Delayed diagnosis of coeliac disease increases cancer risk

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Tamoxifen in treatment of hepatocellular carcinoma: a randomised controlled trial

Background Results from small randomised trials on tamoxifen in the treatment of hepatocellular carcinoma (HCC) are conflicting, We studied whether the addition of tamoxifen to best supportive care prolongs survival of patients with HCC. Methods Patients with any stage of HCC were eligible, irrespective of locoregional treatment. Randomisation was centralised, with a minimisation procedure accounting for centre, evidence of disease, and time from diagnosis. Patients were randomly allocated best supportive care alone or in addition to tamoxifen, Tamoxifen was given orally, 40 mg per day, from randomisation until death. Results 496 patients from 30 institutions were randomly allocated treatment from January, 1995, to January, 1997. Information was available for 477 patients. By Sept 15, 1997, 119 (50%) of 240 and 130 (55%) of 237 patients had died in the control and tamoxifen arms, respectively. Median survival was 16 months and 15 months (p=0.54), respectively, No differences were found within subgroups defined by prognostic variables. Relative hazard of death for patients receiving tamoxifen was 1.07 (95% CI 0.83-1.39). Interpretation Our findings show that tamoxifen is not effective in prolonging survival of patients with HCC

Sleep Home Monitoring: A Technical Option! [monitorização Domiciliar Do Sono: Uma Criteriosa Opção!]

[No abstract available]793266Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., Badr, S., The occurrence of sleep-disordered breathing among middle-aged adults (1993) N Engl J Med, 328 (17), pp. 1230-1235. , http://dx.doi.org/10.1056/NEJM199304293281704Tufik, S., Santos-Silva, R., Taddei, J.A., Bittencourt, L.R., Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study (2010) Sleep Med, 11 (5), pp. 441-446. , http://dx.doi.org/10.1016/j.sleep.2009.10.005Ferber, R., Millman, R., Coppola, M., Fleetham, J., Murray, C.F., Iber, C., Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice (1994) Sleep, 17 (4), pp. 378-39

Three Ebook Outlooks: What Humanists, Social Scientists and Scientists Want and Predict (A LibValue Study)

An e-book survey focused on user attitudes and valuation was conducted at the University of Illinois at Urbana-Champaign between 2013 and 2014 to determine how humanities, social science, and science scholars viewed the current and future use of e-books in their field. Participants were also asked to follow a link to use an e-book in their discipline on the e-brary platform and to report their experiences. Survey questions included an evaluation of present experiences and level of use, the value associated with e-books, and predictions of what their discipline’s e-book future will look like in the next five years. This study, supported by a grant from the Institute of Museum and Library Services (via “LibValue,” http://libvalue.cci.utk.edu/) grew over time to encompass the three disciplines as questions arose concerning how a spectrum of scholars adopted e-books or planned to migrate to the e-book format. The data from this study were used to inform library subject selectors concerning collection trends observed and predicted by their clientele. One result is the patron-driven acquisition of highuse e-books, which demonstrates the use and value scholars find in this book format

Quality of sleep, health and well-being in a population-based study

Estimar a prevalência de sono autoavaliado como ruim e identificar os subgrupos da população mais susceptíveis ao problema. Trata-se de estudo transversal, de base populacional, desenvolvido com dados de Inquérito de Saúde conduzido no município de Campinas (ISACamp 2014/2015). Foram analisados dados de amostra representativa de 1.998 indivíduos com 20 anos ou mais de idade. A qualidade autoavaliada do sono foi analisada segundo características sóciodemográficas, morbidades, comportamentos de saúde e sentimentos de bem-estar. Analisou-se também a associação da qualidade do sono com diferentes queixas e características do sono. Foram estimadas razões de prevalências e desenvolvido modelo de regressão múltipla de Poisson, considerando-se nas análises os pesos amostrais. A prevalência de sono autoavaliado como ruim foi 29,1% e mostrou-se significativamente mais elevada nas mulheres, em indivíduos de 40 a 50 anos de idade, migrantes, sem ocupação, fisicamente inativos em contexto de lazer, com transtorno mental comum (RP = 1,59), com maior número de problemas de saúde (RP = 2,33), com saúde autoavaliada como ruim (RP = 1,61) e que manifestavam insatisfação com a vida. Sono ruim esteve fortemente associado com relatos de dificuldade de iniciar o sono (RP = 4,17), de manter o sono (RP = 4,40) e com nunca ou quase nunca se sentir bem-disposto ao acordar (RP = 4,52). Os resultados identificam os segmentos da população com má qualidade do sono que merecem maior atenção e destacam a necessidade de avaliar, além da presença de comorbidades, a saúde mental e a presença de sentimentos de bem-estar no processo de cuidado dos pacientes com problemas de sono e no planejamento de intervenções voltadas à promoção de sono saudável5382FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2012/23324-3To estimate the prevalence of poor self-rated sleep and to identify the population subgroups most susceptible to the problem. This is a cross-sectional, population-based study developed with data from the Health Survey conducted in the city of Campinas (ISACamp 2014/2015). Data from a sample of 1,998 individuals aged 20 years or older were analyzed. The self-rated quality of sleep was analyzed according to socio-demographic characteristics, morbidities, health behaviors and feeling of well-being. The association of sleep quality with different complaints and characteristics of sleep was also analyzed. Adjusted prevalence ratios were estimed using Poisson multiple regression model allowing for the sample weights. Prevalence of poor self-rated sleep was 29.1% and showed to be significantly higher in women, in individuals aged from 40 to 50 years, migrants, without occupation, physically inactive in leisure context, with common mental disorder (PR = 1.59), with greater number of health problems (PR = 2.33), poor self-rated health (PR = 1.61), and life dissatisfaction. Poor sleep was strongly associated with reports of difficulty in initiating sleep (PR = 4.17), in maintaining sleep (PR = 4.40) and with never or almost never feeling well when waking up (PR = 4.52). The results identify the population subgroups with poor quality of sleep that deserve greater attention. It also highlight the need to consider, in addition to the presence of comorbidities, mental health and the feeling of well-being in the care of patients with sleep problems and in the interventions planed for promoting healthy slee

