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1.
Helicobacter ; 28(3): e12968, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37025012

RESUMO

BACKGROUND: Recent data on the prevalence of H. pylori infection in Jamaica are lacking. It is postulated that there has been a decline in the prevalence of H. pylori infection and its associated complications. We determined sociodemographic characteristics, prevalence of H. pylori infection and clinical outcomes among adults undergoing esophagogastroduodenoscopy (EGD) and histology at the University Hospital of the West Indies (UHWI) between May 2018 and December 2020. MATERIALS AND METHODS: A cross-sectional study of patients (≥18 years old), who underwent EGD and histological evaluation for H. pylori infection, was conducted. Associations of H. pylori positivity and gastric cancer with sociodemographic/clinical variables and endoscopic findings were determined by stepwise logistic regression using backward selection. Unadjusted and adjusted odds ratios with related 95% confidence intervals (Cis) were calculated for H. pylori positivity and gastric cancer status. RESULTS: There were 323 participants (mean age 58.6 ± 17.8 years, 54.2% females). H. pylori prevalence was 22.2% (n = 70 of 315), 5.6% had gastric neoplasia (GN), 15.5% gastric atrophy, 11.4% intestinal metaplasia and 3.7% dysplasia on histology. Mucositis (64.5%), gastric ulcer (14.9%), and duodenal ulcer (13.9%) were the most common endoscopic findings. Participants with peptic ulcer disease (PUD) (unOR = 4.0; p = .017), gastric cancer (unOR = 9.5; p = .003), gastric atrophy (unOR = 12.8; p < .001), and intestinal metaplasia (unOR = 5.0; p < .001) had a significantly higher odds of being H. pylori positive, but after multivariable analyses only gastric atrophy remained significant (aOR = 27.3; p < .001). Participants with mucositis had a significantly lower odds of gastric cancer (unOR 0.1; p = .035) while participants with dysplasia had significantly higher odds (unOR 8.0; p = .042), but these were no longer significant after multivariable analyses (aOR = 0.2; p = .156 and aOR = 18.9; p = .070, respectively). CONCLUSIONS: Histology based prevalence of H. pylori infection is lower than previously reported in Jamaica. Gastric atrophy is a significant predictor of H. pylori positivity.


Assuntos
Gastrite Atrófica , Infecções por Helicobacter , Helicobacter pylori , Mucosite , Neoplasias Gástricas , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Masculino , Estudos Transversais , Jamaica/epidemiologia , Neoplasias Gástricas/patologia , Mucosite/complicações , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Endoscopia Gastrointestinal , Gastrite Atrófica/complicações , Atrofia , Hospitais de Ensino , Metaplasia/complicações , Prevalência
2.
Eur Rev Med Pharmacol Sci ; 25(20): 6232-6244, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34730203

RESUMO

OBJECTIVE: It is controversial whether there is efficacy or safety benefit of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced EGFR-mutated non-small cell lung cancer (NSCLC) compared to standard chemotherapy. We aim to assess the efficacy and safety of EGFR-TKIs compared to other chemotherapeutics in EGFR-mutated NSCLC. MATERIALS AND METHODS: Up to April 27th, 2020, PubMed, Embase, Medline, Scopus, Cochrane library, and ClinicalTrials.gov were searched for articles or trials meeting the inclusion criteria. After filtering, 230 eligible studies were initially identified. Data extraction followed PRISMA and included outcomes were progression-free survival (PFS), overall survival (OS), and severe adverse events (SAEs). Direct and indirect meta-analyses were generated in the context of log-linear mixed-effects models, with fixed effects for each relative comparison and random effects for each study. RESULTS: The results showed that EGFR-TKI therapy had improved PFS with a hazard ratio (HR) of 0.40 (95% CI: 0.36-0.44, p<0.001) compared to standard chemotherapy. Nevertheless, the EGFR-TKIs showed no benefit on OS (HR: 0.96, 95% CI: 0.83-1.10, p=0.556). In the analysis of adverse events, EGFR-TKIs had fewer SAEs than standard chemotherapy (HR: 0.29, 95% CI: 0.26-0.33, p<0.001). CONCLUSIONS: Our systemic review indicates that EGFR-TKI therapy has improved PFS, and reduced SAEs compared to standard chemotherapy in advanced EGFR-mutated NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Inibidores de Proteínas Quinases/farmacologia , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacologia , Carcinoma Pulmonar de Células não Pequenas/genética , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/genética , Mutação , Intervalo Livre de Progressão , Inibidores de Proteínas Quinases/efeitos adversos , Taxa de Sobrevida
3.
BMC Health Serv Res ; 18(1): 380, 2018 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-29843711

