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1.
J Pediatr Orthop ; 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38881536

RESUMO

BACKGROUND: Patients with Osgood-Schlatter disease (OSD) may be at increased risk of tibial tubercle fractures due to an underlying weakness of the tibial tubercle apophysis relative to the patellar tendon as a result of repetitive microtrauma. HYPOTHESIS/PURPOSE: The purpose of this study is to analyze the incidence of tibial tubercle fractures in patients with and without Osgood-Schlatter disease. We hypothesized that the incidence of tibial tubercle fractures would be higher in patients with Osgood-Schlatter disease. METHODS: A retrospective cohort analysis of the PearlDiver database was performed by querying all patients diagnosed with Osgood-Schlatter disease between January 2010 and October 2022. An OSD cohort of 146,672 patients was captured using International Classification of Diseases, Ninth Revision (ICD-9), Tenth Revision (ICD-10) billing codes, and age as inclusion/exclusion criteria. The Student t test and the χ2 analyses were used to compare the demographics and obesity between the OSD and control cohorts. Multivariable logistic regressions, controlling for residual differences in age, sex, and obesity, were used to compare rates of tibial tubercle fractures. RESULTS: Patients with a recent history of OSD were found to have higher rates of tibial tubercle fractures than the control group at all measured time points (P<0.001). The 1-year rate of tibial tubercle fractures was 0.62% in the OSD group. The incidence of tibial tubercle fractures in the OSD group was 627.3 cases per 100,000 person-years compared with 42.7 cases per 100,000 person-years in the control group (P<0.001). Male sex and obesity were also associated with an increased risk of sustaining a tibial tubercle fracture within these patient populations (P<0.001). CONCLUSION: We report a significantly higher incidence of tibial tubercle fractures among patients with OSD compared with controls. This increase was most significant at 1 month following OSD diagnosis, however, held true for all measured time points. In addition, male patients and those with obesity were also noted to have increased incidence of tibial tubercle fractures regardless of an OSD diagnosis.

2.
Support Care Cancer ; 31(2): 136, 2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36700992

RESUMO

PURPOSE: To identify physical activity (PA) barriers and facilitators among Black and African American (Black/AA) cancer survivors that should be considered in future PA intervention development for this population. METHODS: A community advisory board (CAB) of Black/AA cancer survivors and patient advocates guided in-depth qualitative interviews (n = 19) that were completed via telephone using a semi-structured interview guide. Interviews were transcribed verbatim, and data were analyzed using directed content analysis to detail a report of PA barriers and facilitators during and after cancer treatment. The CAB reviewed and interpreted these barriers and facilitators to identify the final results. RESULTS: Survivors (n = 19) of nine different types of cancer completed interviews. PA barriers during cancer treatments included physical and psychological suffering. PA barriers after cancer treatments included social and environmental constraints (e.g., lack of access needed for PA, safety concerns, and competing priorities). PA facilitators both during and after cancer treatments included family support, faith, and support from other survivors. PA facilitators during treatment also included feeling better after doing PA, setting realistic and flexible goals, and gaining a sense of control of one's health by striving for PA goals. CONCLUSIONS: To increase PA among Black/AA cancer survivors, PA interventions are needed that address structural barriers, include the role of faith, leverage family support, highlight the psychological benefits of PA, and use goal setting.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Sobreviventes de Câncer/psicologia , Negro ou Afro-Americano , Exercício Físico/psicologia , Sobreviventes/psicologia , Pesquisa Qualitativa , Neoplasias/terapia
3.
Nurs Res ; 72(2): 123-131, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36450360

RESUMO

BACKGROUND: Researchers who aim to serve a community (i.e., racial, gender, ethnic group) of which they are not a part must do foundational work to understand that community and build intentional, thoughtful collaborations with the community to guide their work. OBJECTIVES: This article aims to share a case exemplar of the formation period of a community advisory board (CAB) that conducts research focused on improving health equity in the Black and African American community. METHODS: CAB development has three phases: formation, operation, and maintenance. Previous work has described and provided best practices for each phase. This article focused on the first phase, formation. Guided by critical race theory, with guidance from her mentor, a researcher partnered with a research assistant and a community health educator to develop a CAB. Details of their processes-which apply to the formation of other CABs-are presented. DISCUSSION: During the board formation period, the major focus has been relationship building and developing a shared mission: "To work in partnership with researchers at the University of North Carolina to reduce cancer disparities in Black/African American communities by informing research and program development. As a liaison between the community and researchers, the Community Advisory Board will identify community needs, promote evidence-based interventions and information, raise awareness about health disparities in communities, and educate researchers." CAB formation is nuanced and unique, dependent upon the nature of the research to be conducted and the characteristics of the community and researchers. This case exemplar provides valuable insights to other researchers working to build community partnerships.


