Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 219
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-31493541

RESUMO

Allogeneic hematopoietic cell transplantation (alloHCT) has been increasingly offered to older adults with hematologic malignancies. However, optimal methods to determine fitness for alloHCT have yet to be defined. We evaluated the ability of a comprehensive geriatric assessment (CGA) to predict post-alloHCT outcomes in a single-center prospective cohort study of patients aged 50 and older. Outcomes included overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM). A total of 148 patients were included, with median age 62 years (range 50-76). In multivariate regression analysis, several CGA measures of functional status were predictive of post-alloHCT outcomes, after adjusting for traditional prognostic factors. Any deficit in Instrumental Activities of Daily Living (IADL) was associated with inferior OS (hazard ratio [HR] 1.81, 95% confidence interval [CI] 1.07-3.08, p=0.03) and PFS (HR 1.85, 95% CI 1.15-2.99, p=0.01). Medical Outcomes Study Physical Health scale (MOS-PH) score <85 was associated with inferior OS (HR 1.96, 95% CI 1.13-3.40, p=0.02), PFS (HR 1.75, 95% CI 1.07-2.88, p=0.03), and increased NRM (subdistribution HR 2.57, 95% CI 1.12-5.92, p=0.03). MOS-PH was also associated with the number of non-hematologic grade ≥3 adverse events within the first 100 days after alloHCT (rate ratio 1.61, 95% CI 1.04-2.49, p=0.03). These findings support previous work suggesting that IADL is an important prognostic tool prior to alloHCT. MOS-PH is newly identified as an additional metric to identify older patients at higher risk of poor post-alloHCT outcomes, including toxicity and NRM.

3.
Phytochem Anal ; 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31359524

RESUMO

INTRODUCTION: Traditional methods to derive experimentally-generated relative correction factors (RCFs) for the quantitative analysis of herbal multi-components by single marker (QAMS) method require reference standards and multiple validations with different instruments and columns, which hampers high throughput implementation. OBJECTIVES: To effectively reduce the application amounts of raw material and provide higher and more stable accuracy, this study aimed to develop a method to computationally generate RCFs of herbal components. MATERIALS AND METHODS: This strategy included the published data collection, calibration curves screening, computer algorithm-based RCFs generation and accuracy validation. RESULTS: Using the in silico approach, we have successfully produced 133 RCFs for the multi-component quantitative analysis of 63 widely used herbs. CONCLUSION: Compared with conventional RCFs, this in silico method would be a low cost and highly efficient way to produce practical RCFs for the QAMS method.

4.
Heart Lung Circ ; 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31353215

RESUMO

BACKGROUND: Right ventricular (RV) dysfunction can occur after cardiac surgery and persist for years. We assessed perioperative RV systolic function in patients undergoing mitral valve (MV) repair and further compared minimally invasive robotic-assisted mitral valve repair (MIMVr) vs standard 'open' MV repair (MVr). Speckle tracking (RV free wall strain [RVS]) was used as a sensitive echocardiography method to assess RV function. METHODS: Retrospective analysis, over 3 years, of consecutive patients (n = 158) referred to Mayo Clinic (Rochester, MN, USA). Preoperative, pre-discharge and 1 year transthoracic echocardiograms were reviewed. A prospective pilot study was performed for sample size estimation. Primary outcome was RV free wall strain (RVS). RESULTS: Right ventricular free wall strain declined after MV repair surgery (-22.6 ± 7% vs -15 ± 6%, p < 0.001). There were smaller reductions in RVS in MIMVr vs MVr group (-6.0 ± 9% vs -10.3 ± 8%, p < 0.01), which persisted after adjusting for baseline values (RVS treatment effect 1.5%, p = 0.007). There was greater recovery in MIMVr vs MVr group at 1 year follow-up vs pre-surgery values (-3.4 ± 9% vs -8.1 ± 8% respectively, p < 0.001, RVS treatment effect 1.7%, p = 0.001). Bypass time was higher in the MIMVr group (80min ± 22 vs 40min ± 20, p < 0.0001). The echo findings remained significant correcting for age, pulmonary pressures and change in ejection fraction. CONCLUSIONS: Right ventricular systolic dysfunction is common after MV repair surgery. Deterioration in RV contraction is less pronounced following MIMVr vs MVr and is associated with enhanced RV functional recovery at 1 year, albeit not to preoperative levels. This may potentially be associated with clinical functional improvement but further studies are warranted to investigate this.

