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1.
Nature ; 569(7758): 663-671, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31142858

RESUMO

Type 2 diabetes mellitus (T2D) is a growing health problem, but little is known about its early disease stages, its effects on biological processes or the transition to clinical T2D. To understand the earliest stages of T2D better, we obtained samples from 106 healthy individuals and individuals with prediabetes over approximately four years and performed deep profiling of transcriptomes, metabolomes, cytokines, and proteomes, as well as changes in the microbiome. This rich longitudinal data set revealed many insights: first, healthy profiles are distinct among individuals while displaying diverse patterns of intra- and/or inter-personal variability. Second, extensive host and microbial changes occur during respiratory viral infections and immunization, and immunization triggers potentially protective responses that are distinct from responses to respiratory viral infections. Moreover, during respiratory viral infections, insulin-resistant participants respond differently than insulin-sensitive participants. Third, global co-association analyses among the thousands of profiled molecules reveal specific host-microbe interactions that differ between insulin-resistant and insulin-sensitive individuals. Last, we identified early personal molecular signatures in one individual that preceded the onset of T2D, including the inflammation markers interleukin-1 receptor agonist (IL-1RA) and high-sensitivity C-reactive protein (CRP) paired with xenobiotic-induced immune signalling. Our study reveals insights into pathways and responses that differ between glucose-dysregulated and healthy individuals during health and disease and provides an open-access data resource to enable further research into healthy, prediabetic and T2D states.


Assuntos
Biomarcadores/metabolismo , Biologia Computacional , Diabetes Mellitus Tipo 2/microbiologia , Microbioma Gastrointestinal , Interações entre Hospedeiro e Microrganismos/genética , Estado Pré-Diabético/microbiologia , Proteoma/metabolismo , Transcriptoma , Adulto , Idoso , Antibacterianos/administração & dosagem , Biomarcadores/análise , Estudos de Coortes , Conjuntos de Dados como Assunto , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Glucose/metabolismo , Voluntários Saudáveis , Humanos , Inflamação/metabolismo , Vacinas contra Influenza/imunologia , Insulina/metabolismo , Resistência à Insulina , Estudos Longitudinais , Masculino , Microbiota/fisiologia , Pessoa de Meia-Idade , Estado Pré-Diabético/genética , Estado Pré-Diabético/metabolismo , Infecções Respiratórias/genética , Infecções Respiratórias/metabolismo , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estresse Fisiológico , Vacinação/estatística & dados numéricos
2.
Acta Pharmacol Sin ; 44(7): 1380-1390, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36991098

RESUMO

Parallel to major changes in fatty acid and glucose metabolism, defect in branched-chain amino acid (BCAA) catabolism has also been recognized as a metabolic hallmark and potential therapeutic target for heart failure. However, BCAA catabolic enzymes are ubiquitously expressed in all cell types and a systemic BCAA catabolic defect is also manifested in metabolic disorder associated with obesity and diabetes. Therefore, it remains to be determined the cell-autonomous impact of BCAA catabolic defect in cardiomyocytes in intact hearts independent from its potential global effects. In this study, we developed two mouse models. One is cardiomyocyte and temporal-specific inactivation of the E1α subunit (BCKDHA-cKO) of the branched-chain α-ketoacid dehydrogenase (BCKDH) complex, which blocks BCAA catabolism. Another model is cardiomyocyte specific inactivation of the BCKDH kinase (BCKDK-cKO), which promotes BCAA catabolism by constitutively activating BCKDH activity in adult cardiomyocytes. Functional and molecular characterizations showed E1α inactivation in cardiomyocytes was sufficient to induce loss of cardiac function, systolic chamber dilation and pathological transcriptome reprogramming. On the other hand, inactivation of BCKDK in intact heart does not have an impact on baseline cardiac function or cardiac dysfunction under pressure overload. Our results for the first time established the cardiomyocyte cell autonomous role of BCAA catabolism in cardiac physiology. These mouse lines will serve as valuable model systems to investigate the underlying mechanisms of BCAA catabolic defect induced heart failure and to provide potential insights for BCAA targeted therapy.


