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1.
Appl Radiat Isot ; 190: 110509, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36306679

RESUMO

To determine the safety of using argon as a deuteron beam stopping material, the  40Ar(d,p)41Ar cross section was measured at average deuteron energies of 3.6 MeV, 5.5 MeV, and 7.0 MeV using an activation method. A 16-MeV deuteron beam produced by Lawrence Berkeley National Laboratory's 88-Inch Cyclotron was degraded to each energy by nickel foils and the front wall of an aluminum gas chamber. The reduced-energy deuterons were used to activate a sample of natAr gas. After each irradiation, the gas chamber's  41Ar activation was measured with a high-purity germanium detector. The cross sections measured were larger than a previous measurement by ∼40%.


Assuntos
Ciclotrons
2.
Appl Radiat Isot ; 170: 109625, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33618214

RESUMO

A discrepancy, well outside reported uncertainties, has been observed between the accepted and measured values of the intensity ratio of the two strongest γ rays following 61Cu ß+ decay. This discrepancy has significant impact since the natNi(d,x)61Cu reaction has historically been one of only a few IAEA recommendations for use as a deuteron flux monitor and a considerable number of published cross sections measured in ratio to that beam monitor cross section may depend on the choice of either the first or second strongest γ ray in those calculations. To determine the magnitude of this error most precisely, over a hundred separate measurements of the 283 keV to 656 keV γ-ray emission ratio were collected from seven experiments and a variety of detectors and detection geometries. A weighted average of all these measurements indicates an error in the value listed in the Nuclear Data Sheets of 11% in either the primary or second-highest intensity γ ray of 61Cu, potentially introducing an 11% error in 61Cu production cross section measurements, cross sections using nickel activation as a deuteron beam current monitor, or in dose rates when 61Cu is used in nuclear medicine. General agreement with the Data Sheets with ten other intensity ratios suggests the most probable error is in the secondary (656 keV) emission, which accordingly should be updated from 10.8% to 9.69%.

4.
Orphanet J Rare Dis ; 13(1): 21, 2018 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-29370874

RESUMO

BACKGROUND: In fructose 1,6 bisphosphatase (FBPase) deficiency, management aims to prevent hypoglycaemia and lactic acidosis by avoiding prolonged fasting, particularly during febrile illness. Although the need for an emergency regimen to avoid metabolic decompensation is well established at times of illness, there is uncertainty about the need for other dietary management strategies such as sucrose or fructose restriction. We assessed international differences in the dietary management of FBPase deficiency. METHODS: A cross-sectional questionnaire (13 questions) was emailed to all members of the Society for the Study of Inborn Errors of Metabolism (SSIEM) and a wide database of inherited metabolic disorder dietitians. RESULTS: Thirty-six centres reported the dietary prescriptions of 126 patients with FBPase deficiency. Patients' age at questionnaire completion was: 1-10y, 46% (n = 58), 11-16y, 21% (n = 27), and >16y, 33% (n = 41). Diagnostic age was: <1y, 36% (n = 46); 1-10y, 59% (n = 74); 11-16y, 3% (n = 4); and >16y, 2% (n = 2). Seventy-five per cent of centres advocated dietary restrictions. This included restriction of: high sucrose foods only (n = 7 centres, 19%); fruit and sugary foods (n = 4, 11%); fruit, vegetables and sugary foods (n = 13, 36%). Twenty-five per cent of centres (n = 9), advised no dietary restrictions when patients were well. A higher percentage of patients aged >16y rather than ≤16y were prescribed dietary restrictions: patients aged 1-10y, 67% (n = 39/58), 11-16y, 63% (n = 17/27) and >16y, 85% (n = 35/41). Patients classified as having a normal fasting tolerance increased with age from 30% in 1-10y, to 36% in 11-16y, and 58% in >16y, but it was unclear if fasting tolerance was biochemically proven. Twenty centres (56%) routinely prescribed uncooked cornstarch (UCCS) to limit overnight fasting in 47 patients regardless of their actual fasting tolerance (37%). All centres advocated an emergency regimen mainly based on glucose polymer for illness management. CONCLUSIONS: Although all patients were prescribed an emergency regimen for illness, use of sucrose and fructose restricted diets with UCCS supplementation varied widely. Restrictions did not relax with age. International guidelines are necessary to help direct future dietary management of FBPase deficiency.


