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1.
Occup Med (Lond) ; 2024 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-39058930

RESUMEN

BACKGROUND: Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity. AIMS: This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability. METHODS: In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment. RESULTS: Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes. CONCLUSIONS: Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.

2.
Br J Surg ; 109(1): 71-78, 2021 12 17.
Artículo en Inglés | MEDLINE | ID: mdl-34643677

RESUMEN

BACKGROUND: The therapeutic value of repeat hepatic resection (rHR) or radiofrequency ablation (RFA) for recurrent hepatocellular carcinoma (HCC) is unknown. This study aimed to investigate the safety and efficacy of rHR or RFA. METHODS: This was a retrospective multicentre study of patients with recurrent HCC within the Milan criteria who underwent rHR or RFA at nine university hospitals in China and Italy between January 2003 and January 2018. Survival after rHR or RFA was examined in unadjusted analyses and after propensity score matching (1 : 1). RESULTS: Of 847 patients included, 307 and 540 underwent rHR and RFA respectively. Median overall survival was 73.5 and 67.0 months after rHR and RFA respectively (hazard ratio 1.01 (95 per cent c.i. 0.81 to 1.26)). Median recurrence-free survival was longer after rHR versus RFA (23.6 versus 15.2 months; hazard ratio 0.76 (95 per cent c.i. 0.65 to 0.89)). These results were confirmed after propensity score matching. RFA was associated with lower morbidity of grade 3 and above (0.6 versus 6.2 per cent; P < 0.001) and shorter hospital stay (8.0 versus 3.0 days, P < 0.001) than rHR. CONCLUSION: rHR was associated with longer recurrence-free survival but not overall survival compared with RFA.


Asunto(s)
Carcinoma Hepatocelular/cirugía , Hepatectomía , Neoplasias Hepáticas/cirugía , Recurrencia Local de Neoplasia/cirugía , Ablación por Radiofrecuencia , Supervivencia sin Enfermedad , Femenino , Hepatectomía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Ablación por Radiofrecuencia/efectos adversos , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento
3.
Conserv Biol ; 33(5): 1151-1163, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-30957293

RESUMEN

Conservation planners need reliable information on spatial patterns of biodiversity. However, existing data sets are skewed because some ecosystems, taxa, and locations are underrepresented. We determined how many articles have been published in recent decades on the biodiversity of different countries and their constituent provinces. We searched the Web of Science catalogues Science Citation Index (SCI) and Social Science Citation Index (SSCI) for biodiversity-related articles published from 1993 to 2016 that included country and province names. We combined data on research publication frequency with other provincial-scale factors hypothesized to affect the likelihood of research activity (i.e., economic development, human presence, infrastructure, and remoteness). Areas that appeared understudied relative to the biodiversity expected based on site climate likely have been inaccessible to researchers for reasons, notably armed conflict. Geographic publication bias is of most concern in the most remote areas of sub-Saharan Africa and South America. Our provincial-scale model may help compensate for publication biases in conservation planning by revealing the spatial extent of research needs and the low cost of redoing this analysis annually.


Efectos del Sesgo de Publicación sobre la Planeación de la Conservación Resumen Los planeadores de la conservación necesitan información confiable sobre los patrones espaciales de la biodiversidad. Sin embargo, los conjuntos de datos existentes están distorsionados porque algunos ecosistemas, taxones y localidades están subrepresentados. Determinamos cuántos artículos sobre la biodiversidad de diferentes países y sus provincias constituyentes han sido publicados en décadas recientes. Buscamos artículos relacionados con la biodiversidad publicados entre 1993 y 2016 que incluyeran el nombre de países y provincias en los catálogos SCI y SSCI de la Web of Science. Combinamos los datos de frecuencia de publicación de investigaciones con otros factores de escala provincial que creemos afectarían la probabilidad de la actividad de investigación (es decir, desarrollo económico, presencia humana, infraestructura y lejanía). Las áreas que aparentaron estar poco estudiadas en relación con la biodiversidad esperada basada en el clima del sitio probablemente han estado inaccesibles para los investigadores por diferentes razones, notablemente los conflictos armados. El sesgo geográfico en las publicaciones es un tema de importancia para las áreas más remotas del África subsahariana y América del Sur. Nuestro modelo de escala provincial puede ayudar a compensar los sesgos de publicación en la planeación de la conservación al revelar la extensión espacial de las necesidades de investigación y los bajos costos de repetir este análisis cada año.


Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , África del Sur del Sahara , Biodiversidad , Humanos , Sesgo de Publicación
4.
Eur J Surg Oncol ; 45(6): 999-1004, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30827803

RESUMEN

BACKGROUND: This study aimed to create a new prognostic score integrating the systemic inflammatory response to predict survival in patients treated with curative intent for colorectal liver metastases (CLM). METHODS: We identified independent prognostic factors in patients who underwent liver surgery for CLM in a tertiary centre in the United Kingdom (UK) between 2010 and 2015. A pre- and a postoperative score (Liverpool score) were created by combining these factors to stratify patients into different risk groups. These new scores were validated in an international cohort of 219 patients from China and France. RESULTS: Multivariate cox regression analysis of the 364 patients of the UK cohort identified 6 preoperative and 1 postoperative prognostic factors for overall survival (OS): American society of anaesthesiologists (ASA) score, location and node status of the primary tumour, number and size of CLM, neutrophil-to-lymphocyte ratio (NLR) and resection margin. Both pre- and postoperative scores can be calculated with an online calculator at https://jscalc.io/calc/PXatrmjfrEFpYy2t. Using the pre-operative model on the UK cohort, median OS was 61.22 (50.23, not reached) months in the low-risk group (n = 162) and 30.36 (23.68, 35.95) months in the high-risk group (n = 162, p < 0.0001). The same difference was observed in the validation cohort. The Liverpool score outperformed previously published scoring system with a c-index of 0.619 pre-operatively and of 0.637 post-operatively. CONCLUSION: We developed a new prognostic score based on clinicopathologic characteristics including the site of the primary tumour location and on measurement of the systemic inflammatory response which could help to tailor patients' management.


Asunto(s)
Neoplasias Colorrectales/terapia , Neoplasias Hepáticas/terapia , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Anciano , Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/patología , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia/tendencias , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Reino Unido/epidemiología
5.
Equine Vet J ; 50(4): 537-543, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29112289

RESUMEN

BACKGROUND: Pharmacokinetics of lithium chloride (LiCl) administered as a bolus, once i.v. have not been determined in horses. There is no point-of-care test to measure lithium (Li+ ) concentrations in horses in order to monitor therapeutic levels and avoid toxicity. OBJECTIVES: To determine the pharmacokinetics of LiCl in healthy adult horses and to compare agreement between two methods of plasma Li+ concentration measurement: spectrophotometric enzymatic assay (SEA) and inductively coupled plasma mass spectrometry (ICP-MS). STUDY DESIGN: Nonrandomised, single exposure with repeated measures over time. METHODS: Lithium chloride was administered (0.15 mmol/kg bwt) as an i.v. bolus to eight healthy adult horses. Blood samples were collected pre-administration and at multiple times until 48 h post-administration. Samples were analysed by two methods (SEA and ICP-MS) to determine plasma Li+ concentrations. Pharmacokinetics were determined based on the reference ICP-MS data. RESULTS: Adverse side effects were not observed. The SEA showed linearity, R2 = 0.9752; intraday coefficient of variation, 2.5%; and recovery, 96.3%. Both noncompartmental and compartmental analyses (traditional two-stage and nonlinear mixed-effects [NLME] modelling) were performed. Geometric mean values of noncompartmental parameters were plasma Li+ concentration at time zero, 2.19 mmol/L; terminal elimination half-life, 25.68 h; area under the plasma concentration-time curve from time zero to the limit of quantification, 550 mmol/L min; clearance, 0.273 mL/min/kg; mean residence time, 31.22 h; and volume of distribution at steady state, 511 mL/kg. Results of the traditional two-stage analysis showed good agreement with the NLME modelling approach. Bland-Altman analyses demonstrated poor agreement between the SEA and ICP-MS methods (95% limits of agreement = 0.14 ± 0.13 mmol/L). MAIN LIMITATIONS: Clinical effects of LiCl have not been investigated. CONCLUSIONS: The LiCl i.v. bolus displayed pharmacokinetics similar to those reported in other species. The SEA displayed acceptable precision but did not agree well with the reference method (ICP-MS). The Summary is available in Spanish - see Supporting Information.