5.
Kaohsiung J Med Sci ; 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31180621

RESUMO

The current study aimed to evaluate the expression and role of miR-323a in the progression of bladder cancer (BC), thereby providing a theoretical basis and potential therapy methods for BC patients. Our data showed that miR-323a levels were significantly reduced in BC tissues compared with those of non-cancerous tissues. Meanwhile, miR-323a was significantly decreased in human BC cell lines (T24, J82, TCCSUP, RT-112) than that in human normal bladder epithelial cell line SV-HUC-1. Furthermore, inhibition of miR-323a markedly enhanced the migration and invasive capacity of T24 and TCCSUP cells. Moreover, overexpression of miR-323a significantly prompted the apoptosis of BC cells. Dual luciferase reporter assay and western blot analysis confirmed that c-Met was a target gene of miR-323a. More importantly, upregulation of c-Met significantly prompted BC cell proliferation mainly as a result of the enhanced level of phosphorylation of AKT. This effect could be abolished when c-Met was silenced in BC cells. In summary, reduced miR-323a expression in BC contributed to enhanced BC cell proliferation and migration mainly by targeting c-Met.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31242695

RESUMO

Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17%-25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM.

7.
Cells ; 8(6)2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31207939

RESUMO

Hyperglycaemia causes endothelial dysfunction, which is the initial process in the development of diabetic vascular complications. Upon injury, endothelial cells undergo an endothelial-to-mesenchymal transition (EndMT), lose their specific marker, and gain mesenchymal phenotypes. This study investigated the effect of liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, on EndMT inhibition and neointima formation in diabetic mice induced by streptozotocin. The diabetic mice with a wire-induced vascular injury in the right carotid artery were treated with or without liraglutide for four weeks. The degree of neointima formation and re-endothelialisation was evaluated by histological assessments. Endothelial fate tracing revealed that endothelium-derived cells contribute to neointima formation through EndMT in vivo. In the diabetic mouse model, liraglutide attenuated wire injury-induced neointima formation and accelerated re-endothelialisation. In vitro, a high glucose condition (30 mmol/L) triggered morphological changes and mesenchymal marker expression in human umbilical vein endothelial cells (HUVECs), which were attenuated by liraglutide or Activin receptor-like 5 (ALK5) inhibitor SB431542. The inhibition of AMP-activated protein kinase (AMPK) signaling by Compound C diminished the liraglutide-mediated inhibitory effect on EndMT. Collectively, liraglutide was found to attenuate neointima formation in diabetic mice partially through EndMT inhibition, extending the potential therapeutic role of liraglutide.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31235340

RESUMO

BACKGROUND: Norovirus (NoV) is recognized as a leading global cause of viral acute gastroenteritis (AGE). To better understand the prevalence and genotypic patterns of NoV infection in Southeast China, we conducted a retrospective study of diarrheal syndrome surveillance of NoV and analyzed the epidemiological characteristics of AGE cases and phylogenetic evolution of NoV strains. METHODS: 1464 AGE patients in two diarrhea surveillance sentinel hospitals were sampled during 2016 and 2017. NoV Positive samples were genotyped by ORF1/ORF2 overlapping regional gene sequencing. Sequences analyses of the NoV genotypes were confirmed by online NoV Genotyping Tool and the phylogenetic analysis was constructed by MEGA 7.0. RESULTS: 139 (9.49%) of the AGE specimens were NoV positive. The GII strain was the main geno-group in NoV infected patients. At least 12 NoV genotypes and seven recombinant strains were detected. Major NoV genotypic transformations were GII.Pe/GII.4, GII.P17/GII.17 and GII.Pe/GII.17 in 2016 to GII.P16/GII.2, GII.P17/GII.17 and GII.Pe/GII.4 in 2017. Phylogenetic analysis showed that GII.P16/GII.2 recombinant strains clustered with those detected in the USA, Russia and Japan in 2016. CONCLUSION: We characterized the molecular epidemiology of NoV infection in AGE patients during 2016-2017. The main three NoV GII genotypes circulating in the population of Taizhou were GII.P17/GII.17, GII.Pe/GII.4 and GII.P16/GII.2.The GII.P16/GII.2 genotype has become the predominant strain since first quarter 2017. Monitoring of the NoV genotypic shift is important for the prevention and control of AGE.