Assuntos
Diabetes Mellitus , Insuficiência Cardíaca , Camundongos , Animais , Miócitos Cardíacos/metabolismo , Insuficiência Cardíaca/metabolismo , Obesidade/metabolismo , Aminoácidos de Cadeia Ramificada/metabolismo , Aminoácidos de Cadeia Ramificada/uso terapêutico
3.
J Clin Microbiol ; 58(1)2019 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-31619531

RESUMO

Metagenomic sequencing for infectious disease diagnostics is an important tool that holds promise for use in the clinical laboratory. Challenges for implementation so far include high cost, the length of time to results, and the need for technical and bioinformatics expertise. However, the recent technological innovation of nanopore sequencing from Oxford Nanopore Technologies (ONT) has the potential to address these challenges. ONT sequencing is an attractive platform for clinical laboratories to adopt due to its low cost, rapid turnaround time, and user-friendly bioinformatics pipelines. However, this method still faces the problem of base-calling accuracy compared to other platforms. This review highlights the general challenges of pathogen detection in clinical specimens by metagenomic sequencing, the advantages and disadvantages of the ONT platform, and how research to date supports the potential future use of nanopore sequencing in infectious disease diagnostics.


Assuntos
Serviços de Laboratório Clínico , Técnicas de Laboratório Clínico , Doenças Transmissíveis/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala , Sequenciamento por Nanoporos , Serviços de Laboratório Clínico/normas , Doenças Transmissíveis/etiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Sequenciamento de Nucleotídeos em Larga Escala/normas , Humanos , Sequenciamento por Nanoporos/métodos , Sequenciamento por Nanoporos/normas
4.
Arch Virol ; 163(12): 3235-3242, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30128612

RESUMO

Wild waterfowl are maintenance hosts of most influenza A virus (IAV) subtypes and are often the subjects of IAV surveillance and transmission models. While maternal antibodies have been detected in yolks and in nestlings for a variety of wild bird species and pathogens, the persistence of maternal antibodies to IAVs in mallard ducklings (Anas platyrhynchos) has not been previously investigated. Nonetheless, this information is important for a full understanding of IAV transmission dynamics because ducklings protected by maternal antibodies may not be susceptible to infection. In this study, we examined the transfer of IAV-specific maternal antibodies to ducklings. Blood samples were collected approximately every five days from ducklings hatched from hens previously infected with an H6 strain of IAV. Serum samples were tested for antibodies to IAV by an enzyme-linked immunosorbent assay. The median persistence of maternal antibodies in ducklings was 12.5 days (range: 4-33 days) post-hatch. The majority of ducklings (71%) had detectable maternal antibodies from 4 to 17 days post-hatch, while a small subset of individuals (29%) had detectable maternal antibodies for up to 21-33 days post-hatch. Antibody concentrations in hens near the time of egg laying were correlated with maternal antibody concentrations in the initial blood sample collected from ducklings (0-4 days post-hatch). Knowledge of the duration of maternal antibodies in ducklings will aid in the interpretation of IAV serological surveillance results and in the modeling of IAV transmission dynamics in waterfowl.


Assuntos
Anticorpos Antivirais/sangue , Vírus da Influenza A/imunologia , Influenza Aviária/virologia , Animais , Animais Selvagens/imunologia , Animais Selvagens/virologia , Patos , Feminino , Vírus da Influenza A/genética , Influenza Aviária/sangue , Masculino , Troca Materno-Fetal , Gravidez
5.
J Bacteriol ; 199(21)2017 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-28784817

