RESUMO
BACKGROUND: Since 1995, a surveillance program for Salmonella has been applied in the Danish pig industry in order to reduce cases of human salmonellosis. The objective of this study was to develop a bead-based Multiplexed Fluorometric ImmunoAssay (MFIA) as an improved serological surveillance method compared to the Salmonella mix ELISA, which has been the national reference immunoassay in the Danish Salmonella surveillance program for about 20 years. RESULTS: An MFIA for detection of antibodies to Salmonella serogroup B and C1 was developed and optimized with regard to coupling of beads with Salmonella lipopolysaccharide antigens and establishing suitable assay conditions. The Salmonella MFIA was validated by testing sera from experimentally infected pigs as well as field sera from non-infected and infected pig herds, and by comparing to results from the Salmonella mix ELISA, which was run in parallel. Sensitivity and specificity was evaluated using receiver operating curve analysis showing an area under curve for the serogroup B and C1 MFIA of 0.984 and 0.998, respectively. The Salmonella MFIA was shown to detect more antibody-positive samples in seropositive herds compared to the Salmonella mix ELISA, and Bayesian statistics confirmed that the MFIA had a considerably higher sensitivity (94.5%) compared to the mix ELISA (75.1%). The assay specificity was slightly lower for the Salmonella MFIA (96.8%) compared to Salmonella mix ELISA (99.5%). Coupled beads were stable for at least 1 year at 4ËC, and MFIA reproducibility and repeatability of the Salmonella MFIA were acceptable. Results from proficiency tests also indicated that the Salmonella MFIA was more sensitive than the Salmonella mix ELISA and that they had similar specificity. CONCLUSIONS: A bead-based MFIA for simultaneous detection of porcine serum antibodies to Salmonella enterica serogroup B and C1 was developed and implemented in the Danish porcine serological Salmonella surveillance program in 2018. The Salmonella MFIA can distinguish, as opposed to the Salmonella mix ELISA, between antibodies to serogroup B and C1 and the MFIA shows considerably better sensitivity.
Assuntos
Salmonelose Animal , Salmonella enterica , Doenças dos Suínos , Animais , Anticorpos Antibacterianos , Teorema de Bayes , Reprodutibilidade dos Testes , Salmonella , Salmonelose Animal/epidemiologia , Sorogrupo , Suínos , Doenças dos Suínos/epidemiologiaRESUMO
BACKGROUND: The social security policy for disability pension (DP) was changed in Denmark in 2013 and eligibility requirements were tightened. We describe and compare the use of healthcare among individuals with incident DP before and after the policy change. METHODS: This was a follow-up study based on data from nationwide databases. The study included individuals with incident DP aged 18-64 years and living in The North Denmark Region. We included individuals with incident DP before (2010-12, n = 6286) and after (2014-15, n = 1042) the 2013 policy change. Poisson regression was used to examine group differences in (i) contact to healthcare and (ii) hospitalization. For this purpose, we used incidence rate ratios stratified on type of contact before being awarded DP. RESULTS: We found a change of diagnoses for healthcare use towards higher proportions of cardiovascular, pulmonary, neurological and cancer diseases and lower proportion with musculoskeletal disorder in the populations being granted DP after policy changes. For individuals with psychiatric contact before being granted DP, we found no significant differences between periods in psychiatric healthcare after DP was awarded. For individuals with somatic contact before being granted DP, we found an increased risk of contact to somatic healthcare and hospitalization after DP requirements were tightened. CONCLUSION: The study demonstrated that individuals who were granted DP after the eligibility requirements had been tightened suffered from more medical conditions and had an ongoing need for healthcare. In contrast, no significant difference in risk of psychiatric contact or hospitalization after DP was demonstrated.
