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1.
Climacteric ; 27(1): 22-31, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38224068

RESUMO

Symptomatic women with angina are more likely to have ischemia with no obstructive coronary arteries (INOCA) compared to men. In both men and women, the finding of INOCA is not benign and is associated with adverse cardiovascular events, including myocardial infarction, heart failure and angina hospitalizations. Women with INOCA have more angina and a lower quality of life compared to men, but they are often falsely reassured because of a lack of obstructive coronary artery disease (CAD) and a perception of low risk. Coronary microvascular dysfunction (CMD) is a key pathophysiologic contributor to INOCA, and non-invasive imaging methods are used to detect impaired microvascular flow. Coronary vasospasm is another mechanism of INOCA, and can co-exist with CMD, but usually requires invasive coronary function testing (CFT) with provocation testing for a definitive diagnosis. In addition to traditional heart disease risk factors, inflammatory, hormonal and psychological risk factors that impact microvascular tone are implicated in INOCA. Treatment of risk factors and use of anti-atherosclerotic and anti-anginal medications offer benefit. Increasing awareness and early referral to specialized centers that focus on INOCA management can improve patient-oriented outcomes. However, large, randomized treatment trials to investigate the impact on major adverse cardiovascular events (MACE) are needed. In this focused review, we discuss the prevalence, pathophysiology, presentation, diagnosis and treatment of INOCA.


Assuntos
Doença da Artéria Coronariana , Isquemia Miocárdica , Masculino , Feminino , Humanos , Doença da Artéria Coronariana/diagnóstico , Qualidade de Vida , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/tratamento farmacológico , Vasos Coronários , Isquemia
2.
Scand J Rheumatol ; 52(3): 283-292, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35442157

RESUMO

OBJECTIVES: This study aims to assess the feasibility of the Coventry ultidisciplinary fast-track cranial giant cell arteritis (FTGCA) pathway, which was set up in 2013 in collaboration with vascular physiology and ophthalmology to enable prompt multidisciplinary assessment, including ultrasound (US). This study also looks at the impact of prior corticosteroid (CS) use on the performance of US in real life. METHOD: Data were collected retrospectively for patients who attended the Coventry FTGCA pathway between 1 January 2014 and 31 December 2017. Patients were identified from US lists and clinical details were obtained from electronic medical records. RESULTS: In total, 620 eligible patients were included in this study. US had a sensitivity of 50%, which improved to nearly 56% in CS-naïve patients. The median duration of CS use prior to US was 2 days, and sensitivity was around 46% in this group. The specificity of US was > 96%, and CS use was avoided completely in 345 patients (56%). CSs natively impacted on the utility of US, with US more likely to be false negative. CONCLUSIONS: This novel multidisciplinary pathway demonstrates excellent feasibility and minimizes the use of CSs in patients without giant cell arteritis. US was performed promptly, was cost effective- and had reassuring real-life sensitivity and specificity in this cohort, with excellent patient feedback. CS-naïve patients showed higher sensitivity for US despite the short duration of CS use.


Assuntos
Arterite de Células Gigantes , Humanos , Arterite de Células Gigantes/diagnóstico por imagem , Arterite de Células Gigantes/tratamento farmacológico , Artérias Temporais/diagnóstico por imagem , Estudos Retrospectivos , Corticosteroides , Sensibilidade e Especificidade
3.
Osteoporos Int ; 33(7): 1521-1533, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35249146

RESUMO

Dialysis patients have compromised bone health that increases their fracture risk due to low bone mass and deterioration in bone microarchitecture. Through meta-analyses of published studies, we conclude that dialysis patients suffer from impaired compartmental bone parameters compared with healthy controls. INTRODUCTION: We performed meta-analyses to determine the effect of chronic kidney disease (CKD) patients under dialysis on the trabecular and cortical parameters of radius and tibia. METHODS: This is a meta-analysis of cross-sectional and prospective clinical studies. PubMed, Web of Science, Google Scholar, and Scopus were searched using various permutation combinations. Dialysis patients were compared with non-CKD healthy controls using quantitative computed tomography. High-resolution peripheral quantitative computed tomography (HR-pQCT) and pQCT data of dialysis patients were dissected from eligible studies for pooled analysis of each parameter. RESULTS: Ten studies met the inclusion criteria that included data from 457 dialysis patients and 2134 controls. Pooled analysis showed a significant decrease (a) in total vBMD at distal radius [standard deviation of the mean (SDM) = -0.842, p = 0.000] and tibia (SMD = -0.705, p = 0.000) and (b) in cortical vBMD (SDM = -1.037, p = 0.000) at radius of dialysis patients compared with control. There were strong correlations between total vBMD and microarchitecture parameters at tibia in dialysis patients. CONCLUSIONS: At radius and tibia, bone mass, microarchitecture, and geometry at trabecular and cortical envelopes displayed impairments in dialysis patients compared with control. Tibial vBMD may have diagnostic value in dialysis. HR-pQCT and pQCT may be used to further understand the compartmental bones response to CKD-induced loss at different stages of CKD.