Assuntos
Deficiência de Frutose-1,6-Difosfatase/dietoterapia , Acidose Láctica/etiologia , Acidose Láctica/prevenção & controle , Estudos Transversais , Carboidratos da Dieta , Suplementos Nutricionais , Jejum , Deficiência de Frutose-1,6-Difosfatase/complicações , Humanos , Hipoglicemia/etiologia , Hipoglicemia/prevenção & controle , Inquéritos e Questionários
5.
Parkinsonism Relat Disord ; 45: 44-49, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29033298

RESUMO

INTRODUCTION: Tobacco smoking is consistently inversely associated with Parkinson's disease (PD) in men and women; recently this has been related to reverse causation, prompting questions as to whether similar patterns exist for passive smoke exposure. We used baseline and follow-up data from the California Teachers Study, a prospective cohort of women, to investigate whether timing, location and cumulative measures of intensity and duration of passive smoke exposure are associated with PD risk. METHODS: Using a nested case-control approach, we included 224 diagnostically validated cases (158 with no history of personal smoking) and selected 3230 age- and race-matched controls (1973 with no history of personal smoking). We estimated odds ratios(ORs) and 95% confidence intervals(CI) by fitting adjusted multivariable unconditional logistic regression models. RESULTS: Among lifelong non-smokers, passive smoke exposure combined across all settings and accumulated over a lifetime was not associated with PD risk (OR = 1.18, 95% CI 0.60, 2.30). Workplace exposure was also not associated with risk. Household exposure during adulthood but not childhood was inversely associated with PD (OR = 0.59, 95% CI 0.40, 0.87). Exposure to passive smoke in other social settings was positively associated with PD (OR = 1.62, 95% CI 1.11, 2.36). These contradictory results may be attributable to chance due to multiple comparisons in subgroup analyses. No pattern emerged to suggest that increasing years of passive smoke exposure, smokiness of the setting, or combined smokiness by exposure years was associated with lower PD risk. CONCLUSION: Results do not convincingly support a protective effect of passive smoking in PD.


Assuntos
Doença de Parkinson/epidemiologia , Professores Escolares , Poluição por Fumaça de Tabaco/efeitos adversos , Idoso , California , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Rev Sci Instrum ; 87(11): 11D825, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27910358

RESUMO

The high-fluence neutron spectrum produced by the National Ignition Facility (NIF) provides an opportunity to measure the activation of materials by fast-spectrum neutrons. A new large-volume gas-cell diagnostic has been designed and qualified to measure the activation of gaseous substances at the NIF. This in-chamber diagnostic is recoverable, reusable and has been successfully fielded. Data from the qualification of the diagnostic have been used to benchmark an Monte Carlo N-Particle Transport Code simulation describing the downscattered neutron spectrum seen by the gas cell. We present early results from the use of this diagnostic to measure the activation of natXe and discuss future work to study the strength of interactions between plasma and nuclei.

7.
Cell Death Differ ; 23(9): 1565-76, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27177019

RESUMO

Necroptosis is a caspase-independent form of cell death that is triggered by activation of the receptor interacting serine/threonine kinase 3 (RIPK3) and phosphorylation of its pseudokinase substrate mixed lineage kinase-like (MLKL), which then translocates to membranes and promotes cell lysis. Activation of RIPK3 is regulated by the kinase RIPK1. Here we analyze the contribution of RIPK1, RIPK3, or MLKL to several mouse disease models. Loss of RIPK3 had no effect on lipopolysaccharide-induced sepsis, dextran sodium sulfate-induced colitis, cerulein-induced pancreatitis, hypoxia-induced cerebral edema, or the major cerebral artery occlusion stroke model. However, kidney ischemia-reperfusion injury, myocardial infarction, and systemic inflammation associated with A20 deficiency or high-dose tumor necrosis factor (TNF) were ameliorated by RIPK3 deficiency. Catalytically inactive RIPK1 was also beneficial in the kidney ischemia-reperfusion injury model, the high-dose TNF model, and in A20(-/-) mice. Interestingly, MLKL deficiency offered less protection in the kidney ischemia-reperfusion injury model and no benefit in A20(-/-) mice, consistent with necroptosis-independent functions for RIPK1 and RIPK3. Combined loss of RIPK3 (or MLKL) and caspase-8 largely prevented the cytokine storm, hypothermia, and morbidity induced by TNF, suggesting that the triggering event in this model is a combination of apoptosis and necroptosis. Tissue-specific RIPK3 deletion identified intestinal epithelial cells as the major target organ. Together these data emphasize that MLKL deficiency rather than RIPK1 inactivation or RIPK3 deficiency must be examined to implicate a role for necroptosis in disease.


