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1.
Am J Obstet Gynecol ; 226(5): 730.e1-730.e10, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34864040

RESUMEN

BACKGROUND: Despite increased e-cigarette use, limited research has focused on changes in e-cigarette and combustible cigarette use around pregnancy and the subsequent effects on infant health. OBJECTIVE: This study aimed to characterize changes in e-cigarette and cigarette use from before to during pregnancy and examine their associations with small-for-gestational-age birth. STUDY DESIGN: This was a secondary data analysis of 2016-2018 data of the US Pregnancy Risk Assessment Monitoring System. We analyzed women aged ≥18 years who had a recent live birth (unweighted: n=105,438; weighted: n=5,446,900). Women were grouped on the basis of their self-reported e-cigarette and/or cigarette use 3 months before pregnancy (exclusive e-cigarette users, exclusive cigarette smokers, dual users, and nonusers) and change in e-cigarette and cigarette use during pregnancy (continuing use, quitting, switching, and initiating use). Small-for-gestational-age was defined as a birthweight below the 10th percentile for infants of the same sex and gestational age. We described the distributions of women's sociodemographic and pregnancy characteristics in both weighted and unweighted samples. We used multivariable log-binomial regression models to estimate the relative risks for the associations between changes in e-cigarette and cigarette use during pregnancy and risk of small-for-gestational-age, adjusting for significant covariates. RESULTS: The rates of cessation during pregnancy were the highest among exclusive e-cigarette users (weighted percentage, 80.7% [49,378/61,173]), followed by exclusive cigarette users (54.4% [421,094/773,586]) and dual users (46.4% [69,136/149,152]). Among exclusive e-cigarette users, continued users of e-cigarettes during pregnancy had a higher risk of small-for-gestational-age than nonusers (16.5% [1849/11,206]) vs 8.8% [384,338/4,371,664]; confounder-adjusted relative risk, 1.52 [95% confidence interval, 1.45-1.60]), whereas quitters of e-cigarettes had a similar risk of small-for-gestational-age with nonusers (7.7% [3730/48,587] vs 8.8% [384,338/4,371,664]; relative risk, 0.84 [95% confidence interval, 0.82-0.87]). Among exclusive cigarette users, those who completely switched to e-cigarettes during pregnancy also had a similar risk of small-for-gestational-age with nonusers (7.6% [259/3412] vs 8.8% [384,338/4,371,664]; relative risk, 0.83 [95% confidence interval, 0.73-0.93]). Among dual users before pregnancy, the risk of small-for-gestational-age decreased from 23.2% (7240/31,208) (relative risk, 2.53 [95% confidence interval, 2.47-2.58]) if continuing use to 16.9% (6617/39,142) (relative risk, 1.88 [95% confidence interval, 1.83-1.92]) if only quitting e-cigarettes or 15.1% (1254/8289) (relative risk, 1.61 [95% confidence interval, 1.52-1.70]) if only quitting cigarettes and further to 11.2% (7589/67,880) (relative risk, 1.23 [95% confidence interval, 1.20-1.25]) if both quitting e-cigarettes and cigarettes during pregnancy, compared with nonusers. CONCLUSION: Among exclusive e-cigarette users, quitting e-cigarettes during pregnancy normalized the risk of small-for-gestational-age. Among exclusive cigarette users, quitting smoking or completely switching to e-cigarettes normalized small for gestational age risk. Among dual users, smoking cessation has a greater effect than quitting e-cigarettes only, although discontinuing the use of both may lead to the greatest reduction in the risk of small-for-gestational-age.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar , Productos de Tabaco , Vapeo , Adolescente , Adulto , Femenino , Humanos , Embarazo , Fumadores , Vapeo/epidemiología
2.
Phys Rev Lett ; 124(14): 141801, 2020 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-32338980

RESUMEN

Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→µ^{+}µ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}µ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{µ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6 GeV/c^{2}.

