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1.
Proc Natl Acad Sci U S A ; 120(23): e2220678120, 2023 06 06.
Artículo en Inglés | MEDLINE | ID: mdl-37252966

RESUMEN

Global change has converted many structurally complex and ecologically and economically valuable coastlines to bare substrate. In the structural habitats that remain, climate-tolerant and opportunistic species are increasing in response to environmental extremes and variability. The shifting of dominant foundation species identity with climate change poses a unique conservation challenge because species vary in their responses to environmental stressors and to management. Here, we combine 35 y of watershed modeling and biogeochemical water quality data with species comprehensive aerial surveys to describe causes and consequences of turnover in seagrass foundation species across 26,000 ha of habitat in the Chesapeake Bay. Repeated marine heatwaves have caused 54% retraction of the formerly dominant eelgrass (Zostera marina) since 1991, allowing 171% expansion of the temperature-tolerant widgeongrass (Ruppia maritima) that has likewise benefited from large-scale nutrient reductions. However, this phase shift in dominant seagrass identity now presents two significant shifts for management: Widgeongrass meadows are not only responsible for rapid, extensive recoveries but also for the largest crashes over the last four decades; and, while adapted to high temperatures, are much more susceptible than eelgrass to nutrient pulses driven by springtime runoff. Thus, by selecting for rapid post-disturbance recolonization but low resistance to punctuated freshwater flow disturbance, climate change could threaten the Chesapeake Bay seagrass' ability to provide consistent fishery habitat and sustain functioning over time. We demonstrate that understanding the dynamics of the next generation of foundation species is a critical management priority, because shifts from relatively stable habitat to high interannual variability can have far-reaching consequences across marine and terrestrial ecosystems.


Asunto(s)
Alismatales , Zosteraceae , Alismatales/fisiología , Ecosistema , Cambio Climático , Bahías
2.
J Med Vasc ; 47(5-6): 256-258, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36464421

RESUMEN

Uretero-Iliac artery fistula (UIAF) is a rare condition in vascular surgery, its prognosis remains poor with a high mortality, requires rapid multidisciplinary diagnosis and treatment. We report the case of an uretero-Iliac artery fistula in a 65-year-old patient who underwent total pelvectomy with trans-ileal cutaneous ureterostomy (Bricker), followed by pelvic radiotherapy, and placement of a single J ureteral stent, diagnosed by abdominal and pelvic CT, and treated by endovascular approach.


Asunto(s)
Procedimientos Endovasculares , Fístula , Humanos , Anciano , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/cirugía , Pelvis , Stents
3.
Nat Commun ; 13(1): 4450, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35915108

RESUMEN

Anti-cancer therapies often exhibit only short-term effects. Tumors typically develop drug resistance causing relapses that might be tackled with drug combinations. Identification of the right combination is challenging and would benefit from high-content, high-throughput combinatorial screens directly on patient biopsies. However, such screens require a large amount of material, normally not available from patients. To address these challenges, we present a scalable microfluidic workflow, called Combi-Seq, to screen hundreds of drug combinations in picoliter-size droplets using transcriptome changes as a readout for drug effects. We devise a deterministic combinatorial DNA barcoding approach to encode treatment conditions, enabling the gene expression-based readout of drug effects in a highly multiplexed fashion. We apply Combi-Seq to screen the effect of 420 drug combinations on the transcriptome of K562 cells using only ~250 single cell droplets per condition, to successfully predict synergistic and antagonistic drug pairs, as well as their pathway activities.


