Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
1.
BMC Womens Health ; 24(1): 189, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515088

RESUMO

OBJECTIVE: To determine whether knowledge of cytology affects the colposcopist's diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2). METHOD: In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations. RESULTS: Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI: 39.3 to 62.8] to 63.7% [95%CI: 52.1 to 73.9] and improved the specificity from 63.5% [95%CI: 52.3 to 73.5] to 76.6% [95%CI: 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade. CONCLUSIONS: Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings.


Assuntos
Infecções por Papillomavirus , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Feminino , Humanos , Colposcopia/métodos , Estudos Cross-Over , Citodiagnóstico , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/métodos
2.
Eur J Health Econ ; 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38194207

RESUMO

OBJECTIVE: To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective. METHODS: Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0-12 years and Trial 2 337 young people aged 13-25 years with eczema scored ≥ 5 on Patient-Oriented Eczema Measure (POEM). Participants were randomized (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2. RESULTS: The intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (> 68%) in most analyses. The exception was the complete case cost-utility analysis for Trial 1 (omitting participants with children aged < 2), with adjusted incremental cost savings of -£34.15 (95% CI - 104.54 to 36.24) and incremental QALYs of - 0.003 (95% CI - 0.021 to 0.015) producing an incremental cost per QALY of £12,466. In the secondary combined (Trials 1 and 2) cost-effectiveness analysis, the adjusted incremental cost was -£20.35 (95% CI - 55.41 to 14.70) with incremental success (≥ 2-point change on POEM) of 10.3% (95% CI 2.3-18.1%). CONCLUSION: The free at point of use online eczema self-management intervention was low cost to run and cost-effective. TRIAL REGISTRATION: This trial was registered prospectively with the ISRCTN registry (ISRCTN79282252). URL www.EczemaCareOnline.org.uk .

3.
Comput Biol Med ; 169: 107809, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38113684

RESUMO

Screening Papanicolaou test samples has proven to be highly effective in reducing cervical cancer-related mortality. However, the lack of trained cytopathologists hinders its widespread implementation in low-resource settings. Deep learning-assisted telecytology diagnosis emerges as an appealing alternative, but it requires the collection of large annotated training datasets, which is costly and time-consuming. In this paper, we demonstrate that the abundance of unlabeled images that can be extracted from Pap smear test whole slide images presents a fertile ground for self-supervised learning methods, yielding performance improvements compared to off-the-shelf pre-trained models for various downstream tasks. In particular, we propose Cervical Cell Copy-Pasting (C3P) as an effective augmentation method, which enables knowledge transfer from public and labeled single-cell datasets to unlabeled tiles. Not only does C3P outperforms naive transfer from single-cell images, but we also demonstrate its advantageous integration into multiple instance learning methods. Importantly, all our experiments are conducted on our introduced in-house dataset comprising liquid-based cytology Pap smear images obtained using low-cost technologies. This aligns with our long-term objective of deep learning-assisted telecytology for diagnosis in low-resource settings.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Infecções por Papillomavirus/diagnóstico , Triagem , Região de Recursos Limitados , Citologia , Neoplasias do Colo do Útero/diagnóstico , Aprendizado de Máquina Supervisionado
5.
J Am Soc Cytopathol ; 12(3): 170-180, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36922319

RESUMO

INTRODUCTION: Cytology is an option for triaging human papillomavirus (HPV)-positive women. The interpretation of cytologic slides requires expertise and financial resources that are not always available in resource-limited settings. A solution could be offered by manual preparation and digitization of slides on site for real-time remote cytologic diagnosis by specialists. In the present study, we evaluated the operational feasibility and cost of manual preparation and digitization of thin-layer slides and the diagnostic accuracy of screening with virtual microscopy. MATERIALS AND METHODS: Operational feasibility was evaluated on 30 cervical samples obtained during colposcopy. The simplicity of the process and cellularity and quality of digitized thin-layer slides were evaluated. The diagnostic accuracy of digital versus glass slides to detect cervical intraepithelial neoplasia grade 2 or worse was assessed using a cohort of 264 HPV-positive Cameroonian women aged 30 to 49 years. The histologic results served as the reference standard. RESULTS: Manual preparation was found to be feasible and economically viable. The quality characteristics of the digital slides were satisfactory, and the mean cellularity was 6078 squamous cells per slide. When using the atypical squamous cells of undetermined significance or worse threshold for positivity, the diagnostic performance of screening digital slides was not significantly different statistically compared with the same set of slides screened using a light microscope (P = 0.26). CONCLUSIONS: We have developed an innovative triage concept for HPV-positive women. A quality-ensured telecytologic diagnosis could be an effective solution in areas with a shortage of specialists, applying a same day "test-triage-treat" approach. Our results warrant further on-site clinical validation in a large prospective screening trial.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Esfregaço Vaginal/métodos , Neoplasias do Colo do Útero/patologia , Papillomavirus Humano , Triagem/métodos , Estudos Prospectivos , Teste de Papanicolaou
6.
Eye (Lond) ; 37(13): 2810-2816, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36725916