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Pessoas com Deficiência , Política Organizacional , Aceitação pelo Paciente de Cuidados de Saúde , Pensões , Adolescente , Adulto , Estudos de Coortes , Dinamarca , Definição da Elegibilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Sistema de Registros , Adulto JovemRESUMO
BACKGROUND: The insulin receptor (INSR) and the insulin growth factor 1 receptor (IGF1R) play important roles in the etiology of both diabetes mellitus and breast cancer. We aimed to evaluate the expression of hormone and insulin-related proteins within or related to the PI3K and MAPK pathway in breast tumors of women with or without diabetes mellitus, treated with or without insulin (analogues). METHODS: Immunohistochemistry was performed on tumor tissue of 312 women with invasive breast cancer, with or without pre-existing diabetes mellitus, diagnosed in 2000-2010, who were randomly selected from a Danish breast cancer cohort. Women with diabetes were 2:1 frequency matched by year of birth and age at breast cancer diagnosis to those without diabetes. Tumor Microarrays were successfully stained for p-ER, EGFR, p-ERK1/2, p-mTOR, and IGF1R, and scored by a breast pathologist. Associations of expression of these proteins with diabetes, insulin treatment (human insulin and insulin analogues) and other diabetes medication were evaluated by multivariable logistic regression adjusting for menopause and BMI; effect modification by menopausal status, BMI, and ER status was assessed using interactions terms. RESULTS: We found no significant differences in expression of any of the proteins in breast tumors of women with (n = 211) and without diabetes (n = 101). Among women with diabetes, insulin use (n = 53) was significantly associated with higher tumor protein expression of IGF1R (OR = 2.36; 95%CI:1.02-5.52; p = 0.04) and p-mTOR (OR = 2.35; 95%CI:1.13-4.88; p = 0.02), especially among women treated with insulin analogues. Menopause seemed to modified the association between insulin and IGF1R expression (p = 0.07); the difference in IGF1R expression was only observed in tumors of premenopausal women (OR = 5.10; 95%CI:1.36-19.14; p = 0.02). We found no associations between other types of diabetes medication, such as metformin, and protein expression of the five proteins evaluated. CONCLUSIONS: In our study, breast tumors of women with pre-existing diabetes did not show an altered expression of selected PI3K/MAPK pathway-related proteins. We observed an association between insulin treatment and increased p-mTOR and IGF1R expression of breast tumors, especially in premenopausal women. This observation, if confirmed, might be clinically relevant since the use of IGF1R and mTOR inhibitors are currently investigated in clinical trials.
Assuntos
Neoplasias da Mama/metabolismo , Complicações do Diabetes , Insulina/farmacologia , Receptores de Somatomedina/genética , Transdução de Sinais , Serina-Treonina Quinases TOR/genética , Neoplasias da Mama/genética , Estudos Transversais , Diabetes Mellitus/tratamento farmacológico , Receptores ErbB/análise , Receptores ErbB/genética , Receptores ErbB/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Insulina/uso terapêutico , Sistema de Sinalização das MAP Quinases , Pessoa de Meia-Idade , Proteína Quinase 1 Ativada por Mitógeno/análise , Proteína Quinase 1 Ativada por Mitógeno/genética , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Receptor IGF Tipo 1 , Receptores de Somatomedina/análise , Receptores de Somatomedina/metabolismo , Serina-Treonina Quinases TOR/análise , Serina-Treonina Quinases TOR/metabolismoRESUMO
OBJECTIVE: Describe prognostic parameters of Danish male breast cancer patients (MBCP) diagnosed from 1980-2009. Determine all-cause mortality compared to the general male population and analyze survival/mortality compared with Danish female breast cancer patients (FBCP) in the same period. MATERIAL AND METHODS: The MBCP cohort was defined from three national registers. Data was extracted from medical journals. Data for FBCP is from the DBCG database. Overall survival (OS) was quantified by Kaplan-Meier estimates. Standardized mortality ratios (SMRs) were calculated based on mortality rate among patients relative to the mortality rate in the general population. The association between SMR and risk factors were analyzed in univariate and multivariable Poisson regression models. Separate models for each gender were used for the analyses. RESULTS: We found a marked difference in OS for the two genders. For the total population of MBCP, 5- and 10-year survivals were 55.1% and 31.7%, respectively. For FBCP, the corresponding figures were 76.8% and 59.3%. Median age at diagnosis for FBCP was 61 years and 70 years for MBCP. By applying SMR, the difference in mortality between genders equalized and showed pronounced age-dependency. For males <40 years, SMR was 9.43 and for females 19.56 compared to SMR for males 80 + years (0.95) and females 80 + years (0.89). During the period 1980-2009, the risk of dying gradually decreased for FBCP (p < .0001). The risk 1980-1984 was 35% higher than 2005-2009 (RR 1.35). Although the risk of dying for MBCP was also lowest in 2005-2009, there was no clear tendency (p = .1439). The risk was highest in 1990-1994 (RR =2.48). CONCLUSION: We found better OS for FBCP than for MBCP. But SMR showed similar mortality rate for the two genders, except for very young FBCP, who had higher SMR. Furthermore, significantly improved survival over time for FBCP was observed, with no clear tendency for MBCP.