Asunto(s)
Perfilación de la Expresión Génica , Transcriptoma , Combinación de Medicamentos , Humanos , Células K562 , Microfluídica
4.
J Environ Manage ; 321: 115901, 2022 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-35998533

RESUMEN

Synthesizing large, complex data sets to inform resource managers towards effective environmental stewardship is a universal challenge. In Chesapeake Bay, a well-studied and intensively monitored estuary in North America, the challenge of synthesizing data on water quality and land use as factors related to a key habitat, submerged aquatic vegetation, was tackled by a team of scientists and resource managers operating at multiple levels of governance (state, federal). The synthesis effort took place over a two-year period (2016-2018), and the results were communicated widely to a) scientists via peer review publications and conference presentations; b) resource managers via web materials and workshop presentations; and c) the public through newspaper articles, radio interviews, and podcasts. The synthesis effort was initiated by resource managers at the United States Environmental Protection Agencys' Chesapeake Bay Program and 16 scientist participants were recruited from a diversity of organizations. Multiple short, immersive workshops were conducted regularly to conceptualize the problem, followed by data analysis and interpretation that supported the preparation of the synthetic products that were communicated widely. Reflections on the process indicate that there are a variety of structural and functional requirements, as well as enabling conditions, that need to be considered to achieve successful outcomes from synthesis efforts.


Asunto(s)
Bahías , Monitoreo del Ambiente , Conservación de los Recursos Naturales/métodos , Ecosistema , Monitoreo del Ambiente/métodos , Humanos , Estados Unidos , Calidad del Agua
5.
Proc Natl Acad Sci U S A ; 118(28)2021 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-34244443

RESUMEN

Single-stranded DNA phages of the family Microviridae have fundamentally different evolutionary origins and dynamics than the more frequently studied double-stranded DNA phages. Despite their small size (around 5 kb), which imposes extreme constraints on genomic innovation, they have adapted to become prominent members of viromes in numerous ecosystems and hold a dominant position among viruses in the human gut. We show that multiple, divergent lineages in the family Microviridae have independently become capable of lysogenizing hosts and have convergently developed hypervariable regions in their DNA pilot protein, which is responsible for injecting the phage genome into the host. By creating microviruses with combinations of genomic segments from different phages and infecting Escherichia coli as a model system, we demonstrate that this hypervariable region confers the ability of temperate Microviridae to prevent DNA injection and infection by other microviruses. The DNA pilot protein is present in most microviruses, but has been recruited repeatedly into this additional role as microviruses altered their lifestyle by evolving the ability to integrate in bacterial genomes, which linked their survival to that of their hosts. Our results emphasize that competition between viruses is a considerable and often overlooked source of selective pressure, and by producing similar evolutionary outcomes in distinct lineages, it underlies the prevalence of hypervariable regions in the genomes of microviruses and perhaps beyond.


Asunto(s)
Microvirus/fisiología , Sobreinfección/virología , Proteínas Virales/química , ADN Viral/metabolismo , Escherichia coli/virología , Inmunidad , Filogenia , Profagos/fisiología , Sobreinfección/inmunología
6.
Rev Sci Instrum ; 92(2): 025107, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33648050

RESUMEN

The design and performance of a room temperature electrical substitution radiometer for use as an absolute standard for measuring continuous-wave laser power over a wide range of wavelengths, beam diameters, and powers are described. The standard achieves an accuracy of 0.46% (k = 2) for powers from 10 mW to 100 mW and 0.83% (k = 2) for powers from 1 mW to 10 mW and can accommodate laser beam diameters (1/e2) up to 11 mm and wavelengths from 300 nm to 2 µm. At low power levels, the uncertainty is dominated by sensitivity to fluctuations in the thermal environment. The core of the instrument is a planar, silicon microfabricated bolometer with vertically aligned carbon nanotube absorbers, commercial surface mount thermistors, and an integrated heater. Where possible, commercial electronics and components were used. The performance was validated by comparing it to a National Institute of Standards and Technology primary standard through a transfer standard silicon trap detector and by comparing it to the legacy "C-series" standards in operation at the U.S. Air Force Metrology and Calibration Division (AFMETCAL).

