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1.
Clin Neuroradiol ; 33(4): 993-1005, 2023 Dec.
Article de Anglais | MEDLINE | ID: mdl-37336867

RÉSUMÉ

PURPOSE: This study aimed to detect age-related brain metabolic and microstructural changes in healthy human brains by the use of whole-brain proton magnetic resonance spectroscopic imaging (1H­MRSI) and quantitative MR imaging (qMRI). METHODS: In this study, 60 healthy participants with evenly distributed ages (between 21 and 69 years) and sex underwent MRI examinations at 3T including whole-brain 1H­MRSI. The concentrations of the metabolites N­acetylaspartate (NAA), choline-containing compounds (Cho), total creatine and phosphocreatine (tCr), glutamine and glutamate (Glx), and myo-inositol (mI), as well as the brain relaxation times T2, T2' and T1 were measured in 12 regions of interest (ROI) in each hemisphere. Correlations between measured parameters and age were estimated with linear regression analysis and Pearson's correlation test. RESULTS: Significant age-related changes of brain regional metabolite concentrations and tissue relaxation times were found: NAA decreased in eight of twelve ROIs, Cho increased in three ROIs, tCr in four ROIs, and mI in three ROIs. Glx displayed a significant decrease in one ROI and an increase in another ROI. T1 increased in four ROIs and T2 in one ROI, while T2' decreased in two ROIs. A negative correlation of tCr concentrations with T2' relaxation time was found in one ROI as well as the positive correlations of age-related T1 relaxation time with concentrations of tCr, mI, Glx and Cho in another ROI. CONCLUSION: Normal aging in human brain is associated with coexistent brain regional metabolic alterations and microstructural changes, which may be related to age-related decline in cognitive, affective and psychomotor domains of life in the older population.


Sujet(s)
Vieillissement , Imagerie par résonance magnétique , Humains , Spectroscopie par résonance magnétique/méthodes , Imagerie par résonance magnétique/méthodes , Vieillissement/métabolisme , Vieillissement/anatomopathologie , Encéphale/anatomopathologie , Créatine/métabolisme , Choline/métabolisme , Acide aspartique , Inositol/métabolisme , Récepteurs aux antigènes des cellules T/métabolisme
2.
Sci Total Environ ; 857(Pt 1): 159400, 2023 Jan 20.
Article de Anglais | MEDLINE | ID: mdl-36243070

RÉSUMÉ

This study examines the ability of the grass species Andropogon virginicus to alter the subsurface transport and redistribution of a suite of radionuclides (99Tc, 133Cs (stable analog for 135Cs and 137Cs), 237Np, 238U) with varying chemical behaviors in a Savannah River Site soil via the use of vegetated and unvegetated soil columns. After an acclimation period, a small volume of solution containing all radionuclides was introduced into the columns via Rhizon© pore water sampling tubes. Plants were grown for an additional 4 weeks before shoots were harvested, and columns were prepared for sampling. Plant presence led to decreased radionuclide release from the columns, mainly due to radionuclide specific combinations of system hydrology differences resulting from plant transpiration as well as plant uptake. For the most mobile radionuclides, 99Tc followed by 237Np, plant presence resulted in significantly different soil concentration profiles between vegetated and unvegetated columns, including notable upward migration for 237Np in columns with plants. Additionally, plant uptake of 99Tc was the greatest of all the radionuclides, with plant tissues containing an average of 44 % of the 99Tc, while plant uptake only accounted for <2 % of 237Np and <0.5 % of 133Cs and 238U in the system. Although overall plant uptake of 133Cs and 238U were similar, the majority of 133Cs taken up by plants was associated with 133Cs already available in the aqueous phase while 238U uptake was mainly associated with the solid phase, meaning that plant activity resulted in a fraction of the native 238U being mobilized and thus, made available for plant uptake. Overall, this study quantified the influence of several plant-mediated physical and biogeochemical factors that have significant influence on radionuclide mobility and transport in this complex system which can be further utilized in future system or site-specific environmental transport and risk assessment models.