Assuntos
Neoplasias da Mama Masculina/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Fatores de RiscoRESUMO
AIM: To evaluate the long-term prognostic impact of age, local treatment and intrinsic subtypes on the risk of local-regional recurrence (LRR) and breast cancer mortality among low-risk patients. MATERIAL AND METHODS: Cohort study with prospectively collected data, balanced five-year age groups, including 514 Danish lymph node negative breast cancer patients diagnosed between 1989 and 1998, treated with mastectomy (N = 320) or breast-conserving therapy (BCT) (N = 194) and without systemic treatment. Intrinsic subtype approximation was performed by combining information on estrogen-, progesterone-, HER2 receptor and Ki67. RESULTS: The majority of the tumors had a luminal subtype: 70% Luminal-A (LumA), 16% Luminal-B (LumB), and 10% Luminal-HER2 + (Lum-HER2+). The distribution of intrinsic subtypes between younger (≤45 years) and older (>45 years) patients was similar. Intrinsic subtypes had no prognostic impact on the 20-year LRR risk, regardless of age. A distinct 20-year mortality pattern was observed among the younger patients: 11% of patients with LumB tumor died of breast cancer within the first five years after primary surgery, 23% of patients with Lum-HER2+ tumor died within a 5-10-year period, whereas patients with LumA tumor died with a constant low rate throughout the 20-year period. After 20 years of follow-up, patients with LumA tumor had breast cancer mortality comparable to that of patients with LumB tumor (20%) and lower than Lum-HER2+ tumor (39%). Among the older patients, no distinct mortality pattern was observed, and the 20-year breast cancer mortality was not associated with intrinsic subtypes. CONCLUSION: Among low-risk patients, 96% of the tumors were Luminal and the distribution of intrinsic subtypes between younger (≤45 years) and older (>45 years) patients was similar. The observed higher frequency of LRR among younger low-risk BCT patients was not associated intrinsic subtype. The 20-year breast cancer mortality was non-significant for LumA tumors among the older patients, whereas among the younger patients, LumA tumors had a comparable mortality with LumB, but lower than for Lum-HER2 + tumors.
Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/mortalidade , Mastectomia Segmentar/mortalidade , Mastectomia/mortalidade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/mortalidade , Fatores Etários , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/mortalidade , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Lobular/mortalidade , Carcinoma Lobular/patologia , Carcinoma Lobular/cirurgia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Fatores de Risco , Taxa de SobrevidaRESUMO
Metabolic and biochemical changes during breast carcinogenesis enhance cellular acid production. Extrusion of the acid load from the cancer cells raises intracellular pH, while it decreases extracellular pH creating an inverted pH gradient across the plasma membrane compared to normal cells and promoting cancer cell metabolism, proliferation, migration, and invasion. We investigated the effects of breast carcinogenesis on the mechanisms of cellular pH control using multicellular epithelial organoids freshly isolated from human primary breast carcinomas and matched normal breast tissue. Intracellular pH was measured by fluorescence microscopy, while protein expression was investigated by immunofluorescence imaging and immunoblotting. We found that cellular net acid extrusion increased during human breast carcinogenesis due to enhanced Na(+),HCO3 (-)-cotransport, which created an alkaline shift (~0.3 units of magnitude) in steady-state intracellular pH of human primary breast carcinomas compared to normal breast tissue. Na(+)/H(+)-exchange activity and steady-state intracellular pH in the absence of CO2/HCO3 (-) were practically unaffected by breast carcinogenesis. These effects were evident under both acidic (pH 6.8, representative of the tumor microenvironment) and physiological (pH 7.4) extracellular conditions. Protein expression of the Na(+),HCO3 (-)-cotransporter NBCn1 (SLC4A7), which has been linked to breast cancer susceptibility in multiple genome-wide association studies, was twofold higher in human breast carcinomas compared to matched normal breast tissue. Protein expression of the Na(+)/H(+)-exchanger NHE1 (SLC9A1) was markedly less affected. We propose that upregulated NBCn1 during human breast carcinogenesis contributes to the characteristic acid distribution within human breast carcinomas and thereby plays a pathophysiological role for breast cancer development and progression.
Assuntos
Neoplasias da Mama/metabolismo , Carcinogênese/metabolismo , Carcinoma/metabolismo , Membrana Celular/metabolismo , Simportadores de Sódio-Bicarbonato/metabolismo , Regulação para Cima , Adulto , Idoso , Feminino , Humanos , Concentração de Íons de Hidrogênio , Transporte de Íons , Pessoa de Meia-Idade , Simportadores de Sódio-Bicarbonato/genéticaRESUMO
BACKGROUND: Residual neck disease after radiotherapy in advanced oropharyngeal squamous cell carcinoma (OPSCC) is associated with increased mortality, and some patients may benefit from post-radiotherapy neck dissection (PRND). The aim of the present study was to assess the value of magnetic resonance imaging (MRI) and other clinical characteristics in selecting patients for PRND. MATERIALS AND METHODS: Retrospective cohort study. Consecutive patients with N+ OPSCC were included. Medical records, pathology reports and imaging reports were reviewed. Pre- and post-therapeutic imaging was re-evaluated. RESULTS: A total of 100 consecutive patients from a three-year period were included. Neck response was evaluated with MRI two months after treatment. Sixty patients were suspicious for residual neck disease, and were offered surgery; seven of these patients had histologic evidence of carcinoma. Cumulative neck failure after three years was 14% (8.4-24%), and did not differ significantly among patients with positive compared to negative MRI (radiologist's initial description; p = 0.47, log-rank test). Applying neck failure as gold standard, sensitivity and specificity of MRI was 69% and 41%, respectively; positive and negative predictive value was 15% and 90%. Patients with p16 + disease had significantly larger lymph nodes after treatment, and imaging based on lymph node size resulted in many false positives. Analysis of receiver operating characteristic curves in 191 individual lymph nodes showed that a short axis ≥ 10 mm should be classified as suspicious. Furthermore, T-stage and p16-status were associated with increased risk of neck recurrence. Salvage was successful in four patients with early detected nodal recurrence. CONCLUSION: These results suggest that lymph node size, T-stage and p16 status could be used in selecting patients for PRND in OPSCC. Yet, early anatomical imaging may be inappropriate for evaluating neck response in patients with p16 + disease as enlarged lymph nodes often do not indicate residual neck disease.