RESUMO

BACKGROUND: The World Health Organization (WHO) called for new clinical diagnostic for settings with limited access to laboratory services. Access to diagnostic testing may not be uniform in rural settings, which may result in poor access to essential healthcare services. The aim of this study is to determine the availability, current usage, and need for point-of-care (POC) diagnostic tests among rural primary healthcare (PHC) clinics in South Africa's KwaZulu-Natal (KZN) province. METHODS: We used the KZN's Department of Health (DoH) clinic classification to identify the 232 rural PHC clinics in KZN, South Africa. We then randomly sampled 100 of 232 rural PHC clinics. Selected health clinics were surveyed between April to August 2015 to obtain clinic-level data for health-worker volume and to determine the accessibility, availability, usage and need for POC tests. Professional healthcare workers responsible for POC testing at each clinic were interviewed to assess the awareness of POC testing. Data were survey weighted and analysed using Stata 13. RESULTS: Among 100 rural clinics, the average number of patients seen per week was 2865 ± 2231 (range 374-11,731). The average number of POC tests available and in use was 6.3 (CI: 6.2-6.5) out of a potential of 51 tests. The following POC tests were universally available in all rural clinics: urine total protein, urine leukocytes, urine nitrate, urine pregnancy, HIV antibody and blood glucose test. The average number of desired POC diagnostic tests reported by the clinical staff was estimated at 15 (CI: 13-17) per clinic. The most requested POC tests reported were serum creatinine (37%), CD4 count (37%), cholesterol (32%), tuberculosis (31%), and HIV viral load (23%). CONCLUSION: Several POC tests are widely available and in use at rural PHC clinics in South Africa's KZN province. However, healthcare workers have requested additional POC tests to improve detection and management of priority disease conditions. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT02692274.


Assuntos
Instituições de Assistência Ambulatorial , Testes Imediatos , Atenção Primária à Saúde , Serviços de Saúde Rural , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Pessoal de Saúde , Humanos , Entrevistas como Assunto , Masculino , Programas de Rastreamento , Gravidez , Atenção Primária à Saúde/organização & administração , África do Sul
4.
Cancer Causes Control ; 29(3): 315-324, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29423760

RESUMO

PURPOSE: The Caribbean population faces a growing burden of multiple non-communicable chronic diseases (NCDs). Breast cancer is the leading cause of cancer death for women in the Caribbean. Given the substantial burden of NCDs across the region, cancer prevention and control strategies may need to be specifically tailored for people with multiple co-morbidities. Preventive screening, such as timely mammography, is essential but may be either facilitated or hampered by chronic disease control. The main objective of this study is to examine the relationship between a chronic disease and timely breast cancer screening. METHODS: We conducted a cross-sectional data analysis using baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study-ECS. Our independent variables were presence of chronic diseases (hypertension or diabetes), defined as having been told by a clinical provider. Our dependent variable was timely screening mammography, as defined by receipt of mammography within the past 2 years. We examined bivariate and multivariate associations of covariates and timely screening mammography. RESULTS: In our sample (n = 841), 52% reported timely screening mammography. Among those with timely screening, 50.8% reported having hypertension, and 22.3% reported having diabetes. In our bivariate analyses, both diabetes and hypertension were associated with timely screening mammography. In partially adjusted models, we found that women with diabetes were significantly more likely to report timely screening mammography than women without diabetes. In our fully adjusted models, the association was no longer significant. Having a usual source of healthcare and a woman's island of residence were significantly associated with timely screening mammography (p < 0.05). CONCLUSIONS: We found that half of eligible women received timely screening mammography. Diabetes and hypertension, though common, are not associated with timely screening mammography. Usual source of care remains an important factor to timely breast cancer screening.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Doenças não Transmissíveis , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Região do Caribe , Doença Crônica , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Mamografia , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , Avaliação de Resultados em Cuidados de Saúde
5.
Genome Announc ; 5(2)2017 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-28082496

RESUMO

We report here the complete genome sequence of a WU polyomavirus (WUPyV) isolate, also known as human polyomavirus 4, collected in 2016 from a patient in Arkansas with an acute respiratory infection. Isolate hPyV4/USA/AR001/2016 has a double-stranded DNA genome of 5,229 bp in length.