Assuntos
Equidade em Saúde , Neoplasias , Feminino , Humanos , Negro ou Afro-Americano , Etnicidade , Neoplasias/epidemiologia , Pesquisadores , Minorias Desiguais em Saúde e Populações Vulneráveis
4.
Comput Inform Nurs ; 41(6): 369-376, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-36728378

RESUMO

Nursing informatics requires an understanding of patient-centered data and clinical workflow, and epigenetic research requires an understanding of data analysis. The purpose of this article is to document the methodology that nursing informatics specialists can use to conduct epigenetic research and subsequently strengthen patient-centered care. A pilot study of a secondary methylation data analysis using The Cancer Genome Atlas data from individuals with colon cancer is utilized to illustrate the methodology. The steps for conducting the study using public and free resources are discussed. These steps include finding a data source; downloading and analyzing differentially methylated regions; annotating differentially methylated region, gene ontology and function analysis; and reporting results. A model of epigenetic testing workflow is provided, as is a list of publicly available data and analysis sources that can be used to conduct epigenetic research.


Assuntos
Informática em Enfermagem , Humanos , Projetos Piloto , Big Data , Análise de Dados
5.
Pediatr Res ; 92(3): 647-652, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34819655

RESUMO

Child abuse is common in the United States but is often undetected. The incidence of this form of abuse is difficult to quantify, but children with a history of abuse are at risk of chronic health conditions. Medical providers are in the unique position of triaging trauma patients and differentiating unintentional from abusive trauma, as well as having the important position of being a mandated reporter of abuse in all states. Obtaining a detailed history and screening for risk factors can help identify children at risk of abuse. Certain orthopedic injuries may be related to abuse, which may trigger clinical suspicion and lead to further workup or intervention. By increasing awareness, through medical provider education and increased screening, earlier detection of abuse may prevent more serious injuries and consequences. This review evaluates current literature regarding the orthopedic manifestations of child abuse in hopes of increasing medical provider awareness. IMPACT: Child abuse is common in the United States but often remains undetected. Medical professionals are in the unique position of evaluating trauma patients and identifying concerns for abusive injuries. Certain orthopedic injuries may raise concern for abuse triggering clinical suspicion and further workup or intervention.


Assuntos
Maus-Tratos Infantis , Criança , Maus-Tratos Infantis/diagnóstico , Humanos , Lactente , Fatores de Risco , Estados Unidos
6.
Proc Natl Acad Sci U S A ; 115(10): 2467-2472, 2018 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-29453278

RESUMO

A subset of patients with metastatic melanoma have sustained remissions following treatment with immune checkpoint inhibitors. However, analyses of pretreatment tumor biopsies for markers predictive of response, including PD-1 ligand (PD-L1) expression and mutational burden, are insufficiently precise to guide treatment selection, and clinical radiographic evidence of response on therapy may be delayed, leading to some patients receiving potentially ineffective but toxic therapy. Here, we developed a molecular signature of melanoma circulating tumor cells (CTCs) to quantify early tumor response using blood-based monitoring. A quantitative 19-gene digital RNA signature (CTC score) applied to microfluidically enriched CTCs robustly distinguishes melanoma cells, within a background of blood cells in reconstituted and in patient-derived (n = 42) blood specimens. In a prospective cohort of 49 patients treated with immune checkpoint inhibitors, a decrease in CTC score within 7 weeks of therapy correlates with marked improvement in progression-free survival [hazard ratio (HR), 0.17; P = 0.008] and overall survival (HR, 0.12; P = 0.04). Thus, digital quantitation of melanoma CTC-derived transcripts enables serial noninvasive monitoring of tumor burden, supporting the rational application of immune checkpoint inhibition therapies.


