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5.
Forensic Sci Int ; 307: 110111, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31901460

RESUMEN

Cranial suture closure has been recognized for over a century as a useful trait for age estimation. Although this indicator has become a standard feature of age assessment protocols in skeletal remains, serious questions have been raised about its reliability. This article attempts to provide a comprehensive review of cranial suture closure as an age indicator from several perspectives, including its anatomy and history, as well as issues relating to validation, statistics, and the potential of technological advancements to improve outcomes. We further suggest a path forward for the use of cranial suture closure as an estimator of age. Although its unreliability has been widely reported, cranial suture closure still appears to have value as an aging method, and it is hoped that the information contained in this article can serve as a stepping stone toward more effective use of this indicator. The cranium is often more durable than other skeletal elements in both archaeological and forensic circumstances, so maximizing the effectiveness of cranial indicators is an important goal. It is hoped that recent advancements in technology and in analytical approaches to the cranial sutures could breathe some new life into this feature as an indicator of age.


Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Suturas Craneales/crecimiento & desarrollo , Suturas Craneales/diagnóstico por imagen , Antropología Forense/métodos , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Osteogénesis , Estadística como Asunto , Tomografía Computarizada por Rayos X
6.
JAMA ; 323(2): 192, 2020 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-31935016
7.
JAMA ; 323(2): 164-176, 2020 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-31935033

RESUMEN

Importance: US law requires testing of new drugs before approval to ensure that they provide a well-defined benefit that is commensurate with their risks. A major challenge for the US Food and Drug Administration (FDA) is to achieve an appropriate balance between rigorous testing and the need for timely approval of drugs that have benefits that outweigh their risks. Objective: To describe the evolution of laws and standards affecting drug testing, the use of new approval programs and standards, expansions of the role and authority of the FDA, and changes in the number of drugs approved from the 1980s to 2018. Evidence: Sources of evidence included principal federal laws and FDA regulations (1962-2018) and FDA databases of approved new drugs (1984-2018), generic drugs (1970-2018), biologics (1984-2018), and vaccines (1998-2018); special development and approval programs (Orphan drug [1984-2018], Fast-Track [1988-2018], Priority Review and its predecessors [1984-2018], Accelerated Approval [1992-2018], and Breakthrough Therapy [2012-2018]); expanded access (2010-2017) and Risk Evaluation and Mitigation Strategies (2008-2018); and user fees paid to the FDA by industry (1993-2018). Findings: From 1983 to 2018, legislation and regulatory initiatives have substantially changed drug approval at the FDA. The mean annual number of new drug approvals, including biologics, was 34 from 1990-1999, 25 from 2000-2009, and 41 from 2010-2018. New biologic product approvals increased from a median of 2.5 from 1990-1999, to 5 from 2000-2013, to 12 from 2014-2018. The median annual number of generic drugs approved was 136 from 1970 to the enactment of the Hatch-Waxman Act in 1984; 284 from 1985 to the enactment of the Generic Drug User Fee Act in 2012; and 588 from 2013-2018. Prescription drug user fee funding expanded from new drugs and biologics in 1992 to generic and biosimilar drugs in 2012. The amount of Prescription Drug User Fee Act fees collected from industry increased from an annual mean of $66 million in 1993-1997 to $820 million in 2013-2017, and in 2018, user fees accounted for approximately 80% of the salaries of review personnel responsible for the approval of new drugs. The proportion of drugs approved with an Orphan Drug Act designation increased from 18% (55/304) in 1984-1995, to 22% (82/379) in 1996-2007, to 41% (154/380) in 2008-2018. Use of Accelerated Approval, Fast-Track, and Priority Review for new drugs has increased over time, with 81% (48/59) of new drugs benefiting from at least 1 such expedited program in 2018. The proportion of new approvals supported by at least 2 pivotal trials decreased from 80.6% in 1995-1997 to 52.8% in 2015-2017, based on 124 and 106 approvals, respectively, while the median number of patients studied did not change significantly (774 vs 816). FDA drug review times declined from more than 3 years in 1983 to less than 1 year in 2017, but total time from the authorization of clinical testing to approval has remained at approximately 8 years over that period. Conclusions and Relevance: Over the last 4 decades, the approval and regulation processes for pharmaceutical agents have evolved and increased in complexity as special programs have been added and as the use of surrogate measures has been encouraged. The FDA funding needed to implement and manage these programs has been addressed by expanding industry-paid user fees. The FDA has increasingly accepted less data and more surrogate measures, and has shortened its review times.