3.
J Endocrinol Invest ; 43(9): 1205-1212, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32124267

RESUMEN

BACKGROUND: Intraoperative monitoring of parathyroid hormone (IOPTH) is a reliable method of predicting the cure of primary hyperparathyroidism (PHPT). The aim of this study is to assess whether common clinical variables (CCV) frequently encountered in patients with PHPT may affect the magnitude of PTH drop or the likelihood of patients meeting the intraoperative cure criterion. DESIGN: Patients who were surgically cured from PHPT caused by single gland disease (SGD) and had full IOPTH protocol (4 measurements) were stratified according to age, gland weight, renal function, vitamin D status and severity of hypercalcemia. The percentage of IOPTH drop and the frequency of patients who had true positive IOPTH test results were compared among groups. RESULTS: 762 patients had surgery for PHPT, of whom 746 were (98%) cured. Of these 746 patients, 511 who had SGD and a full IOPTH protocol were included in this study. The median IOPTH drop was significantly higher among younger patients, those with severe hypercalcaemia at 5, 10, 15 min after gland excision, giant glands (at 5-min only), patients with vitamin D deficiency (at 10, 15 min), and those with normal renal function (at 15 min only). The likelihood of the patients meeting the intraoperative cure criterion was not significantly affected among the groups except in patients with mild hypercalcaemia, who were significantly less likely to have 50% IOPTH drop than those with severe hypercalcaemia at all time points. The frequency of mildly hypercalcaemic patients who met cure criterion was significantly improved by extending measurement to 15 min. CONCLUSIONS: IOPTH monitoring has the ability to mitigate the variability of IOPTH kinetics associated with most clinical variables. Mildly hypercalcemic patients in particular may benefit from waiting for 15-min measurement before any surgical decision is made.


Asunto(s)
Hiperparatiroidismo Primario/cirugía , Monitoreo Intraoperatorio , Hormona Paratiroidea/sangre , Paratiroidectomía , Adenoma/complicaciones , Adenoma/epidemiología , Adenoma/cirugía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Variación Biológica Poblacional , Comorbilidad , Femenino , Humanos , Hipercalcemia/complicaciones , Hipercalcemia/epidemiología , Hipercalcemia/cirugía , Hiperparatiroidismo Primario/sangre , Hiperparatiroidismo Primario/complicaciones , Hiperparatiroidismo Primario/epidemiología , Cinética , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio/estadística & datos numéricos , Hormona Paratiroidea/análisis , Neoplasias de las Paratiroides/complicaciones , Neoplasias de las Paratiroides/epidemiología , Neoplasias de las Paratiroides/cirugía , Paratiroidectomía/estadística & datos numéricos , Estudios Retrospectivos , Reino Unido/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/cirugía
4.
Int J Obes (Lond) ; 43(7): 1435-1439, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30518822

RESUMEN

Rapid infant weight gain predicts childhood obesity. We aimed to estimate effect size and identify critical timing for intervention-assisted smoking cessation during pregnancy to impact infant weight gain. We followed 25 mother-infant dyads in the UB Pregnancy and Smoking Cessation Study (Buffalo, NY, USA). Maternal smoking status was biochemically verified and monitored through pregnancy. Birth weight and length were extracted from birth records. Research staff measured infant weight and length at 2 weeks and monthly from 1 to 12 months of age. Mixed models were used to fit infant BMI-for-age z-score (ZBMI) trajectories. We found infants of quitters had lower ZBMI gain from birth to 12 months (mean ± SD, 1.13 ± 1.16) than infants of persistent smokers (2.34 ± 1.40; p = 0.035), with Cohen's d effect size being large (0.96). The infant ZBMI gain from birth to 12 months was low (<0.47) if smoking cessation was initiated between 15 and 27 weeks of pregnancy, but started to increase if quitting at 28 weeks (0.65) and accelerated with time (e.g., 3.16 if quitting at 36 weeks). We concluded maternal smoking cessation during pregnancy may reduce fetal origins of obesity through reducing infant weight gain, especially if quitting smoking by 27 weeks of pregnancy.