Sujet(s)
Andropogon , Neptunium , Polluants radioactifs du sol , Uranium , Polluants radioactifs du sol/analyse , Uranium/analyse , Poaceae , Sol , Radio-isotopes du césium/analyse , Plantes
3.
J Forensic Odontostomatol ; 38(2): 22-39, 2020 09 30.
Article de Anglais | MEDLINE | ID: mdl-33174535

RÉSUMÉ

The goal of long term research on age assessment is to focus on the strengths and weaknesses of existing reliable methods of age estimation. In cases of age estimation when all teeth are present, maximum accuracy can be obtained using a 7 tooth model. Demirjian's system and Willems models require all seven mandibular teeth in the lower left quadrant for age assessment. Unfortunately, these methods cannot be applied in children with hypodontia. In 2019, Bedek et al., from Croatia, developed new models of age estimation based on a combination of one to seven mandibular teeth. In the present study, we tested the accuracy of the newly developed models for age estimation in South Indian children. Tested in parallel with Willems models, the accuracy of the new models was tested in terms of mean difference, mean absolute error (MAE) and percentage of correct estimations within intervals of +0.5 and +1 years. In terms of mean difference between chronological age (CA) and estimated dental age (DA), all models along with Willems models have underestimated the CA except Bedek et al's 6 tooth model where overestimation of CA was seen in boys. For MAE and percentage of correct estimations, the new models performed better than Willems models. With regards to our results, it can be concluded that the new models for dental age calculation are accurate and suitable. Therefore, we may encourage their use for age estimation in South Indian children, particularly in individuals with hypodontia or when multiple teeth are missing.


Sujet(s)
Détermination de l'âge dentaire , Dent , Adolescent , Enfant , Croatie , Humains , Mâle , Radiographie panoramique , Calcification dentaire
4.
Can J Public Health ; 111(5): 649-653, 2020 10.
Article de Anglais | MEDLINE | ID: mdl-32845460

RÉSUMÉ

This commentary draws on sub-Saharan African health researchers' accounts of their countries' responses to control the spread of COVID-19, including social and health impacts, home-grown solutions, and gaps in knowledge. Limited human and material resources for infection control and lack of understanding or appreciation by the government of the realities of vulnerable populations have contributed to failed interventions to curb transmission, and further deepened inequalities. Some governments have adapted or limited lockdowns due to the negative impacts on livelihoods and taken specific measures to minimize the impact on the most vulnerable citizens. However, these measures may not reach the majority of the poor. Yet, African countries' responses to COVID-19 have also included a range of innovations, including diversification of local businesses to produce personal protective equipment, disinfectants, test kits, etc., which may expand domestic manufacturing capabilities and deepen self-reliance. African and high-income governments, donors, non-governmental organizations, and businesses should work to strengthen existing health system capacity and back African-led business. Social scientific understandings of public perceptions, their interactions with COVID-19 control measures, and studies on promising clinical interventions are needed. However, a decolonizing response to COVID-19 must include explicit and meaningful commitments to sharing the power-the authority and resources-to study and endorse solutions.


Sujet(s)
Infections à coronavirus/prévention et contrôle , Pandémies/prévention et contrôle , Pneumopathie virale/prévention et contrôle , Afrique subsaharienne/épidémiologie , COVID-19 , Infections à coronavirus/épidémiologie , Gouvernement , Humains , Pneumopathie virale/épidémiologie , Facteurs socioéconomiques , Populations vulnérables
6.
AJNR Am J Neuroradiol ; 35(6 Suppl): S31-6, 2014 Jun.
Article de Anglais | MEDLINE | ID: mdl-24481330

RÉSUMÉ

BACKGROUND AND PURPOSE: Increased glycine concentration in the brain is associated with altered metabolism in cancer and can be detected by using in vivo MR spectroscopy. This has been proposed as a marker for grade IV gliomas; however, little is known about the potential significance and frequency of in vivo glycine observation. The purpose of this study was to examine the rate of occurrence and spatial distribution of glycine observation with respect to other MR imaging parameters. MATERIALS AND METHODS: Data from volumetric whole-brain MR spectroscopic imaging of 59 subjects with glioma were analyzed with glycine included in the spectral model. The associations of the signal amplitude and spatial distributions of glycine with findings from contrast-enhanced T1, perfusion, and diffusion MR imaging were then examined. RESULTS: Glycine was detected in 24% of all studies, though with a wide range of signal amplitude and extent of the spatial distributions. While more commonly seen in grade IV tumors (42% of studies), relatively large concentrations were also detected in grade II and III gliomas. Coanalysis with other metabolites indicated a strong association with choline and that glycine was frequently seen to be overlapping with, and adjacent to, areas of high lactate concentration. Increased glycine was always associated with contrast enhancement and areas of increased cerebral blood flow, but without any clear association with other image parameters. CONCLUSIONS: Detection of increased glycine in gliomas appears to identify a subgroup of tumors and areas of increased proliferation.