6.
Trials ; 17(1): 524, 2016 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-27788686

RESUMO

BACKGROUND: Study attrition has the potential to compromise a trial's internal and external validity. The aim of the present study was to identify factors associated with participant attrition in a pilot trial of the effectiveness of a novel behavioural support intervention focused on increasing physical activity to reduce smoking, to inform the methods to reduce attrition in a definitive trial. METHODS: Disadvantaged smokers who wanted to reduce but not quit were randomised (N = 99), of whom 61 (62 %) completed follow-up assessments at 16 weeks. Univariable logistic regression was conducted to determine the effects of intervention arm, method of recruitment, and participant characteristics (sociodemographic factors, and lifestyle, behavioural and attitudinal characteristics) on attrition, followed by multivariable logistic regression on those factors found to be related to attrition. RESULTS: Participants with low confidence to quit, and who were undertaking less than 150 mins of moderate and vigorous physical activity per week at baseline were less likely to complete the 16-week follow-up assessment. Exploratory analysis revealed that those who were lost to follow-up early in the trial (i.e., by 4 weeks), compared with those completing the study, were younger, had smoked for fewer years and had lower confidence to quit in the next 6 months. Participants who recorded a higher expired air carbon monoxide reading at baseline were more likely to drop out late in the study, as were those recruited via follow-up telephone calls. Multivariable analyses showed that only completing less than 150 mins of physical activity retained any confidence in predicting attrition in the presence of other variables. CONCLUSIONS: The findings indicate that those who take more effort to be recruited, are younger, are heavier smokers, have less confidence to quit, and are less physically active are more likely to withdraw or be lost to follow-up.


Assuntos
Terapia Comportamental/métodos , Carência Cultural , Terapia por Exercício/métodos , Cooperação do Paciente , Pacientes Desistentes do Tratamento , Pobreza , Fumantes/psicologia , Redução do Consumo de Tabaco/métodos , Fumar/terapia , Adulto , Fatores Etários , Inglaterra , Feminino , Redução do Dano , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Motivação , Análise Multivariada , Razão de Chances , Projetos Piloto , Fatores de Risco , Fumar/psicologia , Fatores de Tempo , Resultado do Tratamento
7.
Psychopharmacology (Berl) ; 233(14): 2765-74, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27256353

RESUMO

RATIONALE: Habitual physical activity (PA) may have an important role in suppressing cigarette cravings. Systematic reviews show a strong acute effect of bouts of PA on reducing cigarette cravings, and it may be that these effects accumulate. OBJECTIVES: The aim was to investigate the relationship between habitual levels of PA and cigarette cravings in disadvantaged smokers not ready to quit by examining baseline cross-sectional data from the Exercise Assisted Reduction then Stop smoking study (EARS). METHODS: A series of linear regression models were applied to investigate the relationship between habitual PA and cigarette cravings and to identify additional predictors of cigarette cravings. The analyses were extended by including interaction terms with PA to identify potential moderators of the relationship between PA and cravings. RESULTS: A higher level of moderate intensity PA was associated with lower cravings (p = 0.033). Additional predictors were the mood and physical symptoms scale (p = 0.007; higher scores were associated with higher cravings) and alcohol consumption (p = 0.002; higher consumption was associated with lower cravings). In addition, a moderation effect of alcohol consumption was found; at higher levels of alcohol consumption, higher PA was significantly associated with higher cravings (p = 0.023). CONCLUSIONS: Overall, participation in regular PA is associated with reduced cigarette cravings; among those with heavy alcohol consumption, this participation is associated with higher cravings. These exploratory analyses suggest that further research into the relationship between PA, alcohol consumption and cigarette cravings is needed.