Assuntos
Carcinoma de Células Escamosas/terapia , Linfonodos/patologia , Imageamento por Ressonância Magnética , Proteínas de Neoplasias/análise , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Orofaríngeas/terapia , Seleção de Pacientes , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/secundário , Terapia Combinada , Inibidor p16 de Quinase Dependente de Ciclina , Intervalo Livre de Doença , Reações Falso-Positivas , Feminino , Humanos , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual , Tamanho do Órgão , Neoplasias Orofaríngeas/química , Neoplasias Orofaríngeas/patologia , Valor Preditivo dos Testes , Curva ROC , Estudos RetrospectivosRESUMO
The objective of the study was the evaluation of outcomes of cochlear implantation (CI) in children with cochlear malformations. A retrospective case-control study was conducted in a tertiary referral centre. The patients were children with inner ear malformation judged by high-resolution computed tomography and magnetic resonance imaging treated with uni- or bilateral CI and a follow-up period of at least 3 years. They were matched with a control group of children operated for other reasons. The patients were operated by one of two surgeons using similar techniques including a standard perimodiolar electrode in all cases. The intervention was therapeutic and rehabilitative. The main outcome measures were category of auditory performance (CAP) and speech intelligibility rating (SIR). Eighteen children were diagnosed with cochlear malformations (12 % of children receiving CI). No statistical differences regarding CAP and SIR scores were found between the two groups. Only one child was diagnosed with a common cavity and performed below average. Children with auditory neuropathy performed beyond average. Children with cochlear malformations performed equally to children without malformation in the long term. Standard perimodiolar electrodes can be used despite cochlear malformations. The most important factors determining the outcome is the age of the child at the time of implantation and duration of hearing loss before CI. Awareness towards an increased risk of complications in case of inner ear malformations is recommended.
Assuntos
Cóclea/anormalidades , Implante Coclear , Surdez/cirurgia , Adolescente , Percepção Auditiva , Estudos de Casos e Controles , Criança , Pré-Escolar , Implantes Cocleares , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Inteligibilidade da FalaRESUMO
OBJECTIVE: Cirrhotic portal hypertensive patients often develop hemodynamic complications and the diagnosis is often based on liver biopsy and measurements of the hepatic venous pressure gradient (HVPG). Potential noninvasive biomarkers for the severity of cirrhosis are the matrix metalloproteinase and their specific inhibitors such as tissue inhibitor of metalloproteinases-1 (TIMP-1). The aim of the study was to investigate TIMP-1 levels in cirrhosis in relation to the degree of liver dysfunction, portal hypertension, and hemodynamic changes. MATERIALS AND METHODS: We retrospectively studied 84 patients with cirrhosis and 14 controls without liver disease. All individuals underwent a liver vein catheterization with a hemodynamic assessment. TIMP-1 was determined in arterial and hepatic venous plasma using an MAC-15 TIMP-1 ELISA. RESULTS: Hepatic venous concentrations of TIMP-1 were significantly increased in patients compared to controls: 336 (166) ng/ml versus 145 (100) (median/IQ range) (p < 0.001) with a progressive increase throughout the Child classes (p < 0.001). Circulating TIMP-1 correlated significantly with indocyanine green clearance (r = -0.44, p < 0.0001), Child Turcotte score (r = 0.50, p < 0.0001), HVPG (r = 0.40, p < 0.0001), mean arterial pressure (r = -0.29, p = 0.008), and systemic vascular resistance (r = -0.23, p = 0.03). Receiver operating characteristic curve analysis enabled us to establish cutoff values for TIMP-1 with regard to portal hypertension. CONCLUSIONS: TIMP-1 is significantly increased in patients with cirrhosis and correlates with the severity of the disease, degree of portal hypertension, and vasodilatory state. TIMP-1 is therefore a promising new noninvasive marker to predict hemodynamic-related complications in cirrhosis.