Asunto(s)
Aprobación de Drogas/legislación & jurisprudencia , Regulación Gubernamental , Legislación de Medicamentos/tendencias , Preparaciones Farmacéuticas/normas , United States Food and Drug Administration , Aprobación de Drogas/economía , Aprobación de Drogas/estadística & datos numéricos , Historia del Siglo XX , Legislación de Medicamentos/historia , Estados Unidos
8.
Arch Pathol Lab Med ; 144(2): 133-135, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31990227

RESUMEN

• The Archives of Pathology & Laboratory Medicine was first published in 1926 as a specialty journal of the American Medical Association. It became the official journal of the College of American Pathologists in 1995. Under the dynamic leadership of its most recent editor-in-chief, Philip T. Cagle, MD, the Archives has dramatically increased its impact factor and become the most widely read general pathology journal. Dr. Cagle has consistently added leading pathologists to the editorial board, and the collective expertise of these individuals is clearly evident in new, cutting-edge journal masthead sections. The Archives has featured innovative content in the field of digital pathology, including articles on the utilization of smart phones in pathology and the incorporation of whole-slide images and videos into the content of articles. During the current editorial board's tenure, special sections were introduced and have proven immensely popular with the journal's readership. As the Archives celebrates its 94th anniversary, its editorial board remains committed to providing insightful and relevant medical knowledge. The journal's open access Web site ( www.archivesofpathology.org ) allows the dissemination of this information to every corner of the globe at no expense to those who wish to expand their knowledge or improve their medical practice. Dr. Cagle, with support from the editorial board and journal staff, has worked tirelessly during his tenure as Archives editor-in-chief to greatly enhance the content of the journal and its stature within pathology and laboratory medicine.


Asunto(s)
Políticas Editoriales , Ciencia del Laboratorio Clínico/historia , Patología Clínica/historia , Publicaciones Periódicas como Asunto/historia , Historia del Siglo XX , Historia del Siglo XXI , Factor de Impacto de la Revista , Ciencia del Laboratorio Clínico/métodos , Ciencia del Laboratorio Clínico/tendencias , Patología Clínica/métodos , Patología Clínica/tendencias , Publicaciones Periódicas como Asunto/normas , Publicaciones Periódicas como Asunto/tendencias
9.
JAMA ; 323(4): 382, 2020 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-31990302
10.
J Nurs Adm ; 50(2): 61-62, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31977942

RESUMEN

In this Inspiration Column, Pat Reid Ponte interviews Lisa J. Sundean, PhD, MHA, RN, associate professor, University of Massachusetts Boston. Dr Sundean has devoted her career to support the inclusion of nurses on boards.


Asunto(s)
Consejo Directivo/organización & administración , Rol de la Enfermera , Atención de Enfermería/organización & administración , Boston , Femenino , Historia del Siglo XX , Historia del Siglo XXI , Humanos
12.
JAMA ; 323(3): 285, 2020 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-31961407
14.
Zhonghua Wai Ke Za Zhi ; 58(1): 9-12, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31902162

RESUMEN

For more than one hundred years, the surgery and non-surgery around acute necrosis pancreatitis, early and late stage-operative surgery have been strive explored, and every change in treatment concept, technological progress and breakthrough in efficacy have been gradually summarized and improved in practice.Clinical practice and basic research gradually clarified the understanding of the pathological physiological process of acute necrosis pancreatitis "two peaks of death", greatly improved the treatment of early organ failure, deepened the understanding of the diversity of pathological of local complications of acute necrosis pancreatitis, and changed the treatment mode of necrosis pancreatitis. A modern comprehensive treatment system has been gradually formed. That is, in the early stage of the disease, to prevent and control multi-organ failure as the main axis; In the later stage, to explore the best surgical intervention time as the main axis, the implementation of micro-invasive and open combination of intervention strategy, and strive to explore and improve the success rate of one-time surgery. At present, China's treatment level of acute necrosis pancreatitis in many large-capacity centers is in the forefront of the world. Through the Pancreatic Surgery Group of Surgery Society of Chinese Medical Association's tour of the Guide and a large number of academic exchanges, the level of treatment of necrosis pancreatitis in China's primary hospitals is also constantly improving. Therefore, we have reasons to believe that the day when China's acute necrotizing pancreatitis diagnosis and treatment level can break further will not be far away.


Asunto(s)
Pancreatitis Aguda Necrotizante/terapia , China , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Insuficiencia Multiorgánica/etiología , Pancreatitis Aguda Necrotizante/diagnóstico , Pancreatitis Aguda Necrotizante/historia
15.
Zhonghua Wai Ke Za Zhi ; 58(1): 61-69, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31902173