RESUMO

Hemolysins are important virulence factors for many bacterial pathogens, including Serratia marcescens The role of the major hemolysin gene in the insect pathogen Serratia sp. strain SCBI was investigated using both forward and reverse-genetics approaches. Introduction of the major hemolysin gene into Escherichia coli resulted in a gain of both virulence and hemolytic activity. Inactivation of this hemolysin in Serratia sp. SCBI resulted in a loss of hemolysis but did not attenuate insecticidal activity. Unexpectedly, inactivation of the hemolysin gene in Serratia sp. SCBI resulted in significantly increased motility and increased antimicrobial activity. Reverse transcription-quantitative PCR (qRT-PCR) analysis of mutants with a disrupted hemolysin gene showed a dramatic increase in mRNA levels of a nonribosomal peptide synthetase gene, swrA, which produces the surfactant serrawettin W2. Mutation of the swrA gene in Serratia sp. SCBI resulted in highly varied antibiotic activity, motility, virulence, and hemolysis phenotypes that were dependent on the site of disruption within this 17.75-kb gene. When introduced into E. coli, swrA increases rates of motility and confers antimicrobial activity. While it is unclear how inactivation of the major hemolysin gene influences the expression of swrA, these results suggest that swrA plays an important role in motility and antimicrobial activity in Serratia sp. SCBI.IMPORTANCE The opportunistic Gram-negative bacteria of the genus Serratia are widespread in the environment and can cause human illness. A comparative genomics analysis between Serratia marcescens and a new Serratia species from South Africa, termed Serratia sp. strain SCBI, shows that these two organisms are closely related but differ in pathogenesis. S. marcescens kills Caenorhabditis nematodes, while Serratia sp. SCBI is not harmful and forms a beneficial association with them. This distinction presented the opportunity to investigate potential differences in regulation of common virulence mechanisms between these two species. With the emergence of antibiotic-resistant microorganisms, there is a widespread need to understand the regulation of pathogenesis. The significance of this study is the presentation of evidence for cross-pathway regulation of virulence factors and how the elimination of one mechanism may be compensated for by the upregulation of others.


Assuntos
Regulação Bacteriana da Expressão Gênica , Inativação Gênica , Proteínas Hemolisinas/genética , Proteínas Hemolisinas/metabolismo , Peptídeo Sintases/biossíntese , Serratia/genética , Serratia/metabolismo , Animais , Anti-Infecciosos/metabolismo , Clonagem Molecular , Escherichia coli/genética , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/metabolismo , Expressão Gênica , Perfilação da Expressão Gênica , Insetos/microbiologia , Insetos/fisiologia , Locomoção , Peptídeo Sintases/genética , RNA Mensageiro/análise , Reação em Cadeia da Polimerase em Tempo Real , Serratia/enzimologia , Serratia/patogenicidade , Análise de Sobrevida , Virulência
6.
J Bacteriol ; 196(22): 3923-36, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25182493

RESUMO

A newly recognized Serratia species, termed South African Caenorhabditis briggsae isolate (SCBI), is both a mutualist of the nematode Caenorhabditis briggsae KT0001 and a pathogen of lepidopteran insects. Serratia sp. strain SCBI displays high proteolytic activity, and because secreted proteases are known virulence factors for many pathogens, the purpose of this study was to identify genes essential for extracellular protease activity in Serratia sp. strain SCBI and to determine what role proteases play in insect pathogenesis and cytotoxicity. A bank of 2,100 transposon mutants was generated, and six SCBI mutants with defective proteolytic activity were identified. These mutants were also defective in cytotoxicity. The mutants were found defective in genes encoding the following proteins: alkaline metalloprotease secretion protein AprE, a BglB family transcriptional antiterminator, an inosine/xanthosine triphosphatase, GidA, a methyl-accepting chemotaxis protein, and a PIN domain protein. Gene expression analysis on these six mutants showed significant downregulation in mRNA levels of several different types of predicted protease genes. In addition, transcriptome sequencing (RNA-seq) analysis provided insight into how inactivation of AprE, GidA, and a PIN domain protein influences motility and virulence, as well as protease activity. Using quantitative reverse transcription-PCR (qRT-PCR) to further characterize expression of predicted protease genes in wild-type Serratia sp. SCBI, the highest mRNA levels for the alkaline metalloprotease genes (termed prtA1 to prtA4) occurred following the death of an insect host, while two serine protease and two metalloprotease genes had their highest mRNA levels during active infection. Overall, these results indicate that proteolytic activity is essential for cytotoxicity in Serratia sp. SCBI and that its regulation appears to be highly complex.