Assuntos
Inflamação/patologia , Proteínas Quinases/genética , Proteína Serina-Treonina Quinases de Interação com Receptores/genética , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismo , Animais , Apoptose/efeitos dos fármacos , Ceruletídeo/toxicidade , Colite/induzido quimicamente , Colite/metabolismo , Colite/patologia , Sulfato de Dextrana/toxicidade , Modelos Animais de Doenças , Feminino , Inflamação/metabolismo , Lipopolissacarídeos/toxicidade , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pancreatite/induzido quimicamente , Pancreatite/metabolismo , Pancreatite/patologia , Proteínas Quinases/deficiência , Proteínas Quinases/metabolismo , Proteína Serina-Treonina Quinases de Interação com Receptores/antagonistas & inibidores , Proteína Serina-Treonina Quinases de Interação com Receptores/deficiência , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/mortalidade , Traumatismo por Reperfusão/patologia , Sepse/etiologia , Sepse/metabolismo , Sepse/patologia , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/metabolismo , Síndrome de Resposta Inflamatória Sistêmica/patologia , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/deficiência , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/genética
8.
Dis Esophagus ; 29(1): 99-104, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25487184

RESUMO

The incidence of esophageal adenocarcinoma in the United States has risen rapidly over the last 30 years, whereas the incidence of esophageal squamous cell carcinoma has fallen dramatically. In contrast, parts of Asia have extremely high rates of squamous cell carcinoma, but virtually no adenocarcinoma. Within the United States, Asian-Americans as a whole, have low rates of esophageal adenocarcinoma and higher rates of squamous cell carcinoma. It is unclear what the patterns are for those Asians born in the United States. The relative influence of ethnicity and environment on the incidence of esophageal cancer in this population is unknown. We identified all cases of esophageal adenocarcinoma and squamous cell carcinoma from the California Cancer Registry 1988-2004, including 955 cases among 6 different Asian ethnicities. Time trends were examined using Joinpoint software to calculate the annual percentage changes in regression models. Rates of esophageal squamous cell carcinoma varied substantially among different Asian ethnic groups, but squamous cell carcinoma was much more common than adenocarcinoma in both foreign-born and US-born Asian-Americans. Rates of squamous cell carcinoma were slightly higher among US-born Asian men (4.0 per 100,000) compared with foreign-born Asian men (3.2 per 100,000) and White men (2.2 per 100,000), P = 0.03. Rates of adenocarcinoma were also slighter higher among US-born Asian men (1.2 per 100,000) compared with foreign-born Asian men (0.7 per 100,000), P = 0.01. Rates of squamous cell carcinoma decreased for both US-born and foreign-born Asians during this period, whereas adenocarcinoma remained low and stable. These results provide better insight into the genetic and environmental factors affecting the changing incidence of esophageal cancer histologies in the United States and Asia.


Assuntos
Adenocarcinoma/etnologia , Carcinoma de Células Escamosas/etnologia , Neoplasias Esofágicas/etnologia , Características de Residência/estatística & dados numéricos , Adulto , Idoso , Asiático/estatística & dados numéricos , California/epidemiologia , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Espaço-Temporal
10.
Phys Rev Lett ; 115(13): 132502, 2015 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-26451549