Asunto(s)
Adyuvantes Inmunológicos/farmacocinética , Caballos/sangre , Cloruro de Litio/farmacocinética , Adyuvantes Inmunológicos/sangre , Animales , Femenino , Cloruro de Litio/sangre , Masculino
6.
Acute Med ; 16(3): 107-110, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29072868

RESUMEN

In an attempt to reduce the number of inappropriate clotting screens being performed in our Trust, an electronic prompt was introduced to our haematology requesting system. Over the six month period after introduction of this prompt the number of clotting screen requests reduced by 7001, representing a 21% reduction when compared to the same 6 month period one year earlier. This represented a cost saving of over £98,000 without any increase in adverse incidents being reported related to bleeding complications.

7.
R Soc Open Sci ; 4(6): 170453, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28680689

RESUMEN

The tendency for sexual size dimorphism (SSD) to increase with body mass in taxa where males are larger, and to decrease when females are larger, is known as Rensch's rule. In mammals, where the trend occurs, it is believed to be the result of a competitive advantage for larger males, while female mass is constrained by the energetics of reproduction. Here, we examine the allometry of SSD within the Felidae and Canidae, demonstrating distinctly different patterns: in felids, there is positive allometric scaling, while there is no trend in canids. We hypothesize that feeding ecology, via its effect on female spacing patterns, is responsible for the difference; larger male mass may be advantageous only where females are dispersed such that males can defend access to them. This is supported by the observation that felids are predominately solitary, and all are obligate carnivores. Similarly, carnivorous canids are more sexually dimorphic than insectivores and omnivores, but carnivory does not contribute to a Rensch effect as dietary variation occurs across the mass spectrum. The observed inter-familial differences are also consistent with reduced constraints on female mass in the canids, where litter size increases with body mass, versus no observable allometry in the felids.

8.
Cell Microbiol ; 17(8): 1217-29, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25703821

RESUMEN

The parasite Trichomonas vaginalis is the causative agent of trichomoniasis, a prevalent sexually transmitted infection. Here, we report the cellular analysis of T.vaginalis tetraspanin family (TvTSPs). This family of membrane proteins has been implicated in cell adhesion, migration and proliferation in vertebrates. We found that the expression of several members of the family is up-regulated upon contact with vaginal ectocervical cells. We demonstrate that most TvTSPs are localized on the surface and intracellular vesicles and that the C-terminal intracellular tails of surface TvTSPs are necessary for proper localization. Analyses of full-length TvTSP8 and a mutant that lacks the C-terminal tail indicates that surface-localized TvTSP8 is involved in parasite aggregation, suggesting a role for this protein in parasite : parasite interaction.


Asunto(s)
Tetraspaninas/análisis , Trichomonas vaginalis/química , Agregación Celular , Vesículas Citoplasmáticas/química , Análisis Mutacional de ADN , Células Epiteliales/parasitología , Perfilación de la Expresión Génica , Proteínas de la Membrana/análisis , Transporte de Proteínas , Trichomonas vaginalis/genética
9.
Br J Cancer ; 110(8): 2090-8, 2014 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-24691419

RESUMEN

BACKGROUND: The Japanese 'BALAD' model offers the first objective, biomarker-based, tool for assessment of prognosis in hepatocellular carcinoma, but relies on dichotomisation of the constituent data, has not been externally validated, and cannot be applied to the individual patients. METHODS: In this Japanese/UK collaboration, we replicated the original BALAD model on a UK cohort and then built a new model, BALAD-2, on the original raw Japanese data using variables in their continuous form. Regression analyses using flexible parametric models with fractional polynomials enabled fitting of appropriate baseline hazard functions and functional form of covariates. The resulting models were validated in the respective cohorts to measure the predictive performance. RESULTS: The key prognostic features were confirmed to be Bilirubin and Albumin together with the serological cancer biomarkers, AFP-L3, AFP, and DCP. With appropriate recalibration, the model offered clinically relevant discrimination of prognosis in both the Japanese and UK data sets and accurately predicted patient-level survival. CONCLUSIONS: The original BALAD model has been validated in an international setting. The refined BALAD-2 model permits estimation of patient-level survival in UK and Japanese cohorts.