Assuntos
Peptídeo Hidrolases/metabolismo , Serratia/enzimologia , Animais , Caenorhabditis elegans/microbiologia , Linhagem Celular , Chlorocebus aethiops , Regulação para Baixo , Regulação Bacteriana da Expressão Gênica/fisiologia , Regulação Enzimológica da Expressão Gênica , Genoma Bacteriano , Larva/microbiologia , Lepidópteros/microbiologia , Mutação , Peptídeo Hidrolases/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Rodopsinas Microbianas/genética , Rodopsinas Microbianas/metabolismo , Serratia/classificação , Serratia/genética , Serratia/patogenicidade , Regulação para Cima , Virulência
8.
Can J Microbiol ; 59(9): 627-40, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24011346

RESUMO

Found widespread around the globe, Serratia are Gram-negative bacteria capable of thriving in a diverse number of environments that include water, soil, and the digestive tracts of various animals. Known for their ability to produce a myriad of extracellular enzymes, these bacteria also produce various secondary metabolites that directly contribute to their survival. While the effects Serratia species have on other organisms range from parasitic to symbiotic, what these bacteria have in common is their ability to resist attack, respond appropriately to environmental conditions, and outcompete other microorganisms when colonizing their respective niche. This review highlights the mechanisms utilized by Serratia species that drive their ubiquitous nature, with emphasis on the latest findings. Also discussed is how secreted compounds drive these bacteria towards pathogenic, mutualistic, and antagonistic associations.


Assuntos
Serratia/fisiologia , Animais , Humanos , Invertebrados/microbiologia , Plantas/microbiologia , Serratia/química , Serratia/enzimologia , Infecções por Serratia/microbiologia , Simbiose
9.
Appl Environ Microbiol ; 78(24): 8840-4, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23042169

RESUMO

The physiology of a newly recognized Serratia species, termed South African Caenorhabditis briggsae Isolate (SCBI), which is both a nematode mutualist and an insect pathogen, was investigated and compared to that of Serratia marcescens Db11, a broad-host-range pathogen. The two Serratia strains had comparable levels of virulence for Manduca sexta and similar cytotoxic activity patterns, but motility and lipase and hemolytic activities differed significantly between them.


Assuntos
Manduca/microbiologia , Serratia/fisiologia , Serratia/efeitos da radiação , Animais , Caenorhabditis/microbiologia , Hemólise/efeitos da radiação , Lipase/metabolismo , Locomoção/efeitos da radiação , Serratia/isolamento & purificação , Serratia/patogenicidade , Temperatura , Virulência
10.
Biomed Res Int ; 2022: 7440189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36246963

RESUMO

GIMAPs are recognized as an important regulator in the carcinogenesis and development of lung cancer, but the function of GIMAP4 in the tumor microenvironment (TME) of lung cancers is unclear. In this study, we investigated the expression and variation of GIMAP4 in lung adenocarcinoma (LUAD), to explore its association with infiltration of immune cells. The Cancer Genome Atlas (TCGA) data and Gene Expression Omnibus (GEO) data were analyzed. Infiltration of immune cells was identified with TIMER (Tumor Immune Estimation Resource) and TISIDB (an integrated repository portal for tumor-immune system interactions). GIMAP4 expression declined in non-small-cell lung cancer (NSCLC), correlated with a poor overall survival (OS) in LUAD, indicating that GIMAP4 was a promising prognostic biomarker in LUAD. GIMAP4 mutation frequency was 1.76% in TCGA cohort and was relevant to the expression of immune components. TIMER and CIBERSORT analysis further confirmed that high GIMAP4 expression possibly promoted immune cell infiltration into the TME, with low GIMAP4 impairing the efficacy of immunotherapies targeting common immune check point inhibitors (ICI). GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) analyses were performed to provide insights into biological processes involved in LUAD. GIMAP4 was expected to be a prognostic biomarker in LUAD and provides potential adjuvant or neoadjuvant therapeutic strategies for targeting ICIs.


Assuntos
Adenocarcinoma de Pulmão , Carcinoma Pulmonar de Células não Pequenas , Proteínas de Ligação ao GTP , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/patologia , Biomarcadores , Proteínas de Ligação ao GTP/metabolismo , Humanos , Neoplasias Pulmonares/patologia , Prognóstico , Microambiente Tumoral/genética
11.
Clin Lab Med ; 40(1): 83-92, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32008642

RESUMO

The number of companies offering direct-to-consumer genetic tests is increasing. There is growing concern over whether direct-to-consumer genetic companies should be allowed to offer clinically relevant testing that has only been possible under medical care. Direct-to-consumer genetic testing can be incomplete, inaccurate, and inappropriate. The usefulness of such testing is extremely limited and it is unclear how well customers understand reported results. Research on the long-term impact of direct-to-consumer genetic testing is necessary to determine if stricter regulations regarding the performance of direct-to-consumer genetic testing are necessary.