Assuntos
Diálise Renal , Insuficiência Renal Crônica , Absorciometria de Fóton , Densidade Óssea/fisiologia , Estudos Transversais , Humanos , Estudos Prospectivos , Rádio (Anatomia)/diagnóstico por imagem , Diálise Renal/efeitos adversos , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
4.
Lett Appl Microbiol ; 75(4): 857-868, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35673975

RESUMO

A multiplex-nested PCR (M-nested PCR) targeting mpt64 (Rv1980c) + IS6110 was designed to detect Mycobacterium tuberculosis (Mtb) DNA within urine (n = 35), endometrial biopsies (n = 22) and menstrual blood (n = 3) of male/female UGTB patients, and results were compared with M-PCR using the same targets. Detection limit of the purified Mtb DNA was found to be 1 fg by M-nested PCR, which was 106 -fold lower than M-PCR. Moreover, sensitivities of 100% and 81·8% were obtained in confirmed (n = 5) and clinically suspected UGTB (n = 55) cases, respectively, by M-nested PCR, with a specificity of 97·1% (n = 70). Sensitivities attained by M-nested PCR were significantly higher (p < 0·05) than M-PCR in both clinically suspected and total UGTB (n = 60) cases. To confirm the true PCR-negative results, an internal amplification control, that is, human ß-globin gene (hbb) was incorporated in the M-nested PCR/M-PCR assays, wherein all the clinical specimens (positive/negative for mpt64/IS6110) were found to be positive for hbb. Some UGTB specimens (n = 35) were also subjected to GeneXpert® MTB/RIF assay that revealed a significantly lower (p < 0·001) sensitivity (17·1 vs 88·6%) than M-nested PCR, although high specificity (100%) was attained with GeneXpert. After validating the results in a higher number of UGTB specimens, our M-nested PCR may be translated into an attractive diagnostic kit.


Assuntos
Mycobacterium tuberculosis , Tuberculose Urogenital , Feminino , Humanos , Masculino , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Mycobacterium tuberculosis/genética , Sensibilidade e Especificidade , Globinas beta/genética
5.
Lett Appl Microbiol ; 74(1): 17-26, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34592012

RESUMO

Diagnosis of osteoarticular tuberculosis (OATB) exhibits serious challenges owing to paucibacillary nature of specimens and localization of disease at sites that are difficult to access. We recently developed indirect immuno-PCR (I-PCR) and real-time I-PCR (RT-I-PCR) assays for the detection of mycobacterial antigen 85 complex (Ag85) in OATB patients. Detection limits for the purified Ag85 protein were found to be 1 and 41 fg ml-1 by I-PCR and RT-I-PCR, respectively, which were at least 105 -fold lower than respective ELISA. While spiking synovial fluids of non-TB control subjects with the purified Ag85 protein, LODs of 100 and 120 fg ml-1 were obtained by I-PCR and RT-I-PCR, respectively, thus demonstrating the sample matrix effect. Sensitivities of 87·5 and 70·5% were observed in bodily fluids of confirmed (n = 8) and clinically suspected (n = 51) OATB cases, respectively, by I-PCR, with a specificity of 93·9% (n = 33). Markedly, the sensitivities obtained by I-PCR/RT-I-PCR were significantly higher (P < 0·05-0·01) than ELISA and GeneXpert assay (n = 30). However, no substantial difference in sensitivity was observed between the I-PCR and RT-I-PCR assays. After further improving the accuracy of I-PCR, this test may lead to development of an attractive diagnostic kit.