7.
Proc Natl Acad Sci U S A ; 115(14): 3658-3662, 2018 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-29507225

RESUMEN

Humans strongly impact the dynamics of coastal systems, yet surprisingly few studies mechanistically link management of anthropogenic stressors and successful restoration of nearshore habitats over large spatial and temporal scales. Such examples are sorely needed to ensure the success of ecosystem restoration efforts worldwide. Here, we unite 30 consecutive years of watershed modeling, biogeochemical data, and comprehensive aerial surveys of Chesapeake Bay, United States to quantify the cascading effects of anthropogenic impacts on submersed aquatic vegetation (SAV), an ecologically and economically valuable habitat. We employ structural equation models to link land use change to higher nutrient loads, which in turn reduce SAV cover through multiple, independent pathways. We also show through our models that high biodiversity of SAV consistently promotes cover, an unexpected finding that corroborates emerging evidence from other terrestrial and marine systems. Due to sustained management actions that have reduced nitrogen concentrations in Chesapeake Bay by 23% since 1984, SAV has regained 17,000 ha to achieve its highest cover in almost half a century. Our study empirically demonstrates that nutrient reductions and biodiversity conservation are effective strategies to aid the successful recovery of degraded systems at regional scales, a finding which is highly relevant to the utility of environmental management programs worldwide.


Asunto(s)
Conservación de los Recursos Naturales/métodos , Ecosistema , Eutrofización , Alimentos , Fitoplancton/crecimiento & desarrollo , Contaminantes Químicos del Agua/análisis , Biodiversidad , Monitoreo del Ambiente , Estuarios , Maryland , Contaminación del Agua/prevención & control
8.
J Biomech Eng ; 138(1)2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26594023

RESUMEN

Accurate hip joint center (HJC) location is critical when studying hip joint biomechanics. The HJC is often determined from anatomical methods, but functional methods are becoming increasingly popular. Several studies have examined these methods using simulations and in vivo gait data, but none has studied high-range of motion activities, such a chair rise, nor has HJC prediction been compared between males and females. Furthermore, anterior superior iliac spine (ASIS) marker visibility during chair rise can be problematic, requiring a sacral cluster as an alternative proximal segment; but functional HJC has not been explored using this approach. For this study, the quality of HJC measurement was based on the joint gap error (JGE), which is the difference in global HJC between proximal and distal reference segments. The aims of the present study were to: (1) determine if JGE varies between pelvic and sacral referenced HJC for functional and anatomical methods, (2) investigate which functional calibration motion results in the lowest JGE and if the JGE varies depending on movement type (gait versus chair rise) and gender, and (3) assess whether the functional HJC calibration results in lower JGE than commonly used anatomical approaches and if it varies with movement type and gender. Data were collected on 39 healthy adults (19 males and 20 females) aged 14-50 yr old. Participants performed four hip "calibration" tests (arc, cross, star, and star-arc), as well as gait and chair rise (activities of daily living (ADL)). Two common anatomical methods were used to estimate HJC and were compared to HJC computed using a published functional method with the calibration motions above, when using pelvis or sacral cluster as the proximal reference. For ADL trials, functional methods resulted in lower JGE (12-19 mm) compared to anatomical methods (13-34 mm). It was also found that women had significantly higher JGE compared to men and JGE was significantly higher for chair rise compared to gait, across all methods. JGE for sacrum referenced HJC was consistently higher than for the pelvis, but only by 2.5 mm. The results indicate that dynamic hip range of movement and gender are significant factors in HJC quality. The findings also suggest that a rigid sacral cluster for HJC estimation is an acceptable alternative for relying solely on traditional pelvis markers.


Asunto(s)
Articulación de la Cadera/anatomía & histología , Articulación de la Cadera/fisiología , Fenómenos Mecánicos , Movimiento , Adolescente , Adulto , Fenómenos Biomecánicos , Calibración , Femenino , Marcha , Humanos , Masculino , Persona de Mediana Edad , Postura , Estándares de Referencia , Adulto Joven
9.
Anal Chem ; 87(11): 5640-8, 2015 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-25921700

RESUMEN

Microarray-based binding assays facilitate the discovery of protein ligands from large collections of small molecules. Hundreds of ligands can be identified, yet only a small portion of them have interfering effects (competitive or noncompetitive) on a specific protein-receptor binding reaction. Further efficient screening of ligands for those with specific modifying effect is needed in order to take the full advantage of throughputs of microarray-based assays for drug discovery. We report a label-free "microarray-in-microplate" assay platform for simultaneous acquisition of at least 32 dose-response curves in a single experiment, each curve having 12 concentration points. When combined with ligand discovery, this makes the microarray-based platform a true high-throughout means of finding inhibitors to specific protein-receptor reactions starting from a large collection of small-molecule libraries.