Asunto(s)
Bilirrubina/sangre , Carcinoma Hepatocelular/sangre , Neoplasias Hepáticas/sangre , Pronóstico , alfa-Fetoproteínas/metabolismo , Anciano , Biomarcadores/sangre , Biomarcadores de Tumor/sangre , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patología , Femenino , Humanos , Japón , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Precursores de Proteínas/sangre , Protrombina , Albúmina Sérica/metabolismo , Reino Unido
10.
Br J Cancer ; 110(9): 2277-82, 2014 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-24603305

RESUMEN

BACKGROUND: Mass spectroscopy analysis suggested low serum albumin and high immunoglobulin free light chain (sFLC) levels may have diagnostic value in hepatocellular carcinoma (HCC). Our aims were to apply quantitative assays to confirm these observations, determine their diagnostic utility, and investigate the mechanisms involved. METHODS: Albumin, sFLC, routine liver and renal function tests were measured in patients with chronic liver disease with (n=102) and without (n=113) HCC. The discriminant performance was compared with the current standard serological test alpha-fetoprotein (AFP) using receiver operating characteristic (ROC) and area under the curve (AUC) analyses. RESULTS: sFLC and serum albumin were each confirmed to have discriminatory utility in HCC with AUC values of 0.7 and 0.8, respectively. sFLC were strongly correlated with gammaglobulin levels and both these were inversely related to serum albumin levels. The discriminatory utility of sFLC was retained after adjusting for renal and liver function. CONCLUSIONS: Serum levels of sFLC and albumin were strongly associated with HCC as predicted by mass spectroscopy. Discrimination of HCC by AFP was improved by the addition of either albumin or sFLC. Larger prospective studies are required to determine how AFP, sFLC and albumin might be combined in a useful diagnostic approach for HCC.


Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma Hepatocelular/diagnóstico , Cadenas Ligeras de Inmunoglobulina/sangre , Neoplasias Hepáticas/diagnóstico , Albúmina Sérica/análisis , alfa-Fetoproteínas/análisis , Humanos , Espectrometría de Masas
11.
J Vet Intern Med ; 28(1): 215-22, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24479657

RESUMEN

BACKGROUND: Matrix metalloproteinases (MMP) are hypothesized to degrade structurally important components of the laminar extracellular matrix (ECM) in horses with laminitis. OBJECTIVE: To compare levels of expression of stromelysin-1 (MMP-3), collagenases (MMP-1, -13), and membrane type-MMPs (MMP-14, -15, -16), and the distribution of their ECM substrates, in laminae of healthy horses and horses with carbohydrate overload laminitis. ANIMALS: Twenty-five adult horses. METHODS: Gene and protein expression were determined in extracts of laminae using real-time quantitative polymerase chain reaction and Western blotting after sodium dodecylsulfate polyacrylamide gel electrophoresis. Distribution of MMP-13 and ECM components was determined using indirect immunofluorescent microscopy of nonfixed frozen sections. ECM morphology was assessed by hematoxylin and eosin staining. RESULTS: Of the genes studied, only those encoding MMP-1 and -13 were upregulated in CHO-induced laminitis; MMP-1 at Obel grade (OG)1 lameness and MMP-13 at OG3 lameness. Laminar MMP-1 was present as 52 kDa proenzyme only. MMP-13 was present as pro- (61 kDa) and processed (48 kDa) enzyme. MMP-13 localized to the basal epithelium of the secondary epidermal laminae and its increased expression were accompanied by the appearance in secondary dermal laminae (SDL) of multiple foci that were devoid of collagen I, fibronectin, chondroitin and keratan sulfate glycosaminoglycans, and eosin-staining material. CONCLUSIONS AND CLINICAL RELEVANCE: MMP-13 is upregulated in laminae of horses with CHO-induced OG3 lameness and, by degrading components of the ECM, may contribute to the formation of ECM-free lesions (gaps or tears) that appear in the SDL with OG3 lameness.