Assuntos
Antineoplásicos Imunológicos , Biomarcadores Tumorais/sangue , Melanoma , Células Neoplásicas Circulantes , Neoplasias Cutâneas , Antineoplásicos Imunológicos/farmacologia , Antineoplásicos Imunológicos/uso terapêutico , Biomarcadores Tumorais/química , Terapia Baseada em Transplante de Células e Tecidos , Feminino , Humanos , Estimativa de Kaplan-Meier , Biópsia Líquida , Masculino , Melanoma/sangue , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Melanoma/mortalidade , Pessoa de Meia-Idade , Células Neoplásicas Circulantes/química , Células Neoplásicas Circulantes/efeitos dos fármacos , RNA/análise , RNA/genética , RNA/metabolismo , Neoplasias Cutâneas/sangue , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/mortalidade
7.
J Shoulder Elbow Surg ; 30(2): 340-345, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32562763

RESUMO

PURPOSE: To use a nationwide database to determine differences in cost between patients who underwent arthroscopic rotator cuff tear with open vs. arthroscopic biceps tenodesis (BT). METHODS: The 2014 State Ambulatory Surgical and Services Databases from 6 US states was utilized. All cases with CPT codes 29827 (arthroscopic rotator cuff repair [RCR]) and either 23430 (tenodesis of long tendon of biceps) or 29828 (arthroscopic BT) were selected. Cases that included both 23430 and 29828 were excluded, as were those missing demographic data. Generalized linear models were used to model costs based on the surgical and patient variables that were significant in the initial bivariate analysis (P < .05). RESULTS: A total of 3635 RCR and BT cases were identified. There were 2847 (78.3%) with arthroscopic BT and 788 (21.7%) with open BT. Patients undergoing arthroscopic BT were 3.1 years older than patients undergoing open BT (P < .001). For arthroscopic BT, 39.2% of the cases were women compared with 22.6% of the open cases (P < .001). For operative variables, arthroscopic BT required 9 fewer minutes in the OR than open cases (P = .002). Concomitant distal clavicle resection was performed in 35.5% of arthroscopic BT cases compared with 29.8% of open cases (P = .004). While controlling for other significant factors, open BT was associated with $5542 lower costs than arthroscopic BT in the setting of RCR (P < .001). In either case, concomitant subacromial decompression added $10,669 (P < .001), and distal clavicle resection added $3210 (P < .001). High-volume surgical facilities were associated with $4107 lower costs (P < .001). CONCLUSIONS: In a large series of patients undergoing arthroscopic RCR with open vs. arthroscopic BT, open BT was associated with $5542 lower costs than arthroscopic. Given that both techniques have been shown to be similarly effective in long-term follow-up, surgeons should be aware of opportunities for cost saving, particularly with the advent of bundled surgical reimbursements.


Assuntos
Lesões do Manguito Rotador , Tenodese , Artroscopia , Custos e Análise de Custo , Feminino , Humanos , Masculino , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia
8.
Proc Natl Acad Sci U S A ; 114(5): 1123-1128, 2017 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-28096363