Asunto(s)
Bioensayo/métodos , Relación Dosis-Respuesta a Droga , Análisis por Micromatrices/instrumentación , Proteínas Inmovilizadas , Ligandos , Coloración y Etiquetado
10.
J Immunol Methods ; 417: 86-96, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25536073

RESUMEN

Monoclonal antibodies (mAbs) are major reagents for research and clinical diagnosis. For their inherently high specificities to intended antigen targets and thus low toxicity in general, they are pursued as one of the major classes of new drugs. Yet binding properties of most monoclonal antibodies are not well characterized in terms of affinity constants and how they vary with presentations and/or conformational isomers of antigens, buffer compositions, and temperature. We here report a microarray-based label-free assay platform for high-throughput measurements of monoclonal antibody affinity constants to antigens immobilized on solid surfaces. Using this platform we measured affinity constants of over 1410 rabbit monoclonal antibodies and 46 mouse monoclonal antibodies to peptide targets that are immobilized through a terminal cysteine residue to a glass surface. The experimentally measured affinity constants vary from 10 pM to 200 pM with the median value at 66 pM. We compare the results obtained from the microarray-based platform with those from a benchmarking surface-plasmon-resonance-based (SPR) sensor (Biacore 3000).


Asunto(s)
Anticuerpos Monoclonales/inmunología , Afinidad de Anticuerpos/inmunología , Reacciones Antígeno-Anticuerpo/inmunología , Animales , Antígenos/inmunología , Ensayos Analíticos de Alto Rendimiento/métodos , Ratones , Análisis por Matrices de Proteínas/métodos , Conejos , Resonancia por Plasmón de Superficie
11.
Prev Med ; 66: 87-94, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24945693

RESUMEN

OBJECTIVES: To identify determinants of Bacillus Calmette-Guérin (BCG) vaccination among children born in Québec, Canada, in 1974, the last year of the systematic vaccination campaign. METHOD: A retrospective birth cohort was assembled in 2011 through probabilistic linkage of administrative databases (n=81,496). Potential determinants were documented from administrative databases and by interviewing a subset of subjects (n=1643) in 2012. Analyses were conducted among subjects with complete data, 71,658 (88%) birth cohort subjects and 1154 (70%) interviewed subjects, then redone using multiple imputation. Determinants of BCG vaccination during the organized vaccination program (in 1974), and after the program (1975 onwards) were assessed separately. Logistic regression with backward elimination was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Overall, 46% of subjects were BCG vaccinated, 43% during the program and 4% after it ended. BCG vaccination during the program was associated with parents' birthplace and urban or rural residence. BCG vaccination after the organized program was only related to ethnocultural origin of the child's grandparents. CONCLUSION: Different factors were related to vaccination within and after the organized program. Determinants of BCG vaccination in Québec, Canada, have never been studied and will be useful for future research and vaccination campaigns.


Asunto(s)
Vacuna BCG , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Niño , Emigrantes e Inmigrantes , Femenino , Humanos , Programas de Inmunización , Modelos Logísticos , Masculino , Oportunidad Relativa , Quebec , Estudios Retrospectivos , Factores Socioeconómicos , Adulto Joven
12.
Oncogene ; 33(47): 5450-6, 2014 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-24276239