Sujet(s)
Astrocytome/métabolisme , Cartographie cérébrale/méthodes , Tumeurs du cerveau/métabolisme , Glioblastome/métabolisme , Glycine/métabolisme , Spectroscopie par résonance magnétique/méthodes , Adolescent , Adulte , Sujet âgé , Astrocytome/diagnostic , Encéphale/métabolisme , Tumeurs du cerveau/diagnostic , Choline/métabolisme , Imagerie par résonance magnétique de diffusion/méthodes , Glioblastome/diagnostic , Humains , Adulte d'âge moyen , Grading des tumeurs/méthodes , Phosphoryl-choline/métabolisme , Études rétrospectives , Jeune adulte
7.
Asian Pac J Trop Med ; 4(10): 778-85, 2011 Oct.
Article de Anglais | MEDLINE | ID: mdl-22014732

RÉSUMÉ

OBJECTIVE: To investigate antidiabetic efficacy of the extract of field grown and in vitro raised leaves of Solanum xanthocarpum (S. xanthocarpum) against alloxan induced diabetic rats. METHODS: The antidiabetic activity of the crude methanol extracts of the field grown and in vitro raised leaves of S. xanthocarpum at different concentrations (100-200 mg/kg bw) was tested against alloxan induced diabetic rats. The antidiabetic efficacy was validated through various biochemical parameters and the antioxidant effect was also determined. The phytochemical analyses of field grown S. xanthocarpum and in vitro rasied S. xanthocarpum leaves were done by estimating their chlorophyll, carotenoids, total sugar, protein, amino acid and minerals contents. RESULTS: The results revealed that the methanol extracts of both the leaves (field grown and in vitro raised) of S. xanthocarpum was efficient anti hyperglycemic agents at a concentration of 200 mg/kg bw and posses potent antioxidant activity. However, the extracts of in vitro rasied S. xanthocarpum raised leaves exhibit higher efficacy than the field grown leaves in all tested concentrations. Proximal composition and mineral analysis of S. xanthocarpum revealed higher concentration of contents in in vitro rasied S. xanthocarpum than field grown S. xanthocarpum. CONCLUSIONS: From the results it can be concluded that the leaves extracts of S. xanthocarpum can be a potential candidate in treating the hyperglycemic conditions and suits to be an agent to reduce oxidative stress.


Sujet(s)
Diabète expérimental/traitement médicamenteux , Hyperglycémie/traitement médicamenteux , Phytothérapie , Extraits de plantes/usage thérapeutique , Feuilles de plante/composition chimique , Solanum/composition chimique , Animaux , Marqueurs biologiques/sang , Diabète expérimental/complications , Hyperglycémie/étiologie , Mâle , Stress oxydatif/effets des médicaments et des substances chimiques , Extraits de plantes/pharmacologie , Rats , Rat Wistar , Résultat thérapeutique
8.
Niger Med J ; 52(4): 205-6, 2011 Oct.
Article de Anglais | MEDLINE | ID: mdl-22529498
9.
Magn Reson Med ; 64(3): 623-8, 2010 Sep.
Article de Anglais | MEDLINE | ID: mdl-20597119

RÉSUMÉ

There is increasing interest in the use of two-dimensional J-resolved spectroscopic acquisition (multiecho) methods for in vivo proton magnetic resonance spectroscopy due to the improved discrimination of overlapping J-coupled multiplet resonances that is provided. Of particular interest is the potential for discrimination of the overlapping resonances of glutamate and glutamine. In this study, a new time-domain parametric spectral model that makes use of all available data is described for fitting the complete two-dimensional multiecho data, and the performance of this method was compared with fitting of one-dimensional spectra obtained following averaging multiecho data (echo time-averaged) and single-echo time PRESS (Point Resolved Spectroscopy) acquired spectra. These methods were compared using data obtained from a phantom containing typical brain metabolites and a human brain. Results indicate that improved performance and accuracy is obtained for the two-dimensional acquisition and spectral fitting model.