Asunto(s)
Matriz Extracelular/metabolismo , Enfermedades del Pie/veterinaria , Regulación Enzimológica de la Expresión Génica/fisiología , Pezuñas y Garras/metabolismo , Enfermedades de los Caballos/metabolismo , Metaloproteinasas de la Matriz/metabolismo , Animales , Western Blotting/veterinaria , Matriz Extracelular/enzimología , Enfermedades del Pie/enzimología , Enfermedades del Pie/metabolismo , Pezuñas y Garras/enzimología , Enfermedades de los Caballos/enzimología , Caballos , Inmunohistoquímica/veterinaria , Metaloproteinasas de la Matriz/genética , Microscopía Fluorescente/veterinaria , ARN/química , ARN/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Estadísticas no Paramétricas
12.
Equine Vet J ; 46(2): 203-9, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23663159

RESUMEN

REASONS FOR PERFORMING STUDY: Hypoxia-inducible factor-1α (HIF-1A) is an important protein in the regulation/induction of many genes in the cellular and tissue response to hypoxia and a central mediator in inflammatory signalling. As both hypoxia and inflammatory events are purported to occur in the lamellar epidermis in sepsis-related laminitis in the equid, HIF-1A may play a central role in this disease process. OBJECTIVESS: To assess the regulation of HIF-1A and HIF-1A-related genes in the equine keratinocyte in vitro and in the lamellar tissue of horses with sepsis-related laminitis. STUDY DESIGN: In vivo and in vitro experiments. METHODS: Real-time quantitative PCR (RT-qPCR) and immunoblotting were performed to assess the mRNA and protein concentrations of HIF-1A and the mRNA concentrations of HIF-1A-related genes in cultured equine keratinocytes and in lamellar samples from black walnut extract (BWE)- and carbohydrate overload (CHO)-induced laminitis. Hypoxia-inducible factor-1α was further localised via indirect immunofluorescence in frozen lamellar tissue sections. RESULTS: Hypoxia-inducible factor-1α appears to be regulated primarily at the post transcriptional level in the cultured equine keratinocyte, resulting in increased HIF-1A in response to hypoxia but not to lipopolysaccharide exposure. Hypoxia-inducible factor-1α is present at high concentrations in the normal equine lamina, and is increased in Obel grade 1 (OG1) stage laminitis in the CHO model of laminitis. Equine lamellar mRNA concentrations of cyclo-oxygenase-2 and inducible nitric oxide synthase, but not glucose transporter 1, are increased in the BWE and CHO models of laminitis. CONCLUSIONS AND POTENTIAL RELEVANCE: These data indicate that the normal equine lamellae are profoundly hypoxic in comparison with other tissues. The increased mRNA concentrations of cyclo-oxygenase-2 and inducible nitric oxide synthase 2 in equine keratinocytes exposed to hypoxia and lipopolysaccharide, and in lamellar tissue from BWE and CHO models of sepsis-related laminitis, suggest that the marked lamellar inflammatory gene expression in sepsis-related laminitis may be due to an interaction of constitutively high lamellar keratinocyte HIF-1A signalling with inflammatory signalling, possibly induced by circulating inflammatory mediators.


Asunto(s)
Regulación de la Expresión Génica/fisiología , Caballos , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Queratinocitos/metabolismo , Animales , Células Cultivadas , Enfermedades del Pie/metabolismo , Enfermedades del Pie/veterinaria , Enfermedades de los Caballos/metabolismo , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Inflamación/metabolismo , Inflamación/veterinaria
14.
Br J Cancer ; 109(4): 888-90, 2013 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-23880824

