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Non-invasive prenatal testing (NIPT) is an exciting technology with the potential to provide a variety of clinical benefits, including a reduction in miscarriages, via a decline in invasive testing. However, there is also concern that the economic and near-future clinical benefits of NIPT have been overstated and the potential limitations and harms underplayed. NIPT, therefore, presents an opportunity to explore the ways in which a range of social pressures and policies can influence the translation, implementation, and use of a health care innovation. NIPT is often framed as a potential first tier screen that should be offered to all pregnant women, despite concerns over cost-effectiveness. Multiple forces have contributed to a problematic translational environment in Canada, creating pressure towards first tier implementation. Governments have contributed to commercialization pressure by framing the publicly funded research sector as a potential engine of economic growth. Members of industry have an incentive to frame clinical value as beneficial to the broadest possible cohort in order to maximize market size. Many studies of NIPT were directly funded and performed by private industry in laboratories lacking strong independent oversight. Physicians' fear of potential liability for failing to recommend NIPT may further drive widespread uptake. Broad social endorsement, when combined with these translation pressures, could result in the "routinization" of NIPT, thereby adversely affecting women's reproductive autonomy. Policymakers should demand robust independent evidence of clinical and public health utility relevant to their respective jurisdictions before making decisions regarding public funding for NIPT.
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Testes para Triagem do Soro Materno , Obstetrícia/tendências , Feminino , Humanos , Obstetrícia/legislação & jurisprudência , Gravidez , Transferência de Tecnologia , Pesquisa Translacional BiomédicaRESUMO
BACKGROUND: The recent Canadian lawsuit on patent infringement, filed by the Children's Hospital of Eastern Ontario (CHEO), has engendered a significant public debate on whether patenting genes should be legal in Canada. In part, this public debate has involved the use of social networking sites, such as Twitter. This case provides an opportunity to examine how Twitter was used in the context of this gene patent controversy. METHODS: We collected 310 English-language tweets that contained the keyword "gene patents" by using TOPSY.com and Twitter's built-in search engine. A content analysis of the messages was conducted to establish the users' perspectives on both CHEO's court challenge and the broader controversy over the patenting of human DNA. More specifically, we analyzed the users' demographics, geographic locations, and attitudes toward the CHEO position on gene patents and the patentability of human genes in principle. RESULTS: Our analysis has shown that messages tweeted by news media and health care organizations were re-tweeted most frequently in Twitter discussions regarding both the CHEO patent infringement lawsuit and gene patents in general. 34.8% of tweets were supportive of CHEO, with 52.8% of the supportive tweets suggesting that gene patents contravene patients' rights to health care access. 17.6% of the supportive tweets cited ethical and social concerns against gene patents. Nearly 40% of tweets clearly expressed that human genes should not be patentable, and there were no tweets that presented perspectives favourable toward the patenting of human genes. CONCLUSION: Access to healthcare and the use of genetic testing were the most important concerns raised by Twitter users in the context of the CHEO case. Our analysis of tweets reveals an expectation that the CHEO lawsuit will provide an opportunity to clear the confusion on gene patents by establishing a legal precedent on the patentability of human genes in Canada. In general, there were no tweets arguing in favour of gene patents. Given the emerging role of social media in framing the public dialogue on these issues, this sentiment could potentially have an impact on the nature and tone of the Canadian policy debate.
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Atitude Frente a Saúde , Genes , Acessibilidade aos Serviços de Saúde , Síndrome do QT Longo/genética , Patentes como Assunto/legislação & jurisprudência , Direitos do Paciente , Mídias Sociais , Canadá , Criança , Comunicação , Testes Genéticos , Hospitais , Humanos , Internet , Jurisprudência , Ontário , Patentes como Assunto/éticaRESUMO
PURPOSE: This study investigates the portrayal of Angelina Jolie's preventive bilateral mastectomy in the news media. Content analysis of print news was conducted to identify major frames used in press coverage, the overall tone of discussions, how journalists report broader questions about BRCA1/2 testing and hereditary breast/ovarian cancer, and whether they raise concerns about the impact of celebrities on patients' choices and public opinion. METHODS: The Factiva database was used to collect publications on Jolie's preventive mastectomy in elite newspapers in Canada, the United States, and the United Kingdom. The data set consisted of 103 newspaper articles published in the first month of media coverage. RESULTS: The results show that although the press discussed key issues surrounding predictive genetic testing and preventive options for women at high risk of hereditary breast/ovarian cancer, important medical information about the rarity of Jolie's condition was not communicated to the public. CONCLUSION: The results highlight the media's overwhelmingly positive slant toward Jolie's mastectomy, while overlooking the relative rarity of her situation, the challenges of "celebrity medicine," and how celebrities influence people's medical decisions. Future research is required to investigate whether the media hype has influenced demand and use of BRCA1/2 testing and preventive mastectomies.