Asunto(s)
Peso al Nacer/fisiología , Obesidad Infantil , Complicaciones del Embarazo/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Femenino , Humanos , Recién Nacido , Obesidad Infantil/epidemiología , Obesidad Infantil/prevención & control , Embarazo
5.
Br J Surg ; 105(10): 1319-1327, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29663329

RESUMEN

BACKGROUND: In patients with multiple endocrine neoplasia type 2 (MEN2) syndrome, genetic testing offers early diagnosis, stratifies the risk of developing medullary thyroid cancer (MTC) and informs the timing of thyroidectomy. The efficacy of treatment, which depends on timely and safe surgery, is not well established. METHODS: This was a retrospective review of diagnostic and clinicopathological outcomes of prophylactic thyroidectomy in children with MEN2 between 1995 and 2013 in the UK. American Thyroid Association (ATA) 2009 guidelines were used as a benchmark for adequate treatment. RESULTS: Seventy-nine children from 16 centres underwent total thyroidectomy. Thirty-eight patients (48 per cent) underwent genetic testing and 36 (46 per cent) had an operation performed above the age recommended by the ATA 2009 guidelines; pathology showed MTC in 30 patients (38 per cent). Late surgery, above-normal preoperative calcitonin level and MTC on pathology correlated with late genetic testing. Twenty-five children had lymphadenectomy; these patients had more parathyroid glands excised (mean difference 0·61, 95 per cent c.i. 0·24 to 0·98; P = 0·001), and were more likely to have hypocalcaemia requiring medication (relative risk (RR) 3·12, 95 per cent c.i. 1·54 to 6·32; P = 0·002) and permanent hypoparathyroidism (RR 3·24, 1·29 to 8·11; P = 0·010) compared with those who underwent total thyroidectomy alone. Age did not influence the development of complications. CONCLUSION: Late genetic testing may preclude age-appropriate surgery, increasing the risk of operating when MTC has already developed. Early genetic testing and age-appropriate surgery may help avoid unnecessary lymphadenectomy and improve outcomes.


Asunto(s)
Carcinoma Neuroendocrino/prevención & control , Neoplasia Endocrina Múltiple Tipo 2a/cirugía , Neoplasia Endocrina Múltiple Tipo 2b/cirugía , Procedimientos Quirúrgicos Profilácticos , Neoplasias de la Tiroides/prevención & control , Tiroidectomía , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Modelos Logísticos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento
6.
Br J Anaesth ; 121(1): 303-313, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29935585

RESUMEN

BACKGROUND: Both the cerebral cortex and subcortical structures play important roles in consciousness. Some evidence points to general anaesthesia-induced unconsciousness being associated with distinct patterns of superficial cortical electrophysiological oscillations, but how general anaesthetics influence deep brain neural oscillations and interactions between oscillations in humans is poorly understood. METHODS: Local field potentials were recorded in discrete deep brain regions, including anterior cingulate cortex, sensory thalamus, and periaqueductal grey, in humans with implanted deep brain electrodes during induction of unconsciousness with propofol. Power-frequency spectra, phase-amplitude coupling, coherence, and directed functional connectivity analysis were used to characterise local field potentials in the awake and unconscious states. RESULTS: An increase in alpha (7-13 Hz) power and decrease in gamma (30-90 Hz) power were observed in both deep cortical (ACC, anterior cingulate cortex) and subcortical (sensory thalamus, periaqueductal grey) areas during propofol-induced unconsciousness. Robust alpha-low gamma (30-60 Hz) phase-amplitude coupling induced by general anaesthesia was observed in the anterior cingulate cortex but not in other regions studied. Moreover, alpha oscillations during unconsciousness were highly coherent within the anterior cingulate cortex, and this rhythm exhibited a bidirectional information flow between left and right anterior cingulate cortex but stronger left-to-right flow. CONCLUSION: Propofol increases alpha oscillations and attenuates gamma oscillations in both cortical and subcortical areas. The alpha-gamma phase-amplitude coupling and the functional connectivity of alpha oscillations in the anterior cingulate cortex could be specific markers for loss of consciousness.