Assuntos
Mycobacterium tuberculosis , Tuberculose Osteoarticular , Ensaio de Imunoadsorção Enzimática , Humanos , Mycobacterium tuberculosis/genética , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Tuberculose Osteoarticular/diagnóstico
6.
Pediatr Hematol Oncol ; 39(1): 28-47, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34243680

RESUMO

The HIV/AIDS epidemic has driven the rise in cases of Kaposi sarcoma (KS) among children and adolescents living with HIV in countries with high Human gammaherpesvirus 8 (HHV-8) seroprevalence, such as Tanzania, where specialized oncology programs are sparse. Consequently, descriptions of successful treatment of KS in children and adolescents by general pediatricians are important. A retrospective analysis was performed of children and adolescents diagnosed with KS and treated with chemotherapy and combination antiretroviral therapy (cART) at the Baylor College of Medicine Children's Foundation Tanzania Center of Excellence - Mbeya between 2011 and 2017. Sixty-one patients were diagnosed with KS with a median age of 12.6 years (interquartile range (IQR) 9.4 - 15.5). Diagnosis was confirmed by histopathology in 36% (22/61). Among HIV positive patients (59/61), 78% (46/59) were on cART at KS diagnosis. Severe immunosuppression was present in 63% (35/56) of those with CD4 data and 44% (27/61) had SAM. Advanced-stage T1 disease was present in 64% (39/61), including 28% (17/61) with visceral/disseminated KS. Two-year estimated overall survival (OS) was 72% (95% Confidence Interval (CI): 58%-82%) and median follow up for survivors was 25.7 months (IQR 14.2-53.8). No patients were lost to follow up. Two-year OS was 63% (95% CI: 44%-77%) in patients with severe immune suppression and 60% (95% CI: 37%-76%) in patients with SAM. Among patients with visceral/disseminated KS, 53% (9/17) survived. This retrospective analysis demonstrated favorable outcomes in a complex cohort of children and adolescents with KS treated with chemotherapy by general pediatricians in Tanzania.


Assuntos
Sarcoma de Kaposi , Adolescente , Criança , Humanos , Estudos Retrospectivos , Sarcoma de Kaposi/tratamento farmacológico , Sarcoma de Kaposi/epidemiologia , Estudos Soroepidemiológicos , Tanzânia/epidemiologia , Resultado do Tratamento
7.
BMC Cancer ; 20(1): 610, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32605648

RESUMO

BACKGROUND: Feasibility testing of a simultaneous sparing approach of hippocampus, hypothalamus and pituitary gland in patients undergoing whole-brain radiotherapy (WBRT) with and without a concomitant boost to metastatic sites. INTRODUCTION: Cognitive impairment and hormonal dysfunction are common side effects of cranial radiotherapy. A reduced dose application to the patho-physiologically involved functional brain areas, i.e. hippocampus, hypothalamus and pituitary gland, could reduce these common side effects. While hippocampal sparing is already a common practice to improve cognitive outcome, technical experience of additional combined sparing of the hypothalamus/pituitary gland (HT-P) is insufficient. METHODS: Twenty patients were included in the planning study. In 11 patients, a total dose of 36 Gy of WBRT (2 Gy per fraction) plus a simultaneous integrated boost (SIB) of 9 Gy (0.5 Gy per fraction, total dose: 45 Gy) to the brain metastases was applied. In 9 patients, prophylactic cranial irradiation (PCI) was simulated with a total dose of 30 Gy (2 Gy per fraction). In both patient cohorts, a sparing approach of the hippocampus and the HT-P area was simulated during WBRT. For all treatment plans, volumetric modulated arc therapy (VMAT) was used. Quality assurance included assessment of homogeneity, conformality and target coverage. RESULTS: The mean dose to the hippocampus and HT-P region was limited to less than 50% of the prescribed dose to the planning target volume (PTV) in all treatment plans. Dose homogeneity (HI) of the target volume was satisfying (median HI = 0.16 for WBRT+SIB and 0.1 for PCI) and target coverage (conformation number, CN) was not compromised (median CN = 0.82 for SIB and 0.86 for PCI). CONCLUSION: Simultaneous dose reduction to the hippocampus and the HT-P area did not compromise the PTV coverage in patients undergoing WBRT+SIB or PCI using VMAT. While the feasibility of the presented approach is promising, prospective neurologic, endocrine outcome and safety studies are required.