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Neoplasias da Mama/genética , Neoplasias da Mama/prevenção & controle , Pessoas Famosas , Predisposição Genética para Doença , Mastectomia , Jornais como Assunto , Prevenção Primária , Proteína BRCA1/genética , Proteína BRCA2/genética , Canadá , Procedimentos Cirúrgicos Eletivos , Feminino , Testes Genéticos/estatística & dados numéricos , Humanos , Disseminação de Informação , Mutação/genética , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/prevenção & controle , Opinião Pública , Medição de Risco , Inquéritos e Questionários , Reino Unido , Estados UnidosRESUMO
This study was designed to evaluate the potential application of monensin as an oral drug for the treatment of cadmium-induced hepatic dysfunction. The study was performed using ICR mouse model. Twenty-seven adult ICR male mice were divided into three groups of nine animals each: control (received distilled water and food ad libitum for 28 days); Cd-intoxicated (treated orally with 20 mg/kg b.w. Cd(II) acetate from the 1st to the 14th day of the experimental protocol); and monensin treated group (intoxicated with Cd(II) acetate as described for the Cd-intoxicated group followed by an oral treatment with 16 mg/kg b.w. tetraethylammonium salt of monensic acid for two weeks). The obtained results demonstrated that the treatment of Cd-intoxicated animals with monensin restored the liver weight/body weight index to normal values, decreased the concentration of the toxic metal ion by 50% compared to the Cd-treated controls, and recovered the homeostasis of Cu and Zn. Monensin reduced the activity of aspartate aminotransferase, alanine aminotrasnferase and alkaline phosphatase in the plasma of Cd-treated animals to the normal control levels and ameliorated the Cd-induced inflammation in the liver. Taken together, these data demonstrated that monensin could be an effective chelating agent for the treatment of Cd-induced hepatotoxicity.
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INTRODUCTION: Colorectal cancer is the third most common cancer type worldwide. Fluoropyrimidines and their prodrug-based regimens are widely applied as primary medications. The main enzyme responsible for the rate-limiting step in pyrimidine and for the 5-fluorouracil catabolism is dihydropyrimidine dehydrogenase (DPD). AIM: We aimed to screen DPD level and the changes of plasma antioxidant capacity of colorectal cancer patients on 5-fluorouracil regimen. MATERIALS AND METHODS: Human DPD Elisa Kit based on sandwich enzyme-linked immune-sorbent assay and spectrophotometric methods (FRAP and ABTS) were used in the study. RESULTS: No statistically significant changes in plasma scavenging activity according to the results obtained in the ABTS system have been observed after evaluating all patients and considering DPD concentration. A decrease of the ferric reducing ability of patients' plasma taken after the administered treatment was found. The increase of DPD level is accompanied by a decrease in the p values and therefore the statistical significance of the differences increases. CONCLUSIONS: Based on the aforementioned observations, it could be concluded that some aspects of plasma antioxidant capacity and individuals' antioxidant status might be involved in the pathogenesis of the disease and could be altered by the activity of some enzymes. The cancer therapy in question, by the specificity of its mechanism of action, can modify patient's oxidative status.