RESUMO

OBJECTIVES: To determine the feasibility, validity and reliability of automatically extracting clinically meaningful eyelid measurements from consumer-grade videos of individuals with oculofacial disorders. METHODS: A custom computer program was designed to automatically extract clinical measures from consumer-grade videos. This program was applied to publicly available videos of individuals with oculofacial disorders, and age-matched controls. The primary outcomes were margin reflex distance 1 (MRD1) and 2 (MRD2), blink lagophthalmos, and ocular surface area exposure. Test-retest reliability was evaluated using Bland-Altman analysis to compare the agreement in obtained measures between separate videos of the same individual taken within 48 h of each other. RESULTS: MRD1 was reduced in individuals with ptosis versus controls (2.2 mm versus 3.4 mm, p < 0.001), and increased in individuals with facial nerve palsy (FNP) (3.9 mm, p = 0.049) and thyroid eye disease (TED) (4.1 mm; p = 0.038). Blink lagophthalmos was increased in individuals with FNP (3.7 mm); p < 0.001) and those with TED (0.1 mm, p = 0.003) versus controls (0.0 mm). Ocular surface exposure was reduced in individuals with ptosis compared with controls (12.2 mm2 versus 13.1 mm2; p < 0.001) and increased in TED (13.7 mm2; p 0.002). Bland-Altmann analysis demonstrated 95% limits of agreement for video-derived measures: median MRD1: -1.1 to 1.1 mm; median MRD2: -0.9 to 1.0 mm; blink lagophthalmos: -3.5 to 3.7 mm; and average ocular surface area exposure: -1.6 to 1.6 mm2. CONCLUSIONS: The presented program is capable of taking consumer grade videos of patients with oculofacial disease and providing clinically meaningful and reliable eyelid measurements that show promising validity.


Assuntos
Blefaroptose , Paralisia Facial , Oftalmopatia de Graves , Humanos , Reprodutibilidade dos Testes , Estudos de Viabilidade , Pálpebras , Blefaroptose/diagnóstico , Aprendizado de Máquina , Estudos Retrospectivos
7.
Int J Retina Vitreous ; 8(1): 23, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365223

RESUMO

BACKGROUND: Our aim was to examine the long term anatomical and functional outcomes in patients with refractory diabetic macular oedema (DMO) undergoing treatment switch from ranibizumab to aflibercept. METHODS: Retrospective review of patients with DMO undergoing treatment switch from ranibizumab to aflibercept at a single centre between 2015 and 2017. Primary outcomes were best corrected visual acuity (BCVA) and central macular thickness (CMT). RESULTS: 57 eyes from 44 patients were included. Following switch to aflibercept, median (IQR) BCVA improved to 73 (64-77) letters at 3 months (p = 0.0006), to 73 (61-78) letters at 6 months (p = 0.0042), to 73 (65-77) at 9 months (p = 0.0006), and to 73 (63-75) letters at 18 months (p = 0.0444). At 36 months following switch, 12 eyes had gained > 10 letters, 5 eyes had gained 5-9 letters, 25 remained stable (± 5 letters), 7 eyes lost 5-9 letters and 8 eyes lost > 10 letters. A significant reduction in CMT at all trimesters following treatment switch was found except at month 24. CONCLUSIONS: We provide real world data suggesting a sustained anatomical and functional benefit of switching from ranibizumab to aflibercept in the treatment of refractory DMO.