RESUMEN

The DNA damage response (DDR) promotes genome integrity and serves as a cancer barrier in precancerous lesions but paradoxically may promote cancer survival. Genes that activate the DDR when dysregulated could function as useful biomarkers for outcome in cancer patients. Using a siRNA screen in human pancreatic cancer cells, we identified the CHD5 tumor suppressor as a gene, which, when silenced, activates the DDR. We evaluated the relationship of CHD5 expression with DDR activation in human pancreatic cancer cells and the association of CHD5 expression in 80 patients with resected pancreatic adenocarcinoma (PAC) by immunohistochemical analysis with clinical outcome. CHD5 depletion and low CHD5 expression in human pancreatic cancer cells lead to increased H2AX-Ser139 and CHK2-Thr68 phosphorylation and accumulation into nuclear foci. On Kaplan-Meier log-rank survival analysis, patients with low CHD5 expression had a median recurrence-free survival (RFS) of 5.3 vs 15.4 months for patients with high CHD5 expression (P=0.03). In 59 patients receiving adjuvant chemotherapy, low CHD5 expression was associated with decreased RFS (4.5 vs 16.3 months; P=0.001) and overall survival (OS) (7.2 vs 21.6 months; P=0.003). On multivariate Cox regression analysis, low CHD5 expression remained associated with worse OS (HR: 3.187 (95% CI: 1.49-6.81); P=0.003) in patients undergoing adjuvant chemotherapy. Thus, low CHD5 expression activates the DDR and predicts for worse OS in patients with resected PAC receiving adjuvant chemotherapy. Our findings support a model in which dysregulated expression of tumor suppressor genes that induce DDR activation can be utilized as biomarkers for poor outcome.


Asunto(s)
Adenocarcinoma/metabolismo , ADN Helicasas/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Neoplasias Pancreáticas/metabolismo , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adenocarcinoma/terapia , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Quimioterapia Adyuvante , Daño del ADN/efectos de los fármacos , ADN Helicasas/genética , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapéutico , Supervivencia sin Enfermedad , Femenino , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Genes Supresores de Tumor/efectos de los fármacos , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Proteínas del Tejido Nervioso/genética , Neoplasias Pancreáticas/mortalidad , Neoplasias Pancreáticas/cirugía , Neoplasias Pancreáticas/terapia , Pronóstico , Resultado del Tratamiento , Células Tumorales Cultivadas , Gemcitabina
13.
Oncogene ; 32(48): 5471-80, 2013 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-23708655

RESUMEN

The Lim Domain Only 2 (LMO2) leukaemia oncogene encodes an LIM domain transcriptional cofactor required for early haematopoiesis. During embryogenesis, LMO2 is also expressed in developing tail and limb buds, an expression pattern we now show to be recapitulated in transgenic mice by an enhancer in LMO2 intron 4. Limb bud expression depended on a cluster of HOX binding sites, while posterior tail expression required the HOX sites and two E-boxes. Given the importance of both LMO2 and HOX genes in acute leukaemias, we further demonstrated that the regulatory hierarchy of HOX control of LMO2 is activated in leukaemia mouse models as well as in patient samples. Moreover, Lmo2 knock-down impaired the growth of leukaemic cells, and high LMO2 expression at diagnosis correlated with poor survival in cytogenetically normal AML patients. Taken together, these results establish a regulatory hierarchy of HOX control of LMO2 in normal development, which can be resurrected during leukaemia development. Redeployment of embryonic regulatory hierarchies in an aberrant context is likely to be relevant in human pathologies beyond the specific example of ectopic activation of LMO2.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Regulación del Desarrollo de la Expresión Génica/genética , Genes Homeobox , Proteínas con Dominio LIM/genética , Mesodermo/metabolismo , Leucemia-Linfoma Linfoblástico de Células T Precursoras/embriología , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Proteínas Proto-Oncogénicas/genética , Proteínas Adaptadoras Transductoras de Señales/deficiencia , Animales , Secuencia de Bases , Línea Celular Tumoral , Proliferación Celular , Cromatina/genética , Secuencia Conservada , Elementos E-Box , Extremidades/embriología , Técnicas de Silenciamiento del Gen , Proteínas de Homeodominio/metabolismo , Humanos , Intrones/genética , Proteínas con Dominio LIM/deficiencia , Ratones , Datos de Secuencia Molecular , Fenotipo , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patología , Proteínas Proto-Oncogénicas/deficiencia , Activación Transcripcional/genética
14.
Genes Immun ; 14(2): 115-26, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23328844