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Neoplasias Colorretais , Di-Hidrouracila Desidrogenase (NADP) , Antimetabólitos Antineoplásicos/farmacologia , Antimetabólitos Antineoplásicos/uso terapêutico , Antioxidantes/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Di-Hidrouracila Desidrogenase (NADP)/análise , Fluoruracila/efeitos adversos , Fluoruracila/uso terapêutico , HumanosRESUMO
This study examines the representations of human gene patents in Chinese newspapers. We conducted a qualitative content analysis of news articles published between 2006 and 2017 to identify the major themes in media coverage, ethical considerations, perceptions of risks and benefits, and attitudes towards the patentability of human genes. The results show that two key ethical concerns were expressed by journalists: (1) that it is morally wrong to own or patent human genes and (2) that gene patents could potentially impede patients' access to healthcare services. Nonetheless, the press coverage has tended to be largely favorable (57.8%), rather than opposed (17.8%) to human gene patenting. There were no normative claims that human genes should not be patentable in China, which indicates a generally positive attitude towards patentability in media discourse. Most articles that expressed criticism toward gene patenting discussed challenges in other countries, with significant attention given to the United States Supreme Court's ruling in the Myriad case that invalidated Myriad Genetics' patents on the BRCA1 and BRCA2 genes. Overall, the newspapers were uncritical of the Chinese gene patenting regime. News reporting on the issue was highly suggestive of a strong pro-commercialization stance, although some discussions emphasized potential risks over benefits. Our analysis highlights the need for balanced media reporting on human gene patents in China and a top-down approach to engage the public in substantive discussions on the ethical and societal implications of the existing patent regime.
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BACKGROUND AND AIM: Environmental lead (Pb) exposure damages the lungs and is a risk factor for death from cardiovascular disease. Pb induces toxicity by a mechanism, which involves alteration of the essential elements homeostasis. In this study we compare the effects of salinomycin (Sal), monensin (Mon) and meso-2,3-dimercaptosuccinic acid (DMSA) on the concentrations of lead (Pb), calcium (Ca), copper (Cu), iron (Fe) and zinc (Zn) in the lungs and heart of lead-exposed mice. METHODS: Sixty days old male ICR mice were divided into five groups: control (Ctrl) - untreated mice obtained distilled water for 28 days; Pb-intoxicated group (Pb) - exposed to 80â¯mg/kg body weight (BW) Pb(NO3)2 during the first 14 days of the experimental protocol; DMSA-treated (Pbâ¯+â¯DMSA) - Pb-exposed mice, subjected to treatment with an average daily dose of 20â¯mg/kg BW DMSA for two weeks; Monensin-treated (Pbâ¯+â¯Mon) - Pb-exposed mice, obtained an average daily dose of 20â¯mg/kg BW tetraethylammonium salt of monensic acid for 14 days; Pbâ¯+â¯Sal - Pb-exposed mice, treated with an average daily dose of 20â¯mg/kg BW tetraethylammonium salt of salinomycinic acid for two weeks. On the 29th day of the experiment the samples (lungs and heart) were taken for atomic absorption analysis. RESULTS: The results revealed that exposure of mice to Pb for 14 days significantly increased the concentration of the toxic metal in both organs and elevated the cardiac concentrations of Ca, Cu and Fe compared to untreated mice. Pb exposure diminished the lung concentrations of Ca and Zn compared to that of untreated controls. DMSA, monensin and salinomycin decreased the concentration of Pb in the lungs and heart. Among the tested chelating agents, only salinomycin restored the cardiac Fe concentration to normal control values. CONCLUSION: The results demonstrated the potential application of polyether ionophorous antibiotic salinomycin as antidote for treatment of Pb-induced toxicity in the lungs and heart. The possible complexation of the polyether ionophorous antibiotics with Ca(II) and Zn(II), which can diminish the endogenous concentrations of both ions in the lungs should be taken into account.
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Intoxicação por Chumbo/metabolismo , Pulmão/metabolismo , Metais Pesados/metabolismo , Monensin/farmacologia , Miocárdio/metabolismo , Piranos/farmacologia , Succímero/farmacologia , Animais , Cálcio/metabolismo , Cobre/metabolismo , Ferro/metabolismo , Chumbo/metabolismo , Masculino , Camundongos Endogâmicos ICR , Zinco/metabolismoRESUMO
In this study, we present experimental data on the effects of meso-2,3-dimercaptosuccinic acid (DMSA) and tetraethylammonium salt of salinomycinic acid (Sal) on cadmium-induced spleen dysfunction and altered essential metal balance in mice. Sixty-day-old male mice (ICR line) were randomly divided into four groups: untreated control group (Ctrl)-obtained distilled water for 28 days, toxic control group (Cd)-exposed to cadmium acetate dihydrate at average daily dose of 20mg/kg body weight (BW) for 14 days, Cd + DMSA group-obtained cadmium acetate dihydrate as the toxic control group followed by treatment with 20mg/kg BW DMSA for 2 weeks, and Cd + Sal group-mice exposed to cadmium acetate dihydrate at average daily dose of 20mg/kg BW for 2 weeks followed by administration of Sal at an average daily dose of 20mg/kg BW for 2 weeks. The compounds were administered orally via the drinking water of the animals. We found that cadmium exposure caused splenomegaly and reduced the hemoglobin and hematocrit levels and total red blood cell count compared with untreated controls. Cadmium intoxication of mice induced accumulation of the toxic metal ion in the blood and spleen. Alterations in the endogenous levels of calcium (Ca) and iron (Fe) in the spleen of cadmium-exposed mice compared with those in untreated controls were observed. Treatment of cadmium-exposed mice with DMSA or Sal recovered the spleen weight and hematological parameters to normal control values, decreased cadmium concentration in the blood and spleen, and improved splenic architecture. The results prove that Sal is a potential antidote for treatment of Cd-induced spleen dysfunction.