Asunto(s)
Anestesia Intravenosa , Anestésicos Intravenosos , Encéfalo/efectos de los fármacos , Electroencefalografía/efectos de los fármacos , Propofol , Adulto , Algoritmos , Ritmo alfa/efectos de los fármacos , Corteza Cerebral/efectos de los fármacos , Corteza Cerebral/fisiopatología , Estado de Conciencia/efectos de los fármacos , Potenciales Evocados/efectos de los fármacos , Femenino , Ritmo Gamma/efectos de los fármacos , Giro del Cíngulo/efectos de los fármacos , Giro del Cíngulo/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/efectos de los fármacos , Inconsciencia/fisiopatología , Vigilia
7.
Phys Rev Lett ; 118(11): 111801, 2017 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-28368653

RESUMEN

We present a measurement of angular observables and a test of lepton flavor universality in the B→K^{*}ℓ^{+}ℓ^{-} decay, where ℓ is either e or µ. The analysis is performed on a data sample corresponding to an integrated luminosity of 711 fb^{-1} containing 772×10^{6} BB[over ¯] pairs, collected at the ϒ(4S) resonance with the Belle detector at the asymmetric-energy e^{+}e^{-} collider KEKB. The result is consistent with standard model (SM) expectations, where the largest discrepancy from a SM prediction is observed in the muon modes with a local significance of 2.6σ.

8.
Exp Brain Res ; 235(5): 1455-1465, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28246967

RESUMEN

The motor symptoms of both Parkinson's disease and focal dystonia arise from dysfunction of the basal ganglia, and are improved by pallidotomy or deep brain stimulation of the Globus Pallidus interna (GPi). However, Parkinson's disease is associated with a greater degree of basal ganglia-dependent learning impairment than dystonia. We attempt to understand this observation in terms of a comparison of the electrophysiology of the output of the basal ganglia between the two conditions. We use the natural experiment offered by Deep Brain Stimulation to compare GPi local field potential responses in subjects with Parkinson's disease compared to subjects with dystonia performing a forced-choice decision-making task with sensory feedback. In dystonic subjects, we found that auditory feedback was associated with the presence of high gamma oscillations nestled on a negative deflection, morphologically similar to sharp wave ripple complexes described in human rhinal cortex. These were not present in Parkinson's disease subjects. The temporal properties of the high gamma burst were modified by incorrect trial performance compared to correct trial performance. Both groups exhibited a robust low frequency response to 'incorrect' trial performance in dominant GPi but not non-dominant GPi at theta frequency. Our results suggest that cellular processes associated with striatum-dependent memory function may be selectively impaired in Parkinson's disease even if dopaminergic drugs are administered, but that error detection mechanisms are preserved.


Asunto(s)
Cognición/fisiología , Estimulación Encefálica Profunda/métodos , Trastornos Distónicos/terapia , Globo Pálido/fisiología , Enfermedad de Parkinson/terapia , Adulto , Anciano , Trastornos Distónicos/diagnóstico por imagen , Potenciales Evocados/fisiología , Femenino , Globo Pálido/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Enfermedad de Parkinson/diagnóstico por imagen , Estimulación Física , Tiempo de Reacción/fisiología , Tomógrafos Computarizados por Rayos X , Adulto Joven
9.
Phys Rev Lett ; 117(17): 171101, 2016 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-27824449

RESUMEN

The GRAPES-3 tracking muon telescope in Ooty, India measures muon intensity at high cutoff rigidities (15-24 GV) along nine independent directions covering 2.3 sr. The arrival of a coronal mass ejection on 22 June 2015 18:40 UT had triggered a severe G4-class geomagnetic storm (storm). Starting 19:00 UT, the GRAPES-3 muon telescope recorded a 2 h high-energy (∼20 GeV) burst of galactic cosmic rays (GCRs) that was strongly correlated with a 40 nT surge in the interplanetary magnetic field (IMF). Simulations have shown that a large (17×) compression of the IMF to 680 nT, followed by reconnection with the geomagnetic field (GMF) leading to lower cutoff rigidities could generate this burst. Here, 680 nT represents a short-term change in GMF around Earth, averaged over 7 times its volume. The GCRs, due to lowering of cutoff rigidities, were deflected from Earth's day side by ∼210° in longitude, offering a natural explanation of its night-time detection by the GRAPES-3. The simultaneous occurrence of the burst in all nine directions suggests its origin close to Earth. It also indicates a transient weakening of Earth's magnetic shield, and may hold clues for a better understanding of future superstorms that could cripple modern technological infrastructure on Earth, and endanger the lives of the astronauts in space.