RESUMO

Circulating tumor cells (CTCs) are shed into the bloodstream by invasive cancers, but the difficulty inherent in identifying these rare cells by microscopy has precluded their routine use in monitoring or screening for cancer. We recently described a high-throughput microfluidic CTC-iChip, which efficiently depletes hematopoietic cells from blood specimens and enriches for CTCs with well-preserved RNA. Application of RNA-based digital PCR to detect CTC-derived signatures may thus enable highly accurate tissue lineage-based cancer detection in blood specimens. As proof of principle, we examined hepatocellular carcinoma (HCC), a cancer that is derived from liver cells bearing a unique gene expression profile. After identifying a digital signature of 10 liver-specific transcripts, we used a cross-validated logistic regression model to identify the presence of HCC-derived CTCs in nine of 16 (56%) untreated patients with HCC versus one of 31 (3%) patients with nonmalignant liver disease at risk for developing HCC (P < 0.0001). Positive CTC scores declined in treated patients: Nine of 32 (28%) patients receiving therapy and only one of 15 (7%) patients who had undergone curative-intent ablation, surgery, or liver transplantation were positive. RNA-based digital CTC scoring was not correlated with the standard HCC serum protein marker alpha fetoprotein (P = 0.57). Modeling the sequential use of these two orthogonal markers for liver cancer screening in patients with high-risk cirrhosis generates positive and negative predictive values of 80% and 86%, respectively. Thus, digital RNA quantitation constitutes a sensitive and specific CTC readout, enabling high-throughput clinical applications, such as noninvasive screening for HCC in populations where viral hepatitis and cirrhosis are prevalent.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/diagnóstico , Separação Celular/métodos , Detecção Precoce de Câncer/métodos , Ensaios de Triagem em Larga Escala , Neoplasias Hepáticas/diagnóstico , Células Neoplásicas Circulantes , RNA Mensageiro/sangue , RNA Neoplásico/sangue , Transcriptoma , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/terapia , Linhagem da Célula , Separação Celular/instrumentação , Células Hep G2 , Hepatite B Crônica/sangue , Sequenciamento de Nucleotídeos em Larga Escala/instrumentação , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Dispositivos Lab-On-A-Chip , Cirrose Hepática/sangue , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Modelos Logísticos , Lesões Pré-Cancerosas/sangue , Valor Preditivo dos Testes , Análise de Sequência de RNA/instrumentação , Análise de Sequência de RNA/métodos , Análise de Célula Única
9.
Radiology ; 282(1): 202-211, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27509542

RESUMO

Purpose To evaluate whether noninvasive molecular imaging technologies targeting myeloperoxidase (MPO) can reveal early inflammation associated with spinal cord injury after thoracic aortic ischemia-reperfusion (TAR) in mice. Materials and Methods The study was approved by the institutional animal care and use committee. C57BL6 mice that were 8-10 weeks old underwent TAR (n = 55) or sham (n = 26) surgery. Magnetic resonance (MR) imaging (n = 6) or single photon emission computed tomography (SPECT)/computed tomography (CT) (n = 15) studies targeting MPO activity were performed after intravenous injection of MPO sensors (bis-5-hydroxytryptamide-tetraazacyclododecane [HT]-diethyneletriaminepentaacetic acid [DTPA]-gadolinium or indium 111-bis-5-HT-DTPA, respectively). Immunohistochemistry and flow cytometry were used to identify myeloid cells and neuronal loss. Proinflammatory cytokines, keratinocyte chemoattractant (KC), and interleukin 6 (IL-6) were measured with enzyme-linked immunosorbent assay. Statistical analyses were performed by using nonparametric tests and the Pearson correlation coefficient. P < .05 was considered to indicate a significant difference. Results Myeloid cells infiltrated into the injured cord at 6 and 24 hours after TAR. MR imaging confirmed the presence of ischemic lesions associated with mild MPO-mediated enhancement in the thoracolumbar spine at 24 hours compared with the sham procedure. SPECT/CT imaging of MPO activity showed marked MPO-sensor retention at 6 hours (P = .003) that continued to increase at 24 hours after TAR (P = .0001). The number of motor neurons decreased substantially at 24 hours after TAR (P < .01), which correlated inversely with in vivo inflammatory changes detected at molecular imaging (r = 0.64, P = .0099). MPO was primarily secreted by neutrophils, followed by lymphocyte antigen 6 complexhigh monocytes and/or macrophages. There were corresponding increased levels of proinflammatory cytokines KC (P = .0001) and IL-6 (P = .0001) that mirrored changes in MPO activity. Conclusion MPO is a suitable imaging biomarker for identifying and tracking inflammatory damage in the spinal cord after TAR in a mouse model. © RSNA, 2016 Online supplemental material is available for this article.