RESUMEN

Transforming growth factor-ß (TGF-ß) maintains self-tolerance through a constitutive inhibitory effect on T-cell reactivity. In most physiological situations, the tolerogenic effects of TGF-ß depend on the canonical signaling molecule Smad3. To characterize how TGF-ß/Smad3 signaling contributes to maintenance of T-cell tolerance, we characterized the transcriptional landscape downstream of TGF-ß/Smad3 signaling in resting or activated CD4 T cells. We report that in the presence of TGF-ß, Smad3 modulates the expression of >400 transcripts. Notably, we identified 40 transcripts whose expression showed Smad3 dependence in both resting and activated cells. This 'signature' confirmed the non-redundant role of Smad3 in TGF-ß biology and identified both known and putative immunoregulatory genes. Moreover, we provide genomic and functional evidence that the TGF-ß/Smad3 pathway regulates T-cell activation and metabolism. In particular, we show that TGF-ß/Smad3 signaling dampens the effect of CD28 stimulation on T-cell growth and proliferation. The impact of TGF-ß/Smad3 signals on T-cell activation was similar to that of the mTOR inhibitor Rapamycin. Considering the importance of co-stimulation on the outcome of T-cell activation, we propose that TGF-ß-Smad3 signaling may maintain T-cell tolerance by suppressing co-stimulation-dependent mobilization of anabolic pathways.


Asunto(s)
Antígenos CD28/metabolismo , Linfocitos T CD4-Positivos/fisiología , Transducción de Señal , Proteína smad3/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Animales , Linfocitos T CD4-Positivos/metabolismo , Proliferación Celular , Inmunosupresores/farmacología , Activación de Linfocitos , Ratones , Ratones Noqueados , Sirolimus/farmacología , Proteína smad3/genética , Serina-Treonina Quinasas TOR/antagonistas & inhibidores
15.
Diabet Med ; 29(9): e263-72, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22672081

RESUMEN

AIMS: To test the hypothesis that initiation and intensification with 25% insulin lispro, 75% insulin lispro protamine suspension (LM25), is non-inferior to initiation and intensification with glargine + insulin lispro therapy on change from baseline in HbA(1c). METHODS: In this randomized, non-inferiority (margin of 0.4%), parallel, prospective, multi-country, 48-week, open-label study, patients (n = 426) with Type 2 diabetes inadequately controlled with oral anti-hyperglycaemic medications were assigned to either initiating therapy with one daily LM25 injection, progressing up to three daily injections (full analysis set n = 211; per protocol set n = 177) or initiating therapy with one daily glargine injection and progressing up to three daily insulin lispro injections (full analysis set n = 212; per protocol set n = 184). RESULTS: LM25 therapy was found to be non-inferior to glargine + insulin lispro therapy by study end (upper limit of 95% CI < 0.4), with a least-squares mean difference (95% CI) in HbA(1c) (LM25 minus glargine + insulin lispro) of -0.4 mmol/mol (95% CI -2.7 to 1.9); -0.04% (95% CI -0.25 to 0.17). No statistically significant differences between treatment groups were found in the percentage of patients achieving HbA(1c) targets or postprandial blood glucose levels. The increase in insulin dose, number of injections and weight change during the course of the study were similar in both groups. Patients in both groups experienced similar hypoglycaemia rates and safety profile. CONCLUSIONS: For patients with Type 2 diabetes inadequately controlled with oral anti-hyperglycaemic medications, glycaemic control when initiating and intensifying with LM25 therapy was found to be non-inferior to treatment with glargine + insulin lispro therapy.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina Lispro/uso terapéutico , Insulina de Acción Prolongada/uso terapéutico , Administración Oral , Anciano , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Inyecciones Subcutáneas , Insulina Glargina , Insulina Lispro/administración & dosificación , Insulina Lispro/efectos adversos , Insulina de Acción Prolongada/administración & dosificación , Insulina de Acción Prolongada/efectos adversos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento
16.
Chronic Dis Inj Can ; 33(1): 47-52, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23294921

RESUMEN

INTRODUCTION: Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses. METHODS: The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD. RESULTS: True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases. CONCLUSION: The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.