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Substâncias Protetoras/farmacologia , Piranos/farmacologia , Baço/efeitos dos fármacos , Succímero/farmacologia , Poluentes Químicos da Água/toxicidade , Acetatos , Animais , Cádmio/toxicidade , Cálcio , Água Potável , Ferro , Masculino , Camundongos , Camundongos Endogâmicos ICR , Baço/fisiologiaRESUMO
This study presents experimental data on the effects of the tetraethylammonium salt of salinomycinic acid (Sal) on Cd-induced hepatotoxicity and renal dysfunction in Cd-treated mice compared to those of meso-2,3-dimercaptosuccinic acid (DMSA). Forty 60-day-old male ICR mice were randomized into five groups: control group (untreated mice), Cd group (Cd(II) acetate 20 mg/kg body weight provided orally once per day for 14 days), Cd + DMSA group (exposed to Cd(II) acetate as the Cd-exposed group followed by DMSA 20 mg/kg body weight provided orally once per day for 14 days), and Cd + Sal group (exposed to Cd(II) acetate as the Cd-exposed group followed by Sal 20 mg/kg body weight once per day for 14 days). Cd intoxication of mice induced significant liver and kidney injury and a significant elevation of the concentration of Cd in both organs. Treatment of Cd-exposed mice with DMSA or Sal restored the levels of the renal and hepatic functional markers and significantly decreased the concentration of the toxic metal ion in both organs. Administration of Sal improved Cd-induced alterations of the endogenous levels of the essential metal ions. Histological studies revealed that the antibiotic more effectively ameliorated the Cd effect on the liver morphology compared to DMSA. Taken together, the results confirm that the anticancer agent salinomycin is a promising antidote to Cd poisoning.
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Antineoplásicos/farmacologia , Cádmio/toxicidade , Quelantes/farmacologia , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Rim/efeitos dos fármacos , Fígado/efeitos dos fármacos , Piranos/farmacologia , Animais , Rim/metabolismo , Rim/patologia , Testes de Função Renal , Fígado/metabolismo , Fígado/patologia , Testes de Função Hepática , Masculino , Camundongos , Camundongos Endogâmicos ICRRESUMO
Cadmium (Cd) is an environmental pollutant shown to induce multi organ dysfunction. In this study we present novel data about the effects of meso-2,3-dimercaptosuccinic acid (DMSA), monensin and salinomycin on the concentration of Cd in skeletal muscles of mice exposed to Cd (II) acetate treatment for 14 days. The impact of Cd and the chelating agents on the endogenous concentrations of calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), phosphorous (P), selenium (Se) and zinc (Zn) was also investigated. Subacute exposure of mice to Cd (II) acetate resulted in a significant accumulation of the toxic metal ion in the skeletal muscles compared to the untreated controls. Salinomycin most effectively mobilized Cd from the muscles compared to DMSA and monensin. The Cd exposure and the tested chelating agents did not significantly alter the endogenous concentrations of the selected essential elements in mouse muscles. The presented results confirmed that among the tested chelating agents salinomycin is superior as a potential antidote to Cd poisoning.