Assuntos
Fissura/fisiologia , Exercício Físico/psicologia , Fumar/psicologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores Socioeconômicos
8.
Am J Otolaryngol ; 37(1): 41-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26700259

RESUMO

BACKGROUND: Lymphangioma of the head and neck is considered a rare congenital tumor with the vast majority presenting before two years of age. Surgical excision and sclerosing therapy using OK-432 are recognized as effective treatment options for the majority of these lesions; however, treatment options of laryngeal lesions are less straightforward due to the risk of airway compromise and the desire to maintain the integrity of a functional larynx. We present the case of a four month old male who presented with chief complaint of inspiratory stridor after a single episode of pneumonia. His clinical presentation, flexible fiberoptic laryngoscopic examination, and operative evaluation were consistent with a lymphangioma completely encasing the epiglottis and arytenoids and isolated to the supraglottis. This report outlines our approach to workup and treatment of this rare lesion. METHOD: Case report of presentation, diagnosis and treatment is presented. RESULTS: A four-month old male presented to ENT clinic with inspiratory stridor, worsened with crying, without frank respiratory distress. History and initial examination was consistent with airway obstruction. Flexible fiberoptic laryngoscopy showed laryngomalacia as well as diffuse and symmetric supraglottic edema. Surgical evaluation identified edema limited to the supraglottis, notably along the ventral surface of the epiglottis and dorsal surface of bilateral arytenoids. Biopsies were taken and immunohistochemical staining was performed with strong positivity for D2-40 and CD31, supporting the diagnosis of isolated lymphangioma of the supraglottis. Treatment was performed through multiple point spot welding with a fiber equipped CO2 LASER (OmniGuide TM) at 5 watt continuous power. CONCLUSION: Isolated supraglottic lymphangioma was diagnosed via direct laryngoscopy, with pathologic and immunohistochemical confirmation. Carbon dioxide laser spot welding technique was used with excellent clinical improvement in stridor. Clinical improvement is sustained after 6 months follow-up.


Assuntos
Neoplasias Laríngeas/diagnóstico , Linfangioma/diagnóstico , Obstrução das Vias Respiratórias/etiologia , Humanos , Lactente , Neoplasias Laríngeas/congênito , Neoplasias Laríngeas/cirurgia , Laringoscopia , Terapia a Laser , Linfangioma/congênito , Linfangioma/cirurgia , Masculino , Sons Respiratórios/etiologia
9.
Oncogene ; 34(22): 2815-22, 2015 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-25132269

RESUMO

DNA damage response (DDR) includes the activation of numerous cellular activities that prevent duplication of DNA lesions and maintain genomic integrity, which is critical for the survival of normal and cancer cells. Specific genes involved in the DDR such as BRCA1/2 and P53 are mutated during prostate cancer progression, while various oncogenic signaling such as Akt and c-Myc are activated, enhancing the replication stress and increasing the genomic instability of cancer cells. These events may render prostate cancer cells particularly sensitive to inhibition of specific DDR pathways, such as PARP in homologous recombination DNA repair and Chk1 in cell cycle checkpoint and DNA repair, creating opportunities for synthetic lethality or synergistic cytotoxicity. Recent reports highlight the critical role of androgen receptor (AR) as a regulator of DDR genes, providing a rationale for combining DNA-damaging agents or targeted DDR inhibitors with hormonal manipulation or AR inhibition as treatment for aggressive disease. The aims of this review are to discuss specific DDR defects in prostate cancer that occur during disease progression, to summarize recent advances in understanding the regulation of DDR in prostate cancer, and to present potential therapeutic opportunities through combinational targeting of the intact components of DDR signaling pathways.