RESUMEN

BACKGROUND: The prognosis for hepatocellular carcinoma (HCC) is dependent upon tumour stage, performance status (PS), severity of underlying liver disease, and the availability of appropriate therapies. The unavailability of sorafenib may have a significantly adverse effect on the prognosis of UK patients with advanced HCC. During the study period, access to sorafenib was at the discretion of local health funding bodies, a process that may delay or deny access to the drug and that remains in place for Wales, Scotland, and Northern Ireland. Here, we attempt to address the impact of this system on patients with advanced HCC in the United Kingdom. METHODS: This is a retrospective study performed in the two largest specialist hepatobiliary oncology units in the United Kingdom. Funding applications were made to local funding bodies for patients with advanced HCC for whom sorafenib was considered appropriate (advanced HCC not suitable for loco-regional therapies, compensated chronic liver disease, PS 0-2). RESULTS: A total of 133 applications were made, of which 57 (43%) were approved and 76 (57%) declined. Demographics and prognostic factors were balanced between the two groups. This cohort had a number of adverse prognostic features: patients were predominantly PS 1-2; the majority had multifocal disease with the largest lesion being >5 cm; and macroscopic vascular invasion, metastases, and AFP >,000 ng ml(-1), were each present in one-third of cases. The median time from application to funding decision was 17 days (range 3-260 days). For the primary 'intention-to-treat' analysis, median overall survival was 4.1 months when funding was declined, and 9.5 months when funding was approved (hazard ratio (HR) 0.48; 95% CI 0.3186-0.7267; P=0.0005). CONCLUSION: These data support the use of sorafenib for patients with advanced HCC as an effective intervention. In the United Kingdom, this applies to a relatively small group of patients, estimated to total ∼800 per year who, unfortunately, do not survive long enough to themselves lobby for the availability of this drug. These data provide a comparison of sorafenib with supportive care and demonstrate the potential detrimental impact on patient outcomes of rationing health-care resources on the basis of cost.


Asunto(s)
Antineoplásicos/provisión & distribución , Carcinoma Hepatocelular/tratamiento farmacológico , Asignación de Recursos para la Atención de Salud/economía , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Primarias Múltiples/tratamiento farmacológico , Niacinamida/análogos & derivados , Compuestos de Fenilurea/provisión & distribución , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/economía , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Estudios de Cohortes , Femenino , Humanos , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/patología , Niacinamida/economía , Niacinamida/provisión & distribución , Niacinamida/uso terapéutico , Compuestos de Fenilurea/economía , Compuestos de Fenilurea/uso terapéutico , Estudios Retrospectivos , Sorafenib , Reino Unido , Adulto Joven
15.
J Evol Biol ; 26(9): 2063-9, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23786459

RESUMEN

Lower visibility of female scientists, compared to male scientists, is a potential reason for the under-representation of women among senior academic ranks. Visibility in the scientific community stems partly from presenting research as an invited speaker at organized meetings. We analysed the sex ratio of presenters at the European Society for Evolutionary Biology (ESEB) Congress 2011, where all abstract submissions were accepted for presentation. Women were under-represented among invited speakers at symposia (15% women) compared to all presenters (46%), regular oral presenters (41%) and plenary speakers (25%). At the ESEB congresses in 2001-2011, 9-23% of invited speakers were women. This under-representation of women is partly attributable to a larger proportion of women, than men, declining invitations: in 2011, 50% of women declined an invitation to speak compared to 26% of men. We expect invited speakers to be scientists from top ranked institutions or authors of recent papers in high-impact journals. Considering all invited speakers (including declined invitations), 23% were women. This was lower than the baseline sex ratios of early-mid career stage scientists, but was similar to senior scientists and authors that have published in high-impact journals. High-quality science by women therefore has low exposure at international meetings, which will constrain Evolutionary Biology from reaching its full potential. We wish to highlight the wider implications of turning down invitations to speak, and encourage conference organizers to implement steps to increase acceptance rates of invited talks.