Assuntos
Triagem e Testes Direto ao Consumidor , Testes Genéticos , Humanos , Neoplasias/diagnóstico , Neoplasias/genética
12.
Biochim Biophys Acta Mol Basis Dis ; 1866(11): 165890, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32599143

RESUMO

Disruptions of the circadian rhythm and reduced circulating levels of the circadian hormone melatonin predispose to ischemic stroke. Although the nuclear receptor RORα is considered as a circadian rhythm regulator and a mediator of certain melatonin effects, its potential role in cerebral ischemia-reperfusion (CI/R) injury and in the neuroprotective effects of melatonin remain undefined. Here, we observed that CI/R injury in RORα-deficient mice was associated with greater cerebral infarct size, brain edema, and cerebral apoptosis compared with wild-type model. In contrast, transgenic mice with brain-specific overexpression of RORα versus non-transgenic controls exerted significantly reduced infarct volume, brain edema and apoptotic response induced by CI/R. Mechanistically, RORα deficiency was found to exacerbate apoptosis pathways mediated by endoplasmic-reticulum stress and mitochondria and aggravate oxidative/nitrative stress after CI/R. Further studies revealed that RORα deficiency intensified the activation of nuclear factor-κB signaling induced by CI/R. Given the emerging evidence of RORα as an essential melatonin activity mediator, we further investigated the RORα roles in melatonin-exerted neuroprotection against acute ischemic stroke. Melatonin treatment significantly decreased infarct volume and cerebral apoptosis; mitigated endoplasmic reticulum stress and mitochondrial dysfunction; and inhibited CI/R injury-induced oxidative/nitrative stress and nuclear factor-κB activation, which was eradicated in RORα-deficient mice. Collectively, current findings suggest that RORα is a novel endogenous neuroprotective receptor, and a pivotal mediator of melatonin's suppressive effects against CI/R injury.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/metabolismo , Melatonina/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Membro 1 do Grupo F da Subfamília 1 de Receptores Nucleares/metabolismo , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo , Animais , Antioxidantes/metabolismo , Apoptose/efeitos dos fármacos , Isquemia Encefálica/genética , Infarto Cerebral/tratamento farmacológico , Infarto Cerebral/genética , Infarto Cerebral/metabolismo , Ritmo Circadiano/efeitos dos fármacos , Ritmo Circadiano/genética , Modelos Animais de Doenças , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Masculino , Camundongos , Camundongos Transgênicos , Membro 1 do Grupo F da Subfamília 1 de Receptores Nucleares/genética , Estresse Oxidativo/efeitos dos fármacos , Traumatismo por Reperfusão/genética , Transdução de Sinais/efeitos dos fármacos
13.
Nat Commun ; 10(1): 5029, 2019 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-31695033

RESUMO

The 16S rRNA gene has been a mainstay of sequence-based bacterial analysis for decades. However, high-throughput sequencing of the full gene has only recently become a realistic prospect. Here, we use in silico and sequence-based experiments to critically re-evaluate the potential of the 16S gene to provide taxonomic resolution at species and strain level. We demonstrate that targeting of 16S variable regions with short-read sequencing platforms cannot achieve the taxonomic resolution afforded by sequencing the entire (~1500 bp) gene. We further demonstrate that full-length sequencing platforms are sufficiently accurate to resolve subtle nucleotide substitutions (but not insertions/deletions) that exist between intragenomic copies of the 16S gene. In consequence, we argue that modern analysis approaches must necessarily account for intragenomic variation between 16S gene copies. In particular, we demonstrate that appropriate treatment of full-length 16S intragenomic copy variants has the potential to provide taxonomic resolution of bacterial communities at species and strain level.


