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1.
J Dent Res ; 103(3): 227-234, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38344753

RESUMEN

The oral cavity is an epidemiologically relevant route of viral transmission due to the shedding of viruses in saliva. With advancements in salivary diagnostics, an increasing number of viruses have been detected. However, the anatomic source of virus in saliva is still largely unknown. Some viruses have a well-established tropism for the salivary glands (SGs), and recent studies have emphasized the importance of the glands as potential reservoirs for infectious viruses. Viral infections of the SGs have been linked to acute and chronic SG pathology and may be associated with SG dysfunction, with phenotypes similar to those seen in SjÖgren's disease (SjD), an autoimmune condition that affects the salivary and lacrimal glands. Understanding the breadth of viruses that infect the SG and the conserved or distinct host responses to these infections may provide insights into the pathogenesis of virus-mediated SG diseases. There is a need for further research to fully understand the molecular mechanisms by which viruses enter and replicate in the glands, their physiologic impact on SG function, and whether the SGs can serve as a long-term reservoir for infectious viral particles. The purpose of this review is to highlight a group of viruses that infect the salivary gland: hepatitis C virus, hepatitis D virus, severe acute respiratory syndrome coronavirus 2, enteric viruses, human T-cell leukemia virus type I, human immunodeficiency virus, human cytomegalovirus, and BK polyomavirus. We focus on the effects of viral infection on salivary gland (SG) inflammation, function, and its association with SjD.


Asunto(s)
Glándulas Salivales , Síndrome de Sjögren , Humanos , Glándulas Salivales/patología , Saliva , Inflamación
2.
J Dent Res ; 102(12): 1303-1314, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37731320

RESUMEN

The human mouth, or oral cavity, is at the crossroads of our external and internal environments, and it is increasingly evident that local colonization of dental, oral, and craniofacial (DOC) tissues and cells by bacteria and viruses may also have systemic effects across myriad diseases and disorders. Better understanding of this phenomenon will require a holistic understanding of host-microbial interactions in both spatiotemporal and biogeographical contexts while also considering person-, organ-, tissue-, cell-, and molecular-level variation. After the acute phase interaction with microbes, the establishment of site-specific reservoirs constitutes an important relationship to understand within the human body; however, despite a preliminary understanding of how viral reservoirs originate and persist across the human body, the landscape of single-cell and spatial multiomic tools has challenged our current understanding of what cells and niches can support microbial reservoirs. The lack of complete understanding impacts research into these relevant topics and implementing precision care for microbial-induced or microbial-influenced diseases. Here, via the lens of acute and chronic microbial infections of the DOC tissues, the goal of this review is to highlight and link the emerging spatiotemporal biogeography of host-viral interactomics at 3 levels: (1) DOC cell types in distinct tissues, (2) DOC-associated microbes, and (3) niche-specific DOC pathologies. Further, we will focus on the impact of postacute infectious syndromes such as long COVID, neurodegenerative disorders, and other underappreciated postviral conditions. We will provide hypotheses about how DOC tissues may play roles systemically in these conditions. Throughout, we will underscore how COVID-19 has catalyzed a new understanding of these biological questions, discuss future directions to study these phenomena, and highlight the utility of noninvasive oral biofluids in screening, monitoring, and intervening to prevent and/or ameliorate human infectious diseases.


Asunto(s)
Microbiota , Síndrome Post Agudo de COVID-19 , Humanos , Boca/microbiología , Bacterias , Multiómica
3.
Invest New Drugs ; 30(4): 1289-301, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21547369