10.
Phys Rev Lett ; 116(21): 212001, 2016 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-27284649

RESUMEN

We report the analysis of the three-body e^{+}e^{-}→BB[over ¯]π^{±}, BB[over ¯]^{*}π^{±}, and B^{*}B[over ¯]^{*}π^{±} processes, including the first observations of the Z_{b}^{±}(10610)→[BB[over ¯]^{*}+c.c.]^{±} and Z_{b}^{±}(10650)→[B^{*}B[over ¯]^{*}]^{±} transitions that are found to dominate the corresponding final states. We measure Born cross sections for the three-body production of σ(e^{+}e^{-}→[BB[over ¯]^{*}+c.c.]^{±}π^{∓})=[17.4±1.6(stat)±1.9(syst)] pb and σ(e^{+}e^{-}→[B^{*}B[over ¯]^{*}]^{±}π^{∓})=[8.75±1.15(stat)±1.04(syst)] pb and set a 90% C.L. upper limit of σ(e^{+}e^{-}→[BB[over ¯]]^{±}π^{∓})<2.9 pb. The results are based on a 121.4 fb^{-1} data sample collected with the Belle detector at a center-of-mass energy near the ϒ(10860) peak.

11.
Phys Rev Lett ; 116(16): 161801, 2016 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-27152790

RESUMEN

We measure the decay B_{s}^{0}→K^{0}K[over ¯]^{0} using data collected at the ϒ(5S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. The data sample used corresponds to an integrated luminosity of 121.4 fb^{-1}. We measure a branching fraction B(B_{s}^{0}→K^{0}K[over ¯]^{0})=[19.6_{-5.1}^{+5.8}(stat)±1.0(syst)±2.0(N_{B_{s}^{0}B[over ¯]_{s}^{0}})]×10^{-6} with a significance of 5.1 standard deviations. This measurement constitutes the first observation of this decay.

12.
HNO ; 63(9): 629-33, 2015 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-26303520

RESUMEN

BACKGROUND: Balloon Eustachian Tuboplasty (BET) is a new minimally invasive treatment for chronic Eustachian tube dysfunction (ETD). Initially, perioperative prophylactic antibiotic therapy with ciprofloxacin 2 × 500 mg p.o. for 5 days was administered. This study aimed to characterize the bacterial flora in the ET, nose, and pharynx in patients with chronic obstructive ETD. Additionally, we investigated the necessity of perioperative antibiotic prophylaxis in BET patients. PATIENTS AND METHODS: We examined 40 patients undergoing BET: 20 patients with and 20 patients without perioperative antibiotic prophylaxis. All patients were followed-up for clinical signs and symptoms of local infection for at least 2 weeks after surgery. Following BET, the tips of 35 balloon catheters, as well as swabs from the nose and pharynx were sent for microbiologic analysis. RESULTS: None of these 40 patients had postoperative signs of infection. Of the swabs of the balloon catheters, 46% were sterile and 23% showed standard flora. The remaining 31% of swaps revealed specific bacteria. However, none of the nasal or nasopharyngeal swaps were sterile. CONCLUSION: Due to the lack of signs of postoperative infection in either investigated group, the authors no longer favor use of perioperative antibiotic prophylaxis in patients undergoing BET. The relevance of biofilms and pathogen colonization to ET function has recently been intensively discussed, and should be further investigated in future studies.


Asunto(s)
Profilaxis Antibiótica/métodos , Infecciones Bacterianas/etiología , Infecciones Bacterianas/prevención & control , Ventilación del Oído Medio/efectos adversos , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/uso terapéutico , Infecciones Bacterianas/microbiología , Ciprofloxacina/uso terapéutico , Trompa Auditiva/efectos de los fármacos , Trompa Auditiva/microbiología , Humanos , Ventilación del Oído Medio/instrumentación , Ventilación del Oído Medio/métodos , Atención Perioperativa/métodos , Infección de la Herida Quirúrgica/microbiología , Resultado del Tratamiento
13.
Br J Cancer ; 110(10): 2593-603, 2014 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-24762960