RESUMEN

Esophageal cancer surgery originated in the early 20(th) century. However, the true meaning of trans-thoracic esophagectomy and digestive tract reconstruction began in the 1930s. Almost at the same time, Japan and Western countries began the surgical exploration of esophageal cancer. Based on the pathological type of esophageal cancer in Asia, squamous cell carcinoma is the majority, and its biological characteristics and treatment strategies are different from those of European and American patients. After more than eighty years of development, the surgical treatment of esophageal cancer in Japan has been developed from the initial attempt, deep cultivation practice to the pursuit of excellence, and explored a set of more advanced surgical techniques and diagnostic strategies, which is unique in the world. On the basis of the establishment of the Japanese Society of Esophagus, Japanese scholars have developed and irregularly updated the Japanese Classification of Esophageal Cancer and published the professional academic journal Esophagus. The Japanese Clinical Oncology Group organized a number of phase Ⅲ clinical studies on esophageal cancer, providing strong evidence for the diagnosis and treatment of esophageal squamous carcinoma. Focused on the origin, development, current situation and future of esophageal cancer surgery in Japan, this paper summarized the development of esophageal cancer surgery in Japan through literature review, interviews with senior experts and Hot topics of esophageal cancer surgery-questionnaire survey of Japanese experts.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Esofagectomía/historia , Carcinoma de Células Escamosas/historia , Neoplasias Esofágicas/historia , Esofagectomía/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Japón , Estados Unidos
16.
J Homosex ; 67(3): 346-366, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30372381

RESUMEN

Intuitively distinguishing the myriad of critically informed paradigms requires an in-depth analysis of genealogies, histories, and philosophical underpinnings grounding each paradigm. Despite significant parallels between queer theory and intersectionality theory, the distinction of these two paradigms acts in both complicated and complementary manners that necessitate a dialogue on the contributions emanating from both paradigms to LGBTQ studies. This article targets the following goals: (1) explicate genealogy, history, and philosophical tenets of intersectionality and queer theory; (2) dialogue about the complementary yet complex relationships between the two paradigms; and (3) illustrate the promise of the complex relationship and distinction for LGBTQ studies.


Asunto(s)
Homosexualidad , Teoría Psicológica , Minorías Sexuales y de Género , Educación , Femenino , Identidad de Género , Historia del Siglo XX , Historia del Siglo XXI , Homosexualidad/historia , Homosexualidad/psicología , Humanos , Masculino , Minorías Sexuales y de Género/historia
17.
Forensic Sci Int ; 306: 110056, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31765883

RESUMEN

The killings during the Second World War, with nearly one hundred thousand victims, is one of the greatest losses of life in Slovenia's modern history. This article presents the genetic identification of the victims of the largest family massacre that occurred in Slovenia, in which 10 members of the same family were killed. Seven of them were buried in a hidden mass grave and only two children survived. In 2015 and 2016, two graves were found and three incomplete female skeletons and at least three incomplete male skeletons were exhumed. A total of 12 bones and teeth were analysed and compared to two living relatives. Extracted DNA was quantified using the PowerQuant kit, and various autosomal and Y-STR kits were used for STR typing. Up to 2.7 ng DNA/g of powder was acquired from the samples analysed. We managed to obtain nuclear DNA for successful STR typing from seven bones and one molar. From the female grave, autosomal profiles were obtained only from one skeleton, and from the male grave from five out of six femurs. The relationships between the males were additionally confirmed by analyses of Y-STRs. STR profiles made possible the identification of four family members; one of the aunts from the female grave, and two uncles and the father of the surviving children, who were used as family references, from the male grave. The product rule was used to calculate a combined likelihood ratio for autosomal and Y-STRs, and statistical analyses showed high confidence of correct identification with posterior probability (PP) greater than 99.9 % for three out of four victims identified. For identifying the aunt, the PP obtained after ESI-17 and NGM STR typing was too low. To increase the PP, the next-generation sequencing Precision ID GlobalFiler NGS STR Panel was used and, after the analysis of additional STR loci, the statistical analysis showed a PP greater than 99.9 %, indicating that a sufficient number of genetic markers had been investigated in identifying the skeletal remains of the aunt. An elimination database containing the genetic profiles of all individuals that had been in contact with the bones was created to ensure traceability in case of contamination, and no matches were found. After more than 70 years, the skeletal remains were returned to the surviving children, who buried their relatives in a family grave.


Asunto(s)
Huesos/química , Dermatoglifia del ADN , Familia , Diente/química , Restos Mortales , Entierro , Cromosomas Humanos Y , ADN/aislamiento & purificación , Exhumación , Femenino , Genética Forense , Secuenciación de Nucleótidos de Alto Rendimiento , Historia del Siglo XX , Humanos , Masculino , Repeticiones de Microsatélite , Linaje , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , Eslovenia , Segunda Guerra Mundial
18.
Toxicol Lett ; 320: 73-79, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31811912