Assuntos
Dano ao DNA/genética , Reparo do DNA/genética , Neoplasias da Próstata/genética , Neoplasias da Próstata/terapia , Animais , Pontos de Checagem do Ciclo Celular/genética , Replicação do DNA , DNA de Neoplasias/biossíntese , DNA de Neoplasias/genética , Regulação Neoplásica da Expressão Gênica , Instabilidade Genômica/genética , Humanos , Masculino , Receptores Androgênicos/fisiologia
10.
J Aquat Anim Health ; 25(4): 274-80, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24341769

RESUMO

Pacific Lampreys Entosphenus tridentatus have experienced severe population declines in recent years and efforts to develop captive rearing programs are under consideration. However, there is limited knowledge of their life history, ecology, and potential to harbor or transmit pathogens that may cause infectious disease. As a measure of the possible risks associated with introducing wild lampreys into existing fish culture facilities, larval lampreys (ammocoetes) were tested for susceptibility to infection and mortality caused by experimental exposures to the fish rhabdovirus pathogens: infectious hematopoietic necrosis virus (IHNV) and viral haemorrhagic septicaemia virus (VHSV). Two IHNV isolates, representing the U and M genogroups, and one VHSV isolate from the IVa genotype were each delivered to groups of ammocoetes by immersion at moderate and high viral doses, and by intraperitoneal injection. Ammocoetes were then held in triplicate tanks with no substrate or sediment. During 41 d of observation postchallenge there was low or no mortality in all groups, and no virus was detected in the small number of fish that died. Ammocoetes sampled for incidence of infection at 6 and 12 d after immersion challenges also had no detectable virus, and no virus was detected in surviving fish from any group. A small number of ammocoetes sampled 6 d after the injection challenge had detectable virus, but at levels below the original quantity of virus injected. Overall there was no evidence of infection, replication, or persistence of any of the viruses in any of the treatment groups. Our results suggest that Pacific Lampreys are highly unlikely to serve as hosts that maintain or transmit these viruses.


Assuntos
Lampreias/virologia , Infecções por Rhabdoviridae/veterinária , Rhabdoviridae/classificação , Animais , Suscetibilidade a Doenças , Larva/virologia , Noroeste dos Estados Unidos/epidemiologia , Infecções por Rhabdoviridae/epidemiologia , Infecções por Rhabdoviridae/virologia
11.
Br J Cancer ; 109(12): 3105-15, 2013 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-24157827

RESUMO

BACKGROUND: Glutathione S-transferase mu 3 (GSTM3) has been proven to be downregulated in renal cell carcinoma (RCC). We aimed to characterise the role of GSTM3 and its genetic predisposition on the occurrence and postoperative prognosis of RCC. METHODS: The effect of GSTM3 on RCC aggressiveness was examined using transfection and silencing methods. Glutathione S-transferase mu 3 expression in renal tissues was examined by immunohistochemistry. The associations of rs1332018 (A-63C) and rs7483 (V224I) polymorphisms with RCC risk were examined using 400 RCC patients and 802 healthy controls. The factors contributing to postoperative disease-specific survival of RCC patients were evaluated using the Cox proportional hazard model. RESULTS: Glutathione S-transferase mu 3 silencing increased the invasion and anchorage-independent growth of RCC cell lines. rs1332018 (AC+CC vs AA), which correlated with low expression of GSTM3 in kidney, was associated with RCC risk (odds ratio, 1.446; 95% confidence interval (CI), 1.111-1.882). rs1332018 variants and low GSTM3 expression significantly predicted unfavourable postoperative survivals of RCC patients (P<0.05). rs1332018 variants independently predicted a poor prognosis (hazard ratio, 2.119; 95% CI, 1.043-4.307). CONCLUSION: Glutathione S-transferase mu 3 may function as a tumour suppressor in RCC. rs1332018 genetic variants predispose the host to downregulating GSTM3 expression in kidney, facilitate carcinogenesis, and predict an unfavourable postoperative prognosis of RCC.


Assuntos
Carcinoma de Células Renais/enzimologia , Carcinoma de Células Renais/genética , Glutationa Transferase/genética , Neoplasias Renais/enzimologia , Neoplasias Renais/genética , Carcinoma de Células Renais/patologia , Estudos de Casos e Controles , Feminino , Expressão Gênica , Técnicas de Silenciamento de Genes , Predisposição Genética para Doença , Variação Genética , Glutationa Transferase/biossíntese , Glutationa Transferase/deficiência , Glutationa Transferase/metabolismo , Humanos , Imuno-Histoquímica , Neoplasias Renais/patologia , Masculino , Polimorfismo de Nucleotídeo Único , Prognóstico , Regiões Promotoras Genéticas , Fatores de Risco , Transfecção
12.
Oncogene ; 32(49): 5501-11, 2013 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-23752182