Assuntos
Neoplasias Encefálicas/radioterapia , Irradiação Craniana/efeitos adversos , Tratamentos com Preservação do Órgão/métodos , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada/efeitos adversos , Adulto , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundário , Irradiação Craniana/métodos , Fracionamento da Dose de Radiação , Relação Dose-Resposta à Radiação , Estudos de Viabilidade , Feminino , Hipocampo/diagnóstico por imagem , Hipocampo/efeitos da radiação , Humanos , Hipotálamo/diagnóstico por imagem , Hipotálamo/efeitos da radiação , Masculino , Tratamentos com Preservação do Órgão/efeitos adversos , Órgãos em Risco/diagnóstico por imagem , Órgãos em Risco/efeitos da radiação , Hipófise/diagnóstico por imagem , Hipófise/efeitos da radiação , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Tomografia Computadorizada por Raios X
8.
Horm Behav ; 123: 104665, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31904360

RESUMO

Transient shifts in testosterone occur during competition and are thought to positively influence dominance behavior aimed at enhancing social status. However, individual differences in testosterone reactivity to status contests have not been well-studied in relation to real-time expressions of competitive behavior among men and women. This research tests the association between changes in endogenous testosterone levels during competition and performance in terms of competitive endurance. Participant sex, social presence, and relative status outcomes (e.g., winning vs. losing) are tested as moderators of this relationship. In two studies, men and women (total N = 398) competed in the competitive will task (timed weight-holding) either individually or in the presence of an opponent (Study 1) or as a team with and without the presence of a competitor team (Study 2). Results showed a positive relationship between testosterone reactivity and performance for men, particularly those who won or ranked highest among their group - with increasing testosterone predicting better performance and decreasing testosterone predicting worse performance. For women, the effect only emerged among individuals who competed in dyads and lost. In Study 2, an exploratory mediation analysis revealed that individual differences in trait dominance predicted both testosterone reactivity to competition and task performance, with testosterone reactivity (moderated by sex and status outcome) partially explaining the direct relationship between dominance-related traits and behavior. Our goal was to examine testosterone reactivity in relation to real-time competitive effort and highlight the potential role of this relationship in explaining how individual differences in trait dominance produce competitive behavior.


Assuntos
Comportamento Competitivo/fisiologia , Motivação/fisiologia , Testosterona/metabolismo , Volição/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Distância Psicológica , Saliva/química , Saliva/metabolismo , Caracteres Sexuais , Testosterona/análise , Desempenho Profissional , Adulto Jovem
9.
BMC Cancer ; 19(1): 1213, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830931

RESUMO

BACKGROUND: Cranial radiotherapy (cRT) can induce hormonal deficiencies as a consequence of significant doses to the hypothalamic-pituitary (HP) axis. In contrast to profound endocrinological follow-up data from survivors of childhood cancer treated with cRT, little knowledge exists for adult cancer patients. METHODS: A systematic search of the literature was conducted using the PubMed database and the Cochrane library offering the basis for our debate of the relevance of HP axis impairment after cRT in adult cancer patients. Against the background of potential relevance for patients receiving whole brain radiotherapy (WBRT), a particular focus was set on the temporal onset of hypopituitarism and the radiation dose to the HP axis. RESULTS: Twenty-eight original papers with a total of 1728 patients met the inclusion criteria. Radiation doses to the HP area ranged from 4 to 97 Gray (Gy). Hypopituitarism incidences ranged from 20 to 93% for adult patients with nasopharyngeal cancer or non-pituitary brain tumors. No study focused particularly on hypopituitarism after WBRT. The onset of hypopituitarism occurred as early as within the first year following cRT (range: 3 months to 25.6 years). However, since most studies started follow-up evaluation only several years after cRT, early onset of hypopituitarism might have gone unnoticed. CONCLUSION: Hypopituitarism occurs frequently after cRT in adult cancer patients. Despite the general conception that it develops only after several years, onset of endocrine sequelae can occur within the first year after cRT without a clear threshold. This finding is worth debating particularly in respect of treatment options for patients with brain metastases and favorable survival prognoses.