9.
PLoS One ; 14(4): e0215732, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022235

RESUMO

The study of optimal best practice within the context of academia has produced both empirical and theoretical contributions. Optimal best practice, also coined as optimal functioning, is concerned with a person's personal best-that is, "what is the best that I can do for this academic subject?" Research in the social sciences has, to date, explored different types of optimal best-physical, cognitive, emotional, and social. What is of considerable interest, as a related matter, is a question of how a person reaches and experiences a level of optimal best practice. Recent research development, for example, has explored various conceptualizations of optimal best practice-for example, one distinctive theoretical model, the Framework of Achievement Bests [1, 2], makes a concerted effort to explore the underlying process of optimization-that is, in this case, how an optimal level of best practice is achieved. The present study, as detailed below, investigates via means of non-experimental data a theoretical model pertaining to the achievement of optimal best practice. This examination, we postulate, would enable us to add clarity and provide additional theoretical insights the operational nature of the process of optimization. The operational nature of optimization, as described in our recent research [1, 3], emphasizes three major tenets: (i) the main sources of a person's optimal best practice, (ii) the potential 'optimizing' influences of three comparable agencies on the achievement of optimal best practice (i.e., personal resolve, social relationship, and personal self-efficacy), and (iii) the impact of optimal best practice on future adaptive outcomes (i.e., academic striving and personal well-being). We explored this topic via means of the use of a non-experimental, correlational design with participants drawn from Taiwanese university students (N = 1010). Structural equation modelling (SEM) produced evidence, which empirically supported existing research [1, 3] and substantiated our knowledge of the concept of optimal best practice. Evidence established from the present study has also assisted us to identify one pervasive issue, which we call for further research development-namely, to consider, design, and develop an appropriate methodological approach that would enable researchers to accurately measure and assess the process of optimization. Finally, in terms of teaching and learning, we acknowledge that our research investigation has provided some insights into potential educational practices for implementation.

10.
Clin Respir J ; 13(7): 438-445, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30955228

RESUMO

INTRODUCTION: The DECAF score is a simple and effective tool for predicting mortality in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the DECAF score has not been validated in AECOPD patients requiring invasive mechanical ventilation (IMV). We devised the ventilator (v)-DECAF score, in which "anemia" replaces "acidaemia," for use in AECOPD patients requiring IMV. The objective of this study was to compare the predictive efficacy of the v-DECAF score and the DECAF score. METHODS: This study prospectively recruited 112 consecutive AECOPD patients requiring IMV from a single center. The clinical endpoint was 90-day all-cause mortality. Demographic and clinical data were recorded, as well as APACHE II, GCS, CURB-65, BAP-65 and DECAF scores, and the newly devised v-DECAF score. The discriminatory value of the scoring systems in predicting 90-day all-cause mortality was determined using the area under the receiver operating characteristic (AUROC) curve. RESULTS: In multivariate logistic regression analysis, the v-DECAF score was an independent predictor of 90-day all-cause mortality (odds ratio 3.004, 95% CI 1.658-5.445, P < 0.001). The AUROC of the v-DECAF and DECAF scores were 0.852 (95% CI 0.766-0.938) and 0.777 (95%CI: 0.676-0.878), respectively. The v-DECAF score had a better predictive value for 90-day all-cause mortality compared to the DECAF score (Z = 2.338, P = 0.019). CONCLUSION: The v-DECAF score had good discriminatory power in predicting 90-day all-cause mortality in AECOPD patients requiring IMV.