RESUMO

Prostate cancer is the second-leading cause of cancer-related mortality in men in Western societies. Androgen receptor (AR) signaling is a critical survival pathway for prostate cancer cells, and androgen-deprivation therapy (ADT) remains the principal treatment for patients with locally advanced and metastatic disease. Although a majority of patients initially respond to ADT, most will eventually develop castrate resistance, defined as disease progression despite serum testosterone levels of <20 ng/dl. The recent discovery that AR signaling persists during systemic castration via intratumoral production of androgens led to the development of novel anti-androgen therapies including abiraterone acetate and enzalutamide. Although these agents effectively palliate symptoms and prolong life, metastatic castration-resistant prostate cancer remains incurable. An increased understanding of the mechanisms that underlie the pathogenesis of castrate resistance is therefore needed to develop novel therapeutic approaches for this disease. The aim of this review is to summarize the current literature on the biology and treatment of castrate-resistant prostate cancer.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Receptores Androgênicos/metabolismo , Castração , Progressão da Doença , Resistencia a Medicamentos Antineoplásicos , Humanos , Masculino , Metástase Neoplásica/tratamento farmacológico , Receptores Androgênicos/genética
13.
Prostate Cancer Prostatic Dis ; 16(2): 193-203, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23399779

RESUMO

BACKGROUND: To our knowledge, no previous study has examined state-level geographic variability and its predictors in clinical practice patterns to screen for prostate cancer in the United States. METHODS: We used the Behavioral Risk Factor Surveillance System 2010 data set to analyze geographic variability (by state) and its associated predictors in receiving a PSA test and/or a digital rectal examination (DRE). The study population consisted of men aged ≥50 years who responded as yes/no when asked about having a PSA test or DRE performed during the last year. We build two multilevel logistic regression models, differing in dependent variables, that is, (1) any prostate cancer screening (PCS) (either PSA and/or DRE), and (2) PCS based on PSA testing (PSAT). Individual characteristics (age, education, employment, marriage, income, race/ethnicity, self-reported health status, obesity, alcohol consumption, smoking status, personal physician presence, and health insurance coverage) were treated as level-1 variables and state characteristics (number of doctors per 100 000 persons per state, US regions and metropolitan statistical area (MSA) codes) were treated as level-2 variables. RESULTS: We found significant geographic variability in receiving PCS and PSAT screening in the United States. For PCS, MSA code was an independent predictor, with men living in urban areas having lower odds of screening (odds ratio (OR)=0.8, 95% confidence interval (CI)=0.7-0.9). In PSAT, the number of doctors per 100 000 persons per state was an independent predictor, with lowest quartile states (0-25% quartile) having lower odds of PSA-based screening (OR=0.78, 95% CI=063-0.94). In both models, all level-1 variables were independent predictors (P<0.05) of PCS, except self-reported health status. CONCLUSIONS: Men living in urban areas and states with lower prevalence of doctors have lower odds of screening for prostate cancer and PSAT, respectively, after adjusting for individual variables. Future studies should examine the reasons for these health disparities.


Assuntos
Padrões de Prática Médica , Neoplasias da Próstata/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Exame Retal Digital , Detecção Precoce de Câncer/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Calicreínas/sangue , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/epidemiologia , População Rural , Estados Unidos/epidemiologia
15.
Med Phys ; 39(7Part4): 4641, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28516638

RESUMO

Attenuation correction (AC) in PET/MRI is difficult as there is no clear relationship between MR signal and 511 keV attenuation coefficients (µ) as there is with CT. One approach is to register a pre-defined atlas of µ to the PET/MRI for AC. However, the design of the atlas may strongly influence the quantitative accuracy of the AC. Here we compare 3 different atlas design approaches and evaluate their performance in an oncology patient population. The 3 strategies were: use of BMI-dependent atlases; use of gender-dependent atlases, and use of a gender- and sex-independent atlas. Seventeen patients were imaged with FDG PET/CT and subsequently scanned with 3T MRI. MR and PET/CT images were coregistered, CT scans converted to µ-maps, and the resulting MRI/µ-map paired data were used to construct 6 atlases: averaged male and female atlases, averaged BMI-specific atlases (obese >30, overweight 25-29.9, Normal 18.5-24.9), and a single atlas comprised of all patients averaged together. The atlases were then used for PET AC for patients not included in the construction of the atlas in a leave-one-out manner. Resulting PET images were compared to each other and to the gold-standard CT-based PET reconstructions across all voxels and tissue-specific regions (soft-tissue, bone, lung). Sex-specific atlases yielded best results (average relative percent error over the 3 VOIs = 0.4509) & BMI-based atlases yielded highest average relative percent error at 0.9340. In all cases, highest errors were in the VOIs located in the livers.