Assuntos
Neoplasias Encefálicas/radioterapia , Irradiação Craniana/efeitos adversos , Hipopituitarismo/etiologia , Hipotálamo/efeitos da radiação , Hipófise/efeitos da radiação , Lesões por Radiação/etiologia , Humanos , Hipopituitarismo/patologia , Hipotálamo/patologia , Hipófise/patologia , Lesões por Radiação/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Int J Cosmet Sci ; 41(5): 462-471, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31318061

RESUMO

INTRODUCTION: The stratum corneum is the biggest obstacle in cosmetics with respect to skin moisturisation. Many approaches have been taken to overcome the barrier, one of which is incorporating natural cosmeceuticals into cosmetic products to enhance moisturisation effects. Here, a commercial facemask formulation was electrospun to develop dry facemasks capable of hosting cosmeceuticals within the pores of incorporated mesoporous silica. METHODS: Ethanolic solutions containing 40% w/w of the marketed facemask (7th Heaven Dead Sea peel-off facemask) and mesoporous silica were prepared and electrically processed at 30 µL min-1 at an applied voltage of 12 ± 2 kV. In vitro characterisation and release studies using fluorescein dye as a model probe were carried out. RESULTS: SEM images confirmed the fibrous nature of the resulting matrix; showing an average fiber diameter of 298.32 nm. The electrospun mask was found to be advantageous due to this fibrous nature providing high active loading capacity whilst demonstrating 100% probe release within 60 min. Contact Angle hysteresis, thermal analysis and Fourier Transform Infrared Spectroscopy (FTIR) presented evidence of compatibility and stability of and within the formulation. CONCLUSION: Adapting the formulation of a commercial polymeric facemask into an electrospun facemask has shown the versatility of the electrospinning process; now successfully crossing over into the cosmetic industry.


INTRODUCTION: La couche cornée est le premier obstacle à l'hydratation de la peau par des produits cosmétiques. De nombreuses approches ont été adoptées pour surmonter cette entrave, dont l'une consiste à intégrer des cosméceutiques naturels dans les produits cosmétiques afin d'augmenter leur pouvoir hydratant. Ici, la formulation commercialisée d'un masque pour le visage a été modifiée par électrofilage de manière à développer des masques secs pouvant intégrer des cosméceutiques dans les pores de silice mésoporeuse présent dans le produit. MÉTHODES: Des solutions éthanoliques, contenant 40 % p/p du masque pour le visage commercialisé (masque peel-off 7th Heaven Dead Sea) et de la silice mésoporeuse ont été préparées et traitées électriquement à 30 µl/min_ 1, avec une tension appliquée de 12 ± 2 kV. Des études de caractérisation et de libération in vitro ont été menées, utilisant un colorant fluorescéine en tant que sonde. RÉSULTATS: Des images SEM ont confirmé la nature fibreuse de la matrice résultante, avec un diamètre de fibre moyen s'élevant à 298,32 nm. Le masque électrofilé a été jugé avantageux en raison de sa nature fibreuse, qui permet une capacité de charge élevée, ainsi qu'une libération de 100 % de la sonde dans les 60 min. L'hystérèse de l'angle de contact, l'analyse thermique et la spectroscopie infrarouge à transformée de Fourier (IRTF) ont permis d'identifier des preuves de compatibilité et de stabilité dans cette formulation. CONCLUSION: La possibilité d'adapter la formulation d'un masque pour le visage polymérique déjà commercialisé pour en faire un masque électrofilé montre la polyvalence du processus d'électrofilage, qui fait une apparition remarquable dans le domaine des cosmétiques.


Assuntos
Cosméticos , Dióxido de Silício/química , Pele/metabolismo , Água/metabolismo , Varredura Diferencial de Calorimetria , Fluoresceína/química , Humanos , Microscopia Eletrônica de Varredura , Espectroscopia de Infravermelho com Transformada de Fourier
11.
AAPS PharmSciTech ; 21(1): 12, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31807980

RESUMO

Transdermal drug delivery is an emerging field in the pharmaceutical remit compared with conventional methods (oral and parenteral). Microneedle (MN)-based devices have gained significant interest as a strategy to overcome the skin's formidable barrier: the stratum corneum. This approach provides a less invasive, more efficient, patient friendly method of drug delivery with the ability to incorporate various therapeutic agents including macromolecules (proteins and peptides), anti-cancer agents and other hydrophilic and hydrophobic compounds. This short review attempts to assess the various materials involved in the fabrication of MNs as well as incorporation of other excipients to improve drug delivery for novel medical devices. The focus will be on polymers, metals and other inorganic materials utilised for MN drug delivery, as well as their application, limitations and future work to be carried out.