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Cádmio/metabolismo , Cálcio/metabolismo , Cobre/metabolismo , Monensin/farmacologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Piranos/farmacologia , Succímero/farmacologia , Animais , Quelantes/química , Homeostase/efeitos dos fármacos , Ferro/metabolismo , Magnésio/metabolismo , Camundongos , Selênio/metabolismo , Zinco/metabolismoRESUMO
Cadmium (Cd) is a risk factor for neurodegenerative diseases. The purpose of this study was to compare the effects of meso-2,3-dimercaptosuccinic acid (DMSA) and the polyether ionophorous antibiotics monensin and salinomycin on Cd-induced neurodegenerative alterations in mice. The results show that subacute intoxication of mice with Cd (II) acetate (20 mg/kg body weight (BW) for 14 days) caused a significant accumulation of cadmium (Cd) in the brain. Treatment of Cd-exposed mice with DMSA (20 mg/kg BW for 14 days) significantly increased the Cd concentration in the brains compared to those of the Cd-treated group. However, administration of monensin (20 mg/kg BW for 14 days) or salinomycin (20 mg/kg BW for 14 days) significantly reduced the Cd concentration in the brains of Cd-treated mice compared to the toxic control group. Histopathological analysis of brain tissues from the Cd-treated mice revealed that Cd induced neuronal necrosis, characterized by many shrunken, darkly stained pyknotic neurons with prominent perineuronal spaces. Whereas monensin and salinomycin significantly reduced the adverse effects of Cd on brain morphology of Cd-treated mice, DMSA did not. Monensin slightly increased the copper and iron endogenous levels in the brains of Cd-exposed mice compared to those of the untreated mice. Salinomycin did not affect the concentrations of biometal ions in the brain of Cd-exposed mice compared to untreated controls. The results demonstrated salinomycin to be a better potential chelating agent for treatment of Cd-induced brain injury compared to DMSA and monensin.
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Melhoramento Biomédico/ética , Comportamento de Escolha/ética , Obrigações Morais , Pais , Reprodução , Pré-Seleção do Sexo/ética , Beneficência , Transtornos do Desenvolvimento Sexual , Feminino , Identidade de Gênero , Humanos , Expectativa de Vida , Masculino , Parto , Caracteres Sexuais , SexualidadeAssuntos
Hiperplasia Suprarrenal Congênita/tratamento farmacológico , Dexametasona/administração & dosagem , Transtornos do Desenvolvimento Sexual/prevenção & controle , Doenças Fetais/tratamento farmacológico , Comunicação Persuasiva , Política , Hiperplasia Suprarrenal Congênita/complicações , Hiperplasia Suprarrenal Congênita/diagnóstico , Correspondência como Assunto , Transtornos do Desenvolvimento Sexual/etiologia , Feminino , Doenças Fetais/diagnóstico , Glucocorticoides/administração & dosagem , Humanos , Uso Off-Label/ética , Virilismo/prevenção & controleRESUMO
In this Perspective, we examine the portrayal of translational stem cell research in major daily newspapers in Canada, the United States, and the United Kingdom between 2010 and 2013, focusing on how timelines for stem cell therapies were represented before and after Geron terminated its pioneering stem cell program. Our content analysis reveals that press coverage has shifted from ethical, legal, and social issues to clinical translation issues, and highly optimistic timelines were provided with no substantial change in representation over time. Scientists were the dominant voice with respect to translation timelines. The findings raise questions about the degree to which the media's overly optimistic slant fosters unrealistic expectations regarding the speed of clinical translation and highlight the ethical responsibility of stem cell researchers as public communicators.
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Meios de Comunicação , Células-Tronco/citologia , Pesquisa Translacional Biomédica , Previsões , Células-Tronco Embrionárias Humanas/citologia , Humanos , Jornais como AssuntoRESUMO
The practice of travelling abroad to receive unproven and unregulated stem cell treatments has become an increasingly problematic global phenomenon known as 'stem cell tourism'. In this paper, we examine representations of nine major clinics and providers of such treatments on the microblogging network Twitter. We collected and conducted a content analysis of Twitter posts (n = 363) by these establishments and by other users mentioning them, focusing specifically on marketing claims about treatment procedures and outcomes, discussions of safety and efficacy of stem cell transplants, and specific representations of patients' experiences. Our analysis has shown that there were explicit claims or suggestions of benefits associated with unproven stem cell treatments in approximately one third of the tweets and that patients' experiences, whenever referenced, were presented as invariably positive and as testimonials about the efficacy of stem cell transplants. Furthermore, the results indicated that the tone of most tweets (60.2 %) was overwhelmingly positive and there were rarely critical discussions about significant health risks associated with unproven stem cell therapies. When placed in the context of past research on the problems associated with the marketing of unproven stem cell therapies, this analysis of representations on Twitter suggests that discussions in social media have also remained largely uncritical of the stem cell tourism phenomenon, with inaccurate representations of risks and benefits for patients.