Sujet(s)
Algorithmes , Biopolymères/métabolisme , Encéphale/métabolisme , Acide glutamique/métabolisme , Spectroscopie par résonance magnétique/méthodes , Biopolymères/analyse , Acide glutamique/analyse , Humains , Reconnaissance automatique des formes/méthodes , Protons
10.
NMR Biomed ; 23(3): 251-6, 2010 Apr.
Article de Anglais | MEDLINE | ID: mdl-19777506

RÉSUMÉ

The reproducibility of serial measurements using a volumetric proton MR Spectroscopic Imaging (MRSI) acquisition implemented at 3 Tesla and with lipid suppression by inversion-recovery has been evaluated. Data were acquired from two subjects at five time points, and processed using fully-automated procedures that included rigid registration between studies. These data were analyzed to determine coefficients of variance (COV) for each metabolite and for metabolite ratio images based on an individual voxel analysis, as well as for average and grey-matter and white-matter values from atlas-defined brain regions. The volumetric MRSI acquisition was found to obtain data of sufficient quality for analysis over 70 +/- 6% of the total brain volume, and spatial distributions of the resultant COV values were found to reflect the known distributions of susceptibility-induced magnetic field inhomogeneity. Median values of the resultant voxel-based COVs were 6.2%, 7.2%, and 9.7% for N-acetylaspartate, creatine, and choline respectively. The corresponding mean values obtained following averaging over lobar-scale brain regions within the cerebrum were 3.5%, 3.7%, and 5.2%. These results indicate that longitudinal volumetric MRSI studies with post-acquisition registration can provide an intra-subject reproducibility for voxel-based analyses that is comparable to previously-reported single-voxel MRS measurements, while additionally enabling increased sensitivity by averaging over larger tissue volumes.


Sujet(s)
Cartographie cérébrale/méthodes , Encéphale/métabolisme , Imagerie par résonance magnétique/méthodes , Adulte , Acide aspartique/analogues et dérivés , Acide aspartique/métabolisme , Femelle , Humains , Spectroscopie par résonance magnétique , Mâle , Reproductibilité des résultats
11.
Brain Res ; 1073-1074: 325-31, 2006 Feb 16.
Article de Anglais | MEDLINE | ID: mdl-16457789

RÉSUMÉ

Behavioral adaptation in aging may become impaired from abnormal expression of amygdalar corticotropin-releasing hormone (CRH) and/or CRH-binding protein (CRH-BP). In this study, we serially sectioned the amygdala in 4-, 12-, and 24-month-old Fischer 344 rats following perfusion with 4% paraformaldehyde. We determined the amount of CRH and CRH-BP containing cells as well as the density of fibers expressing CRH or CRH-BP utilizing densitometric methods. Images were digitized using Zeiss Axiovision software and densitometrically analyzed using Scion Image. Both sides were analyzed in sections cut at 30 mum thickness. Cell counts of CRH-BP containing cells in the basolateral and lateral nucleus of the amygdala were lower in 24-month-old rats vs. 4-month-old rats, respectively (mean cells/section +/- SE): 31 +/- 6 vs. 72 +/- 10 (n = 3; P < 0.05 via ANOVA and Fisher's PLSD). There was a trend for cell counts of CRH containing cells in the central nucleus of the amygdala to be lower in 24-month-old rats vs. 4-month-old rats, respectively 28 +/- 7 vs. 47 +/- 9 (n = 3; P = 0.07 via ANOVA). Densitometric analysis of the number of CRH-BP positive fibers revealed no age differences in CeA; however, with regards to CRH-positive fibers, both 4- and 12-month rats had greater CeA CRH immunoreactivity relative to 24-month-old rats (Ps < 0.05 via ANOVA and Fisher's PLSD). These changes may contribute to impaired adaptations to stress, cognitive decline, and other pathophysiological processes during aging.


Sujet(s)
Vieillissement/physiologie , Amygdale (système limbique)/métabolisme , Corticolibérine/métabolisme , Récepteur CRH/métabolisme , Facteurs âges , Analyse de variance , Animaux , Numération cellulaire , Régulation de l'expression des gènes/physiologie , Immunohistochimie/méthodes , Mâle , Rats , Rats de lignée F344
12.
Indian J Med Ethics ; 3(3): 97-8, 2006.
Article de Anglais | MEDLINE | ID: mdl-17223683

RÉSUMÉ

Assisted reproductive technology has helped many childless couples. It has also raised questions about how appropriate the technology might be in different situations. How we understand parenthood is crucial in taking a stand on such scientific intervention. It is suggested that physicians should decide on offering artificial insemination, surrogacy and in-vitro fertilisation only after considering if the child will have good parents and if there will be legal complications from the use of the technology.