RESUMEN

Recent research suggests that altered redox control of melanoma cell survival, proliferation, and invasiveness represents a chemical vulnerability that can be targeted by pharmacological modulation of cellular oxidative stress. The endoperoxide artemisinin and semisynthetic artemisinin-derivatives including dihydroartemisinin (DHA) constitute a major class of antimalarials that kill plasmodium parasites through induction of iron-dependent oxidative stress. Here, we demonstrate that DHA may serve as a redox chemotherapeutic that selectively induces melanoma cell apoptosis without compromising viability of primary human melanocytes. Cultured human metastatic melanoma cells (A375, G361, LOX) were sensitive to DHA-induced apoptosis with upregulation of cellular oxidative stress, phosphatidylserine externalization, and activational cleavage of procaspase 3. Expression array analysis revealed DHA-induced upregulation of oxidative and genotoxic stress response genes (GADD45A, GADD153, CDKN1A, PMAIP1, HMOX1, EGR1) in A375 cells. DHA exposure caused early upregulation of the BH3-only protein NOXA, a proapototic member of the Bcl2 family encoded by PMAIP1, and genetic antagonism (siRNA targeting PMAIP1) rescued melanoma cells from apoptosis indicating a causative role of NOXA-upregulation in DHA-induced melanoma cell death. Comet analysis revealed early DHA-induction of genotoxic stress accompanied by p53 activational phosphorylation (Ser 15). In primary human epidermal melanocytes, viability was not compromised by DHA, and oxidative stress, comet tail moment, and PMAIP1 (NOXA) expression remained unaltered. Taken together, these data demonstrate that metastatic melanoma cells display a specific vulnerability to DHA-induced NOXA-dependent apoptosis and suggest feasibility of future anti-melanoma intervention using artemisinin-derived clinical redox antimalarials.


Asunto(s)
Antimaláricos/farmacología , Apoptosis/efectos de los fármacos , Artemisininas/farmacología , Melanocitos/efectos de los fármacos , Melanocitos/patología , Melanoma/patología , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Antioxidantes/farmacología , Apoptosis/genética , Caspasa 3/metabolismo , Células Cultivadas , Citoprotección/efectos de los fármacos , Citoprotección/genética , Daño del ADN/genética , Ensayos de Selección de Medicamentos Antitumorales , Activación Enzimática/efectos de los fármacos , Epidermis/patología , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Genoma Humano/genética , Humanos , Quelantes del Hierro/farmacología , Melanocitos/metabolismo , Melanoma/genética , Melanoma/ultraestructura , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Mitocondrias/patología , Metástasis de la Neoplasia , Análisis de Secuencia por Matrices de Oligonucleótidos , Oxidación-Reducción/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacos , Fosforilación/efectos de los fármacos , Proteínas Proto-Oncogénicas c-bcl-2/genética , Proteína p53 Supresora de Tumor/metabolismo , Regulación hacia Arriba/efectos de los fármacos , Regulación hacia Arriba/genética
4.
J Small Anim Pract ; 63(6): 435-441, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35191029

RESUMEN

OBJECTIVES: To compare detection of Salmonella species and antimicrobial-resistant Escherichia coli in the faeces of dogs eating raw meat or non-raw diets and examine risk factors for their carriage. MATERIALS AND METHODS: Canine faecal samples (raw fed n=114; non-raw fed n=76) were collected from May to July 2015 from across the UK. Enrichment and selective culture and biochemical and PCR assays were used to identify isolates. Escherichia coli underwent susceptibility testing to a range of antimicrobials, including third-generation cephalosporins; PCR assays were used to detect antimicrobial-resistant genes. Questionnaires were used to collect data on independent variables as risks for antimicrobial-resistant (resistant to ≥1 tested antimicrobial), multi-drug-resistant (resistant to ≥3 antimicrobial classes) and third-generation cephalosporin resistant Escherichia coli. RESULTS: Antimicrobial-resistant, multi-drug-resistant and third-generation cephalosporin resistant Escherichia coli were significantly more likely to be detected in raw fed (54, 25 and 31%, respectively) compared to non-raw fed (17, 4 and 4%, respectively) dogs; Salmonella species were detected in eight (4%) raw fed dogs only. CLINICAL SIGNIFICANCE: Raw fed dogs may be a source of Salmonella species and Escherichia coli, resistant to highest priority critically important antimicrobials, representing a potential animal welfare and public health issue. Owners should be aware of the risks, especially households with members, both human and canine, who are very young, elderly or immunocompromised.