16.
Oncogene ; 31(15): 1938-48, 2012 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-21892210

RESUMO

Survivin is a member of the inhibitor of apoptosis protein family and has an essential role in mitosis. Survivin is overexpressed in a large variety of human cancers and represents an attractive target for cancer therapy. Epidermal growth factor receptor and Her/neu-transformed human tumors in particular exhibit high levels of survivin. The survivin protein forms dimers through a conserved region that is critical for subcellular localization and biological functions of the protein. We identified small molecules that target a specific cavity adjacent to the survivin dimerization surfaces. S12, a lead compound identified in the screen, can bind to the survivin protein at the intended target site. Moreover, S12 alters spindle formation, causing mitotic arrest and cell death, and inhibits tumor growth in vitro and in vivo. Cell death occurs in premetaphase stage following mitotic arrest and is not a consequence of general toxicity. Thus, the study validates a novel therapeutic target site in the survivin protein and provides a promising strategy to develop a new class of therapeutic small molecules for the treatment of human cancers.


Assuntos
Sítio Alostérico , Linhagem Celular Tumoral , Proteínas de Ligação a DNA/metabolismo , Proteínas Inibidoras de Apoptose/metabolismo , Fuso Acromático/efeitos dos fármacos , Fatores de Transcrição/metabolismo , Animais , Sítios de Ligação , Sobrevivência Celular/efeitos dos fármacos , Humanos , Proteínas Inibidoras de Apoptose/química , Camundongos , Camundongos Nus , Mitose/efeitos dos fármacos , Transplante de Neoplasias , Neoplasias , Survivina
17.
J Fish Dis ; 34(8): 579-87, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21762169

RESUMO

The AquaPathogen X database is a template for recording information on individual isolates of aquatic pathogens and is freely available for download (http://wfrc.usgs.gov). This database can accommodate the nucleotide sequence data generated in molecular epidemiological studies along with the myriad of abiotic and biotic traits associated with isolates of various pathogens (e.g. viruses, parasites and bacteria) from multiple aquatic animal host species (e.g. fish, shellfish and shrimp). The cataloguing of isolates from different aquatic pathogens simultaneously is a unique feature to the AquaPathogen X database, which can be used in surveillance of emerging aquatic animal diseases and elucidation of key risk factors associated with pathogen incursions into new water systems. An application of the template database that stores the epidemiological profiles of fish virus isolates, called Fish ViroTrak, was also developed. Exported records for two aquatic rhabdovirus species emerging in North America were used in the implementation of two separate web-accessible databases: the Molecular Epidemiology of Aquatic Pathogens infectious haematopoietic necrosis virus (MEAP-IHNV) database (http://gis.nacse.org/ihnv/) released in 2006 and the MEAP- viral haemorrhagic septicaemia virus (http://gis.nacse.org/vhsv/) database released in 2010.


Assuntos
Bases de Dados de Ácidos Nucleicos , Doenças dos Peixes/virologia , Pesqueiros/métodos , Infecções por Rhabdoviridae/veterinária , Rhabdoviridae/genética , Animais , Pesqueiros/instrumentação , Peixes , Vírus da Necrose Hematopoética Infecciosa/genética , Disseminação de Informação , Internet , América do Norte , Novirhabdovirus/genética , Infecções por Rhabdoviridae/virologia
18.
Gene Ther ; 18(10): 969-78, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21512508