Assuntos
Hipertensão Portal/sangue , Cirrose Hepática/sangue , Inibidor Tecidual de Metaloproteinase-1/sangue , Adulto , Idoso , Pressão Arterial , Biomarcadores/sangue , Feminino , Artéria Hepática , Veias Hepáticas , Humanos , Hipertensão Portal/etiologia , Hipertensão Portal/fisiopatologia , Cirrose Hepática/complicações , Cirrose Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Resistência VascularRESUMO
Interpretive criteria for antimicrobial susceptibility testing are lacking for most antimicrobials used for bovine streptococcal mastitis. The objectives of this study were to determine (tentative) epidemiological cut-off ((T)ECOFF) values for clinically relevant antibiotics used for treatment of bovine mastitis, and to estimate the proportion of acquired resistance (non-wild-types) in Streptococcus dysgalactiae subsp. dysgalactiae and Streptococcus uberis. A total of 255 S. uberis and 231 S. dysgalactiae subsp. dysgalactiae isolates were obtained in Denmark and Norway from bovine mastitis. The isolates were tested for susceptibility to 10 antibiotics using broth microdilution. In accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standard operating procedure, additional published MIC distributions were included for the estimation of ECOFFs for cloxacillin, cephapirin, lincomycin and tylosin, and TECOFFs for amoxicillin, benzylpenicillin, cephapirin and oxytetracycline. The proportion of non-wild-type (NWT) isolates for the beta-lactams was significantly higher in the Danish S. uberis (45-55%) compared to the Norwegian isolates (10-13%). For oxytetracycline, the proportion of NWT was significantly higher in the Danish isolates, both for S. uberis (28% vs. 3%) and S. dysgalactiae (22% vs. 0%). A bridging study testing in parallel MICs in a subset of isolates (n = 83) with the CLSI-specified and the EUCAST-specified broths showed excellent correlation between the MICs obtained with the two methods. The new ECOFFs and TECOFFs proposed in this study can be used for surveillance of antimicrobial resistance, and - for antimicrobials licensed for streptococcal bovine mastitis - as surrogate clinical breakpoints for predicting their clinical efficacy for this indication.
Assuntos
Anti-Infecciosos , Doenças dos Bovinos , Cefapirina , Mastite Bovina , Oxitetraciclina , Infecções Estreptocócicas , Streptococcus , Feminino , Animais , Bovinos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Mastite Bovina/tratamento farmacológico , Cefapirina/uso terapêutico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/veterinária , Anti-Infecciosos/uso terapêutico , Testes de Sensibilidade Microbiana/veterináriaRESUMO
Genome-wide association studies recently linked the locus for Na(+),HCO(3)(-)-cotransporter NBCn1 (SLC4A7) to breast cancer susceptibility, yet functional insights have been lacking. To determine whether NBCn1, by transporting HCO(3)(-) into cells, may dispose of acid produced during high metabolic activity, we studied the expression of NBCn1 and the functional impact of Na(+),HCO(3)(-)-cotransport in human breast cancer. We found that the plasmalemmal density of NBCn1 was 20-30% higher in primary breast carcinomas and metastases compared to matched normal breast tissue. The increase in NBCn1 density was similar in magnitude to that observed for Na(+)/H(+)-exchanger NHE1 (SLC9A1), a transporter previously implicated in cell migration, proliferation and malignancy. In primary breast carcinomas, the apparent molecular weight for NBCn1 was increased compared to normal tissue. Using pH-sensitive fluorophores, we showed that Na(+),HCO(3)(-)-cotransport is the predominant mechanism of acid extrusion and is inhibited 34 ± 9% by 200 µM 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid in human primary breast carcinomas. At intracellular pH (pH(i) ) levels >6.6, CO(2)/HCO(3)(-)-dependent mechanisms accounted for >90% of total net acid extrusion. Na(+)/H(+)-exchange activity was prominent only at lower pH(i) -values. Furthermore, steady-state pH(i) was 0.35 ± 0.06 units lower in the absence than in the presence of CO(2)/HCO(3)(-). In conclusion, expression of NBCn1 is upregulated in human primary breast carcinomas and metastases compared to normal breast tissue. Na(+),HCO(3)(-)-cotransport is a major determinant of pH(i) in breast cancer and the modest DIDS-sensitivity is consistent with NBCn1 being predominantly responsible. Hence, our results suggest a major pathophysiological role for NBCn1 that may be clinically relevant.