Asunto(s)
Antiinfecciosos , Infecciones por Escherichia coli , Animales , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Cefalosporinas , Dieta/veterinaria , Perros , Farmacorresistencia Bacteriana , Escherichia coli , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/veterinaria , Heces , Carne , Pruebas de Sensibilidad Microbiana/veterinaria , Salmonella , Reino Unido/epidemiología
5.
J Dent Res ; 101(5): 534-541, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35045743

RESUMEN

Hepatitis C virus (HCV) infection is the most common blood-borne chronic infection in the United States. Chronic lymphocytic sialadenitis and sicca syndrome have been reported in chronic HCV infection. Up to 55% of these patients may have xerostomia; the mechanisms of the xerostomia and salivary gland (SG) hypofunction remain controversial. The objectives of this project are to establish if xerostomia associates with SG and HCV infection and to characterize the structural changes in SG and saliva composition. Eighteen HCV-infected patients with xerostomia were evaluated for SG dysfunction; 6 of these patients (patients 1-6) were further evaluated for SG histopathological changes and changes in saliva composition. The techniques used include clinical and laboratory assessment, SG ultrasonography, histological evaluation, sialochemical and proteomics analysis, and RNA in situ hybridization. All the HCV patients had low saliva flow, chronic sialadenitis, and SG fibrosis and lacked Sjögren syndrome (SS) characteristic autoantibodies. Further evaluation of a subgroup of 6 HCV patients (patients 1-6) demonstrated diffuse lymphocytic infiltrates that are predominantly CD8+ T cells with a significant increase in the number of inflammatory cells. Alcian Blue/periodic acid-Schiff staining showed significant changes in the ratio and intensity of the acinar secretory units of the HCV patients' minor SG. The submandibular glands showed significant ultrasonographic abnormalities in the parenchyma relative to the parotid glands. Significant changes were also observed in the concentration of sodium and mucin 5b. Although no significant correlation was observed between the lymphocytic infiltrates and the years of HCV chronic infection, a positive correlation was observed between HCV RNA-positive epithelial cells and the years of HCV infection. Consistent with the low saliva flow and xerostomia, patients showed changes in several markers of SG acinar and ductal function. Changes in the composition of the saliva suggest that HCV infection can cause xerostomia by mechanisms distinct from SS.


Asunto(s)
Hepatitis C , Sialadenitis , Síndrome de Sjögren , Xerostomía , Linfocitos T CD8-positivos/patología , Hepacivirus , Hepatitis C/complicaciones , Humanos , Inflamación , ARN , Saliva , Glándulas Salivales/patología , Síndrome de Sjögren/complicaciones , Xerostomía/etiología
6.
J Perinatol ; 42(9): 1183-1188, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35449444

RESUMEN

BACKGROUND: Congenital diaphragmatic hernia (CDH) accounts for 8% of all major congenital anomalies. Neonates who are small for gestational age (SGA) generally have a poorer prognosis. We sought to identify risk factors and variables associated with outcomes in neonates with CDH who are SGA in comparison to neonates who are appropriate for gestational age (AGA). METHODS: We used the multicenter Diaphragmatic Hernia Research & Exploration Advancing Molecular Science (DHREAMS) study to include neonates enrolled from 2005 to 2019. Chi-squared or Fisher's exact tests were used to compare categorical variables and t tests or Wilcoxon rank sum for continuous variables. Cox model analyzed time to event outcomes and logistic regression analyzed binary outcomes. RESULTS: 589 neonates were examined. Ninety were SGA (15.3%). SGA patients were more likely to be female (p = 0.003), have a left sided CDH (p = 0.05), have additional congenital anomalies and be diagnosed with a genetic syndrome (p < 0.001). On initial single-variable analysis, SGA correlated with higher frequency of death prior to discharge (p < 0.001) and supplemental oxygen requirement at 28 days (p = 0.005). Twice as many SGA patients died before repair (12.2% vs 6.4%, p = 0.04). Using unadjusted Cox model, the risk of death prior to discharge among SGA patients was 1.57 times the risk for AGA patients (p = 0.029). There was no correlation between SGA and need for ECMO, pulmonary hypertensive medication at discharge or oxygen at discharge. After adjusting for confounding variables, SGA no longer correlated with mortality prior to discharge or incidence of unrepaired defects but remained significant for oxygen requirement at 28 days (p = 0.03). CONCLUSION: Infants with CDH who are SGA have worse survival and poorer lung function than AGA infants. However, the outcome of SGA neonates is impacted by other factors including gestational age, genetic syndromes, and particularly congenital anomalies that contribute heavily to their poorer prognosis.