Sujet(s)
Techniques de reproduction assistée/éthique , Mères porteuses , Femelle , Fécondation in vitro/éthique , Humains , Insémination artificielle avec donneur/éthique , Mâle , Pratiques éducatives parentales
13.
Regul Pept ; 132(1-3): 91-101, 2005 Dec 15.
Article de Anglais | MEDLINE | ID: mdl-16213038

RÉSUMÉ

Internalization of cloned rat or human Y4 receptors expressed in Chinese hamster ovary (CHO) cells increased with concentration of all types of Y4 agonists, including human and rat pancreatic polypeptides, the Y1 receptor group co-agonists possessing C-terminal TRPRY.NH2 pentapeptide, and a C-terminally amidated dimeric nonapeptide related to neuropeptide Y, GR231118. These peptides also inhibited forskolin-stimulated adenylyl cyclase activity in Y4 receptor-expressing cells, and stimulated the binding of 35S-labeled GTP-gamma-S to pertussis toxin-sensitive G-proteins in particulates from these cells. Peptide VD-11 (differing from GR231118 only by C-terminal oxymethylation) acted as a competitive antagonist in all of the above processes. Agonist-induced stimulation of the Y4 receptor internalization persisted in the presence of allosteric inhibitors of hPP binding, N5-substituted amilorides, which also were relatively little active in G-protein stimulation and cyclase inhibition by Y4 agonists. Acceleration of Y4 receptor internalization by agonists apparently is related to relaxation of allosteric constraints to ligand attachment and sequestration of the receptor-ligand complex.


Sujet(s)
Peptides/pharmacologie , Récepteur neuropeptide Y/agonistes , Récepteur neuropeptide Y/métabolisme , Adenylate Cyclase/métabolisme , Animaux , Composés de l'arsenic/pharmacologie , Cellules CHO , Clonage moléculaire , Cricetinae , Cricetulus , Femelle , Humains , Peptides cycliques/pharmacologie , Rats , Récepteur neuropeptide Y/antagonistes et inhibiteurs
14.
Life Sci ; 73(6): 769-81, 2003 Jun 27.
Article de Anglais | MEDLINE | ID: mdl-12801598

RÉSUMÉ

Studies involving regulation of corticotropin-releasing hormone (CRH) in vitro have been used to validate findings obtained in vivo and more importantly have been used as model systems to better understand signalling mechanisms responsible for the expression of the CRH gene and peptide. Many in vitro studies examining CRH have utilized hypothalamic tissue while a few have focused on the amygdala. Clonal cell lines have also been utilized as models of central nervous system CRH neurons. Stimuli that have been implicated in regulating hypothalamic CRH regulation in vitro include protein kinase A (PKA) and protein kinase C (PKC) activators, glucocorticoids, biogenic amines, cytokines and the gaseous neurotransmitters. Amygdalar CRH levels in vitro are affected by some of the same stimuli that regulate hypothalamic CRH; however there is evidence supporting differential regulation of CRH in these two brain regions by some of the same stimuli. Only a few studies in aggregate have investigated signal transduction mechanisms and these studies have focused on PKA- and glucocorticoid-mediated changes in CRH expression. Thus, much more investigative work in better understanding CRH regulation in vitro is needed.


Sujet(s)
Amygdale (système limbique) , Corticolibérine/génétique , Régulation de l'expression des gènes , Hypothalamus , Transduction du signal/physiologie , Amygdale (système limbique)/cytologie , Amygdale (système limbique)/enzymologie , Amygdale (système limbique)/métabolisme , Cellules cultivées , Corticolibérine/biosynthèse , Hypothalamus/cytologie , Hypothalamus/enzymologie , Hypothalamus/métabolisme , Transduction du signal/génétique
15.
J Neuroendocrinol ; 15(5): 521-9, 2003 May.
Article de Anglais | MEDLINE | ID: mdl-12694378