12.
Neurourol Urodyn ; 38(4): 1120-1128, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30848840

RESUMO

AIMS: Pubovisceral (PV) muscle tears are associated with pelvic floor disorders. The goal of this study was to determine whether index finger palpatory assessment of PV muscle body integrity through the lateral vaginal wall is a reliable indicator of PV muscle tear severity diagnosed by magnetic resonance imaging (MRI). METHODS: We studied 85 women, 7 weeks after vaginal birth. All had at least one risk factor for obstetric-related PV muscle tear. The ordinal outcome measure of MRI-documented PV muscle tear was defined as: none, less than 50% unilateral tear, 50% or greater unilateral tear or less than 50% bilateral tear, and 50% or greater bilateral tear. PV muscle body integrity by palpatory assessment was scored on a matrix, with each side scored independently and classified as PV muscle body "present" (assuredly felt), "equivocal" (not sure if felt), or "absent" (assuredly not felt). Proportional odds models were constructed to estimate the relationship between PV muscle body integrity palpatory assessment and MRI-documented PV muscle tears. RESULTS: Thirty-five percent of study participants exhibited varying degrees of MRI-documented PV muscle tears. Using palpatory assessment, we identified "PV muscle body present bilaterally" in 20%, "equivocal unilaterally or present contralaterally" in 8%, "equivocal or absent unilaterally" or "equivocal bilaterally" in 62%, and "absent bilaterally" in 9%. The odds ratio for estimating MRI results from palpatory assessment was 3.62 (95% confidence interval = 1.70-7.73, P = 0.001). CONCLUSIONS: A rapid and inexpensive palpatory assessment in the clinic was highly associated with the risk of MRI-documented PV muscle tear and is a useful component of a clinical assessment.

13.
Endocr Pract ; 25(6): 534-544, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30865546

RESUMO

Objective: To summarize the characteristics of patients with pituitary stalk thickening, analyze the association between pituitary stalk width and hypopituitarism, and develop a diagnostic model to differentiate neoplastic and inflammatory origins. Methods: A total of 325 patients with pituitary stalk thickening in a tertiary teaching hospital between January 2012 and February 2018 were enrolled. Basic characteristics and hormonal status were evaluated. Indicators to predict etiology in patients with histologic diagnoses were analyzed. Results: Of the 325 patients, 62.5% were female. Deficiency in gonadotropin was most common, followed by corticotropin, growth hormone, and thyrotropin. The increase in pituitary stalk width was associated with a risk of central diabetes insipidus (odds ratio [OR], 3.57; P<.001) and with a combination of central diabetes insipidus and anterior pituitary deficiency (OR, 2.28; P = .029). The cut-off pituitary stalk width of 4.75 mm had a sensitivity of 69.2% and a specificity of 71.4% for the presence of central diabetes insipidus together with anterior pituitary deficiency. Six indicators (central diabetes insipidus, pattern of pituitary stalk thickening, pituitary stalk width, neutrophilic granulocyte percentage, serum sodium level, and gender) were used to develop a model having an accuracy of 95.7% to differentiate neoplastic from inflammatory causes. Conclusion: Pituitary stalk width could indicate the presence of anterior pituitary dysfunction, especially in central diabetes insipidus patients. With the use of a diagnostic model, the neoplastic and inflammatory causes of pituitary stalk thickening could be preliminarily differentiated. Abbreviations: APD = anterior pituitary dysfunction; AUC = area under the curve; CDI = central diabetes insipidus; GH = growth hormone; MRI = magnetic resonance imaging; OR = odd ratio; PHBS = posterior hypophyseal bright spots; PST = pituitary stalk thickening; PSW = pituitary stalk width.


Assuntos
Diabetes Insípido Neurogênico , Hipopituitarismo , Doenças da Hipófise , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Hipófise
14.
Head Neck ; 41(7): 2277-2284, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30759328

RESUMO

BACKGROUND: This study was to investigate the association of fasting serum glucose (FSG), thyroid-stimulating hormone (TSH), and thyroid hormones with papillary thyroid cancer (PTC). METHODS: A total of 649 participants were included in this case-control study. The associations of FSG, TSH, free triiodothyronine (FT3) and free thyroxine (FT4) with PTC were estimated using an unconditional logistic regression. RESULTS: Compared with the lowest quintile of TSH levels, odds ratios (ORs) and 95% confidence intervals (CIs) for association between PTC risk and highest quintile of TSH levels were 1.67 (95% CI, 0.99-2.83). However, this risk correlation was more significant in PTC cases with ≤1.0 cm tumor size (adjusted OR, 1.95; 95% CI, 1.08-3.54; adjusted P-trend, 0.05). The PTC risk was also inversely associated with the serum FT3 level in all participants (adjusted P-trend, 0.001), but positively associated with the serum FT4 (adjusted P-trend, 0.001) and FSG (adjusted P-trend, 0.01) levels. Among the participants without diabetes, the individuals with high FSG levels and abnormal TSH concentration had an increased PTC risk (adjusted OR, 3.38; 95% CI, 1.78-6.42). CONCLUSION: The current study provides evidence for the association of FSG, TSH, and thyroid hormones (FT3 and FT4) with PTC risk. However, larger relative studies are needed.