Asunto(s)
Oxigenación por Membrana Extracorpórea , Hernias Diafragmáticas Congénitas , Femenino , Edad Gestacional , Hernias Diafragmáticas Congénitas/complicaciones , Humanos , Lactante , Recién Nacido , Masculino , Oxígeno , Estudios Retrospectivos , Factores de Riesgo
8.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 3): o506-7, 2010 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-21580282

RESUMEN

The title mol-ecule, also called 4-chloro-N,N-bis-(trifluoro-methane-sulfon-yl)aniline, C(8)H(4)ClF(6)NO(4)S(2), has non-crystallographic twofold symmetry with the pseudo-axis aligned along the Cl-C⋯C-N backbone of the mol-ecule: the SO(2)CF(3) residues lie to either side of the benzene ring. In the crystal, the presence of C-H⋯O contacts lead to the formation of a sequence of 12-membered {⋯HC(2)NSO}(2) synthons within a supra-molecular chain aligned along [101].

9.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 3): o521-2, 2010 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-21580295

RESUMEN

Two independent but virtually identical mol-ecules comprise the asymmetric unit of the title compound, C(16)H(14)ClN(3). The mol-ecules have a slightly curved shape owing to puckering in the six-membered C(4)N(2) ring; the respective dihedral angles formed between the benzene rings are 12.64 (7) and 11.72 (7)°. In the crystal, layers sustained by a combination of N-H⋯N hydrogen bonding as well as C-H⋯N and C-H⋯π contacts are formed; these stack along [011] and are connected by further C-H⋯π contacts.

10.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 4): o958, 2010 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-21580761

RESUMEN

A twisted conformation is found in the title compound, C(8)H(9)ClN(2), with the ethanimidamide residue being twisted substantially to the benzene ring [dihedral angle = 66.54 (14)°]. The conformation about the C=N double bond [1.299 (3) Å] is Z. A two-dimensional array with a zigzag topology is formed in the crystal structure via N-H⋯N and N-H⋯Cl hydrogen-bonding inter-actions.

11.
Anal Chem ; 81(6): 2043-52, 2009 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-19231844

RESUMEN

In many settings, molecular testing is needed but unavailable due to complexity and cost. Simple, rapid, and specific DNA detection technologies would provide important alternatives to existing detection methods. Here we report a novel, rapid nucleic acid detection method based on the accelerated photobleaching of the light-sensitive cyanine dye, 3,3'-diethylthiacarbocyanine iodide (DiSC(2)(3) I(-)), in the presence of a target genomic DNA and a complementary peptide nucleic acid (PNA) probe. On the basis of the UV-vis, circular dichroism, and fluorescence spectra of DiSC(2)(3) with PNA-DNA oligomer duplexes and on characterization of a product of photolysis of DiSC(2)(3) I(-), a possible reaction mechanism is proposed. We propose that (1) a novel complex forms between dye, PNA, and DNA, (2) this complex functions as a photosensitizer producing (1)O(2), and (3) the (1)O(2) produced promotes photobleaching of dye molecules in the mixture. Similar cyanine dyes (DiSC(3)(3), DiSC(4)(3), DiSC(5)(3), and DiSC(py)(3)) interact with preformed PNA-DNA oligomer duplexes but do not demonstrate an equivalent accelerated photobleaching effect in the presence of PNA and target genomic DNA. The feasibility of developing molecular diagnostic assays based on the accelerated photobleaching (the smartDNA assay) that results from the novel complex formed between DiSC(2)(3) and PNA-DNA is under way.