RÉSUMÉ

Corticotropin-releasing hormone (CRH) is a 41 amino acid neuropeptide which plays an important role in the stress response in the hypothalamus. We describe the development of an immortalized hypothalamic cell line which expresses CRH. We hypothesized that this cell line would possess the relevant characteristics of parvocellular CRH-expressing neurones such as glucocorticoid receptor (GR) expression and vasopressin (VP) coexpression. For production of hypothalamic cells, embryonic day 19 rat pup hypothalami were dissected and dissociated into tissue culture dishes. They were immortalized by retrovirus-mediated transfer of the SV40 large T antigen gene at 3 days of culture and then screened for expression of CRH following dilution cloning. One cell line was chosen (IVB) which exhibited CRH-like immunoreactivity (CRH-LI) and expressed CRH, VP and CRH1 receptor RNA via the reverse transcriptase-polymerase chain reaction. In addition, the cell line expressed the neuronal marker, microtubule-associated protein-2. We verified that the CRH-LI from IVB cell lysates coeluted with CRH standard via reversed-phase high-performance liquid chromatography (HPLC). Furthermore, oxidation of the lysate converted its HPLC profile to that identical with oxidized CRH standard. In addition, IVB cells exhibited high affinity binding to CRH. Incubation of IVB cells with CRH lead to increases in cAMP levels and protein kinase A activity in a concentration-dependent manner. Incubation of IVB cells with CRH also resulted in increases in phospho-cyclic-AMP response element binding protein (CREB) immunostaining as detected by immunocytochemical analysis. Finally, CRH treatment of IVB cell lines has been linked to CREB-mediated gene expression as determined via the PathDetect CREB trans-reporting system. The characteristics of IVB cells, such as CRH and VP coexpression, GR expression and a biologically active CRH-R1-mediated signalling pathway, suggest that this neuronal cell line may serve as model of parvocellular CRH neurones.


Sujet(s)
Corticolibérine/génétique , Cyclic AMP-Dependent Protein Kinases/métabolisme , Expression des gènes , Hypothalamus/métabolisme , Récepteur CRH/métabolisme , Transduction du signal , Animaux , Antigènes transformants de polyomavirus/génétique , Technique de Western , Lignée de cellules transformées , Chromatographie en phase liquide à haute performance , Corticolibérine/métabolisme , Corticolibérine/pharmacologie , AMP cyclique/pharmacologie , Protéine de liaison à l'élément de réponse à l'AMP cyclique/métabolisme , Dexaméthasone/pharmacologie , Expression des gènes/effets des médicaments et des substances chimiques , Hypothalamus/composition chimique , Phosphorylation , Pro-opiomélanocortine/génétique , ARN messager/analyse , Rats , Rat Sprague-Dawley , Récepteurs aux glucocorticoïdes/analyse , Récepteurs aux glucocorticoïdes/génétique , Transfection , Vasopressines/génétique
17.
Org Lett ; 3(25): 3987-90, 2001 Dec 13.
Article de Anglais | MEDLINE | ID: mdl-11735566

RÉSUMÉ

[structure: see text] 2-Aryl-2,2-difluoroacetamido-proline and pipecolate esters are high affinity FKBP12 ligands whose rotamase inhibitory activity is comparable to that seen for the corresponding ketoamides. X-ray structural studies suggest that the fluorine atoms participate in discrete interactions with the Phe36 phenyl ring and the Tyr26 hydroxyl group, with the latter resembling a moderate-to-weak hydrogen bond.


Sujet(s)
Acétamides/composition chimique , Hydrocarbures fluorés/composition chimique , Hydrocarbures fluorés/synthèse chimique , Protéine 1A de liaison au tacrolimus/composition chimique , Tacrolimus/composition chimique , Animaux , Sites de fixation , Cristallographie aux rayons X , Hydrocarbures fluorés/métabolisme , Immunosuppresseurs/composition chimique , Immunosuppresseurs/métabolisme , Ligands , Spectroscopie par résonance magnétique , Modèles moléculaires , Structure moléculaire , Liaison aux protéines , Tacrolimus/métabolisme , Protéine 1A de liaison au tacrolimus/métabolisme , Protéines de liaison au tacrolimus/antagonistes et inhibiteurs
18.
Pediatrics ; 108(2): 317-25, 2001 Aug.
Article de Anglais | MEDLINE | ID: mdl-11483794