Assuntos
Teste de Materiais/instrumentação , Teste de Materiais/métodos , Microinjeções/instrumentação , Microinjeções/métodos , Agulhas , Administração Cutânea , Animais , Sistemas de Liberação de Medicamentos/instrumentação , Sistemas de Liberação de Medicamentos/métodos , Epiderme/efeitos dos fármacos , Humanos , Agulhas/normas , Preparações Farmacêuticas/administração & dosagem
12.
Immunogenetics ; 70(10): 633-638, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30128812

RESUMO

Human leukocyte antigen (HLA) molecules play a key role in regulating the immune response towards infectious agents like human immunodeficiency virus type-1 (HIV-1). They have been shown to influence transmission as well as the progression of HIV-1 towards acquired immune deficiency syndrome (AIDS). Roles of HLA-A and HLA-B have been documented extensively; however, HLA-C has been poorly studied. In the present study, we have evaluated the role of HLA-C in discordant couple and mother-to-child cohorts. HLA-C*07 was higher both in HIV-1-infected spouses and infants as compared to exposed uninfected spouses and infants. However, this was not significant. HLA-C*15 was significantly higher in HIV-1-exposed uninfected babies as compared to infected babies. Lack of treatment in mothers and breastfeeding were significantly associated with HIV-1 transmission. HLA-C*07 may be a susceptible allele in HIV-1 transmission, whereas HLA-C*15 may be a protective allele in mother-to-child cohorts, independent of feeding options and treatment. These findings could be important in targeting immune responses via population-specific vaccine strategies against HIV-1.


Assuntos
Infecções por HIV/genética , Infecções por HIV/transmissão , HIV-1/genética , Antígenos HLA-C/genética , Adulto , Alelos , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1/patogenicidade , Antígenos HLA-C/imunologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Relações Mãe-Filho
14.
Dis Esophagus ; 29(8): 937-943, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26455829

RESUMO

Studies on associations of various polymorphism in xenobiotic metabolizing genes with different cancers including esophageal squamous cell carcinoma (ESCC) are mixed and inconclusive. To evaluate the association of CYP1A1*4, SULT1A1*2 and SULT1A2*2 genotypes with ESCC risk and their modifying effects on different risk factors of ESCC, we conducted a case-control study in Kashmir, India, an area with relative high incidence of ESCC. We recruited 404 histopathologically confirmed ESCC cases, and equal number of controls, individually matched for sex, age and district of residence to respective case. Information was obtained on various dietary, lifestyle and environmental factors in face-to-face interviews, using a structured questionnaire, from each subject. Genotypes were analyzed by polymerase chain reaction, restriction fragment length polymorphism and direct sequencing. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). A higher risk was observed in the subjects who harbored variant genotype of CYP1A1*4 (OR = 2.06; 95% CI: 1.28-3.32); and the risk was further enhanced in ever smokers (OR = 3.47; 95% CI: 1.62-7.42), adobe dwellers (OR = 6.71; 95% CI: 3.02-14.89), and biomass fuel users (OR = 5.11; 95% CI: 1.34-19.50). We did not find any significant differences in the polymorphic variants of SULT1A1*2 and SULT1A2*2 between cases and controls. The study indicates that, unlike SULT1A1*2 and SULT1A2*2, the polymorphism of CYP1A1*4 is associated with ESCC risk. However, replicative studies with larger sample size are needed to substantiate our findings.


Assuntos
Arilsulfotransferase/genética , Carcinoma de Células Escamosas/genética , Citocromo P-450 CYP1A1/genética , Neoplasias Esofágicas/genética , População Branca/genética , Idoso , Biocombustíveis/estatística & dados numéricos , Carcinoma de Células Escamosas/epidemiologia , Estudos de Casos e Controles , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Incidência , Índia/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Reação em Cadeia da Polimerase , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Fatores de Risco , Análise de Sequência de DNA , Fumar/epidemiologia
15.
J Postgrad Med ; 62(4): 228-234, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27763479