Asunto(s)
Benzotiazoles/química , Carbocianinas/química , Colorantes/química , Sondas de Oligonucleótidos/química , Ácidos Nucleicos de Péptidos/química , Fotoblanqueo , Análisis de Secuencia de ADN/métodos , Catálisis , Dicroismo Circular , ADN/química , Técnicas de Diagnóstico Molecular , Espectrofotometría Ultravioleta
12.
Science ; 166(3907): 876-7, 1969 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-17815750

RESUMEN

Synchronous signal averaging, applied to the photometry of the steller system DQ Herculis in order to study the 71.1-second pulsations discovered by Walker in 1956, yields a light curve which is a pure sinusoid, within the accuracy of measurement. The binary period is increasing, probably as a result of mass lost from the system.

13.
Science ; 218(4573): 675-7, 1982 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-17791586

RESUMEN

New radiocarbon dates and plant macrofossil data establish that parts of the Queen Charlotte Islands, British Columbia, were ice-free during and subsequent to the late Wisconsin glacial maximum on the Pacific coast of Canada. A paleoecological investigation of dated sediments at Cape Ball has indicated that a varied flora consisting of terrestrial and aquatic plants was present there about 16,000 years ago. This finding provides support for the existence of a heretofore questioned biotic refugium on the Queen Charlotte Islands during the last glaciation. These results shed new light on problems of glacial chronology, climatic change, biogeography, and archeology along the western margin of North America.

14.
Science ; 269(5225): 814-6, 1995 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-17778739

RESUMEN

The Bergman cyclization has been the subject of renewed interest with the discovery of naturally occurring enediyne-based antitumor agents that cleave DNA by means of an aromatic diradical. These natural substrates have a means to trigger this cycloaromatization process. Control of this reaction by substrate modification would allow aromatic diradicals to be generated selectively. In the studies presented here it is disclosed that the Bergman cyclization of 1,2-bis(diphenyl phosphinoethynyl) benzene was accelerated by a factor of >30,000 by the addition of palladium(II) chloride or platinum(II) chloride and was inhibited by the addition of mercury(II) chloride.

15.
Science ; 167(3917): 368-70, 1970 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-17790146

RESUMEN

Acquisition measurements of the round-trip travel time of light, from the McDonald Observatory to the Laser Ranging Retro-Reflector deployed on the moon by the Apollo 11 astronauts, were made on 20 August and on 3, 4, and 22 September 1969. The uncertainty in the round-trip travel time was +/- 15 nanoseconds, with the pulsed ruby laser and timing system used for the acquisition. The uncertainty in later measurements of a planned long-term sequence from this observatory is expected to be an order of magnitude smaller. The successful performance of the retro-reflector at several angles of solar illumination, as well as during and after a lunar night, confirms the prediction of thermal design analyses.

16.
J Dent Res ; 98(2): 209-217, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30392435

RESUMEN

Significant effort has been applied to identify the genome-wide gene expression profiles associated with salivary gland development and pathophysiology. However, relatively little is known about the regulators that control salivary gland gene expression. We integrated data from DNase1 digital genomic footprinting, RNA-seq, and gene expression microarrays to comprehensively characterize the cis- and trans-regulatory components controlling gene expression of the healthy submandibular salivary gland. Analysis of 32 human tissues and 87 mouse tissues was performed to identify the highly expressed and tissue-enriched transcription factors driving salivary gland gene expression. Following RNA analysis, protein expression levels and subcellular localization of 39 salivary transcription factors were confirmed by immunohistochemistry. These expression analyses revealed that the salivary gland highly expresses transcription factors associated with endoplasmic reticulum stress, human T-cell lymphotrophic virus 1 expression, and Epstein-Barr virus reactivation. DNase1 digital genomic footprinting to a depth of 333,426,353 reads was performed and utilized to generate a salivary gland gene regulatory network describing the genome-wide chromatin accessibility and transcription factor binding of the salivary gland at a single-nucleotide resolution. Analysis of the DNase1 gene regulatory network identified dense interconnectivity among PLAG1, MYB, and 13 other transcription factors associated with balanced chromosomal translocations and salivary gland tumors. Collectively, these analyses provide a comprehensive atlas of the cis- and trans-regulators of the salivary gland and highlight known aberrantly regulated pathways of diseases affecting the salivary glands.