RÉSUMÉ

OBJECTIVE: To investigate the economic implications of a 2-dose hepatitis B virus vaccination regimen compared with the current 3-dose vaccination regimen for adolescents in 3 settings: public schools, public health clinics, and private sector settings in the United States. METHODS: To measure resource utilization and costs associated with the administration of the 3-dose regimen and to assess vaccination compliance rates with this regimen, primary data were collected with the use of questionnaires tailored for each setting. Conservative modeling assumptions were used to derive 2-dose compliance rates from 3-dose compliance data. The results were incorporated into a decision analytic model, which was used to examine short-term and lifetime scenarios for an adolescent cohort receiving the 2-dose versus the 3-dose regimen. In the short-term analysis, the vaccination program costs were compared for the 2 regimens. In the lifetime analysis, the model also incorporated long-term disease costs for those individuals who contract hepatitis B. RESULTS: Predicted increases in compliance with a 2-dose vaccination regimen contributed to a higher probability of seroprotection in each setting. In the lifetime analysis, this positive impact of improved compliance resulted in a lower infection rate and greater cost-effectiveness for the 2-dose regimen in all settings, including private sector settings, where it cost an average of only $964 per year of life gained, and in public schools, costing an average of $1246 per year of life gained. In public health clinics, the 2-dose regimen had both lower expected lifetime costs and better clinical outcomes than the 3-dose regimen. In the short-term analysis, costs were higher for the 2-dose regimen, reflecting higher total vaccine acquisition costs without the long-term offset of cost savings from reduced infection. Sensitivity analyses identified cost per dose of vaccine and the probability of completing the regimens as the most sensitive model variables. CONCLUSIONS: Improved compliance with a 2-dose regimen would contribute to a higher probability of adolescents' achieving seroprotection. When the long-term consequences of hepatitis B virus infection are included, the 2-dose regimen would be cost-effective compared with the 3-dose regimen in all settings and cost saving in public health clinic settings.


Sujet(s)
Services de santé pour adolescents/économie , Vaccins anti-hépatite B/administration et posologie , Programmes de vaccination/économie , Calendrier vaccinal , Vaccination/économie , Adolescent , Services de santé pour adolescents/statistiques et données numériques , Facteurs âges , Production d'anticorps/immunologie , Services de santé communautaires/économie , Services de santé communautaires/statistiques et données numériques , Analyse coût-bénéfice , Techniques d'aide à la décision , Relation dose-réponse (immunologie) , Comportement en matière de santé , Coûts des soins de santé , Hépatite B/économie , Hépatite B/immunologie , Hépatite B/prévention et contrôle , Vaccins anti-hépatite B/économie , Humains , Programmes de vaccination/statistiques et données numériques , Modèles économiques , Services de santé scolaire/économie , Services de santé scolaire/statistiques et données numériques , États-Unis
19.
Peptides ; 22(5): 705-12, 2001 May.
Article de Anglais | MEDLINE | ID: mdl-11337083

RÉSUMÉ

Studies examining regulation of corticotropin-releasing hormone (CRH) in vitro have been used to validate findings obtained in vivo and more importantly have been used as model systems to better understand signalling mechanisms responsible for the expression of the CRH gene and peptide. Most in vitro studies examining CRH have utilized hypothalamic tissue while a few have focused on the amygdala. Furthermore, clonal cell lines have also been utilized as models of central nervous system CRH neurons. Stimuli that have been implicated in regulating hypothalamic CRH in vitro include protein kinase A (PKA) and protein kinase C (PKC) activators, glucocorticoids, biogenic amines, cytokines and the gaseous neurotransmitters. CRH levels in the amygdala in vitro are affected by some of the same stimuli that regulate hypothalamic CRH; however there is evidence supporting differential regulation of CRH in these two brain regions by some of the same stimuli. Only a few studies in aggregate have investigated the signal transduction mechanisms responsible for CRH expression. These mechanistic studies have focused on PKA- and glucocorticoid-mediated changes in CRH expression. Clearly much more investigative work in better understanding CRH regulation in vitro is needed.


Sujet(s)
Amines biogènes/métabolisme , Corticolibérine/métabolisme , Cytokines/métabolisme , Glucocorticoïdes/métabolisme , Transduction du signal/physiologie , Animaux , Monoxyde de carbone/métabolisme , Lignée cellulaire , Corticolibérine/génétique , Cyclic AMP-Dependent Protein Kinases/métabolisme , Humains , Techniques in vitro , Monoxyde d'azote/métabolisme , Protéine kinase C/métabolisme
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