8.
Front Nutr ; 9: 841454, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35360690

RESUMO

Aroma-active compounds in raw bovine milk produced from cows fed perennial ryegrass (GRS) or total mixed ration (TMR) consisting of grass silage, maize silage, and concentrates were identified by direct immersion sorptive extraction (DI Hi-Sorb), coupled with gas-chromatography-mass spectrometry and olfactometry using odour intensity (OI) and aroma extraction dilution analysis (AEDA). Ninety-nine volatile organic compounds (VOC) were identified in these raw GRS and TMR milk samples; 33 of which were also present in the feed and rumen samples from these diets. Only the abundance of 13 VOC varied significantly based on diet. However, the odours of both raw milks were quite distinct as aroma perception is not influenced by abundance alone but also by the odour activity of each VOC. Approximately, 30% of the VOC influenced the aroma perception of these raw milks. This study clearly highlighted the significant impact of VOC transferring from the diet that influenced the aroma perception of both raw GRS and TMR milk. The aroma of the raw TMR milk was more complex than that of the raw GRS milk, and many of the key dietary-derived-odour-active VOC likely arose during the production of the TMR feed as most were either derived from Maillard reactions or impacted by heat. Seventeen of the 44 odour activities detected differed between both sample types. This study has clearly demonstrated the impact of diet on the aroma perception of raw bovine milk.

9.
Cureus ; 14(2): e21803, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35261829

RESUMO

Background Neodymium-doped yttrium aluminium garnet (Nd:YAG) posterior capsulotomy is a common treatment for posterior capsular opacification. Practice varies regarding routine follow-up. In this study, we reviewed follow-up rates and treatment-related complications from a district general hospital's ophthalmology unit to assess areas for improvement and cost-effectiveness. Methodology We conducted a retrospective review of electronic patient records for all patients treated with Nd:YAG capsulotomy in 2019 at our hospital. Primary outcomes included visual acuity, complications, and follow-up data. Secondary outcomes included medication prescribing and the grade of surgeon. Results In total, 912 eyes of 744 patients were included. Overall, 536 (58.8%) eyes were discharged immediately following their laser. Complication rate was 4.3% (39 eyes). Junior training grades had a higher rate of medication prescribing (40/46 eyes; 87.0%) and follow-up (36/40 eyes; 78.3%). Conclusions Certain selected patients may be safely discharged following capsulotomy with safety-netting advice. This strategy increases the capacity to follow-up patients at higher risk of complications. Higher rates of follow-up among junior ophthalmologists offers potential for training.

10.
Nat Med ; 27(11): 1961-1969, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34750553

RESUMO

Bruton's tyrosine kinase (BTK) is crucial for FcεRI-mediated mast cell activation and essential for autoantibody production by B cells in chronic spontaneous urticaria (CSU). Fenebrutinib, an orally administered, potent, highly selective, reversible BTK inhibitor, may be effective in CSU. This double-blind, placebo-controlled, phase 2 trial (EudraCT ID 2016-004624-35 ) randomized 93 adults with antihistamine-refractory CSU to 50 mg daily, 150 mg daily and 200 mg twice daily of fenebrutinib or placebo for 8 weeks. The primary end point was change from baseline in urticaria activity score over 7 d (UAS7) at week 8. Secondary end points were the change from baseline in UAS7 at week 4 and the proportion of patients well-controlled (UAS7 ≤ 6) at week 8. Fenebrutinib efficacy in patients with type IIb autoimmunity and effects on IgG-anti-FcεRI were exploratory end points. Safety was also evaluated. The primary end point was met, with dose-dependent improvements in UAS7 at week 8 occurring at 200 mg twice daily and 150 mg daily, but not at 50 mg daily of fenebrutinib versus placebo. Asymptomatic, reversible grade 2 and 3 liver transaminase elevations occurred in the fenebrutinib 150 mg daily and 200 mg twice daily groups (2 patients each). Fenebrutinib diminished disease activity in patients with antihistamine-refractory CSU, including more patients with refractory type IIb autoimmunity. These results support the potential use of BTK inhibition in antihistamine-refractory CSU.