RESUMO

Two isomers decaying by electromagnetic transitions with half-lives of 4.7(1.1) and 247(73) µs have been discovered in the heavy ^{254}Rf nucleus. The observation of the shorter-lived isomer was made possible by a novel application of a digital data acquisition system. The isomers were interpreted as the K^{π}=8^{-}, ν^{2}(7/2^{+}[624],9/2^{-}[734]) two-quasineutron and the K^{π}=16^{+}, 8^{-}ν^{2}(7/2^{+}[624],9/2^{-}[734])⊗8^{-}π^{2}(7/2^{-}[514],9/2^{+}[624]) four-quasiparticle configurations, respectively. Surprisingly, the lifetime of the two-quasiparticle isomer is more than 4 orders of magnitude shorter than what has been observed for analogous isomers in the lighter N=150 isotones. The four-quasiparticle isomer is longer lived than the ^{254}Rf ground state that decays exclusively by spontaneous fission with a half-life of 23.2(1.1) µs. The absence of sizable fission branches from either of the isomers implies unprecedented fission hindrance relative to the ground state.

11.
Ann Oncol ; 26(11): 2257-66, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26347100

RESUMO

BACKGROUND: Body mass index (BMI), a measure of obesity typically assessed in middle age or later, is known to be positively associated with pancreatic cancer. However, little evidence exists regarding the influence of central adiposity, a high BMI during early adulthood, and weight gain after early adulthood on pancreatic cancer risk. DESIGN: We conducted a pooled analysis of individual-level data from 20 prospective cohort studies in the National Cancer Institute BMI and Mortality Cohort Consortium to examine the association of pancreatic cancer mortality with measures of central adiposity (e.g. waist circumference; n = 647 478; 1947 pancreatic cancer deaths), BMI during early adulthood (ages 18-21 years) and BMI change between early adulthood and cohort enrollment, mostly in middle age or later (n = 1 096 492; 3223 pancreatic cancer deaths). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. RESULTS: Higher waist-to-hip ratio (HR = 1.09, 95% CI 1.02-1.17 per 0.1 increment) and waist circumference (HR = 1.07, 95% CI 1.00-1.14 per 10 cm) were associated with increased risk of pancreatic cancer mortality, even when adjusted for BMI at baseline. BMI during early adulthood was associated with increased pancreatic cancer mortality (HR = 1.18, 95% CI 1.11-1.25 per 5 kg/m(2)), with increased risk observed in both overweight and obese individuals (compared with BMI of 21.0 to <23 kg/m(2), HR = 1.36, 95% CI 1.20-1.55 for BMI 25.0 < 27.5 kg/m(2), HR = 1.48, 95% CI 1.20-1.84 for BMI 27.5 to <30 kg/m(2), HR = 1.43, 95% CI 1.11-1.85 for BMI ≥30 kg/m(2)). BMI gain after early adulthood, adjusted for early adult BMI, was less strongly associated with pancreatic cancer mortality (HR = 1.05, 95% CI 1.01-1.10 per 5 kg/m(2)). CONCLUSIONS: Our results support an association between pancreatic cancer mortality and central obesity, independent of BMI, and also suggest that being overweight or obese during early adulthood may be important in influencing pancreatic cancer mortality risk later in life.


Assuntos
Obesidade Abdominal/mortalidade , Obesidade/mortalidade , Neoplasias Pancreáticas/mortalidade , Adolescente , Estudos de Coortes , Humanos , Obesidade/diagnóstico , Obesidade Abdominal/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
12.
Rev Sci Instrum ; 86(7): 076105, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26233419

RESUMO

A new radiochemical method for determining deuterium-tritium (DT) fuel and plastic ablator (CH) areal densities (ρR) in high-convergence, cryogenic inertial confinement fusion implosions at the National Ignition Facility is described. It is based on measuring the (198)Au/(196)Au activation ratio using the collected post-shot debris of the Au hohlraum. The Au ratio combined with the independently measured neutron down scatter ratio uniquely determines the areal densities ρR(DT) and ρR(CH) during burn in the context of a simple 1-dimensional capsule model. The results show larger than expected ρR(CH) values, hinting at the presence of cold fuel-ablator mix.

13.
Rev Sci Instrum ; 85(6): 063508, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24985820

RESUMO

We describe a radiochemical measurement of the ratio of isotope concentrations produced in a gold hohlraum surrounding an Inertial Confinement Fusion capsule at the National Ignition Facility (NIF). We relate the ratio of the concentrations of (n,γ) and (n,2n) products in the gold hohlraum matrix to the down-scatter of neutrons in the compressed fuel and, consequently, to the fuel's areal density. The observed ratio of the concentrations of (198m+g)Au and (196g)Au is a performance signature of ablator areal density and the fuel assembly confinement time. We identify the measurement of nuclear cross sections of astrophysical importance as a potential application of the neutrons generated at the NIF.