Assuntos
Aorta Torácica/diagnóstico por imagem , Imagem Molecular , Mielite/diagnóstico por imagem , Traumatismo por Reperfusão/diagnóstico por imagem , Animais , Aorta Torácica/lesões , Biomarcadores/sangue , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Imuno-Histoquímica , Interleucina-6/sangue , Interleucina-8/sangue , Imageamento por Ressonância Magnética , Camundongos , Camundongos Endogâmicos C57BL , Mielite/fisiopatologia , Peroxidase/sangue , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Traumatismo por Reperfusão/fisiopatologia
11.
Mol Carcinog ; 54(9): 669-78, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25845339

RESUMO

An important characteristic of cancer is that the disease can overcome the surveillance of the immune system. A possible explanation for this resistance arises from the ability of tumor cells to block the tumoricidal activity of host immune cells such as natural killer (NK) cells by inducing the localized accumulation of regulatory T (Treg) cells. Evidence exists that components in commonly consumed foods including vitamins A, D, and E, water-soluble constituents of mushrooms, polyphenolics in fruits and vegetables, and n-3 fatty acids in fish oil can modulate NK cell activities, Treg cell properties, and the interactions between those two cell types. Thus, it is extremely important for cancer prevention to understand the involvement of dietary components with the early stage dynamics of interactions among these immune cells. This review addresses the potential significance of diet in supporting the function of NK cells, Treg cells, and the balance between those two cell types, which ultimately results in decreased cancer risk.


Assuntos
Dieta , Células Matadoras Naturais/imunologia , Neoplasias/imunologia , Neoplasias/prevenção & controle , Linfócitos T Reguladores/imunologia , Animais , Citocinas/imunologia , Ácidos Graxos Ômega-3/imunologia , Humanos , Neoplasias/dietoterapia , Polifenóis/imunologia , Vitamina A/imunologia , Vitamina D/imunologia
12.
J Surg Res ; 198(2): 515-24, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25959834

RESUMO

BACKGROUND: Obesity is a major risk factor for diabetes and peripheral arterial disease, which frequently leads to lower limb demand ischemia. Skeletal muscle autophagy and mitochondrial biogenesis are important processes for proper oxidative capacity and energy metabolism, which are compromised in diabetes. This study compares autophagy, mitochondrial biogenesis, energy metabolism, and morphology in the hind limbs of obese diabetic mice subjected to demand or sedentary ischemia. MATERIALS AND METHODS: Unilateral hind limb demand ischemia was created in a group of diet-induced obese mice after femoral artery ligation and 4 wk of daily exercise. A parallel group of mice underwent femoral artery ligation but remained sedentary for 4 wk. Hind limb muscles were analyzed for markers of autophagy, mitochondrial biogenesis, adenosine triphosphate, and muscle tissue morphology. RESULTS: At the end of the 4-wk exercise period, demand ischemia increased the autophagy mediator Beclin-1, but it did not alter the autophagy indicator, LC3B-II/I ratio, or markers of mitochondrial biogenesis, optic atrophy/dynamin-related protein. In contrast, exercise significantly increased the level of mitochondrial protein-succinate dehydrogenase subunit-A and reduced adipocyte accumulation and the percentage of centrally nucleated myofibers in the demand ischemia limb. In addition, demand ischemia resulted in decreased uncoupling protein-3 levels without altering muscle adenosine triphosphate or pS473-Akt levels. CONCLUSIONS: Limb demand ischemia markedly decreased adipocyte accumulation and enhanced muscle regeneration in obese mice, but it did not appear to enhance autophagy, mitochondrial biogenesis, energy metabolism, or insulin sensitivity. Future studies aimed at evaluating novel therapies that enhance autophagy and mitochondrial biogenesis in diabetes with peripheral arterial disease are warranted.


Assuntos
Diabetes Mellitus Experimental/complicações , Isquemia/metabolismo , Extremidade Inferior/irrigação sanguínea , Mitocôndrias Musculares/metabolismo , Obesidade/complicações , Trifosfato de Adenosina/metabolismo , Adipócitos/patologia , Animais , Autofagia , Peso Corporal , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Resistência à Insulina , Canais Iônicos/metabolismo , Isquemia/patologia , Isquemia/fisiopatologia , Extremidade Inferior/patologia , Extremidade Inferior/fisiopatologia , Masculino , Camundongos Endogâmicos C57BL , Proteínas Mitocondriais/metabolismo , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Obesidade/metabolismo , Obesidade/fisiopatologia , Condicionamento Físico Animal , Proteínas Proto-Oncogênicas c-akt/metabolismo , Regeneração , Proteína Desacopladora 3
13.
J Nutr ; 144(7): 1128S-36S, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24812070