15.
Int Arch Occup Environ Health ; 92(4): 587-598, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30627853

RESUMO

PURPOSE: In the past 60 years, the prevalences of asthma and allergy among children have increased around the world. Neither genetic nor outdoor environmental factors can explain this increase. METHODS: We performed a cross-sectional study of 7366 children in Tianjin, China, on associations of home environment and lifestyles with asthma and allergy. RESULTS: The prevalences of diagnosed asthma, rhinitis and eczema among 0- to 8-year-old children in the Tianjin area were 4%, 9% and 39%. Home environment and lifestyle, together with infections, were strong risk factors. For asthma and allergy, the population attributable fraction (PAF) due to modern floors and wall coverings (i.e., laminated wooden floors and painted walls compared to tile floors and lime-coated walls) was 22%. Window condensation in winter and air conditioner use in summer, both of which are proxies for less ventilation, accounted for 7-17% of rhinitis and eczema. Cesarean delivery accounted for 10% of eczema symptoms. We developed a modern life index from appropriate home characteristics and lifestyle and food consumption habits and found it to have a clear dose-response relationship with asthma and allergy in Tianjin children. CONCLUSIONS: The results indicate that a "modern" home environment together with a modern lifestyle is associated with increased prevalences of asthma and allergies among children. Appropriate indoor environmental interventions and education of children's caregivers are important in the management of childhood asthma and allergy.

16.
Chem Asian J ; 14(10): 1667-1671, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30537351

RESUMO

Insulated molecular wires (IMWs) bearing non-centrosymmetric conjugated axle components were precisely synthesized via iterative cross-coupling reactions in organic solvents and subsequent intramolecular slippage transformation in aqueous solvents. This programmable synthetic procedure selectively afforded both insulated and uninsulated molecular wires bearing oligo(phenylene ethynylene) and permethylated α-cyclodextrins with well-defined conjugation lengths and supramolecular structures. High selectivity of this method was confirmed by NMR and mass spectroscopic analyses. The resultant IMWs exhibited distinct optical properties because of different conjugation lengths and insulated structures. This synthetic strategy for structurally defined IMWs bearing non-centrosymmetric conjugated axle components could provide a platform for obtaining diverse functionalized materials useful in the fields of non-centrosymmetric molecular machines and molecular electronics.

17.
Oxid Med Cell Longev ; 2018: 7518920, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30416645

RESUMO

This study tested the hypothesis that extracorporeal shock wave- (ECSW-) assisted adipose-derived stromal vascular fraction (SVF) therapy could preserve left ventricular ejection fraction (LVEF) and inhibit LV remodeling in a rat after acute myocardial infarction (AMI). Adult male SD rats were categorized into group 1 (sham control), group 2 (AMI induced by left coronary artery ligation), group 3 [AMI + ECSW (280 impulses at 0.1 mJ/mm2, applied to the chest wall at 3 h, days 3 and 7 after AMI), group 4 [AMI + SVF (1.2 × 106) implanted into the infarct area at 3 h after AMI], and group 5 (AMI + ECSW-SVF). In vitro, SVF protected H9C2 cells against menadione-induced mitochondrial damage and increased fluorescent intensity of mitochondria in nuclei (p < 0.01). By day 42 after AMI, LVEF was highest in group 1, lowest in group 2, significantly higher in group 5 than in groups 3 and 4, and similar between the latter two groups (all p < 0.0001). LV remodeling and infarcted, fibrotic, and collagen deposition areas as well as apoptotic nuclei exhibited an opposite pattern to LVEF among the groups (all p < 0.0001). Protein expressions of CD31/vWF/eNOS/PGC-1α/α-MHC/mitochondrial cytochrome C exhibited an identical pattern, whilst protein expressions of MMP-9/TNF-α/IL-1ß/NF-κB/caspase-3/PARP/Samd3/TGF-ß/NOX-1/NOX-2/oxidized protein/ß-MHC/BNP exhibited an opposite pattern to LVEF among five groups (all p < 0.0001). Cellular expressions of CXCR4/SDF-1α/Sca-1/c-Kit significantly and progressively increased from groups 1 to 5 (all p < 0.0001). Cellular expression of γ-H2AX/CD68 displayed an opposite pattern to LVEF among the five groups (all p < 0.0001). In conclusion, ECSW-SVF therapy effectively preserved LVEF and inhibited LV remodeling in rat AMI.