Asunto(s)
Evolución Biológica , Congresos como Asunto/tendencias , Investigadores/estadística & datos numéricos , Sexismo/tendencias , Femenino , Humanos , Investigadores/tendencias
16.
Br J Cancer ; 108(9): 1854-61, 2013 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-23591195

RESUMEN

BACKGROUND: Proteomic discovery of cancer biomarkers in body fluids is challenging because of their low abundance in a complex background. Altered gene expression in tumours may not reflect protein levels in body fluids. We have tested combining gene expression profiling of tumours with proteomic analysis of cancer cell line secretomes as a strategy to discover urinary biomarkers for bladder cancer. METHODS: We used shotgun proteomics to identify proteins secreted by three bladder cancer cell lines. Secreted proteins with high mRNA levels in bladder tumours relative to normal urothelium were assayed by ELISA in urine samples from 642 patients. RESULTS: Midkine and HAI-1 were significantly increased in bladder cancer patients, with the highest levels in invasive disease (area under the receiver operating characteristic curve 0.89 vs non-cancer). The urinary concentration of both proteins was too high to be explained by bladder cancer associated haematuria and most likely arises by direct tumour secretion. CONCLUSIONS: This 'dual-omic' strategy identified tumour secreted proteins whose urine concentrations are increased significantly by bladder cancer. Combined secretome-transcriptome analysis may be more useful than direct proteomic analysis of body fluids for biomarker discovery in both bladder cancer and other tumour types.


Asunto(s)
Biomarcadores de Tumor/orina , Citocinas/orina , Proteínas Inhibidoras de Proteinasas Secretoras/orina , Neoplasias Urológicas/orina , Biomarcadores de Tumor/genética , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/orina , Línea Celular Tumoral , Perfilación de la Expresión Génica , Humanos , Midkina , Análisis por Matrices de Proteínas , Proteinuria , Proteoma/análisis , ARN Mensajero/análisis , Transcriptoma , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/orina , Neoplasias Urológicas/patología , Urotelio/patología
17.
Eur Surg ; 45(3)2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24385980

RESUMEN

BACKGROUND: Tissue engineering has been defined as "an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function or a whole organ". Traumatic peripheral nerve injury resulting in significant tissue loss at the zone of injury necessitates the need for a bridge or scaffold for regenerating axons from the proximal stump to reach the distal stump. METHODS: A review of the literature was used to provide information on the components necessary for the development of a tissue engineered peripheral nerve substitute. Then, a comprehensive review of the literature is presented composed of the studies devoted to this goal. RESULTS: Extensive research has been directed toward the development of a tissue engineered peripheral nerve substitute to act as a bridge for regenerating axons from the proximal nerve stump seeking the distal nerve. Ideally this nerve substitute would consist of a scaffold component that mimics the extracellular matrix of the peripheral nerve and a cellular component that serves to stimulate and support regenerating peripheral nerve axons. CONCLUSIONS: The field of tissue engineering should consider its challenge to not only meet the autograft "gold standard" but also to understand what drives and inhibits nerve regeneration in order to surpass the results of an autograft.

18.
Handb Clin Neurol ; 109: 575-94, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23098738

RESUMEN

Substantial research effort in the spinal cord injury (SCI) field is directed towards reduction of secondary injury changes and enhancement of tissue sparing. However, pathway repair after complete transections, large lesions, or after chronic injury may require the implantation of some form of oriented bridging structure to restore tissue continuity across a trauma zone. These matrices or scaffolds should be biocompatible and create an environment that facilitates tissue growth and vascularization, and allow axons to regenerate through and beyond the implant in order to reconnect with "normal" tissue distal to the injury. The myelination of regrown axons is another important requirement. In this chapter, we describe recent advances in biomaterial technology designed to provide a terrain for regenerating axons to grow across the site of injury and/or create an environment for endogenous repair. Many different types of scaffold are under investigation; they can be biodegradable or nondegradable, natural or synthetic. Scaffolds can be designed to incorporate immobilized signaling molecules and/or used as devices for controlled release of therapeutic agents, including growth factors. These bridging structures can also be infiltrated with specific cell types deemed suitable for spinal cord repair.