RESUMO

The Mushroom Council convened the Mushrooms and Health Summit in Washington, DC, on 9-10 September 2013. The proceedings are synthesized in this article. Although mushrooms have long been regarded as health-promoting foods, research specific to their role in a healthful diet and in health promotion has advanced in the past decade. The earliest mushroom cultivation was documented in China, which remains among the top global mushroom producers, along with the United States, Italy, The Netherlands, and Poland. Although considered a vegetable in dietary advice, mushrooms are fungi, set apart by vitamin B-12 in very low quantity but in the same form found in meat, ergosterol converted with UV light to vitamin D2, and conjugated linoleic acid. Mushrooms are a rare source of ergothioneine as well as selenium, fiber, and several other vitamins and minerals. Some preclinical and clinical studies suggest impacts of mushrooms on cognition, weight management, oral health, and cancer risk. Preliminary evidence suggests that mushrooms may support healthy immune and inflammatory responses through interaction with the gut microbiota, enhancing development of adaptive immunity, and improved immune cell functionality. In addition to imparting direct nutritional and health benefits, analysis of U.S. food intake survey data reveals that mushrooms are associated with higher dietary quality. Also, early sensory research suggests that mushrooms blended with meats and lower sodium dishes are well liked and may help to reduce intakes of red meat and salt without compromising taste. As research progresses on the specific health effects of mushrooms, there is a need for effective communication efforts to leverage mushrooms to improve overall dietary quality.


Assuntos
Agaricales/química , Alimento Funcional/análise , Promoção da Saúde , Agaricales/crescimento & desenvolvimento , Congressos como Assunto , Humanos
14.
Annu Rev Nutr ; 32: 73-95, 2012 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-22404120

RESUMO

The discovery of multiple selenoproteins has raised tantalizing questions about their role in maintaining normal cellular function. Unfortunately, many of these remain inadequately investigated. While they have a role in maintaining redox balance, other functions are becoming increasingly recognized. As the roles of these selenoproteins are further characterized, a better understanding of the true physiological significance of this trace element will arise. This knowledge will be essential in defining optimum intakes to achieve cellular homeostasis in order to optimize health, including a reduction in cancer, for diverse populations. Human variation in the response to selenium likely reflects significant interactions between the type and amounts of selenium consumed with the genome and a host of environmental factors including the totality of the diet, as discussed in this review.


Assuntos
Suplementos Nutricionais , Predisposição Genética para Doença , Neoplasias/genética , Neoplasias/prevenção & controle , Polimorfismo Genético , Selênio/uso terapêutico , Selenoproteínas/genética , Animais , Glutationa Peroxidase/genética , Glutationa Peroxidase/metabolismo , Humanos , Isoenzimas/genética , Isoenzimas/metabolismo , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Neoplasias/metabolismo , Selênio/metabolismo , Selenoproteína P/genética , Selenoproteína P/metabolismo , Selenoproteínas/metabolismo , Tiorredoxina Redutase 1/genética , Tiorredoxina Redutase 1/metabolismo
15.
J Nutr ; 143(8): 1349-54, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23784071

RESUMO

Proper nutrition offers one of the most effective and least costly ways to decrease the burden of many diseases and their associated risk factors, including obesity. Nutrition research holds the key to increasing our understanding of the causes of obesity and its related comorbidities and thus holds promise to markedly influence global health and economies. After outreach to 75 thought leaders, the American Society for Nutrition (ASN) convened a Working Group to identify the nutrition research needs whose advancement will have the greatest projected impact on the future health and well-being of global populations. ASN's Nutrition Research Needs focus on the following high priority areas: 1) variability in individual responses to diet and foods; 2) healthy growth, development, and reproduction; 3) health maintenance; 4) medical management; 5) nutrition-related behaviors; and 6) food supply/environment. ASN hopes the Nutrition Research Needs will prompt collaboration among scientists across all disciplines to advance this challenging research agenda given the high potential for translation and impact on public health. Furthermore, ASN hopes the findings from the Nutrition Research Needs will stimulate the development and adoption of new and innovative strategies that can be applied toward the prevention and treatment of nutrition-related diseases. The multidisciplinary nature of nutrition research requires stakeholders with differing areas of expertise to collaborate on multifaceted approaches to establish the evidence-based nutrition guidance and policies that will lead to better health for the global population. In addition to the identified research needs, ASN also identified 5 tools that are critical to the advancement of the Nutrition Research Needs: 1) omics, 2) bioinformatics, 3) databases, 4) biomarkers, and 5) cost-effectiveness analysis.