RESUMEN

BACKGROUND: Accumulating evidence demonstrates high levels of aldehyde dehydrogense (ALDH) activity in human cancer types, in part, because of its association with cancer stem cells. Whereas ALDH1A1 and ALDH7A1 isoforms were reported to associate with prostate tumorigenesis, whether other ALDH isoforms are associated with prostate cancer (PC) remains unclear. METHODS: ALDH3A1 expression was analysed in various PC cell lines. Xenograft tumours and 54 primary and metastatic PC tumours were stained using immunohistochemistry for ALDH3A1 expression. RESULTS: In comparison with the non-stem counterparts, a robust upregulation of ALDH3A1 was observed in DU145-derived PC stem cells (PCSCs). As DU145 PCSCs produced xenograft tumours with more advanced features compared with those derived from DU145 cells, higher levels of ALDH3A1 were detected in the former; a dramatic elevation of ALDH3A1 occurred in DU145 cell-derived lung metastasis compared with local xenograft tumours. Furthermore, while ALDH3A1 was not observed in prostate glands, ALDH3A1 was clearly present in PIN, and further increased in carcinomas. In comparison with the paired local carcinomas, ALDH3A1 was upregulated in lymph node metastatic tumours; the presence of ALDH3A1 in bone metastatic PC was also demonstrated. CONCLUSIONS: We report here the association of ALDH3A1 with PC progression.


Asunto(s)
Adenocarcinoma/enzimología , Aldehído Deshidrogenasa/análisis , Proteínas de Neoplasias/análisis , Neoplasias de la Próstata/enzimología , Adenocarcinoma/patología , Aldehído Deshidrogenasa/biosíntesis , Aldehído Deshidrogenasa/genética , Andrógenos , Animales , Neoplasias Óseas/enzimología , Neoplasias Óseas/secundario , Línea Celular Transformada , Línea Celular Tumoral , Transformación Celular Neoplásica , Progresión de la Enfermedad , Inducción Enzimática , Células Epiteliales/enzimología , Regulación Neoplásica de la Expresión Génica , Humanos , Neoplasias Pulmonares/enzimología , Neoplasias Pulmonares/secundario , Metástasis Linfática , Masculino , Ratones , Ratones Endogámicos NOD , Ratones SCID , Proteínas de Neoplasias/biosíntesis , Proteínas de Neoplasias/genética , Trasplante de Neoplasias , Neoplasias Hormono-Dependientes/enzimología , Neoplasias Hormono-Dependientes/patología , Células Madre Neoplásicas/enzimología , Neoplasia Intraepitelial Prostática/enzimología , Neoplasia Intraepitelial Prostática/patología , Neoplasias de la Próstata/patología
14.
J Neurol Neurosurg Psychiatry ; 85(7): 811-5, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24306513

RESUMEN

OBJECTIVES: To evaluate the efficacy of deep brain stimulation (DBS) in the treatment of tremor resulting from acquired brain injury (ABI). METHODS: A series of eight consecutive patients with post-ABI tremor were treated with DBS of the ventro-oralis posterior (VOP)/zona incerta (ZI) region, and subsequently underwent blinded assessments using Bain's tremor severity scale. RESULTS: VOP/ZI DBS produced a mean reduction in tremor severity of 80.75% based on Bain's tremor severity scale, with significant reductions in all five component tremor subscores: rest, postural, kinetic, proximal and distal. No adverse neurological complications were reported, although one patient experienced exacerbation of pre-existing gait ataxia. CONCLUSION: VOP/ZI stimulation is demonstrated here to be an effective and safe approach for the treatment of post-ABI tremor in the largest series published at the time of writing.