Asunto(s)
Displasia Broncopulmonar/clasificación , Displasia Broncopulmonar/diagnóstico , Bases de Datos Factuales/normas , Clasificación Internacional de Enfermedades , Puntaje de Apgar , Peso al Nacer , Recolección de Datos , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Edad Gestacional , Servicios de Salud/estadística & datos numéricos , Humanos , Recién Nacido , Masculino , Edad Materna , Readmisión del Paciente/estadística & datos numéricos , Nacimiento Prematuro/clasificación , Quebec , Estudios Retrospectivos , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
17.
Int J Clin Pract ; 64(11): 1520-1529, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20846199

RESUMEN

BACKGROUND: We conducted exploratory analyses of the data from a multinational, randomised study to identify factors associated with weight change after 16 weeks of treatment with standard olanzapine tablets (SOT) or sublingual orally disintegrating olanzapine (ODO). METHODS: One hundred and forty nine outpatients who gained weight during prior SOT therapy were enrolled into the study and treated with ODO (N = 84) or SOT (N = 65). Exploratory analyses were conducted with the subset of compliant patients (ODO: n = 60; SOT: n = 47). RESULTS: The decrease in the rate of weight gain at the end of study therapy (change from baseline) was greater in the ODO group than the SOT group (-0.59 kg/week vs. -0.38 kg/week, p = 0.0246). Age was negatively associated with weight change (p = 0.0203) in both treatment groups combined: patients gained 0.7 kg less for every 10 years of age. The least squares mean weight gain was lower with ODO than SOT in male patients (0.35 kg vs. 3.04 kg, p = 0.061), but not female patients and in American patients (0.55 kg vs. 6.21 kg, p < 0.0001), but not Canadian or Mexican patients. CONCLUSIONS: Although not conclusive, these data suggest that ODO may be a reasonable treatment option for some patients who gain weight with SOT. Further research is required to confirm these findings.


Asunto(s)
Antipsicóticos/administración & dosificación , Benzodiazepinas/administración & dosificación , Trastorno Bipolar/tratamiento farmacológico , Trastornos Psicóticos/tratamiento farmacológico , Aumento de Peso/efectos de los fármacos , Administración Oral , Adulto , Anciano , Análisis de Varianza , Índice de Masa Corporal , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Olanzapina , Distribución por Sexo , Comprimidos , Adulto Joven
18.
Oncogene ; 29(43): 5796-808, 2010 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-20676125

RESUMEN

The T-cell oncogene Lim-only 2 (LMO2) critically influences both normal and malignant haematopoiesis. LMO2 is not normally expressed in T cells, yet ectopic expression is seen in the majority of T-acute lymphoblastic leukaemia (T-ALL) patients with specific translocations involving LMO2 in only a subset of these patients. Ectopic lmo2 expression in thymocytes of transgenic mice causes T-ALL, and retroviral vector integration into the LMO2 locus was implicated in the development of clonal T-cell disease in patients undergoing gene therapy. Using array-based chromatin immunoprecipitation, we now demonstrate that in contrast to B-acute lymphoblastic leukaemia, human T-ALL samples largely use promoter elements with little influence from distal enhancers. Active LMO2 promoter elements in T-ALL included a previously unrecognized third promoter, which we demonstrate to be active in cell lines, primary T-ALL patients and transgenic mice. The ETS factors ERG and FLI1 previously implicated in lmo2-dependent mouse models of T-ALL bind to the novel LMO2 promoter in human T-ALL samples, while in return LMO2 binds to blood stem/progenitor enhancers in the FLI1 and ERG gene loci. Moreover, LMO2, ERG and FLI1 all regulate the +1 enhancer of HHEX/PRH, which was recently implicated as a key mediator of early progenitor expansion in LMO2-driven T-ALL. Our data therefore suggest that a self-sustaining triad of LMO2/ERG/FLI1 stabilizes the expression of important mediators of the leukaemic phenotype such as HHEX/PRH.