Assuntos
Avaliação das Necessidades , Ciências da Nutrição , Saúde Pública , Biomarcadores/análise , Comportamento de Escolha , Biologia Computacional , Análise Custo-Benefício , Dieta , Comportamento Alimentar , Preferências Alimentares , Abastecimento de Alimentos , Humanos , Metagenoma , Nutrigenômica , Estado Nutricional , Obesidade/prevenção & controle , Fatores de Risco
16.
Urol Int ; 91(2): 236-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23221366

RESUMO

This is the case of a 69-year-old woman with a history of right iliac fossa living-related kidney transplant that developed acute renal failure due to an obstructing stone in the proximal transplant ureter. She was successfully treated with mini-percutaneous nephrolithotomy wherein a 14-Fr tract was created with serial dilation and a 14-Fr ureteral access sheath was used for access. A flexible ureteroscope with holmium laser and a helical wire basket were used to fragment and extract the stone, respectively. A 10-Fr nephrostomy tube was left for postoperative drainage. There are only a few published reports of mini-percutaneous nephrolithotomy in transplant kidneys, but those reports suggest that the procedure is safe and effective.


Assuntos
Transplante de Rim/métodos , Nefrostomia Percutânea/métodos , Ureter/cirurgia , Cálculos Ureterais/cirurgia , Injúria Renal Aguda/fisiopatologia , Idoso , Feminino , Humanos , Lasers , Complicações Pós-Operatórias , Ureter/patologia , Cálculos Ureterais/etiologia , Ureteroscopia/métodos
17.
Am J Med ; 136(5): 415-421, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36740213

RESUMO

Osteoarthritis is a common cause of morbidity in an increasingly aging population. Although the weight-bearing joints of the leg and foot are frequently affected by osteoarthritis, degenerative changes in the joints of the upper extremity are likewise common and can be both particularly debilitating for affected individuals and uniquely challenging for the health care providers managing it. The present review seeks to overview the epidemiology, anatomy, diagnosis, and management of osteoarthritis in the joints of the shoulder, elbow, and hand with the intent of providing accessible and relevant information to the range of medical professionals involved in patient care.


Assuntos
Osteoartrite , Humanos , Idoso , Osteoartrite/diagnóstico , Osteoartrite/epidemiologia , Osteoartrite/terapia , Extremidade Superior , Mãos , Cotovelo , Ombro
18.
Phys Sportsmed ; 51(2): 139-143, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34878369

RESUMO

PURPOSE: To (1) characterize hamstring injury (HSI) recurrence rates across the 2009-2010 to 2019-2020 NFL seasons and (2) to identify HSI recurrence risk factors among positions and determine the weekly return to play (RTP) recurrence risk. We hypothesized that older players, skill position players, and players returning to play faster were most at risk. METHODS: Public data from the 2009-2010 to 2019-2020 seasons were reviewed to identify HSIs. Player characteristics were collected before and two seasons following injury. A week-by-week analysis of recurrence risk was evaluated with linear and logarithmic trendlines of the best fit. RESULTS: A total of 2075 HSI were identified with a mean age of 26.2 years (20.0-43.0), BMI of 29.6 (22.7-43.5), and 3.4 seasons of experience (0-17), with 1826 strains (88.0%), 236 partial tears (11.3%), and 13 complete tears (0.63%). Of the 2075 injuries, 796 (38.4%) were recurrent, with 247 (11.9%) being a same-season reinjury. Logistic regression found that fewer weeks before RTP, in-game injury, and lower BMI were risk factors for same-season recurrence. For any recurrence, logistic regression identified more recent year of injury, lower BMI, and longer playing experience as significant risk factors. Wide receivers were found to be at risk for same-season recurrence. For any-season recurrence, defensive backs, linebackers, running backs, tight ends, and wide receivers were at risk. Week-by-week recurrence analysis determined the greatest risk to be when players returned within 2 weeks (13.4%). CONCLUSIONS: There is a high rate of HSI recurrence in the NFL. Risk factors for same-season injury include shorter time to RTP, in-game injury, lower BMI, and playing wide receiver. Risk factors for any-season recurrence were more recent year of injury, lower BMI, longer playing experience, and playing defensive back, linebacker, running back, tight end, or wide receiver. The greatest risk factor for HSI recurrence was RTP within 2 weeks.