14.
J Clin Microbiol ; 52(7): 2684-5, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24829243

RESUMO

This study's objective was to determine the in vitro antimicrobial activities of gallium maltolate (GaM) and 20 other antimicrobial agents against clinical equine isolates of Corynebacterium pseudotuberculosis. The growth of cultured isolates was not inhibited by any concentration of GaM. MIC data revealed susceptibility to commonly used antimicrobials.


Assuntos
Anti-Infecciosos/farmacologia , Infecções por Corynebacterium/veterinária , Corynebacterium pseudotuberculosis/efeitos dos fármacos , Corynebacterium pseudotuberculosis/isolamento & purificação , Doenças dos Cavalos/microbiologia , Compostos Organometálicos/farmacologia , Pironas/farmacologia , Animais , Infecções por Corynebacterium/microbiologia , Cavalos , Testes de Sensibilidade Microbiana
15.
J Vet Pharmacol Ther ; 37(6): 571-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24730377

RESUMO

Antimicrobial efficacy against Lawsonia intracellularis is difficult to evaluate in vitro, thus, the effects of gallium maltolate's (GaM) were investigated in a rabbit model for equine proliferative enteropathy (EPE). Juvenile (5-6-week-old) does were infected with 3.0 × 10(8) L. intracellularis/rabbit and allocated into three groups (n = 8). One week postinfection, one group was treated with GaM, 50 mg/kg; one, with doxycycline, 5 mg/kg; and one with a sham-treatment (control). Feces and blood were collected daily and weekly, respectively, to verify presence of L. intracellularis fecal shedding using qPCR, and seroconversion using immunoperoxidase monolayer assay. Rabbits were sacrificed after 1 week of treatment to collect intestinal tissues focusing on EPE-affected sections. Intestinal lesions were confirmed via immunohistochemistry. No difference was noted between treatments regarding EPE-lesions in jejunum (P = 0.51), ileum (P = 0.74), and cecum (P = 0.35), or in L. intracellularis fecal shedding (P = 0.64). GaM and doxycycline appear to have similar efficacy against EPE in infected rabbits.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Desulfovibrionaceae/veterinária , Lawsonia (Bactéria)/efeitos dos fármacos , Compostos Organometálicos/uso terapêutico , Pironas/uso terapêutico , Animais , Infecções por Desulfovibrionaceae/tratamento farmacológico , Infecções por Desulfovibrionaceae/microbiologia , Infecções por Desulfovibrionaceae/patologia , Modelos Animais de Doenças , Feminino , Coelhos , Resultado do Tratamento
16.
J Vet Pharmacol Ther ; 37(5): 486-99, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24628462

RESUMO

Oral gallium maltolate (GaM) pharmacokinetics (PK) and intestinal tissue (IT) concentrations of elemental gallium ([Ga]) and iron ([Fe]) were investigated in a rabbit model of equine proliferative enteropathy (EPE). New Zealand white does (uninfected controls and EPE-infected, n = 6/group) were given a single oral GaM dose (50 mg/kg). Serial blood samples were collected from 0 to 216 h post-treatment (PT) and IT samples after euthanasia. Serology, qPCR, and immunohistochemistry confirmed, or excluded, EPE. Blood and IT [Ga] and [Fe] were determined using inductively coupled plasma-mass spectrometry. PK parameters were estimated through noncompartmental approaches. For all statistical comparisons on [Ga] and [Fe] α = 5%. The Ga log-linear terminal phase rate constant was lower in EPE rabbits vs. uninfected controls [0.0116 ± 0.004 (SD) vs. 0.0171 ± 0.0028 per hour; P = 0.03]; but half-life (59.4 ± 24.0 vs. 39.4 ± 10.8 h; P = 0.12); Cmax (0.50 ± 0.21 vs. 0.59 ± 0.42 µg/mL; P = 0.45); tmax (1.75 ± 0.41 vs. 0.9 ± 0.37 h; P = 0.20); and oral clearance (6.743 ± 1.887 vs. 7.208 ± 2.565 L/h; P = 0.74) were not. IT's [Ga] and [Fe] were higher (P < 0.0001) in controls. In conclusion, although infection reduces IT [Ga] and [Fe], a 48 h GaM dosing interval is appropriate for multidose studies in EPE rabbits.