Assuntos
Neoplasias da Mama/metabolismo , Simportadores de Sódio-Bicarbonato/fisiologia , Proteínas de Transporte de Cátions/genética , Feminino , Humanos , Concentração de Íons de Hidrogênio , RNA Mensageiro/análise , Receptor ErbB-2/fisiologia , Simportadores de Sódio-Bicarbonato/genética , Trocador 1 de Sódio-Hidrogênio , Trocadores de Sódio-Hidrogênio/genéticaRESUMO
Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested as a marker of prognosis and response to treatment in breast cancer. In vitro, TIMP-1 can regulate shedding of the extracellular domain of HER2 and signalling via the Akt pathway, and we hypothesize that TIMP-1 therefore can affect sensitivity to the HER2-targeting drugs trastuzumab and lapatinib. SK-BR-3 human breast cancer cells were stably transfected with TIMP-1, characterized with regard to TIMP-1 protein expression, proliferation, and functionality of the secreted TIMP-1, and the sensitivity to trastuzumab and lapatinib was studied in five selected single-cell subclones expressing TIMP-1 protein at various levels plus the parental SK-BR-3 cell line. Both trastuzumab and lapatinib reduced cell viability, as determined by MTT assay, but the sensitivity to the drugs was not associated with the expression level of TIMP-1 protein. Western blotting showed that the activation of Akt, PTEN, and HER2 as well as ADAM10 was similar in all clones. In conclusion, in this model, TIMP-1 overexpression does not affect HER2 cleavage by ADAM10 or signalling via the Akt pathway, and TIMP-1 does not influence sensitivity to trastuzumab and lapatinib.
Assuntos
Anticorpos Monoclonais Humanizados/farmacologia , Neoplasias da Mama/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos/genética , Quinazolinas/farmacologia , Receptor ErbB-2/genética , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Western Blotting , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Hibridização in Situ Fluorescente , Lapatinib , PTEN Fosfo-Hidrolase/metabolismo , Fosforilação/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Receptor ErbB-2/metabolismo , Trastuzumab , Células Tumorais CultivadasRESUMO
The emergence of methicillin-resistant Staphylococcus aureus (MRSA) comprises a global threat to humans and animals. Here, we report and characterize the MRSA t304/ST6 variant which, to our knowledge, represents the first case found in bovine clinical mastitis. In general, the MRSA t304/ST6 variant is rarely described in livestock, contrary to humans where it is widely recognized. Phenotypic and genotypic resistance profiling showed that the bovine-MRSA t304/ST6 isolate expressed low susceptibility toward cefoxitin (MICcefoxitin = 16 µg/mL) and carried the mecA resistance gene in the SCCmec IVa. The bovine-MRSA t304/ST6 isolate carried a plasmid similar to that which has been frequently observed among human-MRSA t304/ST6 isolates in Denmark (GenBank accession no. NZ_CP047022). In addition, a Staphylococcus prophage 3 (ÏSA3) was detected, encoding an immune evasion cluster (IEC) of putative virulence genes associated with human host-specificity (sea, sak, and scn). Taken together, these findings suggest that the MRSA t304/ST6 found in this study represents a recent host-jump event, with human to cow transmission. This study emphasizes the importance of and the need for performance of antimicrobial resistance surveillance among bovine mastitis pathogens, including S. aureus and MRSA.
RESUMO
Background: Breast cancer survivors are primarily followed up to monitor the effectiveness of treatment and complications and to detect recurrences. Many breast cancer survivors may experience prolonged adverse physical and psychological effects, which should also be addressed at follow-ups. The objective of this study was to develop a brief symptom assessment tool for breast cancer survivors to be used as a guideline for the survivors and all health care professionals conducting the routine follow-up. The second objective was to describe the women's individual experiences with follow-ups. Methods: A literature review, a focus group of 6 healthcare professionals using a nominal group technique process, and the experience and feedback via qualitative interviews with 16 breast cancer survivors was used to develop the Breast Cancer Survivors Symptom Assessment Checklist (BCS-SC). Results: The BCS-SC consists of a set of 13 symptoms/burdens and one question. On a scale from 0 (no symptom) to 10 (worst imaginable), survivors indicated the extent to which they experience each symptom. All survivors perceived the annual follow-ups as important, but none prepared for them. Eight of the 16 survivors reported that they had 2 or more of the symptoms/burdens listed in the BCS-SC. However, only one of the survivors had mentioned her symptom to the doctor at follow-up. Conclusion: The BCS-SC is a comprehensive assessment tool for symptoms/burdens that are common among breast cancer survivors and can aid efforts to optimize their follow-up. Furthermore, the BCS-SC allows for a more patient-initiated and focused consultation, leading to more patient-centered quality care.