Assuntos
Futebol Americano , Futebol , Lesões dos Tecidos Moles , Humanos , Adulto , Futebol Americano/lesões , Ruptura , Fatores de Risco
19.
Mol Carcinog ; 51(3): 244-56, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21520295

RESUMO

In the present studies, we utilized prostate cancer cell culture models to elucidate the mechanisms of action of broccoli-derived phytochemicals 3,3'-diindolylmethane (DIM) and indole-3-carbinol (I3C). We found DIM and I3C at 1-5 µM inhibited androgen and estrogen-mediated pathways and induced xenobiotic metabolism pathway. By contrast, DIM and I3C induced cyclin inhibitors, indicators of stress/DNA damage, only at ≥25 µM. We also demonstrated that an inhibitory effect of DIM and I3C on cell growth involves inhibition of insulin-like growth factor-1 receptor expression. More importantly, we showed that differences in efficacies and mechanisms existed between DIM and I3C. These included differences in effective concentrations, a differential effect on androgen receptor binding, and a differential effect on xenobiotic metabolic pathway through aryl hydrocarbon receptor-dependent and -independent mechanism. Furthermore we determined that several other diet-derived cancer protective compounds, similar to DIM and I3C, exhibited pleiotrophic effects on signaling pathways that included proliferation, cell cycle, and nuclear receptors-mediated pathways. However, the efficacies and mechanisms of these compounds vary. We also showed that some cellular pathways are not likely to be affected by DIM or I3C when circulating concentration of orally ingested DIM or I3C is considered. Based on our results, a model for cancer protective effects of DIM and I3C was proposed.


Assuntos
Anticarcinógenos/farmacologia , Brassica/química , Indóis/farmacologia , Neoplasias da Próstata/metabolismo , Androgênios/metabolismo , Biomarcadores Tumorais/genética , Proliferação de Células/efeitos dos fármacos , Inibidor de Quinase Dependente de Ciclina p21/genética , Inibidor de Quinase Dependente de Ciclina p27/genética , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Ligantes , Masculino , Antígeno Prostático Específico/genética , Ligação Proteica/efeitos dos fármacos , RNA Mensageiro/genética , Receptores Androgênicos/metabolismo , Xenobióticos/metabolismo
20.
J Nutr ; 142(7): 1360S-9S, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22649262

RESUMO

Knowledge gaps persist about the efficacy of cancer prevention strategies based on dietary food components. Adaptations to nutrient supply are executed through tuning of multiple protein networks that include transcription factors, histones, modifying enzymes, translation factors, membrane and nuclear receptors, and secreted proteins. However, the simultaneous quantitative and qualitative measurement of all proteins that regulate cancer processes is not practical using traditional protein methodologies. Proteomics offers an attractive opportunity to fill this knowledge gap and unravel the effects of dietary components on protein networks that impinge on cancer. The articles presented in this supplement are from talks proffered in the "Nutrition Proteomics and Cancer Prevention" session at the American Institute for Cancer Research Annual Research Conference on Food, Nutrition, Physical Activity and Cancer held in Washington, DC on October 21 and 22, 2010. Recent advances in MS technologies suggest that studies in nutrition and cancer prevention may benefit from the adoption of proteomic tools to elucidate the impact on biological processes that govern the transition from normal to malignant phenotype; to identify protein changes that determine both positive and negative responses to food components; to assess how protein networks mediate dose-, time-, and tissue-dependent responses to food components; and, finally, for predicting responders and nonresponders. However, both the limited accessibility to proteomic technologies and research funding appear to be hampering the routine adoption of proteomic tools in nutrition and cancer prevention research.


Assuntos
Dieta , Neoplasias/metabolismo , Ciências da Nutrição , Proteoma/metabolismo , Proteômica , Humanos , Neoplasias/prevenção & controle , Fenótipo
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