Assuntos
Tirosina Quinase da Agamaglobulinemia/antagonistas & inibidores , Urticária Crônica/tratamento farmacológico , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Liberação de Histamina/efeitos dos fármacos , Piperazinas/uso terapêutico , Piridonas/uso terapêutico , Adolescente , Adulto , Angioedema/tratamento farmacológico , Autoimunidade/imunologia , Método Duplo-Cego , Resistência a Medicamentos/fisiologia , Feminino , Antagonistas dos Receptores Histamínicos H1/efeitos adversos , Humanos , Imunoglobulina E/imunologia , Masculino , Mastócitos/metabolismo , Pessoa de Meia-Idade , Piperazinas/efeitos adversos , Placebos/administração & dosagem , Piridonas/efeitos adversos , Receptores de IgE/antagonistas & inibidores , Transaminases/análise , Adulto Jovem
11.
Foods ; 10(10)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34681366

RESUMO

Lipid oxidation (LO) is a primary cause of quality deterioration in fat-containing dairy powders and is often used as an estimation of a products shelf-life and consumer acceptability. The LO process produces numerous volatile organic compounds (VOC) including aldehydes, ketones and alcohols, which are known to contribute to the development of off-flavours in dairy powders. The main factors influencing the oxidative state of dairy powders and the various analytical techniques used to detect VOC as indicators of LO in dairy powders are outlined. As the ability to identify and quantify specific VOC associated with LO improves this review highlights how these techniques can be used in conjunction with olfactory and sensory analysis to better understand product specific LO processes with the aim of maximizing shelf-life without compromising quality.

12.
MHSalud ; 18(1)jun. 2021.
Artigo em Inglês | LILACS, SaludCR | ID: biblio-1386146

RESUMO

Abstract Purpose: Hydration has been shown to play a pivotal role in sport. Soccer is a team sport in which the integrity of all players is vital for team performance; thus, individual player hydration status is important. The primary aim of this study was to investigate the hydration status of female collegiate soccer players during regular season. Methods: Sixteen collegiate female soccer players (age: 20.4 ± 0.8 years; height: 163.6 ± 6.9 cm; weight: 65.3 ± 12 kg) provided urine over 9 days to monitor their hydration status. Hydration was determined by urine specific gravity (Usg). Usg was analyzed in the morning (AM) and in the afternoon before practice/game (PM). Results: All 16 players were at least minimally hypohydrated (Usg > 1.010) in the AM on 5 of the 9 days tested. Players had significantly higher Usg values in the AM as compared to PM (F(1,250) = 23.09; p < 0.0001); however, there was no significant time*day interaction (F(1,250) = 1.98; p = 0.16). Conclusion: Data show a high prevalence of hypohydration occurring in this specific population. This sub-optimal hydration status could be a cause for concern in terms of overall performance. Efforts should be made to integrate hydration interventions and daily monitoring to minimize hypohydration in players.


Resumen Propósito: Se ha demostrado que la hidratación juega un papel fundamental en el deporte. El fútbol es un deporte de equipo en el que la integridad de todos los jugadores es vital para su rendimiento; por lo tanto, el estado de hidratación de cada jugador es importante. El objetivo principal de este estudio fue investigar el estado de hidratación de las jugadoras universitarias de fútbol durante la temporada regular. Métodos: Dieciséis jugadoras universitarias de fútbol (edad: 20.4 ± 0.8 años; estatura: 163.6 ± 6.9 cm; peso: 65.3 ± 12 kg) proporcionaron muestras de orina durante 9 días para controlar su estado de hidratación, la cual se determinó por la gravedad específica de la orina (Usg). La Usg se analizó en la mañana (AM) y en la tarde antes del entrenamiento o el juego (PM). Resultados: Las 16 jugadoras estaban al menos mínimamente hipohidratadas (Usg > 1.010) en la AM en 5 de los 9 días medidos. Las jugadoras tuvieron valores Usg significativamente más altos en AM en comparación con PM (F (1,250) = 23.09; p < 0.0001); sin embargo, no hubo interacción significativa de tiempo * día (F(1,250) = 1.98; p = 0.16). Conclusión: los datos muestran una alta prevalencia de hipohidratación en esta población específica. Este estado de hidratación subóptimo podría ser motivo de preocupación en términos de rendimiento general. Se deberían hacer esfuerzos para integrar las intervenciones de hidratación y el monitoreo diario para reducir al mínimo la hipohidratación en las jugadoras.