RESUMO

We previously identified the mouse and human Glipr1 and GLIPR1/RTVP-1 genes, respectively, as direct p53 targets with proapoptotic activities in various cancer cell lines, including prostate cancer (PCa). Intratumoral injection of an adenoviral vector capable of efficient transduction and expression of Glipr1 (AdGlipr1) yielded promising therapeutic results in an orthotopic, metastatic mouse model of PCa. AdGlipr1-transduced macrophages (Mφ/Glipr1) generated greater surface expression of CD40, CD80 and major histocompatibility complex class II molecules and greater production of interleukin 12 (IL-12) and IL-6 in vitro than control macrophages did. Mechanistic analysis indicated that increased production of IL-12 in Mφ/Glipr1 depends on activation of the p38 signaling cascade. Mφ/Glipr1 injected into orthotopic 178-2BMA tumors in vivo resulted in significantly suppressed prostate tumor growth and spontaneous lung metastases and longer survival relative to those observed in control-treated mice. Furthermore, these preclinical data indicate the generation of systemic natural killer cell activity and tumor-specific cytotoxic T lymphocyte responses. Trafficking studies confirmed that intratumorally injected Mφ/Glipr1 could migrate to draining lymph nodes. Overall, our data suggest that this novel gene-modified cell approach is an effective treatment avenue that induces antitumor immune responses in preclinical studies.


Assuntos
Terapia Genética/métodos , Macrófagos/metabolismo , Metástase Neoplásica/prevenção & controle , Neoplasias da Próstata/genética , Neoplasias da Próstata/terapia , Proteínas/genética , Adenoviridae , Animais , Antígeno B7-1/metabolismo , Antígenos CD40/metabolismo , Vetores Genéticos/administração & dosagem , Interleucina-12/metabolismo , Interleucina-6/metabolismo , Células Matadoras Naturais/imunologia , Cinética , Masculino , Camundongos , Neoplasias da Próstata/imunologia , Linfócitos T Citotóxicos/imunologia
19.
Prostate Cancer Prostatic Dis ; 13(1): 6-11, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19581923

RESUMO

Caveolin-1 (cav-1) is reportedly overexpressed in prostate cancer cells and is associated with disease progression. Specific oncogenic activities of cav-1 associated with Akt activation also occur in prostate cancer. A membrane-associated protein, cav-1, is nonetheless secreted by prostate cancer cells; results of recent studies showed that secreted cav-1 can stimulate cell survival and angiogenic activities, defining a role for cav-1 in the prostate cancer microenvironment. Serum cav-1 levels were also higher in prostate cancer patients than in control men without prostate cancer, and the preoperative serum cav-1 concentration had prognostic potential in men undergoing radical prostatectomy. Secreted cav-1 is therefore a potential biomarker and therapeutic target for prostate cancer.


Assuntos
Caveolina 1/fisiologia , Neoplasias da Próstata/fisiopatologia , Biomarcadores Tumorais , Caveolina 1/sangue , Caveolina 1/metabolismo , Progressão da Doença , Humanos , Masculino , Neovascularização Patológica , Prognóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Regulação para Cima
20.
Prostate Cancer Prostatic Dis ; 12(3): 301-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19104507

RESUMO

We evaluated the potential use of intraoperative gelatin matrix hemostatic sealant (GMHS; FloSeal; Baxter Healthcare) embedded with macrophages (Mphi) transduced with murine interleukin (IL)-12 recombinant adenoviral vector (G/Mphi/AdmIL-12) for prevention of recurrence of prostate cancer following radical prostatectomy. Application of G/Mphi/AdmIL-12 resulted in significant suppression of tumor growth and spontaneous lung metastases, a statistically significant survival advantage of the G/Mphi/AdmIL-12-treated animals, more efficient trafficking of Mphi to lymph nodes draining from the prostate and generation of systemic natural killer cell activity and tumor-specific cytolytic T lymphocyte responses compared to the controls in a preclinical mouse model of residual prostate cancer. Our data recommend this treatment as a novel adjuvant for prevention of local recurrence of prostate cancer following radical prostatectomy.


Assuntos
Terapia Genética , Interleucina-12/genética , Macrófagos/fisiologia , Neoplasias da Próstata/terapia , Adenoviridae/genética , Animais , Movimento Celular , Sobrevivência Celular/efeitos dos fármacos , Modelos Animais de Doenças , Gelatina , Hemostáticos/farmacologia , Interleucina-12/imunologia , Macrófagos/imunologia , Masculino , Camundongos , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia
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