Asunto(s)
Proteínas de Unión al ADN/genética , Regulación Neoplásica de la Expresión Génica/genética , Metaloproteínas/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Regiones Promotoras Genéticas/genética , Proteínas Adaptadoras Transductoras de Señales , Animales , Inmunoprecipitación de Cromatina , Expresión Génica , Proteínas de Homeodominio/biosíntesis , Proteínas de Homeodominio/genética , Humanos , Proteínas con Dominio LIM , Ratones , Ratones Transgénicos , Análisis de Secuencia por Matrices de Oligonucleótidos , Proteína Proto-Oncogénica c-fli-1/genética , Proteínas Proto-Oncogénicas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transactivadores/genética , Factores de Transcripción/biosíntesis , Factores de Transcripción/genética , Transcripción Genética , Regulador Transcripcional ERG
19.
Ann Dermatol Venereol ; 136(11): 806-10, 2009 Nov.
Artículo en Francés | MEDLINE | ID: mdl-19917434

RESUMEN

BACKGROUND: The increasing use of anti-TNFalpha exposes patients to emerging risks, particularly that of infection. We report a case of severe cutaneous Mycobacterium marinum infection in a patient treated with infliximab and we discuss therapeutic options. PATIENTS AND METHODS: A man treated with infliximab for Crohn's disease developed a severe cutaneous infection with M. marinum. Despite withdrawal of infliximab and the introduction of triple antibiotic therapy, the patient's lesions worsened and surgical treatment was required. DISCUSSION: The worsening experienced by our patient 1 week after the beginning of the treatment is comparable with the immune reconstitution syndrome occasionally observed in tuberculosis in immunocompromised hosts, thus raising the question of the potential value of continuing infliximab treatment. Recommendations are needed concerning the prevention and treatment of M. marinum infections in patients on anti-TNFalpha biotherapies.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Enfermedad de Crohn/tratamiento farmacológico , Fármacos Gastrointestinales/uso terapéutico , Infecciones por Mycobacterium no Tuberculosas/inducido químicamente , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Antibacterianos/uso terapéutico , Anticuerpos Monoclonales/efectos adversos , Fármacos Gastrointestinales/efectos adversos , Humanos , Infliximab , Masculino , Persona de Mediana Edad , Infecciones por Mycobacterium no Tuberculosas/patología , Infecciones por Mycobacterium no Tuberculosas/cirugía , Mycobacterium marinum , Necrosis , Enfermedades Cutáneas Bacterianas/inducido químicamente , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/cirugía , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
20.
Anal Chem ; 81(13): 5373-80, 2009 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-19563213

RESUMEN

We explored two macromolecular scaffolds, bovine serum albumin (BSA) and polyvinyl alcohol (PVA), as chemically complementary platforms for immobilizing small molecule compounds on functionalized glass slides. We conjugated biotin molecules to BSA and amine-derivatized PVA and subsequently immobilized the conjugates on epoxy-functionalized glass slides through reaction of free amine residues on BSA and PVA with surface-bound epoxy groups. We studied binding reactions of such immobilized small molecule targets with solution-phase protein probes using an oblique-incidence reflectivity difference scanning optical microscope. The results showed that both BSA and amine-derivatized PVA were effective and efficient as carriers of small molecules with NHS residues and fluoric residues and for immobilization on epoxy-coated solid surfaces. A significant fraction of the conjugated small molecules retain their innate chemical activity.


Asunto(s)
Ligandos , Análisis por Matrices de Proteínas/métodos , Albúmina Sérica Bovina/química , Animales , Biotina/química , Biotina/inmunología , Bovinos , Fragmentos Fab de Inmunoglobulinas/química , Fragmentos Fab de Inmunoglobulinas/inmunología , Cinética , Alcohol Polivinílico/química , Unión Proteica
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