Resumo Objetivo: Foi demonstrado que a hidratação desempenha um papel fundamental no esporte. O futebol é um esporte coletivo no qual a integridade de todos os jogadores é vital para o desempenho da equipe; portanto, o estado de hidratação de cada jogador é importante. O objetivo principal deste estudo foi investigar o estado de hidratação de universitárias jogadoras de futebol do sexo feminino durante a temporada regular. Métodos: Dezesseis universitárias jogadoras de futebol (idade: 20,4 ± 0,8 anos; altura: 163,6 ± 6,9 cm; peso: 65,3 ± 12 kg) forneceram amostras de urina por 9 dias para monitorar seu estado de hidratação. A hidratação foi determinada pela gravidade específica da urina Usg. Sua Usg foi analisado pela manhã (matutino) e à tarde (vespertino) antes do treino ou jogo. Resultados: As 16 jogadoras estavam minimamente hipohidratadas (Usg > 1.010) no período matutino em 5 dos 9 dias medidos. As jogadoras apresentaram valores de Usg significativamente maiores no período matutino em comparação ao vespertino (F (1.250) = 23,09; p <0,0001); no entanto, não houve interação tempo * dia significativa (F (1.250) = 1,98; p = 0,16). Conclusão: os dados mostram uma alta prevalência de hipohidratação nesta população específica. Este estado de hidratação abaixo do ideal pode ser uma preocupação em termos de desempenho geral. Devem ser feitos esforços para integrar intervenções de hidratação e monitoramento diário para minimizar a hipohidratação em jogadoras.


Assuntos
Humanos , Feminino , Adulto , Futebol , Estado de Hidratação do Organismo
13.
J Med Internet Res ; 23(5): e24236, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-33998998

RESUMO

BACKGROUND: Novel consumer and lifestyle data, such as those collected by supermarket loyalty cards or mobile phone exercise tracking apps, offer numerous benefits for researchers seeking to understand diet- and exercise-related risk factors for diseases. However, limited research has addressed public attitudes toward linking these data with individual health records for research purposes. Data linkage, combining data from multiple sources, provides the opportunity to enhance preexisting data sets to gain new insights. OBJECTIVE: The aim of this study is to identify key barriers to data linkage and recommend safeguards and procedures that would encourage individuals to share such data for potential future research. METHODS: The LifeInfo Survey consulted the public on their attitudes toward sharing consumer and lifestyle data for research purposes. Where barriers to data sharing existed, participants provided unstructured survey responses detailing what would make them more likely to share data for linkage with their health records in the future. The topic modeling technique latent Dirichlet allocation was used to analyze these textual responses to uncover common thematic topics within the texts. RESULTS: Participants provided responses related to sharing their store loyalty card data (n=2338) and health and fitness app data (n=1531). Key barriers to data sharing identified through topic modeling included data safety and security, personal privacy, requirements of further information, fear of data being accessed by others, problems with data accuracy, not understanding the reason for data linkage, and not using services that produce these data. We provide recommendations for addressing these issues to establish the best practice for future researchers interested in using these data. CONCLUSIONS: This study formulates a large-scale consultation of public attitudes toward this kind of data linkage, which is an important first step in understanding and addressing barriers to participation in research using novel consumer and lifestyle data.


Assuntos
Aplicativos Móveis , Atitude , Humanos , Armazenamento e Recuperação da Informação , Privacidade , Inquéritos e Questionários
14.
BJU Int ; 128(4): 440-450, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33991045

RESUMO

OBJECTIVE: To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. PATIENTS AND METHODS: This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. RESULTS: Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15; P < 0.001), male sex 1.30 (95% CI 1.14-1.50; P < 0.001), and smoking 2.70 (95% CI 2.30-3.18; P < 0.001). CONCLUSIONS: A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer.