Induction of adipose differentiation related protein and neutral lipid droplet accumulation in keratinocytes by skin irritants

Keratinocytes play an important role in skin irritation. In an attempt to investigate mechanistic bases of human skin irritation response, we recently identified the upregulation by skin irritants of adipose differentiation related protein (ADRP) in reconstituted human epidermis. ADRP is a lipid-storage-droplet-associated protein, governing deposition and release of lipids from droplets. The purpose of this study was to characterize, in a human keratinocyte cell line (NCTC 2544), sodium-dodecyl-sulfate-induced ADRP expression, to identify the biochemical events that lead to ADRP expression, and to understand its function in sodium dodecyl sulfate cytotoxicity. Sodium dodecyl sulfate induced a concentration- and time-related production of ADRP that was associated with lipid droplet accumulation. Lipid accumulation following sodium dodecyl sulfate treatment was due to intracellular redistribution rather than lipid neosynthesis, as indicated by equivalent (14) C-oleate and (14) C-acetate incorporations. Other skin irritants, namely benzalkonium chloride, tributyltin, and 12-O-tetradecanoylphorbol 13-acetate, also induce lipid droplet accumulation. Sodium-dodecyl-sulfate-induced ADRP expression and lipid droplet accumulation were modulated by the calcium chelator BAPTA, indicating a role of calcium in ADRP induction. Decrease of sodium-dodecyl-sulfate-induced ADRP expression by specific ADRP antisense oligonucleotide resulted in increased cytotoxicity, indicating a protective role of ADRP and lipid accumulation in the process of cell damage induced by skin irritants. ADRP expression was also induced in vivo following treatment with sodium dodecyl sulfate in an experimental model of skin irritation, indicating that the in vitro model represents irritation

Rapid maxillary expansion in pediatric patients with obstructive sleep apnea: an umbrella review

Objective: To compare polysomnographic parameters with others from the literature in order to provide more accurate information about Rapid Maxillary Expansion (RME) for treating Obstructive Sleep Apnea (OSA) in children, through raising the question: Is RME a good option for treating OSA in children? Prevention of mouth breathing during children's growth remains a challenge with significant clinical consequences. In addition, OSA induces anatomofunctional changes during the critical period of craniofacial growth and development. Methods: The Medline, PubMed, EMBASE, CINAHL, Web of Science, SciELO and Scopus electronic databases were searched up to February 2021 for systematic reviews with meta-analysis in the English language. Among 40 studies on RME for treating OSA in children, we selected seven in which polysomnographic measurements of the Apnea-Hypopnea Index (AHI) had been made. Data were extracted and examined in order to clarify whether any consistent evidence exists for indicating RME as a treatment for OSA in children. Results: We found no consistent evidence favoring RME for long-term treatment of OSA in children. All the studies presented considerable heterogeneity due to variability of age and length of follow-up. Conclusion: Through this umbrella review, the need for methodologically better studies on RME is supported. Moreover, it can be considered that RME is not recommended for treating OSA in children. Further studies and more evidence identifying early signs of OSA are necessary in order to achieve consistent healthcare practice