219 research outputs found

    Gender and Vascular Complications in the JAK2 V617F-Positive Myeloproliferative Neoplasms

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    We previously found that gender influenced the JAK2 V617F allele burden, but it is unknown whether this gender difference in molecular epidemiology influences complications in the myeloproliferative neoplasms (MPNs). Historically, vascular complications represented the most common cause of mortality in polycythemia vera and essential thrombocytosis and contributed to morbidity in primary myelofibrosis. To determine the influence of gender on vascular complications, we retrospectively analyzed associations between gender and vascular complications. Despite their younger age, less prevalent dyslipidemia or smoking history, lower white blood counts, and lower JAK2 V617F allele burden, women had higher rates of abdominal venous thrombosis and comparable rates of all vascular complications. Vascular risk is currently not easily stratified by MPN-disease burden or traditional risk factors. Our analysis contributes to growing literature emphasizing gender differences in the MPN and further supports the important impact of individual and host variation on MPN clinical manifestations, and especially vascular risk

    Design of a Prostate Cancer Patient Navigation Intervention for a Veterans Affairs Hospital

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    Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago

    Oropharyngeal Swallow Efficiency as a Representative Measure of Swallowing Function

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    The purpose of this investigation was to correlate oropharyngeal swallow efficiency (OPSE), a summary measure of swallowing function, with its component variables. Videofluorographic assessment of oropharyngeal swallow resulted in the measurement of multiple measures of swallow function in five patient populations and a group of normal volunteers. In total, 759 swallows were studied in 149 persons. Specific dimensions of impairment were identified in the patient groups. Multiple regression analyses were used to relate multiple component variables to OPSE. In patient groups with distinct swallow impairments, OPSE was shown to be representative of the dimensions of impairment. In patient groups with limited impairment and in normal volunteers, the strongest correlates of OPSE were bolus transit times. In all groups, at least four variables were significantly related to OPSE and the squared multiple correlation coefficients ranged from 76% to 89%. We conclude that oropharyngeal swallow efficiency is a representative summary measure of swallowing function across populations characterized by a wide range of swallowing impairment

    Digital dermoscopy to determine skin melanin index as an objective indicator of skin pigmentation

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    Clinical assessment of skin photosensitivity is subjectively determined by erythema and tanning responses to sunlight recalled by the subject, alternatively known as Fitzpatrick Skin Phototype (SPT). Responses may be unreliable due to recall bias, subjective bias by clinicians and subjects, and lack of cultural sensitivity of the questions. Analysis of red-green-blue (RGB) color spacing of digital images may provide an objective determination of SPT. This paper presents the studies to assess the melanin index (MI), as determined by RGB images obtained by both standard digital camera as well as by videodermoscope, and to correlate the MI with SPT based upon subjects' verbal responses to standardized questions administered by a dermatologist. A sample of subjects representing all SPTs I–VI was selected. Both the digital camera and videodermoscope were calibrated at standard illumination, light source and white balance. Images of constitutive skin of the upper ventral arm were taken of each subject using both instruments. The studies showed that 58 subjects (20 M, 38 F) were enrolled in the study (mean age: 47 years; range: 20–89), stratified to skin phototype I–VI. MI obtained by using both digital camera and videodermoscope increased significantly as the SPT increased (p = 0.004 and p &lt; 0.0001, respectively) and positively correlated with dermatologist-assessed SPT (Spearman correlation, r = 0.48 and r = 0.84, respectively). Digital imaging can quantify melanin content in order to quantitatively approximate skin pigmentation in all skin phototypes including Type VI skin. This methodology holds promise as a simple, non-invasive, rapid and objective approach to reliably determine skin phototype and, with further investigation, may prove to be both practical and useful in the prediction of skin cancer risk.</p

    Аліментні обов'язки інших членів сім'ї та родичів

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    Виявлено проблеми у врегулюванні аліментних обов’язків інших членів сім’ї та родичів, вироблено рекомендації щодо їх вирішення. Проаналізовано специфіку правового регулювання аліментних зобов’язань зазначених суб’єктів, сімейне законодавство та міжнародний досвід. Ключові слова: аліментні обов’язки, правове регулювання, сімейне законодавство.Выявлены проблемы в урегулировании алиментных обязанностей других членов семьи и родственников, выработаны рекомендации по их решению. Проанализирована специфика правового регулирования алиментных обязательств указанных субъектов, семейное законодательство и международный опыт. Ключевые слова: алиментные обязанности, правовое регулирование, семейное законодавствоThis article is dedicated to identifying problems in the regulation of the alimentary obligations of other family members and relatives, and to making recommendations and proposing solutions. Studing the specificity of the legal regulation of alimentary obligations of these entities, analysing the current family law and international experience are very important. Key words: alimentary obligations, legal regulation, family law

    Visualization of HIV-1 interactions with penile and foreskin epithelia: clues for female-to-male HIV transmission

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    To gain insight into female-to-male HIV sexual transmission and how male circumcision protects against this mode of transmission, we visualized HIV-1 interactions with foreskin and penile tissues in ex vivo tissue culture and in vivo rhesus macaque models utilizing epifluorescent microscopy. 12 foreskin and 14 cadaveric penile specimens were cultured with R5-tropic photoactivatable (PA)-GFP HIV-1 for 4 or 24 hours. Tissue cryosections were immunofluorescently imaged for epithelial and immune cell markers. Images were analyzed for total virions, proportion of penetrators, depth of virion penetration, as well as immune cell counts and depths in the tissue. We visualized individual PA virions breaching penile epithelial surfaces in the explant and macaque model. Using kernel density estimated probabilities of localizing a virion or immune cell at certain tissue depths revealed that interactions between virions and cells were more likely to occur in the inner foreskin or glans penis (from local or cadaveric donors, respectively). Using statistical models to account for repeated measures and zero-inflated datasets, we found no difference in total virions visualized at 4 hours between inner and outer foreskins from local donors. At 24 hours, there were more virions in inner as compared to outer foreskin (0.0495 +/- 0.0154 and 0.0171 +/- 0.0038 virions/image, p = 0.001). In the cadaveric specimens, we observed more virions in inner foreskin (0.0507 +/- 0.0079 virions/image) than glans tissue (0.0167 +/- 0.0033 virions/image, p&lt;0.001), but a greater proportion was seen penetrating uncircumcised glans tissue (0.0458 +/- 0.0188 vs. 0.0151 +/- 0.0100 virions/image, p = 0.099) and to significantly greater mean depths (29.162 +/- 3.908 vs. 12.466 +/- 2.985 &mu;m). Our in vivo macaque model confirmed that virions can breach penile squamous epithelia in a living model. In summary, these results suggest that the inner foreskin and glans epithelia may be important sites for HIV transmission in uncircumcised men
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