Asunto(s)
Regulación de la Expresión Génica , Redes Reguladoras de Genes , Neoplasias de las Glándulas Salivales/genética , Glándulas Salivales , Animales , Epigénesis Genética , Humanos , Ratones , Factores de Transcripción
17.
J Dent Res ; 98(7): 772-778, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31095438

RESUMEN

Salivary gland dysfunction occurs in several autoimmune and immune-related conditions, including Sjögren syndrome (SS); immune checkpoint inhibitor-induced sicca (ICIS) that develops in some cancer patients and is characterized by severe, sudden-onset dry mouth; and autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). Although subjects with these conditions present with oral dryness and often exhibit inflammatory infiltration of the salivary gland, little is known about the B-cell humoral responses directed against salivary gland protein targets. In this study, autoantibodies were evaluated against Ro52, Ro60, and La, as well as against a panel of 22 proteins derived from the salivary proteome. The tested cohort included healthy volunteers and subjects with SS, ICIS, and APECED without and with sicca. As expected, a high percentage of autoantibody seropositivity was detected against Ro52, Ro60, and La in SS, but only a few ICIS patients were seropositive for these autoantigens. A few APECED subjects also harbored autoantibodies to Ro52 and La, but only Ro60 autoantibodies were weakly associated with a small subset of APECED patients with sicca. Additional testing of the salivary panel failed to detect seropositive autoantibodies against any of the salivary-enriched proteins in the SS and ICIS subjects. However, APECED subjects selectively demonstrated seropositivity against BPI fold containing family A member 1 (BPIFA1), BPI fold containing family A member 2 (BPIFA2)/parotid salivary protein (PSP), and lactoperoxidase, 3 salivary-enriched proteins. Moreover, high levels of serum autoantibodies against BPIFA1 and BPIFA2/PSP occurred in 30% and 67% of the APECED patients with sicca symptoms, respectively, and were associated with an earlier age onset of oral dryness (P = 0.001). These findings highlight the complexity of humoral responses in different sicca diseases and provide new insights and biomarkers for APECED-associated sicca (ClinicalTrials.gov: NCT00001196; NCT00001390; NCT01425892; NCT01386437).


Asunto(s)
Autoanticuerpos/análisis , Proteínas y Péptidos Salivales/inmunología , Síndrome de Sjögren/inmunología , Adulto , Anciano , Autoantígenos/inmunología , Femenino , Humanos , Inmunidad Humoral , Masculino , Persona de Mediana Edad , Poliendocrinopatías Autoinmunes/inmunología , Proteoma , Adulto Joven
18.
Br J Cancer ; 99(1): 72-7, 2008 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-18577995

RESUMEN

Serum chromogranin A is the most useful general and prognostic tumour marker available for neuroendocrine tumour (NET) patients. The role of other tumour markers is less clear. In order to determine the diagnostic and prognostic value of serum alpha-fetoprotein (AFP) and human chorionic gonadotrophin-beta (hCGbeta) in NETs, a database containing biochemical, histological, and survival data on 360 NET patients was constructed. This data was statistically assessed, using Statistical Package for the Social Sciences, to determine the utility of commonly measured tumour markers with particular emphasis on AFP and hCGbeta. Alpha-fetoprotein and hCGbeta were raised in 9.5 and 12.3% of patients respectively and jointly raised in 9.1% of patients in whom it was measured. Alpha-fetoprotein levels associated strongly and positively with tumour grade, serum CgA and hCGbeta levels, and worse survival. Human chorionic gonadotrophin-beta levels also associated strongly and positively with serum CgA and AFP levels, and worsening survival. Alpha-fetoprotein and hCGbeta are elevated in high-grade NETs, with a rapidly progressive course and poorer survival. They also correlate with chromogranin-A, which is known to be a marker of tumour burden and to have prognostic value. Thus AFP and hCGbeta are clinically important in NETs and when elevated are poor prognostic markers.


