirrhotic patients with refractory or recidivant ascites. Methods: 21 cirrhotic patients who underwent TIPS for refractory or recidivant ascites were investigated. All patients were pretreated with repeated paracentesis for at least 1 year. Before the procedure and at 3 and 6 months during follow-up, the patients themselves rated QOL, fatigue and physical performance on a visual analogue scale (range 0-100). Furthermore, QOL was determined by the QOL index (range 0-10) according to Spitzer. Results: Patients' rating of the QOL on the visual analogue scale significantly increased from 35 +/- 25 (baseline) to 64 +/- 28 (3 months), and 66 +/- 24 (6 months; p = 0.02). Similarly, the QOL index significantly increased from 6.9 +/- 2.0 (baseline) to 8.3 +/- 2.1 (3 months), and 8.6 +/- 1.7 (6 months; p < 0.001). The increase of QOL was more pronounced in patients with complete response to TIPS. Conclusions: We demonstrate that TIPS for refractory or recidivant ascites improves the QOL in patients with cirrhosis. Our data indicates that this improvement is dependent on the response to therapy. Copyright (C) 2002 S. Karger AG, Basel

    The environmental security debate and its significance for climate change

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    Policymakers, military strategists and academics all increasingly hail climate change as a security issue. This article revisits the (comparatively) long-standing “environmental security debate” and asks what lessons that earlier debate holds for the push towards making climate change a security issue. Two important claims are made. First, the emerging climate security debate is in many ways a re-run of the earlier dispute. It features many of the same proponents and many of the same disagreements. These disagreements concern, amongst other things, the nature of the threat, the referent object of security and the appropriate policy responses. Second, given its many different interpretations, from an environmentalist perspective, securitisation of the climate is not necessarily a positive development

    The Metabolic Syndrome among Postmenopausal Women in Gorgan

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    In this study, we aimed to assess levels of serum 25-hydroxyvitamin D in relation to metabolic syndrome among postmenopausal women in Gorgan. The study group included 100 postmenopausal women who were referred to the different Health Centers in Gorgan. Body mass index, waist circumference, Hip, waist to hip ratio, diastolic blood pressure, triglyceride, fasting blood glucose and 25-hydroxyvitamin D levels were significantly higher in postmenopausal women with metabolic syndrome, but HDL-cholesterol was lower. Prevalence of the metabolic syndrome was 31%. There were significant differences in 25-hydroxy vitamin D of postmenopausal women with and without vitamin D deficiency. Prevalence of the vitamin D deficiency in postmenopausal women was 30%. There were significant differences in 25-hydroxy vitamin D of postmenopausal women with and without vitamin D deficiency who had metabolic syndrome. Our results show that postmenopausal status might be a predictor of metabolic syndrome in this area. Our findings suggested that vitamin D levels have no association with metabolic syndrome. There were no significant differences in vitamin D levels in postmenopausal women with and without metabolic syndrome. Vitamin D deficiency is not associated with the metabolic syndrome

    The Pegasus spyware scandal: a critical review of Citizen Lab's "CatalanGate"

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    This document dissects the report “CatalanGate: Extensive Mercenary Spyware Operation against Catalans Using Pegasus and Candiru”, published on 18 April 2022, by Citizen Lab at the Munk School of Global Affairs and Public Policy, University of Toronto, and reveals a series of serious methodological and ethical issues that severely undermine its value as evidentiary basis for parliamentary committees and court trials. This critical review shows that Citizen Lab’s research design, fieldwork, and reporting of findings in the “CatalanGate” report clash with commonly accepted norms of academic research conduct and integrity. The variety and gravity of the pitfalls discovered suggest that Citizen Lab and the political organisations that collaborated with them in the elaboration of the report may have tried to purposefully induce a strong political bias to shape public opinion and achieve strong media impact. This critical review recommends the University of Toronto to launch an independent investigation on this report and to retract its publication. The CatalanGate report cannot be considered a rigorous academic work. It breaches most academic research conventions and does not respect the protocols and principles of digital forensic investigation. It appears to have been designed and conducted with the purpose of becoming a political instrument for Catalan nationalists, feeding evidence for lawsuits that both Apple and secessionist parties were planning, and attempting to justify ex-post the nullity of several trials that had taken place after the unilateral secession attempt in October 2017 —based on the pretended illegal monitoring of lawyers by the Spanish authorities at the time these trials took place—. As such, it could be considered as a key element in a disinformation campaign. It is beyond the scope of this review to assess whether Spain spied —legally or illegally— on some of the participants in the investigation or if Pegasus was the spyware of choice. This review shows, however, that the CatalanGate report does not meet the minimal requisites to be used as evidentiary basis for either legal procedures or parliamentary committees of enquiry. An independent investigation for research misconduct is expected in cases as serious as this one. Any parliamentary committee or court of justice investigating CatalanGate should request independent forensic experts —without connections to Citizen Lab or Amnesty Tech— to reproduce the analyses and assess their validity and reliability. It is important to rule out false positives as well as to identify any potential alterations or fabrications of evidence, such as manufactured positive results, taking advantage of the absence of a chain of custody of evidence in this investigation. The lack of checks on the actions of internet security and privacy watchdogs, such as Citizen Lab, and their potential “capture” by Big Tech corporations and partisan political groups should be a source of concern for the European Union. Citizen Lab is right to demand public accountability and transparency from European Member states, but it is also important that they also adhere to these same principles and that accusations against governments do not drive attention away from responsibilities and challenges incurred by Big Tech corporations regarding internet security
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