Asunto(s)
Lesiones Encefálicas/complicaciones , Estimulación Encefálica Profunda , Temblor/terapia , Adulto , Anciano , Estimulación Encefálica Profunda/efectos adversos , Estimulación Encefálica Profunda/métodos , Electrodos Implantados , Femenino , Humanos , Masculino , Índice de Severidad de la Enfermedad , Método Simple Ciego , Resultado del Tratamiento , Temblor/etiología , Adulto Joven
15.
J Neurol Neurosurg Psychiatry ; 85(12): 1371-6, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24691580

RESUMEN

BACKGROUND: There is solid evidence of the long term efficacy of deep brain stimulation of the globus pallidus pars interna in the treatment of generalised dystonia. However there are conflicting reports concerning whether certain subgroups gain more benefit from treatment than others. We analysed the results of a series of 60 cases to evaluate the effects of previously proposed prognostic factors including dystonia aetiology, dystonia phenotype, age at onset of dystonia, and duration of dystonia prior to treatment. METHODS: 60 patients with medically intractable primary or secondary generalised dystonia were treated with deep brain stimulation of the globus pallidus pars interna during the period 1999-2010 at the Department of Neurosurgery in Oxford, UK. Patients were assessed using the Burke-Fahn-Marsden (BFM) Dystonia Rating Scale prior to surgery, 6 months after implantation and thereafter at 1 year, 2 years and 5 years follow-up. RESULTS: The group showed mean improvements in the BFM severity and disability scores of 43% and 27%, respectively, by 6 months, and this was sustained. The results in 11 patients with DYT gene mutations were significantly better than in non-genetic primary cases. The results in 12 patients with secondary dystonia were not as good as those seen in non-genetic primary cases but there remained a significant beneficial effect. Age of onset of dystonia, duration of disease prior to surgery, and myoclonic versus torsional disease phenotype had no significant effect on outcome. CONCLUSIONS: The aetiology of dystonia was the sole factor predicting a better or poorer outcome from globus pallidus pars interna stimulation in this series of patients with generalised dystonia. However even the secondary cases that responded the least well had a substantial reduction in BFM scores compared with preoperative clinical assessments, and these patients should still be considered for deep brain stimulation.


Asunto(s)
Estimulación Encefálica Profunda , Distonía/terapia , Adolescente , Adulto , Edad de Inicio , Anciano , Niño , Estimulación Encefálica Profunda/efectos adversos , Distonía/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto Joven
16.
Nature ; 452(7185): 332-5, 2008 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-18354478

RESUMEN

Equal amounts of matter and antimatter are predicted to have been produced in the Big Bang, but our observable Universe is clearly matter-dominated. One of the prerequisites for understanding this elimination of antimatter is the nonconservation of charge-parity (CP) symmetry. So far, two types of CP violation have been observed in the neutral K meson (K(0)) and B meson (B(0)) systems: CP violation involving the mixing between K(0) and its antiparticle (and likewise for B(0) and ), and direct CP violation in the decay of each meson. The observed effects for both types of CP violation are substantially larger for the B(0) meson system. However, they are still consistent with the standard model of particle physics, which has a unique source of CP violation that is known to be too small to account for the matter-dominated Universe. Here we report that the direct CP violation in charged B(+/-)-->K(+/-)pi(0) decay is different from that in the neutral B(0) counterpart. The direct CP-violating decay rate asymmetry, (that is, the difference between the number of observed B(-)-->K(-)pi(0) event versus B(+)-->K(+) pi(0) events, normalized to the sum of these events) is measured to be about +7%, with an uncertainty that is reduced by a factor of 1.7 from a previous measurement. However, the asymmetry for versus B(0)-->K(+)pi(-) is at the -10% level. Although it is susceptible to strong interaction effects that need further clarification, this large deviation in direct CP violation between charged and neutral B meson decays could be an indication of new sources of CP violation-which would help to explain the dominance of matter in the Universe.

17.
Curr Oncol ; 21(3): e521-4, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24940113

RESUMEN

Although metastases are common in patients with renal cell carcinoma (rcc), it is extremely rare for patients to present with metastatic rcc (mrcc) without evidence of a primary mass in the kidney. Two cases of mrcc with no detectable primary renal mass are reported here. Both patients had bilateral native kidneys in situ and no significant prior urologic history. The first patient presented with a hip fracture and was found to have multiple radiologic bony and lung metastases. Biopsy of a mass involving the pubic bone demonstrated clear cell mrcc. Multiple scans by computed tomography (ct) and confirmatory imaging by magnetic resonance demonstrated no renal mass. This first patient had disease stabilization for 18 months on sunitinib and was still alive at last follow-up. The second patient was diagnosed with clear-cell mrcc after thickened synovium was discovered and biopsied during a knee arthroplasty. Multiple scans by ct in this second patient demonstrated no primary renal mass. Sunitinib and radiotherapy to the knee lesion were initiated, but unfortunately, the patient deteriorated clinically and passed away from disease progression shortly after diagnosis. Because of the rare nature of these cases, a standardized course of action has not yet been established. However, we hypothesize that it is reasonable to manage metastases in these patients by following established mrcc protocols.