Assuntos
Bactérias/classificação , Bactérias/genética , Variação Genética , Microbiota/genética , Filogenia , RNA Ribossômico 16S/genética , Bactérias/isolamento & purificação , Técnicas Bacteriológicas , Sequência de Bases , Biologia Computacional , Simulação por Computador , DNA Bacteriano/genética , Fezes/microbiologia , Dosagem de Genes , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Polimorfismo Genético , Análise de Sequência de DNA
14.
Microbiome ; 5(1): 98, 2017 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-28797298

RESUMO

BACKGROUND: Changes in diet and exercise can alter the gut microbiome of humans and mice; however, few studies to date have assessed the microbiomes of highly fit athletes. In this pilot study, we used metagenomic whole genome shotgun (mWGS) and metatranscriptomic (RNA-Seq) sequencing to show what organisms are both present and active in the gut microbiomes of both professional and amateur level competitive cyclists and to determine if any significant differences exist between these two groups. RESULTS: Using mWGS sequencing data, we showed that the gut microbiomes of 33 cyclists split into three taxonomic clusters, characterized by either high Prevotella, high Bacteroides or a mix of many genera including Bacteroides, Prevotella, Eubacterium, Ruminococcus, and Akkermansia. While no significant correlations could be found between taxonomic cluster and being either a professional or amateur level cyclist, high abundance of the genus Prevotella (≥2.5%) was significantly correlated with time reported exercising during an average week. Increased abundance of Prevotella was correlated with a number of amino acid and carbohydrate metabolism pathways, including branched chain amino acid metabolism. Further analysis of the metatranscriptome revealed significant taxonomic differences when compared to the metagenome. There was increased abundance of Methanobrevibacter smithii transcripts in a number of professional cyclists in comparison to amateur cyclists and this archaeon had upregulation of genes involved in the production of methane. Furthermore, when methane metabolism was upregulated, there was similar upregulation of energy and carbohydrate metabolism pathways. CONCLUSIONS: These results provide a framework for common constituents of the gut community in individuals who follow an exercise-rich lifestyle. These data also suggest how certain organisms such as M. smithii may beneficially influence the metabolic efficiency of the gut community in professional cyclists due to synergistic metabolic cross-feeding events.


Assuntos
Atletas , Bactérias/genética , Bactérias/isolamento & purificação , Ciclismo , Microbioma Gastrointestinal , Metano/metabolismo , Adulto , Bactérias/classificação , Bacteroides/genética , Bacteroides/isolamento & purificação , Metabolismo dos Carboidratos/genética , Dieta , Exercício Físico , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Estilo de Vida , Masculino , Redes e Vias Metabólicas/genética , Metagenoma , Metagenômica , Pessoa de Meia-Idade , Projetos Piloto , Prevotella/genética , Prevotella/isolamento & purificação
16.
Int J Med Inform ; 73(9-10): 687-94, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15325325

RESUMO

PURPOSE: The web, a widely accessed medium for patients to obtain health information, has special relevance for patients with diabetes. This paper critiques the publicly available web sites for diabetes, and it establishes criteria for excellence in these sites. METHODS: A web search for diabetes mellitus based on Google, Yahoo, and the directory Mendosa provided the basis for the study. We defined and evaluated three major categories for each site: usability, content, and reliability. Usability was defined by design, ease of navigation, interactivity, and internal search capability. Content was based on the quality of general information about diabetes, discussions about monitoring blood glucose, meal planning, exercise, complications, medications, alternative therapies, resources, and support systems. Reliability was defined by the presence of the HON code, identification of an author, and the availability of experts. RESULTS: The focused Mendosa search produced 47 web sites. The majority were published by commercial organizations. Five sites were found to have the best usability. Other sites were cluttered or inundated with distracting information from advertisements. Content was generally excellent but limited by an absence of specific advice and information about controlling associated risk factors for cardiovascular disease. Only 17% of sites met all criteria for reliability. The sites that best met the criteria for quality were the American Diabetes Association (www.diabetes.org) and the Joslin Diabetes Center (www.joslin.org). CONCLUSIONS: Despite the large numbers of publicly available web sites for diabetes, only a few met criteria for quality. The physician's input and ongoing evaluation of these quality measures are essential to assure that patients get meaningful and relevant information from the web about managing diabetes.


Assuntos
Diabetes Mellitus , Serviços de Informação , Internet/normas , Educação de Pacientes como Assunto , Humanos , Relações Médico-Paciente , Controle de Qualidade
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