RESUMEN

INTRODUCTION: Choking agent exposure, among them chlorine gas, occurs in household or industrial accidents, chemical warfare and terrorist attacks. AIMS: Review of published animal and human data regarding the history, pathophysiology, clinical effects and management of chlorine exposure. PATHOPHYSIOLOGY: Highly soluble agents cause quick upper respiratory tract symptoms. Chlorine gas has a medium solubility, also causing delayed lower airway symptoms, mainly due to its oxidizing potential by releasing hypochlorous and hydrochloric acid, but also by interacting with Transient Receptor Potential channels. SYMPTOMS: Eyes may show conjunctival injection, abrasions and corrosions. Burns of the oronasal mucosa and trachea can occur. Dyspnea, bronchospasm and possible retrosternal pain occur frequently. Glottis edema or laryngospasm are acute life-threatening emergencies. Chlorine gas can cause toxic pneumonitis, lung edema and acute respiratory distress syndrome (ARDS). MANAGEMENT: General management includes physical examination, pulse oximetry and arterial blood gases. Eyes should be irrigated, humidified oxygen and inhalative bronchodilators administered. An EKG, cardiac enzymes and complete-blood-count should be obtained if there is retrosternal pain. Routine chest x-ray is not recommended - except if pulmonary edema is suspected. Laryngoscopy should be performed if glottis edema is suspected. Sodium bicarbonate inhalation after chlorine gas inhalation is discussed controversially. Mechanical ventilation with continuous-positive-airway-pressure or intubation/tracheotomy with high positive-end-expiratory-pressure may be necessary. Glucocorticoids for prevention of pulmonary edema should be applied restrictively. Prophylactic antibiotics are not recommended. In severe ARDS, extracorporeal membrane oxygenation (ECMO) can be considered. CONCLUSION: Treatment is mainly symptom oriented. New and promising therapies are in development.


Asunto(s)
Accidentes Domésticos , Accidentes de Trabajo , Quemaduras Químicas/terapia , Sustancias para la Guerra Química/envenenamiento , Cloro/envenenamiento , Quemaduras Oculares/terapia , Enfermedades Respiratorias/terapia , Animales , Quemaduras Químicas/etiología , Quemaduras Químicas/historia , Quemaduras Químicas/fisiopatología , Sustancias para la Guerra Química/historia , Cloro/historia , Quemaduras Oculares/inducido químicamente , Quemaduras Oculares/historia , Quemaduras Oculares/fisiopatología , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Exposición por Inhalación/efectos adversos , Exposición Profesional/efectos adversos , Pronóstico , Enfermedades Respiratorias/inducido químicamente , Enfermedades Respiratorias/historia , Enfermedades Respiratorias/fisiopatología , Medición de Riesgo
19.
Integr Zool ; 15(1): 69-78, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31305020

RESUMEN

Plague, a devastating infectious disease caused by Yersinia pestis, has killed millions of people in the past and is still active in the natural foci of the world today. Understanding the spatiotemporal patterns of plague outbreaks in history is critically important, as it may help to facilitate prevention and control of potential future outbreaks. In this study, we explored spatiotemporal clusters of human plague occurrences in China using a machine-learning clustering method and reconstructed the potential transmission pattern during the Third Pandemic (1772-1964). We succeeded in identifying 6 clusters in the space domain (2D) and 13 clusters in the spatiotemporal domain (3D). Our results suggest that there were several temporal outbreaks and transmissions of plague in different spatial clusters. Together with the spatiotemporal nearest neighbor approach (ST-NNA), this method could allow us to have a clearer look at the spatiotemporal patterns of plague.


Asunto(s)
Análisis por Conglomerados , Pandemias , Peste/epidemiología , Peste/historia , China/epidemiología , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Factores de Tiempo
20.
J Forensic Sci ; 65(1): 304-313, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31145812

RESUMEN

In 1949, the American Graves Registration Service Pacific Zone proposed the identification of 27 sets of remains (skulls/crania/mandibles) based on comparisons with written dental records. All were denied, and the remains were buried as unknowns. In 2003 and 2015, the remains were exhumed by the DPAA. Currently, 26 individuals previously recommended for identification have been positively identified. The DPAA Science Director's opinion corresponded with 24 of their recommendations, while DNA excluded three. Caution should be taken by the forensic scientist when building assemblages through skeletal and dental articulation. The forensic odontologist must always consider variations in restorative care/extraction patterns and the possibility of documentation errors when reviewing/interpreting historical and current day dental records used for AM/PM comparisons. The odontologist should base their opinion on the strength of the antemortem/postmortem comparison, number and type of concordances, and distinct dental care and extraction patterns.


Asunto(s)
Restos Mortales , Registros Odontológicos , Odontología Forense/métodos , Amalgama Dental , Prótesis Dental , Exhumación , Historia del Siglo XX , Humanos , Mandíbula/patología , Maxilar/patología , Personal Militar/historia , Fotograbar , Radiografía Dental , Diente/patología , Estados Unidos , Segunda Guerra Mundial
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