Assuntos
Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico , Infecções por Desulfovibrionaceae/microbiologia , Lawsonia (Bactéria) , Compostos Organometálicos/farmacocinética , Compostos Organometálicos/uso terapêutico , Pironas/farmacocinética , Pironas/uso terapêutico , Animais , Infecções por Desulfovibrionaceae/tratamento farmacológico , Feminino , Meia-Vida , Coelhos
17.
Ann Oncol ; 25(6): 1106-15, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24631943

RESUMO

Pancreatic cancer has few early symptoms, is usually diagnosed at late stages, and has a high case-fatality rate. Identifying modifiable risk factors is crucial to reducing pancreatic cancer morbidity and mortality. Prior studies have suggested that specific foods and nutrients, such as dairy products and constituents, may play a role in pancreatic carcinogenesis. In this pooled analysis of the primary data from 14 prospective cohort studies, 2212 incident pancreatic cancer cases were identified during follow-up among 862 680 individuals. Adjusting for smoking habits, personal history of diabetes, alcohol intake, body mass index (BMI), and energy intake, multivariable study-specific hazard ratios (MVHR) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazards models and then pooled using a random effects model. There was no association between total milk intake and pancreatic cancer risk (MVHR = 0.98, 95% CI = 0.82-1.18 comparing ≥500 with 1-69.9 g/day). Similarly, intakes of low-fat milk, whole milk, cheese, cottage cheese, yogurt, and ice-cream were not associated with pancreatic cancer risk. No statistically significant association was observed between dietary (MVHR = 0.96, 95% CI = 0.77-1.19) and total calcium (MVHR = 0.89, 95% CI = 0.71-1.12) intake and pancreatic cancer risk overall when comparing intakes ≥1300 with <500 mg/day. In addition, null associations were observed for dietary and total vitamin D intake and pancreatic cancer risk. Findings were consistent within sex, smoking status, and BMI strata or when the case definition was limited to pancreatic adenocarcinoma. Overall, these findings do not support the hypothesis that consumption of dairy foods, calcium, or vitamin D during adulthood is associated with pancreatic cancer risk.


Assuntos
Laticínios/efeitos adversos , Dieta/efeitos adversos , Neoplasias Pancreáticas/epidemiologia , Estudos de Coortes , Humanos , Modelos de Riscos Proporcionais , Fatores de Risco
18.
Breast Cancer Res Treat ; 144(1): 171-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24481681

RESUMO

Sequence-based testing of disease-susceptibility genes has identified many variants of unknown significance (VUSs) whose pathogenicity is unknown at the time of their measurement. Female breast cancer cases aged 20-49 years at diagnosis and who have VUSs in BRCA1 and no mutations in BRCA2 have previously been identified through the population-based Los Angeles County Cancer Surveillance Program. These nominal BRCA1 VUSs have been classified as "low," "medium," and "high" risk by four classification methods: Align-GVGD, Polyphen, Grantham matrix scores, and sequence conservation in mammalian species. Average hazard ratios (HRs) for classes of variants, i.e., the age-specific incidences of cancer for carriers of such variants divided by the population incidences, were estimated from the cancer family histories of first- and second-degree relatives of the index cases using modified segregation analysis. The study sample comprised 270 index cases and 4,543 of their relatives. There was weak evidence that the risk of breast cancer increases with the degree of sequence conservation (P = 0.03) and that missense variants at highly conserved sites are associated with a 5.6-fold (95 % confidence interval 1.4-22.2; P = 0.05) increased incidence of breast cancer. An upper bound of 2.3 is given for the average breast cancer HRs corresponding to variants classified as "low risk" by any of the four VUS classification methods. In summary, we have given a method to estimate cancer risks for groups of VUSs by combining existing classification methods with traditional penetrance analyses. This analysis suggests that classification methods for BRCA1 variants based on sequence conservation might be useful in a clinical setting. We have shown in principle that our method can be used to classify VUSs into clinically useful risk categories, but our specific findings should not be put into clinical practice unless confirmed by larger studies.