RESUMO

AIMS: Comparison of conventional blood culture with BACTEC 9050 for rate and time to detection of microorganisms. SETTINGS AND DESIGN: A prospective study was carried out in a multispecialty tertiary care teaching hospital. SUBJECTS AND METHODS: A total of 835 paired specimens (797 blood and 38 nonblood specimens) were collected and processed according to standard microbiological procedures by both conventional method as well as by BACTEC 9050 automated culture system. Clinical details of patients were recorded. Data were analyzed for time to detection and isolation rate by the two systems and compared. RESULTS: Overall culture positivity for BACTEC 9050 and the conventional system was 32% and 19.88%, respectively. Eighty-five demonstrated concordant growth, 136 specimens were culture positive by BACTEC only, and 38 specimens were culture positive by conventional only. Twelve contaminants in BACTEC and nine contaminants in conventional system were detected. Using BACTEC 9050, higher isolation was observed for Acinetobacter spp., coagulase negative Staphylococcus spp., Streptococcus spp., and Candida spp. A total of 410 patients were on antimicrobial treatment and culture positivity was significantly higher with BACTEC 9050 (P < 0.0001). There was a significant difference in the mean time to detection with BACTEC 9050 recovering 86.8% of isolates within 48 h (P < 0.0001). CONCLUSIONS: Although BACTEC 9050 demonstrated a significantly higher recovery of microorganisms from blood, an appropriately performed conventional blood culture can facilitate the choice of therapy.


Assuntos
Bactérias , Técnicas Bacteriológicas/instrumentação , Hemocultura/métodos , Sangue/microbiologia , Adolescente , Adulto , Bactérias/classificação , Bactérias/crescimento & desenvolvimento , Bactérias/isolamento & purificação , Técnicas Bacteriológicas/métodos , Técnicas Bacteriológicas/estatística & dados numéricos , Candida/classificação , Candida/isolamento & purificação , Criança , Pré-Escolar , Meios de Cultura , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
16.
Crit Care Med ; 43(10): 2076-84, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26110488

RESUMO

OBJECTIVE: Clinical protocols may decrease unnecessary variation in care and improve compliance with desirable therapies. We evaluated whether highly protocolized ICUs have superior patient outcomes compared with less highly protocolized ICUs. DESIGN: Observational study in which participating ICUs completed a general assessment and enrolled new patients 1 day each week. PATIENTS: A total of 6,179 critically ill patients. SETTING: Fifty-nine ICUs in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary exposure was the number of ICU protocols; the primary outcome was hospital mortality. A total of 5,809 participants were followed prospectively, and 5,454 patients in 57 ICUs had complete outcome data. The median number of protocols per ICU was 19 (interquartile range, 15-21.5). In single-variable analyses, there were no differences in ICU and hospital mortality, length of stay, use of mechanical ventilation, vasopressors, or continuous sedation among individuals in ICUs with a high versus low number of protocols. The lack of association was confirmed in adjusted multivariable analysis (p = 0.70). Protocol compliance with two ventilator management protocols was moderate and did not differ between ICUs with high versus low numbers of protocols for lung protective ventilation in acute respiratory distress syndrome (47% vs 52%; p = 0.28) and for spontaneous breathing trials (55% vs 51%; p = 0.27). CONCLUSIONS: Clinical protocols are highly prevalent in U.S. ICUs. The presence of a greater number of protocols was not associated with protocol compliance or patient mortality.


Assuntos
Cuidados Críticos/normas , Estado Terminal/mortalidade , Estado Terminal/terapia , Mortalidade Hospitalar , Avaliação de Resultados da Assistência ao Paciente , Protocolos Clínicos , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estados Unidos
17.
Oral Dis ; 21(3): 349-54, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25158861

RESUMO

OBJECTIVE: We conducted a cross-sectional study to describe the prevalence and correlates of type-specific human papillomavirus (HPV) DNA in the oral cavities of persons with Fanconi anemia. MATERIALS AND METHODS: Oral swabs were collected from 67 participants with Fanconi anemia and tested for 27 HPV genotypes using polymerase chain reaction-based methods. RESULTS: Participants were a mean of 18.6 (standard deviation, 10.0) years of age (range 4-47 years). The prevalence of oral HPV infection was 7.5%, and the prevalence of high-risk HPV infection was 6.0%. HPV type 16 was not detected in any samples. Prevalence was higher in adults than in children (13.3% vs 2.7% in those ≥18 vs <18 years of age). Among adults, prevalence was higher in males than in females (25.0% vs 9.1%, respectively). CONCLUSIONS: Prevalence of oral HPV infection in persons with Fanconi anemia was comparable to estimates from other studies in the general population. However, in contrast to previous studies, we did not identify HPV type 16 (the type found in most HPV-related head and neck cancers) in any participants.