Asunto(s)
Traumatismos de la Médula Espinal/terapia , Regeneración de la Medula Espinal/fisiología , Andamios del Tejido , Animales , Materiales Biocompatibles , Regeneración Tisular Dirigida , Humanos
19.
Br J Cancer ; 107(9): 1595-601, 2012 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-22968650

RESUMEN

BACKGROUND: There is a need for sensitive and specific blood-borne markers for the detection of gastric cancer. Raised serum macrophage inhibitory factor (MIF) levels have been proposed as a marker for gastric cancer diagnosis but, to date, studies have only encompassed patients from high-incidence areas. METHODS: We have compared the serum concentration of MIF in a large cohort of UK and Japanese gastric cancer patients, together with appropriate control subjects (age and gender matched). Carcinoembryonic antigen and H. pylori IgG were also measured, as was DJ-1, a novel candidate protein biomarker identified by analysis of gastric cancer cell line secretomes. RESULTS: Marked elevations of the serum concentration of MIF and DJ-1 were seen in Japanese patients with gastric cancer compared with Japanese controls, a trend not seen in the UK cohort. These results could not be accounted for by differences in age, disease stage or H. pylori status. CONCLUSION: In regions of high, but not low incidence of gastric cancer, both MIF and DJ-1 have elevated serum concentrations in gastric cancer patients, compared with controls. This suggests that differing mechanisms of disease pathogenesis may be at play in high- and low-incidence regions.


Asunto(s)
Péptidos y Proteínas de Señalización Intracelular/sangre , Factores Inhibidores de la Migración de Macrófagos/sangre , Proteínas Oncogénicas/sangre , Neoplasias Gástricas/sangre , Neoplasias Gástricas/epidemiología , Estudios de Cohortes , Femenino , Humanos , Incidencia , Japón/epidemiología , Masculino , Estudios Prospectivos , Proteína Desglicasa DJ-1 , Reino Unido/epidemiología
20.
J Vet Intern Med ; 26(4): 996-1004, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22805114

RESUMEN

BACKGROUND: STAT1 and STAT3 are important signaling molecules in disorders of systemic inflammation and are likely to be involved in laminitis, as laminar and systemic inflammation have been well documented in experimental models of laminitis. HYPOTHESIS: The STAT1 and STAT3 activation (via phosphorylation of tyrosine and serine moieties) is occurring in the laminar tissue during the developmental and onset of lameness time points in both the black walnut extract (BWE) and carbohydrate overload (CHO) models of laminitis. ANIMALS: Archived laminar tissue from horses. METHODS: Experimental studies of induced laminitis (BWE and CHO administration) in horses were conducted and laminar tissue samples archived. Western hybridization was performed to determine concentrations of Tyr- and Ser-phosphorylated STAT1 and STAT3 from these archived samples. The RT-qPCR was also performed to assess mRNA concentrations of target genes of STAT1 and STAT3. RESULTS: Increases (P < .05) in phosphorylation of tyrosine705 and serine727 of STAT3, demonstrated by band intensity ratios, are present in laminar tissue from both the BWE and CHO models at the DEV and OG1 time points. No change in phosphorylation of tyrosine701 or serine727 of STAT1 was present in the laminar tissue from either the BWE or the CHO models. The SOCS3 mRNA concentrations were increased at the onset of lameness in both the CHO and BWE models. CONCLUSIONS AND CLINICAL RELEVANCE: The STAT3 activation likely plays a role in equine laminitis, similar to its reported involvement in organ injury/failure in human sepsis. Regulation of JAK-STAT, through STAT3 inhibitors, might serve as potential therapeutic target for controlling the inflammatory response in the septic horse.


Asunto(s)
Enfermedades del Pie/veterinaria , Enfermedades de los Caballos/metabolismo , Cojera Animal/metabolismo , Factor de Transcripción STAT1/metabolismo , Factor de Transcripción STAT3/metabolismo , Animales , Western Blotting , Modelos Animales de Enfermedad , Enfermedades del Pie/metabolismo , Caballos , Inmunohistoquímica/veterinaria , Inflamación/metabolismo , Inflamación/veterinaria , Cojera Animal/genética , Fosforilación , ARN Mensajero/biosíntesis , ARN Mensajero/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Estudios Retrospectivos , Factor de Transcripción STAT1/biosíntesis , Factor de Transcripción STAT1/genética , Factor de Transcripción STAT3/biosíntesis , Factor de Transcripción STAT3/genética , Estadísticas no Paramétricas
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