Assuntos
Neoplasias Renais/diagnóstico , Neoplasias Ureterais/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Adulto , Idoso , Feminino , Hematúria/etiologia , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Encaminhamento e Consulta , Neoplasias Ureterais/complicações , Neoplasias da Bexiga Urinária/complicações
15.
Nutrients ; 13(3)2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33807747

RESUMO

Creatine is an organic compound, consumed exogenously in the diet and synthesized endogenously via an intricate inter-organ process. Functioning in conjunction with creatine kinase, creatine has long been known for its pivotal role in cellular energy provision and energy shuttling. In addition to the abundance of evidence supporting the ergogenic benefits of creatine supplementation, recent evidence suggests a far broader application for creatine within various myopathies, neurodegenerative diseases, and other pathologies. Furthermore, creatine has been found to exhibit non-energy related properties, contributing as a possible direct and in-direct antioxidant and eliciting anti-inflammatory effects. In spite of the new clinical success of supplemental creatine, there is little scientific insight into the potential effects of creatine on cardiovascular disease (CVD), the leading cause of mortality. Taking into consideration the non-energy related actions of creatine, highlighted in this review, it can be speculated that creatine supplementation may serve as an adjuvant therapy for the management of vascular health in at-risk populations. This review, therefore, not only aims to summarize the current literature surrounding creatine and vascular health, but to also shed light onto the potential mechanisms in which creatine may be able to serve as a beneficial supplement capable of imparting vascular-protective properties and promoting vascular health.


Assuntos
Fármacos Cardiovasculares/farmacologia , Doenças Cardiovasculares/tratamento farmacológico , Fenômenos Fisiológicos Cardiovasculares/efeitos dos fármacos , Creatina/farmacologia , Suplementos Nutricionais , Fatores de Risco de Doenças Cardíacas , Humanos
16.
Nutrients ; 12(9)2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32947909

RESUMO

Creatine is a naturally occurring compound, functioning in conjunction with creatine kinase to play a quintessential role in both cellular energy provision and intracellular energy shuttling. An extensive body of literature solidifies the plethora of ergogenic benefits gained following dietary creatine supplementation; however, recent findings have further indicated a potential therapeutic role for creatine in several pathologies such as myopathies, neurodegenerative disorders, metabolic disturbances, chronic kidney disease and inflammatory diseases. Furthermore, creatine has been found to exhibit non-energy-related properties, such as serving as a potential antioxidant and anti-inflammatory. Despite the therapeutic success of creatine supplementation in varying clinical populations, there is scarce information regarding the potential application of creatine for combatting the current leading cause of mortality, cardiovascular disease (CVD). Taking into consideration the broad ergogenic and non-energy-related actions of creatine, we hypothesize that creatine supplementation may be a potential therapeutic strategy for improving vascular health in at-risk populations such as older adults or those with CVD. With an extensive literature search, we have found only four clinical studies that have investigated the direct effect of creatine on vascular health and function. In this review, we aim to give a short background on the pleiotropic applications of creatine, and to then summarize the current literature surrounding creatine and vascular health. Furthermore, we discuss the varying mechanisms by which creatine could benefit vascular health and function, such as the impact of creatine supplementation upon inflammation and oxidative stress.


Assuntos
Creatina/farmacologia , Suplementos Nutricionais , Doenças Vasculares/prevenção & controle , Creatina/uso terapêutico , Humanos
17.
Antioxidants (Basel) ; 9(4)2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32326117

RESUMO

Lipid oxidation (LO) is a recognised problem in dairy powders due to the formation of volatile odour compounds that can negatively impact sensory perception. Three commercial dairy powders, fat-filled whole milk powder (FFWMP), skim milk powder (SMP), and infant milk formula (IMF), stored under different conditions (21 °C, 37 °C, or 25 °C with 50% humidity), were evaluated by consumer acceptance studies, ranked descriptive sensory analysis, and LO volatile profiling using headspace solid phase microextraction gas chromatography mass spectrometry (HS-SPME GCMS) over 16 weeks. Significant (p = 0.001) differences in the concentration of LO compounds and sensory perception were evident between sample types in the different storage conditions. The sensory acceptance scores for FFWMP and SMP remained stable throughout storage in all conditions, despite the increased perception of some LO products. The IMF sample was perceived negatively in each storage condition and at each time point. Overall increases in hexanal, heptanal, and pentanal correlated with "painty", "oxidised", "cooked", and "caramelised" attributes in all samples. The concentration of some LO volatiles in the IMF was far in excess of those in FFWMP and SMP. High levels of LO volatiles in IMF were presumably due to the addition of polyunsaturated fatty acids (PUFA) in the formulation.