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Antibiotic consumption is considered to be a main driver of antibiotic resistant bacteria. Mink breeding follows a distinctive seasonal reproduction cycle, and all of the mink produced in the northern hemisphere are bred, born, and pelted around the same time of year. Some of the diseases are age-related, which is reflected in the seasonal variation of antibiotic consumption. The seasonality makes mink a good model for the investigation of the association between antibiotic consumption and resistance. The objectives of this study were (1) to monitor the farm level of antibiotic resistance during one production cycle and (2) to assess the potential associations between antibiotic consumption and resistance. Twenty-four farms were included in this study (Denmark n = 20, Iceland n = 2, and The Netherlands n = 2), following a cohort of animals born in 2018. Staphylococcus delphini and Escherichia coli were isolated from samples of the carcasses and faeces and were collected randomly. The isolates were susceptibility tested and subsequently divided into the sensitive wildtype (WT) and the resistant non-wildtype (NWT) populations. The antibiotic consumption relative to the sampling periods was assessed as having a short-term or a long-term impact, i.e., in two explanatory factors. For both S. delphini and E. coli, a large between-farm variation of NWT profiles was detected. In the final multivariable, generalized linear mixed models, significant associations between NWT isolates and the consumption of specific antibiotics were found: the short-term use of tetracyclines in the growth period was associated with the occurrence of tetracycline NWT E. coli in the growth period (OR: 11.94 [1.78; 89.28]), and the long-term use of macrolide and tetracyclines was associated with the occurrence of erythromycin NWT S. delphini in the weaning period (OR: 18.2 [2.26; 321.36]) and tetracycline NWT S. delphini in the growth period (OR: 8.2 [1.27; 63.31]), respectively. Farms with zero consumption in the study years prior to sampling also had a substantial proportion of NWT isolates, indicating that NWT isolates are persistent and/or widely spread in the environment. Generally, a high occurrence of tetracycline NWTs was observed. NWT isolates with resistance against the most commonly used antibiotics were found on all the farms, stressing the need for routine surveillance and the prudent use of antibiotics. The results offer a preview of the complex relationship between consumption and resistance, demonstrating some significant associations between use and resistance. Moreover, antibiotic-resistant bacteria are present even on farms with no antibiotic consumption over extended periods, and theoretical explanations supported by the data are offered.
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Intervertebral disc calcification and herniation commonly affects Dachshund where the predisposition is caused by an early onset degenerative process resulting in disc calcification. A continuous spectrum of disc degeneration is seen within and among dog breeds, suggesting a multifactorial etiology. The number of calcified discs at 2 years of age determined by a radiographic evaluation is a good indicator of the severity of disc degeneration and thus serves as a measure for the risk of developing intervertebral disc herniation. The aim of the study was to identify genetic variants associated with intervertebral disc calcification in Dachshund through a genome-wide association (GWA) study. Based on thorough radiographic examinations, 48 cases with ≥ 6 disc calcifications or surgically treated for disc herniation and 46 controls with 0-1 disc calcifications were identified. GWA using the Illumina CanineHD BeadChip identified a locus on chromosome 12 from 36.8 to 38.6 Mb with 36 markers reaching genome-wide significance (P(genome) = 0.00001-0.026). This study suggests that a major locus on chromosome 12 harbors genetic variations affecting the development of intervertebral disc calcification in Dachshund.
Assuntos
Calcinose/veterinária , Doenças do Cão/genética , Loci Gênicos/genética , Marcadores Genéticos/genética , Degeneração do Disco Intervertebral/veterinária , Animais , Calcinose/diagnóstico por imagem , Calcinose/genética , Doenças do Cão/diagnóstico por imagem , Cães , Estudo de Associação Genômica Ampla , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/genética , Análise de Sequência com Séries de Oligonucleotídeos , RadiografiaRESUMO
INTRODUCTION: Collection of systematic information on education is a long-established practice in Denmark. CONTENT: We describe the education registers available through Statistics Denmark. In particular, we describe the most widely used register: the Population Education Register (PER). VALIDITY AND COVERAGE: In 2008, 96% of the Danish population aged 15-69 have non-missing education information in PER. For the immigrant population born in the same cohorts the coverage is 85-90%, which is a high coverage in an international context. CONCLUSION: The validity and coverage of the Danish education registers are very high.
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Escolaridade , Sistema de Registros , Adulto , Criança , Dinamarca , Educação Continuada , Humanos , Sistema de Registros/normasRESUMO
This study investigated the potential effects of management and health related factors on the productivity in the commercial mink production, during 2015-2018. Data were available from the database at Kopenhagen Fur, the national veterinary prescription database, VetStat, and the laboratory database at the Center for Diagnostics, Technological University of Denmark. A cross-sectional study, including 1.464 min. farms grouped into 1.187 epidemiological units, was applied. Data were analyzed in two models with different outcomes representing productivity on the mink farms, namely skin size and economical value (value sum) of the produced skin. The studied risk factors included use of vaccines and antibacterials, herd size, associated feed producer, purchases and sales of live animals, breeding results (litter size after weaning), Aleutian mink disease virus antibody (AMDV status) and stamping out, and laboratory test results. Vaccination against mink enteritis parvovirus and high breeding results were found to have a positive association with both outcomes, skin size and value sum. Both outcomes also varied significantly between farm clusters associated with different feed producers. Significant effects of antibacterial treatment were found, but the results were complex with both positive and negative associations with the outcome variables, depending on season and interactions with feed producer. Positive effects on antibacterial prescription on skin size were observed, except for farms associated with two small feed producers, known to have a variable microbiological feed quality. In farms receiving feed of very high quality, the positive effect of antibacterial prescription was marginal. CONCLUSIONS: The use of mink data has allowed us to assess the impact of feed quality as well as antibacterial prescription on productivity. The results showed a positive quantitative effect of vaccination against mink enteritis parvovirus on skin size and value, with an optimal effect by vaccination of the whole litter. Antibacterial prescription in the growth period, particularly around weaning, was found to have a positive quantitative effect on productivity in some farms, and the results suggest that the effect was associated with the feed quality. Use of antibacterials to counteract negative effects of low feed quality is not in accordance with principles for prudent use of antibacterials.