Asunto(s)
Gonadotropina Coriónica Humana de Subunidad beta/sangre , Tumores Neuroendocrinos/diagnóstico , alfa-Fetoproteínas/análisis , Biomarcadores de Tumor , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/sangre , Tumores Neuroendocrinos/mortalidad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia
19.
Zoonoses Public Health ; 65(5): 465-480, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29676526

RESUMEN

Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral zoonosis with a case-fatality rate ranging from 9% to 50% in humans. Although a licensed vaccine to prevent infection by the CCHF virus (CCHFV) exists, its ability to induce neutralizing antibodies is limited and its efficacy against CCHFV remains undetermined. In addition, controlling CCHF infections by eradication of the tick reservoir has been ineffective, both economically and logistically, and the treatment options for CCHF remain limited. In this review, we first critically discuss the existing animal models to evaluate therapeutics for CCHF. We then review the therapeutic options for CCHF that have been investigated in human cases, followed by investigational drugs that have been evaluated in pre-clinical studies. We highlight the importance of understanding human prognostic factors in developing an animal model for CCHF that recapitulates hallmarks of human disease and its implication for selecting therapeutic candidates.


Asunto(s)
Modelos Animales de Enfermedad , Virus de la Fiebre Hemorrágica de Crimea-Congo/fisiología , Fiebre Hemorrágica de Crimea/prevención & control , Animales , Vectores Artrópodos/virología , Virus de la Fiebre Hemorrágica de Crimea-Congo/inmunología , Humanos , Garrapatas/virología
20.
JMIR Cardio ; 2(2)2018 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-30596204

RESUMEN

BACKGROUND: Blood pressure (BP) is a key modifiable risk factor for patients with CKD, with current guidelines recommending strict control to reduce the risk of both progression of CKD and cardiovascular disease. Trials of BP lowering require multiple visits to achieve target BP which increases the costs of such trials, and in routine care BP measured in clinic may not accurately reflect usual BP. OBJECTIVE: We sought to assess whether a telemonitoring system for BP (using a Bluetooth-enable BP machine which could transmit BP measurements to a tablet device which had a bespoke app to guide measurement of BP and collect questionnaire data) was acceptable to patients with CKD, and whether patients would provide sufficient BP readings to assess variability and guide treatment. METHODS: 25 participants with CKD were trained to use the telemonitoring equipment, asked to record BP daily for 30 days, attend a study visit, and then record BP on alternate days for the next 60 days. They were also offered a wrist-worn applanation tonometry device (BPro) which measures BP every 15 minutes over a 24 hour period.Participants were given questionnaires at the one-month and three-month time points, derived from the System Usability Scale and Technology Acceptance Model. All eligible participants completed the study. RESULTS: Mean age was 58 (SD 11) years and mean eGFR was 36 (SD 13) mL/min/1.73m2. 13 out of 25 (52%) participants provided >90% of expected data and 18 out of 25 (72%) provided >80% expected data. The usability of the telemonitoring system was rated highly with mean scores of 84.9/100 (SE 2.8) after 30 days and 84.2/100 (SE 4.1) after 90 days. The coefficient of variation (CV) for variability of telemonitoring systolic BP was 9.4% (95% confidence interval [CI] 7.8 to 10.9), compared to 7.9% (95% CI 6.4-9.5) for the BPro device (P=0.05) (and 9.0% over one year in a recently completed trial with identical eligibility criteria), indicating that most variation in BP is short-term. CONCLUSIONS: Telemonitoring is acceptable to patients with CKD and provides sufficient data to inform titration of antihypertensive therapies in either a randomized trial setting (comparing different targets BPs) or routine clinical practice. Such methods could be employed in both scenarios and reduce costs currently associated with such activities.Registration ISRCTN13725286.

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