Assuntos
Neoplasias da Mama/genética , Genes BRCA1 , Predisposição Genética para Doença/genética , Adulto , Sequência Conservada/genética , Feminino , Variação Genética , Humanos , Pessoa de Meia-Idade , Risco , Adulto Jovem
19.
Osteoporos Int ; 25(5): 1519-26, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24566584

RESUMO

UNLABELLED: Guidelines recommend screening for osteoporosis with bone mineral density (BMD) testing in menopausal women, particularly those with additional risk factors for fracture. Many eligible women remain unscreened. This randomized study demonstrates that a single outreach interactive voice response phone call improves rates of BMD screening among high-risk women age 50-64. INTRODUCTION: Osteoporotic fractures are a major cause of disability and mortality. Guidelines recommend screening with BMD for menopausal women, particularly those with additional risk factors for fracture. However, many women remain unscreened. We examined whether telephonic interactive voice response (IVR) or patient mailing could increase rates of BMD testing in high risk, menopausal women. METHODS: We studied 4,685 women age 50-64 years within a not-for-profit health plan in the United States. All women had risk factors for developing osteoporosis and no prior BMD testing or treatment for osteoporosis. Patients were randomly allocated to usual care, usual care plus IVR, or usual care plus mailed educational materials. To avoid contamination, patients within a single primary care physician practice were randomized to receive the same intervention. The primary endpoint was BMD testing at 12 months. Secondary outcomes included BMD testing at 6 months and medication use at 12 months. RESULTS: Mean age was 57 years. Baseline demographic and clinical characteristics were similar across the three study groups. In adjusted analyses, the incidence of BMD screening was 24.6% in the IVR group compared with 18.6% in the usual care group (P < 0.001). There was no difference between the patient mailing group and the usual care group (P = 0.3). CONCLUSIONS: In this large community-based randomized trial of high risk, menopausal women age 50-64, IVR, but not patient mailing, improved rates of BMD screening. IVR remains a viable strategy to incorporate in population screening interventions.


Assuntos
Programas de Rastreamento/organização & administração , Osteoporose Pós-Menopausa/diagnóstico , Serviços Postais , Telefone , Densidade Óssea , Diagnóstico por Computador/métodos , Feminino , Educação em Saúde/organização & administração , Promoção da Saúde/organização & administração , Humanos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/fisiopatologia , Fraturas por Osteoporose/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Interface para o Reconhecimento da Fala , Estados Unidos , Interface Usuário-Computador
20.
J Hum Nutr Diet ; 27 Suppl 2: 4-11, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23607595

RESUMO

BACKGROUND: Three international surveys were developed aiming to identify the current nutrition educational tools used in the management of phenylketonuria (PKU) and the perceived effectiveness of these tools by clinicians, parents and patients. METHODS: The first two surveys were distributed through the Metabolic Dietitians ListServe (pno-metabl@listserv.cc.emory.edu), and the third survey was distributed by international clinics and the National PKU Alliance website (www.npkua.org). A total of 888 responses (S1, n = 88; S2, n = 81; S3, n = 719) were collected from all three surveys. The surveys represent participants from 17 countries, in Europe; North America (USA and Canada); Mexico; Argentina; Turkey; Australia; and Africa (Tunisia). RESULTS: A consistent decline in 'parents as role models' as an educational tool was observed starting at age 10 years. Patients responded they feel their families are the most effective form of education, whereas handouts were selected as the least effective educational tool by patients. Parents responded they feel the most effective educational tool is one-on-one counselling. Patients and parents show a desirable trend in wanting to attend group clinic, even in centres where this type of educational tool is not offered. CONCLUSIONS: There was a discrepancy between clinicians and patient views regarding the perceived effectiveness of the nutrition education tools. Future research is needed surrounding the impact nutrition education may have on improved dietary compliance in patients with PKU.


Assuntos
Gerenciamento Clínico , Educação em Saúde/métodos , Inquéritos Epidemiológicos , Terapia Nutricional/métodos , Fenilcetonúrias/dietoterapia , Adolescente , Adulto , Criança , Aconselhamento/educação , Dieta , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Pais/educação , Cooperação do Paciente , Médicos , Projetos Piloto , Adulto Jovem
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