Assuntos
Criação de Animais Domésticos , Bem-Estar do Animal , Vison , Vírus da Doença Aleutiana do Vison , Animais , Estudos Transversais , Fazendas , Feminino , Tamanho da Ninhada de Vivíparos , GravidezRESUMO
OBJECTIVE: To evaluate changes in antimicrobial consumption and productivity by Danish swine farms during 1992 to 2008. SAMPLE POPULATION: All Danish swine farms for antimicrobial consumption data and a representative sample of Danish swine herds for productivity data. PROCEDURES: Antimicrobial consumption by Danish swine farms from 1992 to 2008 was determined and evaluated in light of policies to regulate antimicrobial consumption, changes in disease patterns, and productivity data. Trend analyses of productivity data were conducted before and after a ban on use of antimicrobial growth promoters (AGPs). Results-Antimicrobial consumption peaked at 100 mg/kg of swine produced in 1992, decreased to 31 mg/kg in 1999, and increased to 49 mg/kg in 2008. Key factors for changes were regulations banning subtherapeutic use of antimicrobials and veterinary profits from the prescription and sale of antimicrobials in 1994 and termination of AGP use by January 2000. Pig production increased from 18.4 to 271 million pigs, and the mean number of pigs per sow per year raised for slaughter increased from 21 in 1992 to 25 in 2007 Average daily gain for weaning (< 35 kg) and finishing (> 35 kg) pigs was higher in 2008 than in 1992, but mortality rates for weaning and finishing pigs were similar in 1992 and 2008. CONCLUSIONS AND CLINICAL RELEVANCE: From 1992 to 2008, antimicrobial consumption per kilogram of pig produced in Denmark decreased by > 50%. Furthermore, there was improvement in productivity, suggesting that long-term swine productivity was not negatively impacted by a ban on AGP use.
Assuntos
Anti-Infecciosos/uso terapêutico , Doenças dos Suínos/tratamento farmacológico , Animais , Anti-Infecciosos/farmacologia , Dinamarca , Feminino , Crescimento/efeitos dos fármacos , Masculino , Carne , Análise de Regressão , Reprodução/efeitos dos fármacos , Reprodução/fisiologia , Software , Suínos , Doenças dos Suínos/mortalidade , Aumento de PesoRESUMO
The emergence and dissemination of antimicrobial resistant pathogens have led to rising concern about the widespread and excessive use of antimicrobials in veterinary medicine. Denmark has implemented several initiatives to reduce antimicrobial use in animals since the 90s, with the Yellow Card scheme implemented in 2010. The aim of the present study is to investigate the effects on antimicrobial use in Danish pig farms of changes in the legislation regarding the Yellow Card, based on analysis of temporal trends in monthly antimicrobial consumption calculated at herd-level from 2010 to 2017. A dynamic linear model with a linear growth component was used to model the data. The percentage of herds with a negative growth component and a significant decline below zero (based on 95% credible intervals) was assessed for the entire study period. The analysis was run separately for the different age groups within each farm: weaners (up to 30 kg), sows and finishers herds, and categorized according to antimicrobial use before the Yellow Card initiative (2008-2009), as groups of herds with "low," "moderate," or "high" consumption. The results evidence a decline of the antimicrobial consumption in Danish pig herds, more pronounced during two periods: with the introduction of the Yellow Card and in relation to the announcements and changes in the legislation in 2014. Weaner herds in the high consumption category had the highest percentage of herds with a negative growth component, reaching 82% of herds in January 2011, followed by weaner herds with moderate antimicrobial consumption reaching 71% of herds in October 2012. For finisher herds in the moderate consumption category, the proportion with a negative growth increased from 38% in January 2010 to 71% in July 2011. A decline in antimicrobial consumption was also evident after announcements and changes in the legislation in 2014, particularly for sows and finishers. Our findings suggest that changes in the Yellow Card scheme promoted a continuous reduction in antimicrobial use in Danish pig herds, particularly in herds with high antimicrobial consumption.