18.
ChemistryOpen ; 9(4): 431-441, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32257751

RESUMO

The influence of various physical and chemical factors on the swelling of polystyrene and PEG based resins in greener organic solvents has been systematically investigated. In general, chemical factors: the nature of the functionality/linker and the degree of loading were found to have a far larger influence on the swelling of the resins than physical parameters such as bead size. The results are interpreted in terms of Hansen solubility parameters for the solvents and there is evidence that some solvents interact with the polymeric core of a resin whilst others interact with the functionality. The results are extended to a study of the changes in resin swelling observed during both deprotection and chain elongation reactions during solid phase peptide synthesis.

19.
Nutrients ; 12(2)2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32098418

RESUMO

Vitamin D is known to elicit a vasoprotective effect, while vitamin D deficiency is a risk factor for endothelial dysfunction (ED). ED is characterized by reduced bioavailability of a potent endothelium-dependent vasodilator, nitric oxide (NO), and is an early event in the development of atherosclerosis. In endothelial cells, vitamin D regulates NO synthesis by mediating the activity of the endothelial NO synthase (eNOS). Under pathogenic conditions, the oxidative stress caused by excessive production of reactive oxygen species (ROS) facilitates NO degradation and suppresses NO synthesis, consequently reducing NO bioavailability. Vitamin D, however, counteracts the activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase which produces ROS, and improves antioxidant capacity by enhancing the activity of antioxidative enzymes such as superoxide dismutase. In addition to ROS, proinflammatory mediators such as TNF-α and IL-6 are risk factors for ED, restraining NO and eNOS bioactivity and upregulating the expression of various atherosclerotic factors through the NF-κB pathway. These proinflammatory activities are inhibited by vitamin D by suppressing NF-κB signaling and production of proinflammatory cytokines. In this review, we discuss the diverse activities of vitamin D in regulating NO bioavailability and endothelial function.


Assuntos
Aterosclerose/prevenção & controle , Endotélio Vascular/fisiopatologia , Deficiência de Vitamina D/complicações , Vitamina D/administração & dosagem , Aterosclerose/sangue , Aterosclerose/etiologia , Aterosclerose/fisiopatologia , Ensaios Clínicos como Assunto , Suplementos Nutricionais , Endotélio Vascular/efeitos dos fármacos , Humanos , NADPH Oxidases/metabolismo , Óxido Nítrico/biossíntese , Óxido Nítrico Sintase Tipo III/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Superóxido Dismutase/metabolismo , Resultado do Tratamento , Vitamina D/sangue , Vitamina D/metabolismo , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/dietoterapia , Deficiência de Vitamina D/fisiopatologia
20.
Molecules ; 25(1)2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31861730

RESUMO

The main aim of this study was to evaluate the volatile profile, sensory perception, and phytochemical content of bovine milk produced from cows fed on three distinct feeding systems, namely grass (GRS), grass/clover (CLV), and total mixed ration (TMR). Previous studies have identified that feed type can influence the sensory perception of milk directly via the transfer of volatile aromatic compounds, or indirectly by the transfer of non-volatile substrates that act as precursors for volatile compounds. In the present study, significant differences were observed in the phytochemical profile of the different feed and milk samples. The isoflavone formonoetin was significantly higher in CLV feed samples, but higher in raw GRS milk, while other smaller isoflavones, such as daidzein, genistein, and apigenin were highly correlated to raw CLV milk. This suggests that changes in isoflavone content and concentration in milk relate to diet, but also to metabolism in the rumen. This study also found unique potential volatile biomarkers in milk (dimethyl sulfone) related to feeding systems, or significant differences in the concentration of others (toluene, p-cresol, ethyl and methyl esters) based on feeding systems. TMR milk scored significantly higher for hay-like flavor and white color, while GRS and CLV milk scored significantly higher for a creamy color. Milk samples were easily distinguishable by their volatile profile based on feeding system, storage time, and pasteurization.


Assuntos
Ração Animal/análise , Leite/química , Compostos Fitoquímicos/análise , Compostos Orgânicos Voláteis/análise , Animais , Apigenina/química , Bovinos , Dimetil Sulfóxido/química , Feminino , Genisteína/química , Isoflavonas/química , Sulfonas/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...