Assuntos
Anemia de Fanconi/virologia , Doenças da Boca/epidemiologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Boca/virologia , Doenças da Boca/virologia , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , Prevalência , Fatores Sexuais , Adulto Jovem
18.
Opt Express ; 22(17): 20366-74, 2014 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-25321245

RESUMO

We demonstrate a polarization-managed 8-dimensional modulation format that is time domain coded to reduce inter-channel nonlinearity. Simulation results show a 2.3 dB improvement in maximum net system margin (NSM) relative to polarization multiplexed (PM)-BPSK, and a 1.0 dB improvement relative to time interleaved return-to-zero (RZ)-PM-BPSK, for five WDM channels propagating over 1600 km ELEAF with 90% inline optical dispersion compensation. In contrast to the other modulations considered, the new 8-dimensional format has negligible sensitivity to the polarization states of the neighboring WDM channels. High-density WDM (HD-WDM) measurements on a 5000 km dispersion-managed link show a 1.0 dB improvement in net system margin relative to PM-BPSK.

19.
Appl Microbiol Biotechnol ; 98(1): 83-94, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24104468

RESUMO

Alcaligenes sp. MTCC 10675 has been isolated from soil sample using enrichment method and has nitrilase catalytic system which is highly specific for the hydrolysis of arylaliphatic nitriles. Optimization of culture conditions using response surface methodology and inducer-mediated approach enhanced arylacetonitrilase production significantly (2.4-fold). Isobutyronitrile acted as an effective inducer for the induction of arylacetonitrilase, and it is highly specific for arylacetonitriles (phenyl acetonitrile and mandelonitrile). Arylacetonitrilase has no effect on its relative velocity (V r) up to 20 mM substrate (mandelonitrile) concentration and at 30 mM mandelonitrile, 23.4 % degree of inhibition (I d) was recorded. Half life of arylacetonitrilase of Alcaligenes sp. MTCC 10675 was 27.5 h at 25 °C. Hg(2+), Ag(+), Pb(3+), and Co(2+) were strong inhibitor of arylacetonitrilase activity which resulted into 100 %, 91 %, 84 %, and 83 % inhibition, respectively. Polar protic solvent (dichloromethane, dimethylsulphooxide, and n-butanol) reduce arylacetonitrilase activity up to 80-94 % at 10 % concentration. Alcaligenes sp. MTCC 10675 has higher biocatalytic activity, i.e., 3.9 gg(-1) dcw, which is highest in comparison to till reported organism. Arylacetonitrilase-mediated hydrolysis of racemic mandelonitrile resulted into R-(-) mandelic acid with 99.0 % enantiomeric excess (e.e.).


Assuntos
Alcaligenes/enzimologia , Aminoidrolases/metabolismo , Ácidos Mandélicos/metabolismo , Acetonitrilas/metabolismo , Alcaligenes/química , Alcaligenes/isolamento & purificação , Aminoidrolases/química , Inibidores Enzimáticos/metabolismo , Estabilidade Enzimática , Regulação Enzimológica da Expressão Gênica , Concentração de Íons de Hidrogênio , Cinética , Metais/metabolismo , Nitrilas/metabolismo , Microbiologia do Solo , Temperatura , Ativação Transcricional
20.
Opt Express ; 21(11): 13075-83, 2013 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-23736561

RESUMO

The nonlinear transmission properties of hydrogenated amorphous silicon (a-Si:H) core fibers are characterized from the near-infrared up to the edge of the mid-infrared regime. The results show that this material exhibits linear losses on the order of a few dB/cm, or less, over the entire wavelength range, decreasing down to a value of 0.29 dB/cm at 2.7µm, and negligible nonlinear losses beyond the two-photon absorption (TPA) edge ~ 1.7µm. By measuring the dispersion of the nonlinear Kerr and TPA parameters we have found that the nonlinear figure of merit (FOM(NL)) increases dramatically over this region, with FOM(NL) > 20 around 2µm and above. This characterization demonstrates the potential for a-Si:H fibers and waveguides to find use in nonlinear applications extending beyond telecoms and into the mid-infrared regime.

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