18.
Am J Transplant ; 13(9): 2441-9, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23865679

RESUMEN

The prevalence of pediatric RRT and transplantation are low in developing countries, 6-12 and <1 to 5 per million child population (pmcp), respectively. This is due to low GDP/capita of <$10 000, government expenditure on health of <2.6-9% of GDP and paucity of facilities. The reported incidence of pediatric CKD and ESRD is <1.0-8 and 3.4-35 pmcp, respectively. RRT and transplantation are offered mostly in private centers in cities where HD costs $20-100/session and transplants $10 000-20 000. High costs and long distance to centers results in treatment refusal in up to 35% of the cases. In this backdrop 75-85% of children with ESRD are disfranchised from RRT and transplantation. Our center initiated an integrated dialysis-transplant program funded by a community-government partnership where RRT and transplantation was provided "free of cost" with life long follow-up and medication. Access to free RRT at doorsteps and transplantation lead to societal acceptance of transplantation as the therapy of choice for ESRD. This enabled us to perform 475 pediatric transplants in 25 years with 1- and 5-year graft survival of 96% and 81%, respectively. Our model shows that pediatric transplantation is possible in developing countries when freely available and accessible to all who need it in the public sector.


Asunto(s)
Trasplante de Riñón/economía , Terapia de Reemplazo Renal/economía , Adolescente , Adulto , Niño , Países en Desarrollo/economía , Humanos , Inmunosupresores/economía , Fallo Renal Crónico/economía , Fallo Renal Crónico/terapia
19.
Phys Rev Lett ; 110(13): 131801, 2013 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-23581309

RESUMEN

We measure the branching fraction of B- → τ- ν(τ) using the full Υ(4S) data sample containing 772×10(6) BB pairs collected with the Belle detector at the KEKB asymmetric-energy e+ e- collider. Events with BB pairs are tagged by reconstructing one of the B mesons decaying into hadronic final states, and B- → τ- ν(τ) candidates are detected in the recoil. We find evidence for B- → τ- ν(τ) with a significance of 3.0 standard deviations including systematic errors and measure a branching fraction B(B- → τ- ν(τ))=[0.72(-0.25)(+0.27)(stat)±0.11(syst)]×10(-4).


Asunto(s)
Partículas Elementales , Física Nuclear/métodos , Teoría Cuántica
20.
Phys Rev Lett ; 111(11): 112001, 2013 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-24074074

RESUMEN

We search for bottomonium states in Υ(2S) → (bb)γ decays with an integrated luminosity of 24.7 fb(-1) recorded at the Υ(2S) resonance with the Belle detector at KEK, containing (157.8±3.6)×10(6) Υ(2S) events. The (bb) system is reconstructed in 26 exclusive hadronic final states composed of charged pions, kaons, protons, and K(S)(0) mesons. We find no evidence for the state recently observed around 9975 MeV (X(bb)) in an analysis based on a data sample of 9.3×10(6) Υ(2S) events collected with the CLEO III detector. We set a 90% confidence level upper limit on the branching fraction B[Υ(2S) → X(bb)γ] × ∑(i)B[X(bb) → h(i)] < 4.9×10(-6), summed over the exclusive hadronic final states employed in our analysis. This result is an order of magnitude smaller than the measurement reported with CLEO data. We also set an upper limit for the ηb(1S) state of B[Υ(2S) → ηb(1S)γ] × ∑(i)B[ηb(1S) → h(i)] < 3.7×10(-6).


Asunto(s)
Interacciones de Partículas Elementales , Modelos Teóricos , Física Nuclear/métodos , Método de Montecarlo
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