18.
ACS Sens ; 2018 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-30468073

RESUMO

We develop a novel amplified split aptamer sensor for highly sensitive detection and imaging of small molecules in living cells by using cationic block copolymer nanoparticles (BCNs) with entrapped fluorescent conjugated polymer as a delivery agent. The design of split aptamer as the initiator of hybridization chain reaction (HCR) affords the possibility of enhancing the signal-to-background ratio and thus allows high-contrast imaging for small molecules with relatively weak interactions with their aptamers. The novel design of using fluorescent cationic BCNs as the nanocarrier enables efficient and self-tracking transfection of DNA probes. Results reveal that BCNs exhibit high fluorescence brightness allowing direct tracking of the delivery location. The developed amplified split aptamer sensor is shown to have high sensitivity and selectivity for in vitro quantitative detection of ATP with a detection limit of 30 nM. Live cell studies show that the sensor provides a "signal on" approach for specific, high-contrast imaging of ATP. The DNA sensor based HCR system may provide a new generally applicable platform for detection and imaging of low-abundance biomarkers.

19.
Am J Med ; 2018 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-30419224

RESUMO

BACKGROUND: Prescription opioid use and opioid related deaths continue to increase nationwide. Several states have adopted legislation allowing for recreational use of cannabis. Little is known about how recreational cannabis law impacts compliance in chronic pain patients prescribed opioid therapy. The goals of this study were to: 1) Retrospectively assess the effect of cannabis use on compliance with opioid therapy in a high-risk patient population and 2) Determine the impact that legalization of recreational cannabis had on patients prescribed therapeutic opioids. METHODS: We conducted a retrospective cohort study on results from a "high-risk" urine drug testing panel. Results from one year before and one year after initiation of recreational cannabis legislation were analyzed. This testing panel included qualitative assays for cannabinoids and nine other common drugs of abuse, in addition to a quantitative LC-MS/MS assay for 23 different opioids and metabolites. Opioid compliance was assigned by reviewing pathologist's interpretations. RESULTS: In the pre-legalization period 1,776 panels were performed and post-legalization, 1,648 panels were performed. An increase (6%) in the rate of positive cannabinoid results was observed after legalization of recreational cannabis, however the overall compliance rate was consistent. CONCLUSIONS: This study suggests that legalization of recreational cannabis does not affect compliance rate in patients treated with opioid therapy for chronic pain.

20.
Biochem Biophys Res Commun ; 506(1): 298-305, 2018 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-30348527

RESUMO

Ischemia reperfusion (IR) injury is known as a major issue in cardiac transplantation and various pathogenesis are involved in myocardial IR injury. Here, we show that tumor necrosis factor receptor-associated factor 3 (TRAF3) was increased in hearts of mice with cardiac IR injury and in cardiomyocytes incubated with lipopolysaccharide (LPS) and H2O2. Reducing TRAF3 expression in vivo markedly reduced the infacrted area, attenuated the histological changes, improved cardiac dysfunction and injury in mice subjected to IR injury. Functional study further indicated that TRAF3 knockdown inhibited apoptosis in murine hearts of mice with cardiac IR injury and in LPS and H2O2-cotreated cardiomyocytes, as evidenced by the decreased expression of cleaved Caspase-3 and poly (ADP-ribose) polymerases (PARP). In addition, inflammatory response and oxidative stress observed in hearts of mice with IR operation were significantly alleviated by TRAF3 knockdown through inhibiting nuclear factor-κB (NF-κB) and xanthine oxidase (XO) signaling pathways, and similar results were detected in LPS and H2O2-cotreated cardiomyocytes in vitro. Moreover, the loss of TRAF3 also restrained the phosphorylated c-Jun N-terminal protein kinase (JNK) activation following cardiac IR injury. Importantly, blocking JNK activation, as TRAF3 knockdown, greatly reduced apoptosis, inflammation and reactive oxygen species (ROS) production in LPS and H2O2-cotreated cardiomyocytes. In contrast, TRAF3 knockdown-reduced apoptosis, inflammatory response and oxidative stress were significantly rescued by promoting JNK activity in LPS and H2O2-cotreated cardiomyocytes. In summary, the results of our study indicated that repressing TRAF3 expression could be served as essential therapeutic target for protection against cardiac IR injury through restraining JNK-meditated apoptosis, inflammation and the production of ROS.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA