555 results on '"Slow progression"'
Search Results
2. Endovascular treatment for acute ischemic stroke beyond the 24-h time window: Selection by target mismatch profile.
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Nguyen, Trung Quoc, Tran, Mai Hoang, Phung, Hai Ngoc, Nguyen, Khang Vinh, Tran, Hang T Minh, Walter, Silke, Hoang, Dinh C Bao, Pham, Binh Nguyen, Truong, Anh Le Tuan, Tran, Vu Thanh, Nguyen, Thanh N, Pham, An Le, and Nguyen, Huy-Thang more...
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ISCHEMIC stroke , *ENDOVASCULAR surgery , *STROKE patients , *INTRACRANIAL hemorrhage , *CEREBRAL infarction - Abstract
Introduction: Endovascular treatment for acute ischemic stroke patients with large vessel occlusion (LVO) has been established as a promising clinical intervention within a late time window of 6–24 h after symptom onset. Patients with slow progression, however, may still benefit from endovascular treatment beyond the 24-h time window (very late window). Aim: The aim of this study is to report insight into the potential clinical benefits of endovascular treatment for acute ischemic stroke beyond 24 h from symptom onset. Methods: A retrospective analysis was performed on consecutive patients undergoing endovascular treatment for acute anterior circulation LVO ischemic stroke beyond 24 h. Participants were recruited between July 2019 and November 2020. Patients were selected based on the DAWN/DEFUSE 3 criteria (Perfusion-RAPID, iSchemaView) and patients receiving treatment beyond 24 h were compared to a group of patients receiving endovascular treatment between 6 and 24 h after symptom onset. The primary outcome was the proportion of patients with functional independence at 90 days (modified Rankin Scale score of 0–2). The secondary outcomes were shift modified Rankin Scale (mRS) analysis and successful reperfusion was defined by thrombolysis in cerebral infarction (TICI) 2b-3 on the final procedure. Safety outcomes were symptomatic intracranial hemorrhage and death at the 90-day follow-up. Propensity score (PS)-matched analyses were employed to rectify the imbalanced baseline characteristics between the two groups. Results: A total of 166 patients were recruited with a median age of 63.0 (56.0–69.0) and 28.9% of all patients were females. Patients in the beyond 24-h group had a longer onset-to-groin time (median = 27.2 vs 14.3 h, p < 0.001) than those in the 6- to 24-h group. There were no statistically significant differences between the two groups in National Institutes of Health Stroke Scale (NIHSS) (median = 12.0 vs 15.0, p = 0.37), perfusion imaging characteristics (core: median = 11.0 vs 9.0 mL, p = 0.86; mismatch volume: median = 106.0 vs 96.0, p = 0.44; mismatch ratio = 6.46 vs 7.24, p = 0.91), and perfusion-to-groin time (median = 72.5 vs 76.0 min, p = 0.77). No significant differences were noted among patients between the two groups in the primary endpoint functional independence analysis (50.0% vs 46.6%, p = 0.77) and in the safety endpoint analysis: mortality (15.0% vs 11.0%, p = 0.71) or symptomatic hemorrhage (0% vs 3.42%, p > 0.999). In PS-matched analyses, there were no significant differences among patients between the two groups in functional independence (50.0% vs 54.8%, p = 0.74), mortality (16.7% vs 9.68%, p = 0.50), or symptomatic hemorrhage (0% vs 6.45%, p = 0.53). Conclusion: Endovascular treatment can be performed safely and effectively in LVO patients beyond 24 h from symptom onset when selected by target mismatch profile. The clinical outcome of these patients was comparable to those treated in the 6- to 24-h window. Larger studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR] more...
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- 2024
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3. Activated but functionally impaired memory Tregs are expanded in slow progressors to type 1 diabetes.
- Author
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Boldison, Joanne, Long, Anna E., Aitken, Rachel J., Wilson, Isabel V., Megson, Clare, Hanna, Stephanie J., Wong, F. Susan, and Gillespie, Kathleen M.
- Abstract
Aims/hypothesis: Slow progressors to type 1 diabetes are individuals positive for multiple pancreatic islet autoantibodies who have remained diabetes-free for at least 10 years; regulation of the autoimmune response is understudied in this group. Here, we profile CD4
+ regulatory T cells (Tregs) in a small but well-characterised cohort of extreme slow progressors with a median age 43 (range 31–72 years), followed up for 18–32 years. Methods: Peripheral blood samples were obtained from slow progressors (n = 8), age- and sex-matched to healthy donors. One participant in this study was identified with a raised HbA1c at the time of assessment and subsequently diagnosed with diabetes; this donor was individually evaluated in the analysis of the data. Peripheral blood mononuclear cells (PBMCs) were isolated, and to assess frequency, phenotype and function of Tregs in donors, multi-parameter flow cytometry and T cell suppression assays were performed. Unsupervised clustering analysis, using FlowSOM and CITRUS (cluster identification, characterization, and regression), was used to evaluate Treg phenotypes. Results: Unsupervised clustering on memory CD4+ T cells from slow progressors showed an increased frequency of activated memory CD4+ Tregs, associated with increased expression of glucocorticoid-induced TNFR-related protein (GITR), compared with matched healthy donors. One participant with a raised HbA1c at the time of assessment had a different Treg profile compared with both slow progressors and matched controls. Functional assays demonstrated that Treg-mediated suppression of CD4+ effector T cells from slow progressors was significantly impaired, compared with healthy donors. However, effector CD4+ T cells from slow progressors were more responsive to Treg suppression compared with healthy donors, demonstrated by increased suppression of CD25 and CD134 expression on effector CD4+ T cells. Conclusions/interpretations: We conclude that activated memory CD4+ Tregs from slow progressors are expanded and enriched for GITR expression, highlighting the need for further study of Treg heterogeneity in individuals at risk of developing type 1 diabetes. [ABSTRACT FROM AUTHOR] more...- Published
- 2022
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4. Clinical study of apatinib combined with EGFR‐TKI in the treatment of chronic progression after EGFR‐TKI treatment in non‐small cell lung cancer (ChiCTR1800019185)
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Xin Li, Minghui Liu, Hongbing Zhang, Hongyu Liu, and Jun Chen
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Apatinib ,EGFR‐TKIs ,non‐small cell lung cancer ,slow progression ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract This clinical trial (ChiCTR1800019185) is designed to be an open‐label, prospective, single‐center, single arm exploratory research study. The study will recruit non‐small cell lung cancer patients (NSCLC) with slow progression after first‐line treatment with EGFR‐TKI drugs. Slow progression will be confirmed by the presence of serum carcinoembryonic antigen or imaging evaluation. The primary aim is to assess progression‐free survival after EGFR‐TKIs treatment combined with apatinib 250 mg once daily. The secondary objectives are to evaluate objective efficacy, disease control rates, quality of life, overall survival, and safety. From September 2018 to September 2020, under specific entry and discharge standards, we plan to enroll 38 eligible patients until the end of the study. We hope that our study will help to explore a new way of combining the small molecular inhibitors of antiangiogenesis with EGFR‐TKIs to overcome acquired drug resistance. more...
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- 2020
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5. Underlying pathology identified after 20 years of disease course in two cases of slowly progressive frontotemporal dementia syndromes.
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Hokelekli, Fatma Ozlem, Whitwell, Jennifer L., Machulda, Mary M., Jones, David T., Uitti, Ryan J., Pham, Nha Trang Thu, Giannini, Caterina, Baker, Matthew, Lowe, Val J., Dickson, Dennis W., and Josephs, Keith A. more...
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FRONTOTEMPORAL dementia , *FRONTOTEMPORAL lobar degeneration , *DISEASE progression , *PATHOLOGY , *SYNDROMES , *SYMPTOMS - Abstract
We report two cases from the frontotemporal lobar degeneration (FTLD) spectrum with remarkably slow progression. The first case demonstrated insidious-onset behavioral symptoms and personality changes resembling behavioral variant of frontotemporal dementia, followed a benign course over 26 years, his brain autopsy revealed the diffuse form of argyrophilic grain disease. The second case presented with slowly progressive cognitive and motor deficits, reminiscent of the corticobasal syndrome, deteriorated slowly over 22 years, his brain autopsy revealed FTLD-TDP with C9ORF72 pathology. These two cases confirm the notion of slowly progressive frontotemporal lobar degeneration caused by an underlying FTLD pathology, rather than a phenocopy. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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6. Factors associated with slow progression of cognitive impairment following first dementia diagnosis.
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Perera, Gayan, Mueller, Christoph, and Stewart, Robert
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DEMENTIA , *DIAGNOSIS , *COGNITION disorders , *ALZHEIMER'S disease , *VASCULAR dementia , *MEDICAL research , *MILD cognitive impairment - Abstract
Objectives: To investigate the extent to which slow progression of dementia after diagnosis might be predicted from routine longitudinal healthcare data, in order to clarify characteristics of people who experience this outcome. Methods: A retrospective observational study was conducted using data from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre Case Register. This study included all patients receiving a first dementia diagnosis between 2006 and 2017, restricted to those with a baseline Mini–Mental State Examination (MMSE) score within 6 months of initial diagnosis of dementia and at least one MMSE score after 3 years post‐diagnosis. Slow progression was defined as a change in MMSE score of −1, 0 or an increase at the follow‐up point. This group was compared to the remainder with an MMSE decline of −2 or more. Results: Overall, 682 patients with slow progression were compared to 1045 with faster progression. In the confounder‐adjusted multivariate logistic regression model, slow progression was more likely in younger patients (age 65–74 years; odds ratio: 1.18; 95% confidence intervals: 1.04–1.37), males (1.24; 1.01–1.53), those with moderate or severe dementia according to MMSE, patients with mixed‐type dementia (2.06; 1.11–3.82) compared to Alzheimer's disease and less likely in those receiving acetylcholinesterase inhibitor (AChEI) treatment (0.57; 0.46–0.71). Conclusion: Slow dementia progression after diagnosis was common in patients with mixed Alzheimer's and vascular dementia, younger age, males and non‐receipt of AChEIs, possibly suggesting non‐Alzheimer pathologies and clarifying such predictors is important, as there is currently very limited information on which to base prognosis estimates in post‐diagnosis counselling. [ABSTRACT FROM AUTHOR] more...
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- 2021
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7. Slow progression of amyotrophic lateral sclerosis in a Chinese patient carrying SOD1 p.S135T mutation.
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Fu, Hanhui, Zhang, Kang, Yang, Xunzhe, Li, Libo, and Cui, Liying
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AMYOTROPHIC lateral sclerosis , *GENETIC mutation , *MISSENSE mutation , *NEURODEGENERATION , *RESPIRATORY insufficiency - Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Most patients die of respiratory failure within 3 years of onset. In this study, we reported a female Chinese ALS patient with SOD1 c.404G > C, p.S135T mutation. The missense mutation was identified as "Likely pathogenic" according to the ACMG/AMP 2015 guideline. The patient presented with weakness and atrophy of lower limbs with slow progression. We reviewed two other reports on patients with the same SOD1 p.S135T mutation. These patients had lower extremity onset, negative Babinski sign, slow disease progression, and prolonged survival. This report indicates that specific phenotype-genotype correlations of SOD1 p.S135T mutation in ALS. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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8. Clinical study of apatinib combined with EGFR‐TKI in the treatment of chronic progression after EGFR‐TKI treatment in non‐small cell lung cancer (ChiCTR1800019185).
- Author
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Li, Xin, Liu, Minghui, Zhang, Hongbing, Liu, Hongyu, and Chen, Jun
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CHRONIC diseases , *CLINICAL trials , *DRUG resistance , *EPIDERMAL growth factor , *LONGITUDINAL method , *LUNG cancer , *QUALITY of life , *RESEARCH , *SAFETY , *SURVIVAL , *TUMOR antigens , *PROTEIN-tyrosine kinase inhibitors , *DISEASE progression - Abstract
This clinical trial (ChiCTR1800019185) is designed to be an open‐label, prospective, single‐center, single arm exploratory research study. The study will recruit non‐small cell lung cancer patients (NSCLC) with slow progression after first‐line treatment with EGFR‐TKI drugs. Slow progression will be confirmed by the presence of serum carcinoembryonic antigen or imaging evaluation. The primary aim is to assess progression‐free survival after EGFR‐TKIs treatment combined with apatinib 250 mg once daily. The secondary objectives are to evaluate objective efficacy, disease control rates, quality of life, overall survival, and safety. From September 2018 to September 2020, under specific entry and discharge standards, we plan to enroll 38 eligible patients until the end of the study. We hope that our study will help to explore a new way of combining the small molecular inhibitors of antiangiogenesis with EGFR‐TKIs to overcome acquired drug resistance. [ABSTRACT FROM AUTHOR] more...
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- 2020
- Full Text
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9. What Have Slow Progressors Taught Us About T1D-Mind the Gap!
- Author
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Gillespie, Kathleen M. and Long, Anna E.
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AUTOANTIBODIES ,DISEASE progression ,TYPE 1 diabetes ,ISLANDS of Langerhans ,IMMUNITY - Abstract
Purpose Of Review: Progression rate from islet autoimmunity to clinical diabetes is unpredictable. In this review, we focus on an intriguing group of slow progressors who have high-risk islet autoantibody profiles but some remain diabetes free for decades.Recent Findings: Birth cohort studies show that islet autoimmunity presents early in life and approximately 70% of individuals with multiple islet autoantibodies develop clinical symptoms of diabetes within 10 years. Some "at risk" individuals however progress very slowly. Recent genetic studies confirm that approximately half of type 1 diabetes (T1D) is diagnosed in adulthood. This creates a conundrum; slow progressors cannot account for the number of cases diagnosed in the adult population. There is a large "gap" in our understanding of the pathogenesis of adult onset T1D and a need for longitudinal studies to determine whether there are "at risk" adults in the general population; some of whom are rapid and some slow adult progressors. [ABSTRACT FROM AUTHOR] more...- Published
- 2019
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10. Using crowdsourcing to understand patients attitudes toward a clinical trial for retinitis pigmentosa requiring 4 years of participation
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Susie trotochaud, Xiangrong Kong, Carl A. Latkin, Fahd Naufal, Cory Dorfman, and Peter A. Campochiaro
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Crowdsourcing ,Article ,Slow progression ,Retinitis pigmentosa ,medicine ,Humans ,Patient compliance ,Genetics (clinical) ,Text Messaging ,business.industry ,Infant ,Middle Aged ,medicine.disease ,Clinical trial ,Ophthalmology ,Attitude ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Cell Phone ,Retinitis Pigmentosa - Abstract
BACKGROUND: Clinical trials for retinitis pigmentosa (RP) likely require long follow-ups because of the slow progression of RP. Understanding patients’ attitudes toward participation in a long trial and their acceptability of strategies aimed at promoting retention/compliance is important for assessing feasibility and resource needs and optimizing trial design. METHODS: A crowdsourcing survey to adult RP patients was administered on social media in 2020 July-November. Patient enthusiasm level of study participation, acceptability of attending clinic visits every 4–5 months for 45-months, tele-visits with doctors, and of receiving text messages for medication reminders and for reporting missed dosages were surveyed. RESULTS: Among the 1473 respondents, over 95% use email or a mobile phone and receive text messages; 1157 (79%) respondents were very/somewhat enthusiastic about participation, among them, 80.6% were “very willing” to attend clinic visits every 4–5 months for 45 months; 90.3% were “very willing” to have tele-visits; 64.7% and 77.1% were willing to receive text reminders to take medication and messages surveying missed doses, respectively. The youngest age group (18–30) (22.1%) and oldest age group (70+) (26.1%) compared to the 41–50 years age group (14%) and women (23.5%) compared to men (14.2%) were statistically significantly more likely not to report high willingness to participate in clinical visits for 45 months. CONCLUSIONS: A trial requiring 4-years of commitment is feasible although retention can be challenging. Strategies including supplementing in-clinic visits with tele-visits and frequent communications may facilitate retention. This study also demonstrates a methodology useful for planning clinical trials for chronic diseases. more...
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- 2023
11. Evaluation of Strategies for Measuring Lysosomal Glucocerebrosidase Activity
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Shalini Padmanabhan, Warren D. Hirst, Maria Nguyen, Tiffany J. Young, Nicolas Dzamko, Daniel Ysselstein, and Dimitri Krainc
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Movement disorders ,Parkinson's disease ,business.industry ,Dementia with Lewy bodies ,Disease ,medicine.disease ,Lysosomal Glucocerebrosidase ,Neurology ,Slow progression ,Medicine ,Dementia ,Neurology (clinical) ,medicine.symptom ,business ,Glucocerebrosidase ,Neuroscience - Abstract
Mutations in GBA1, which encode for the protein glucocerebrosidase (GCase), are the most common genetic risk factor for Parkinson's disease and dementia with Lewy bodies. In addition, growing evidence now suggests that the loss of GCase activity is also involved in onset of all forms of Parkinson's disease, dementia with Lewy bodies, and other dementias, such as progranulin-linked frontal temporal dementia. As a result, there is significant interest in developing GCase-targeted therapies that have the potential to stop or slow progression of these diseases. Despite this interest in GCase as a therapeutic target, there is significant inconsistency in the methodology for measuring GCase enzymatic activity in disease-modeling systems and patient populations, which could hinder progress in developing GCase therapies. In this review, we discuss the different strategies that have been developed to assess GCase activity and highlight the specific strengths and weaknesses of these approaches as well as the gaps that remain. We also discuss the current and potential role of these different methodologies in preclinical and clinical development of GCase-targeted therapies. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. more...
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- 2021
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12. Activated but functionally impaired memory Tregs are expanded in slow progressors to type 1 diabetes
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Clare Megson, Anna E. Long, Isabel V. Wilson, F. Susan Wong, Rachel J Aitken, Stephanie J. Hanna, Kathleen M Gillespie, and Joanne Boldison
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Adult ,CD4-Positive T-Lymphocytes ,Male ,autoantibodies ,Endocrinology, Diabetes and Metabolism ,T cell ,Peripheral blood mononuclear cell ,T-Lymphocytes, Regulatory ,regulatory T cells ,Article ,Flow cytometry ,Memory T Cells ,Diabetes mellitus ,Glucocorticoid-Induced TNFR-Related Protein ,Internal Medicine ,medicine ,Humans ,CD134 ,IL-2 receptor ,Lymphocyte Count ,Autoantibodies ,Aged ,Type 1 diabetes ,medicine.diagnostic_test ,business.industry ,Autoantibody ,Regulatory T cells ,Middle Aged ,medicine.disease ,Flow Cytometry ,CD4+ T cells ,Slow progression ,medicine.anatomical_structure ,Diabetes Mellitus, Type 1 ,Immunology ,Female ,business ,Follow-Up Studies - Abstract
Aims/hypothesis Slow progressors to type 1 diabetes are individuals positive for multiple pancreatic islet autoantibodies who have remained diabetes-free for at least 10 years; regulation of the autoimmune response is understudied in this group. Here, we profile CD4+ regulatory T cells (Tregs) in a small but well-characterised cohort of extreme slow progressors with a median age 43 (range 31–72 years), followed up for 18–32 years. Methods Peripheral blood samples were obtained from slow progressors (n = 8), age- and sex-matched to healthy donors. One participant in this study was identified with a raised HbA1c at the time of assessment and subsequently diagnosed with diabetes; this donor was individually evaluated in the analysis of the data. Peripheral blood mononuclear cells (PBMCs) were isolated, and to assess frequency, phenotype and function of Tregs in donors, multi-parameter flow cytometry and T cell suppression assays were performed. Unsupervised clustering analysis, using FlowSOM and CITRUS (cluster identification, characterization, and regression), was used to evaluate Treg phenotypes. Results Unsupervised clustering on memory CD4+ T cells from slow progressors showed an increased frequency of activated memory CD4+ Tregs, associated with increased expression of glucocorticoid-induced TNFR-related protein (GITR), compared with matched healthy donors. One participant with a raised HbA1c at the time of assessment had a different Treg profile compared with both slow progressors and matched controls. Functional assays demonstrated that Treg-mediated suppression of CD4+ effector T cells from slow progressors was significantly impaired, compared with healthy donors. However, effector CD4+ T cells from slow progressors were more responsive to Treg suppression compared with healthy donors, demonstrated by increased suppression of CD25 and CD134 expression on effector CD4+ T cells. Conclusions/interpretations We conclude that activated memory CD4+ Tregs from slow progressors are expanded and enriched for GITR expression, highlighting the need for further study of Treg heterogeneity in individuals at risk of developing type 1 diabetes. Graphical abstract more...
- Published
- 2021
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13. Characteristics of slow progression to diabetes in multiple islet autoantibody-positive individuals from five longitudinal cohorts: the SNAIL study.
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Long, Anna E., Wilson, Isabel V., Becker, Dorothy J., Libman, Ingrid M., Arena, Vincent C., Wong, F. Susan, Steck, Andrea K., Rewers, Marian J., Yu, Liping, Achenbach, Peter, Casas, Rosaura, Ludvigsson, Johnny, Williams, Alistair J. K., and Gillespie, Kathleen M. more...
- Abstract
Aims/hypothesis: Multiple islet autoimmunity increases risk of diabetes, but not all individuals positive for two or more islet autoantibodies progress to disease within a decade. Major islet autoantibodies recognise insulin (IAA), GAD (GADA), islet antigen-2 (IA-2A) and zinc transporter 8 (ZnT8A). Here we describe the baseline characteristics of a unique cohort of ‘slow progressors’ (
n = 132) who were positive for multiple islet autoantibodies (IAA, GADA, IA-2A or ZnT8A) but did not progress to diabetes within 10 years.Methods: Individuals were identified from five studies (BABYDIAB, Germany; Diabetes Autoimmunity Study in the Young [DAISY], USA; All Babies in Southeast Sweden [ABIS], Sweden; Bart’s Oxford Family Study [BOX], UK and the Pittsburgh Family Study, USA). Multiple islet autoantibody characteristics were determined using harmonised assays where possible. HLA class II risk was compared between slow progressors and rapid progressors (n = 348 diagnosed <5 years old from BOX) using theχ 2 test.Results: In the first available samples with detectable multiple antibodies, the most frequent autoantibodies were GADA (92%), followed by ZnT8A (62%), IAA (59%) and IA-2A (41%). High risk HLA class II genotypes were less frequent in slow (28%) than rapid progressors (42%,p = 0.011), but only two slow progressors carried the protective HLA DQ6 allele.Conclusion: No distinguishing characteristics of slow progressors at first detection of multiple antibodies have yet been identified. Continued investigation of these individuals may provide insights into slow progression that will inform future efforts to slow or prevent progression to clinical diabetes. [ABSTRACT FROM AUTHOR] more...- Published
- 2018
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14. Introduction of human anatomy before modern China: The preface of anatomical education in mainland China
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Yi Zhang
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Mainland China ,China ,Histology ,History ,Greece ,Anthropology ,Mesopotamia ,Slow progression ,Human anatomy ,Humans ,Medicine ,Egypt ,Medicine, Chinese Traditional ,Anatomy ,History, Ancient ,Ecology, Evolution, Behavior and Systematics ,Biotechnology - Abstract
Anatomy is an early researched discipline of natural science. Ancient civilizations (e.g., Greece, Egypt, Mesopotamia, and China) made significant contributions to our current understanding of medicine, including human anatomy. However, in modern China (from 1912 to the present), some contemporary scholars prefer to overlook the fact that anatomy was studied before modern China. Therefore, the author chronologically lists typical hallmark events and publications related to human anatomy before modern China, summarizes the influences of anatomy on traditional Chinese medicine, and analyzes the reasons for the slow progression of anatomy before modern China. The purpose is to better understand the history and culture of anatomy before modern China, serving as the first step of anatomical education for medical students in mainland China. more...
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- 2021
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15. A Case of Surgical Removal of a Giant and Multiple Acquired Plate-Like Osteoma Cutis After Implantation of a Dilator
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Huiqing Pan, Weilong Qiao, Renliang He, Chengzhi Li, Fangfang Wu, and Xiangdong Sun
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dilator implantation ,medicine.medical_specialty ,Ossification ,business.industry ,Case Report ,Dermatology ,medicine.disease ,Surgery ,surgery ,body regions ,medicine.anatomical_structure ,plate-like osteoma cutis ,Slow progression ,Dilator ,Surgical removal ,giant ,medicine ,Forehead ,Osteoma cutis ,medicine.symptom ,Family history ,business ,Pathological - Abstract
Osteoma cutis (OC) is a group of rare skin ossification diseases, most of which are secondary to inflammation, scarring, trauma, or tumors, but a small portion are primary. Plate-like osteoma cutis is rare, especially after puberty. This report documents a case of a 30-year-old female, who presented with multiple stone-hard plates on the forehead and bilateral temples, with no relevant family history, or abnormalities in metabolism. These lesions showed slow progression over the last 11 years. The pathological diagnosis confirmed osteoma cutis. The forehead lesions were treated surgically due to aesthetic problems. In addition, long-term follow-up and observations are still needed to determine progression to deeper levels of tissue. more...
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- 2021
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16. Ligament Augmentation With Mersilene Tape Reduces the Rates of Proximal Junctional Kyphosis and Failure in Adult Spinal Deformity
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Luke Hiatt, Joseph B. Wick, Hai Le, Eric O. Klineberg, Rolando Figueroa Roberto, Yashar Javidan, Pope Rodnoi, and Joshua Barber
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Pediatric Research Initiative ,medicine.medical_specialty ,Radiography ,Proximal junctional kyphosis ,Kyphosis ,Adult spinal deformity ,Proximal junctional angle ,Clinical Research ,Slow progression ,Adjacent segment disease ,Medicine ,RC346-429 ,Pelvis ,Proximal junctional failure ,Proximal junction disease ,business.industry ,medicine.disease ,Sagittal plane ,Surgery ,Rate of increase ,medicine.anatomical_structure ,Ligament ,Spinal deformity ,Original Article ,Neurology (clinical) ,Neurology. Diseases of the nervous system ,business - Abstract
Author(s): Rodnoi, Pope; Le, Hai; Hiatt, Luke; Wick, Joseph; Barber, Joshua; Javidan, Yashar; Roberto, Rolando; Klineberg, Eric O | Abstract: ObjectiveTo investigate prevention of proximal junctional kyphosis (PJK) and failure (PJF) following adult spinal deformity (ASD) surgery utilizing a novel technique of posterior ligament augmentation with polyester fiber tether.MethodsThis study evaluated ASD adult patients who underwent posterior decompression and instrumented fusion from the thoracolumbar junction (T9-L1) to the pelvis from 2011-2017. Basic demographic data were obtained. Radiographic outcomes included proximal junctional angle (PJA), sagittal vertical axis, PJK, and PJF. The study population was divided into patients who had ASD surgery with and without ligamentous augmentation.ResultsA total of 43 subjects were evaluated, including 20 without and 23 with ligamentous augmentation. PJA increased over time for both groups. PJA was smaller for the augmented group, and rate of increase in PJA was slower in the augmented group (p l 0.0001). The rate of PJK was significantly higher in the nonaugmented group (p = 0.01). PJF was significantly less common in the augmented group (p = 0.003). Time to revision surgery was lower in the nonaugmented group (p = 0.003).ConclusionOur novel ligament augmentation technique utilizing polyethylene tape is an effective technique to slow progression of the PJA and lower the risk for proximal junctional disease in ASD surgery. more...
- Published
- 2021
17. Independent predictors of forecasting the course of congenital HIV infection in children
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V. B. Denisenko and E. M. Simovanyan
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medicine.medical_specialty ,Viremia ,Disease ,Pediatrics ,01 natural sciences ,RJ1-570 ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,children ,Acquired immunodeficiency syndrome (AIDS) ,Slow progression ,Internal medicine ,medicine ,030212 general & internal medicine ,0101 mathematics ,hiv infection ,course prediction ,business.industry ,General Engineering ,Odds ratio ,medicine.disease ,Confidence interval ,Multivariate logistic regression model ,business ,Viral load - Abstract
The purpose is to characterize the clinical and laboratory parameters in children with different rates of congenital HIV infection progression and, based on the data obtained, to develop independent predictors of forecasting the course of the disease.Research methods. The comparison of clinical, immunological and virological parameters in 91 children with HIV infection with rapid (26%) and slow progression of the disease (74%) was carried out. The criterion for the rapid progression of HIV infection was considered the development of the AIDS clinic in the first two years of life.Results. Testing of clinical, immunological and virological parameters in a multivariate logistic regression model revealed independent predictors of rapid progression in children aged 6 months — HIV blood viral load more than 1 00 000 cop./ml (odds ratio OR 23.9; 95% confidence interval 95% CI 4.6—71.8; P < 0.001) and a decrease of blood CD4-lymphocytes less than 25% (OR 6.3; 95% CI 1.2—33.4; P = 0.029). The predictor «HIV blood viral load more than 100 000 cop./ml» was characterized by a higher sensitivity (91.3%), specificity (97.1 %) compared to the indicator «CD4 lymphocyte count less than 25%» (88.2% and 86.9%).Conclusion. In 26% of children with HIV infection, there is a rapid progression of the disease with the development of AIDS clinic during the first two years of life. The independent predictors of forecasting an unfavorable course of the disease are HIV blood viral load of more than 1 00 000 cop./ml and a decrease in CD4 lymphocytes in the blood of less than 25% at the age of 6 months. The level of viremia seems to be more preferable for predicting the course of HIV infection in children due to its high sensitivity and specificity. more...
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- 2021
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18. An Analysis of Analytic Hierarchy Process for Inter-Korean Cooperation in Crisisonomy
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Young Ho Eom, Sang Il Ryu, and Seol A Kwon
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genetic structures ,Coronavirus disease 2019 (COVID-19) ,Unification ,Operations research ,Slow progression ,Response type ,Analytic hierarchy process ,Christian ministry ,Joint (building) ,General Medicine ,Business ,Contingency - Abstract
The Ministry of Unification, for alleviation of tensions between the two Koreas, is planning cooperation in the health and medical fields such as COVID-19 quarantine and preparation against disaster. The relative priorities were determined for the areas for inter-Korean joint cooperation and the method. The results are as follows: First, experts suggested that the inter- Korean disaster safety cooperation is more important in Inter-Korean exchange area such as Mt. Kumgang and Kaesong Industrial Complex compared to in Area requiring joint response Second, they suggested that the inter-Korean disaster safety cooperation is more important in Recovery-centered type such as contingency and earthquake compared to in Slow progression or Strong-response types. Third, they recognized that the inter-Korean disaster cooperation is more important in the urgent response type than in the Permanent dispatch type. Fourth, they suggested that, although it is more difficult to reach an agreement between the two Koreas, the form of supporting using both equipment and personnel from is more necessary in inter-Korean cooperation in disaster safety. more...
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- 2021
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19. Promotion of Women Physicians in Academic Medicine
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Allison R. Larson and Sarah E. Nocco
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Male ,Faculty, Medical ,media_common.quotation_subject ,education ,Women Physicians ,030204 cardiovascular system & hematology ,Physicians, Women ,03 medical and health sciences ,0302 clinical medicine ,Promotion (rank) ,Slow progression ,Interim ,Humans ,Medicine ,030212 general & internal medicine ,Academic medicine ,Schools, Medical ,health care economics and organizations ,media_common ,Medical education ,Equity (economics) ,business.industry ,General Medicine ,humanities ,Career Mobility ,Leadership ,Workforce ,Female ,Women in science ,business - Abstract
Women currently represent nearly half of all medical school graduates and assistant professors at academic institutions. Despite the large pool of women in the academic medicine pipeline, relatively few ascend to top leadership positions and women remain grossly underrepresented among full professors, permanent department chairs, and highest-level deans/interim deans. Considerable evidence suggests that the gender imbalance observed at the top tiers of academic medicine is, in part, due to gender differences in promotional rates, with women being promoted more slowly than their male colleagues. The well-documented gender gaps in publications, grant support, recognition awards, speaker invitations, and leadership positions contribute to the slow progression of women in medicine, as promotions committees rely heavily upon these traditional measures of academic success to select candidates for career advancement. Additionally, implicit biases, which have been shown to favor men over women in science and leadership, influence decision-making processes relevant to the promotion of women in academia. With the large number of highly qualified women entering medicine, it is imperative that organizations, academic institutions, and leaders in the medical community address the systemic inequities that are preventing half the workforce from reaching its full potential. more...
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- 2021
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20. Impacto do déficit de investimentos para o tratamento da doença de chagas no Brasil: revisão narrativa
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Carolina dos Reis Alves, Vitor Hugo Maraslis Soares, Ana Patrícia Fonseca Coelho Galvão, Patrick Leonardo Nogueira da Silva, Fábio Batista Miranda, and Fabrícia Josely Oliveira Barbosa
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SciELO ,Chagas disease ,business.industry ,MEDLINE ,Disease ,Investment (macroeconomics) ,medicine.disease ,Slow progression ,Environmental health ,Medicine ,General Materials Science ,Narrative review ,business ,Bireme - Abstract
Objetivo: discutir sobre o impacto do déficit de investimentos para o tratamento da Doença de Chagas no Brasil. Método: trata-se de uma revisão narrativa da literatura realizada nas seguintes bases de dados: SCIELO, LILACS, BIREME e MEDLINE. A amostra final foi composta por 27 artigos científicos publicados entre o período de 2000 a 2020. Resultados: o Brasil é um dos países com maior prevalência de pacientes portadores da doença, porém pouco se avançou em pesquisas nessa área, de modo a repercutir em um baixo incentivo e investimento dos governantes e da indústria farmacêutica para a Doença de Chagas, tendo em vista a doença ser de progressão lenta e o diagnóstico e o tratamento serem tardios. Conclusão: fica evidente a falta de investimento e políticas públicas que possibilitem o diagnóstico e o tratamento precoce da doença tendo como conseqüência um déficit na qualidade de vida dos pacientes. more...
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- 2021
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21. Lipomas as an Extremely Rare Cause for Brachial Plexus Compression: A Case Series and Systematic Review
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Anne-Kathrin Uerschels, Ulrich Sure, Karsten H. Wrede, Mehdi Chihi, Oliver Gembruch, Daniela Pierscianek, Thiemo Florin Dinger, Yahya Ahmadipour, Ramazan Jabbarli, and Laurèl Rauschenbach
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medicine.medical_specialty ,Medizin ,lipoma ,030204 cardiovascular system & hematology ,lcsh:RC346-429 ,surgery ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,Slow progression ,medicine ,Peripheral nerve lesion ,lcsh:Neurology. Diseases of the nervous system ,Thoracic outlet syndrome ,Plexus ,brachial plexus ,Cochrane collaboration ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Original Contribution ,Lipoma ,medicine.disease ,body regions ,lcsh:RD701-811 ,monitoring ,Neurology ,intraoperative ,Neurology (clinical) ,Radiology ,business ,Brachial plexus ,030217 neurology & neurosurgery - Abstract
Introduction Brachial plexus lipomas are extremely rare benign tumors that may cause slow progression of neurological deficits leading to thoracic outlet syndrome. Up to now, surgery remains challenging. The aim of this study is to present our surgical treatment regime and long-term neurological outcome in three cases of giant brachial plexus lipomas and to show results of systematic review.Patients and Methods Retrospective analysis of our database “peripheral nerve lesion” to identify patients suffering from brachial plexus lipomas between January 1, 2012, and December 31, 2019. Systematic review was performed for literature published until March 31, 2020, analyzing PubMed, Google Scholar, Scopus, and the Cochrane Collaboration Library independently by two authors.Results Over the past years, three patients suffering from giant brachial plexus lipomas attended to our neurosurgical department. All patients underwent preoperative magnetic resonance imaging (MRI), ultrasound examinations, and electrophysiological testing. Tumors were removed microsurgically via anterior/posterior, supraclavicular/infraclavicular, and combined approaches. The patients were accessed postoperatively by MRI and clinical follow-up. Systematic review of the literature revealed 22 cases, which were analyzed in regard to demographics, surgical treatment, and neurological outcome.Conclusion Brachial plexus lipomas are an extremely rare cause for brachial plexus compression. Total microsurgical removal with intraoperative electrophysiological monitoring is the treatment of choice with excellent long-term MRI and clinical outcome. more...
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- 2021
22. An overview on mechanism, cause, prevention and multi-nation policy level interventions of dietary iron deficiency
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G. Raja Krishna Kumar, Abhishek Kulkarni, Tomal Dattaroy, Pranesh Badami, Santanu Dasgupta, Sharadha Arun, Monika Khade, and Badrish Soni
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030309 nutrition & dietetics ,Iron ,Population ,Psychological intervention ,Industrial and Manufacturing Engineering ,World health ,03 medical and health sciences ,0404 agricultural biotechnology ,Slow progression ,Development economics ,medicine ,Humans ,education ,0303 health sciences ,Dietary iron ,education.field_of_study ,Government ,Anemia, Iron-Deficiency ,Mechanism (biology) ,Malnutrition ,Iron Deficiencies ,04 agricultural and veterinary sciences ,General Medicine ,medicine.disease ,040401 food science ,Policy ,Iron-deficiency anemia ,Dietary Supplements ,Business ,Iron, Dietary ,Food Science - Abstract
Iron deficiency anemia (IDA) is probably the most ignored situation in the world of malnutrition-largely due to its slow progression. Multiple reasons can be attributed as the cause of IDA, which is not limited to any specific region or population; therefore, making it a matter of global concern. Despite the human body's ability to absorb and conserve iron stores, the gradual loss due to various physiological conditions leads to net deficiency of iron. Countless commercial iron supplements are available, but at given physiological conditions, almost all of these "Bio-not-available" iron forms quite often become ineffective. World Health Organization and other government bodies have jointly developed health advisories and tried to developed nutrition supplements several times in the last two decades. IDA, when combined with other disease conditions, becomes a life-threatening situation. At the same time, an overdose of iron could also be very harmful to the body. Therefore, it is important to deal with this situation with caution. This article covers iron metabolism, available options for iron supplementation, regulatory aspects and strategies to prevent IDA. more...
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- 2021
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23. Stem cell-based therapy as a promising approach in Alzheimer's disease: current perspectives on novel treatment
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Saeid Bagheri-Mohammadi
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Transplantation ,medicine.medical_specialty ,business.industry ,Biomedical Engineering ,Context (language use) ,Cell Biology ,Disease ,Insidious onset ,Biomaterials ,Cell therapy ,Therapeutic approach ,Transplant surgery ,Slow progression ,medicine ,Stem cell ,Intensive care medicine ,business - Abstract
Alzheimer's disease (AD) is a neuronal disorder with insidious onset and slow progression, leading to growing global concern with huge implications for individuals and society. The occurrence of AD has been increased and has become an important health issue throughout the world. In recent years, the care of more than 35 million patients with AD costs over $ 600 billion per year, it is approximately 1 percent of the global Gross Domestic Product. Currently, the therapeutic approach is not effective for neurological deficits especially after the development of these major neurological disorders. The discovery of the technique called cell-based therapy has shown promising results and made important conclusions beyond AD using the stem cells approach. Here we review recent progress on stem cell-based therapy in the context of AD. more...
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- 2021
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24. Barriers to initiation of insulin therapy in poorly controlled type 2 diabetes based on self-determination theory
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Soghra Rabizadeh, Salome Sadat Salehi, Pegah Khaloo, Alireza Esteghamati, Manouchehr Nakhjavani, Armin Rajab, Reza Majdzadeh, Hossein Mirmiranpour, Hamid Alemi, and Assadollah Rajab
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medicine.medical_specialty ,business.industry ,Insulin ,medicine.medical_treatment ,General Medicine ,Type 2 diabetes ,medicine.disease ,Diabetes Mellitus, Type 2 ,Slow progression ,Surveys and Questionnaires ,Diabetes mellitus ,Internal medicine ,Personal Autonomy ,Severity of illness ,medicine ,Humans ,Patient Compliance ,Intrinsic motivation ,Medical prescription ,business ,Self-determination theory - Abstract
Proper glycaemic control can slow progression of diabetes complications. One of the main causes of poor glycaemic control is delayed initiation of insulin therapy.To explain the reasons for delayed insulin initiation based on a behavioural model using patients' innate psychological needs.We enrolled 151 patients with type 2 diabetes who had indications for insulin therapy. Thirty general practitioners (GPs) were included as care providers. Patients were studied by questionnaires evaluating components of self determination theory, such as competency, relatedness and autonomy. We also evaluated patients' attitudes towards insulin therapy using the Insulin Treatment Appraisal Scale questionnaire. GPs' attitudes towards insulin therapy were assessed with a different questionnaire.Competency of patients was scored as acceptable (14.44/20). Relatedness score was low at around 15.63/30. The findings suggested that the patients' intrinsic motivation was less than their extrinsic motivation (8.41/15 vs 15.03/20). The main barrier to insulin therapy on the patients' side was rejection of severity of illness (67.5%). According to GPs, low compliance (96.7%) was the main cause of delayed insulin prescription.We observed that patients do not have a proper understanding about their illness. Due to the low score of relatedness as a representative of patients and care providers' relationship, we highlight the importance of educating both about insulin therapy and how they can have the most effective relationship in this process.العوائق التي تَُول دون بدء العلاج بالأنسولين لداء السُّكَّري من النمط الثاني الذي لا يمكن ضبطه جيداً استناداً إلى نظرية تقرير المصير.أرمين رجب، بيجا خالو، صغرى رابي زاده، حميد العليمي، سالومي صالحي، رضا مجدزاده، حسين ميرميرانبور، أسد الله رجب، علي رضا إستغاماتي، منوچهر نخجواني.يمكن أن يؤدي ضبط سكر الدم على نحوٍ صحيح إلى إبطاء تفاقم مضاعفات السُّكَّري. ويُعد تأخر بدء العلاج بالأنسولين أحد الأسباب الرئيسية التي تحول دون الضبط الجيد لسكر الدم.هدفت هذه الدراسة إلى شرح أسباب تأخُّر بدء العلاج بالأنسولين بِناءً على نموذج سلوكي يستند إلى احتياجات المرضى النفسية الفطرية.شملت هذه الدراسة 151 مريضاً بالسُّكَّري من النمط الثاني تستدعي حالاتهم العلاج بالأنسولين. وشملت ثلاثين ممارساً عاماً يضطلعون بدور مُقدِّمي خدمات الرعاية. وخضع المرضى للدراسة عن طريق استبيانات لتقييم مكوِّنات نظرية تقرير المصير، مثل الكفاءة والارتباط والاستقلالية. كما أجرينا تقييماً لمواقف المرضى تجاه العلاج بالأنسولين باستخدام استبيان مقياس تقييم العلاج بالأنسولين. وقُيّمَت مواقف الممارسين العامِّين تجاه العلاج بالأنسولين باستخدام استبيان مختلف.حصلت كفاءة المرضى على درجة مقبولة (14.44 / 20)، فيما حصل الارتباط على درجة منخفضة تُقدَّر بنحو 15.63 / 30. وأشارت النتائج إلى أن الدافع الذاتي للمرضى كان أقلَّ من دوافعهم الخارجية (8.41 / 15 مقابل 15.03 / 20). وتَثَّل العائق الرئيسي الذي يحُول دون إقدام المرضى على العلاج بالأنسولين في عدم الاعتراف بشدة المرض (67.5٪). ووَفْقاً للممارسين العامِّين، كان انخفاض الامتثال (96.7٪) السبب الرئيسي لتأخُّر وصف الأنسولين.لاحظنا أن المرضى لا يتمتعون بفهمٍ صحيحٍ لمرضهم. ونظراً لانخفاض درجة الارتباط كممثل للعلاقة بين المرضى ومُقدِّمي خدمات الرعاية، فإننا نُسلّط الضوءَ على أهمية تثقيف كلٍ منهما بشأن العلاج بالأنسولين، وكيف يمكن الوصول إلى أفضل علاقة فعّالة بين الطرفين في إطار هذه العملية.Obstacles face à la mise en place de l’insulinothérapie dans le diabète de type 2 mal contrôlé selon la théorie de l’autodétermination.Un contrôle adéquat de la glycémie permet de ralentir la progression des complications du diabète. Le retard dans la mise en place de l’insulinothérapie constitue l’une des principales causes d’un mauvais contrôle de la glycémie.Expliquer les raisons du retard de la mise en place du traitement par insuline sur la base d’un modèle comportemental fondé sur les besoins psychologiques innés des patients.Nous avons recruté 151 patients atteints de diabète de type 2 pour lesquels l’insulinothérapie était indiquée. Une trentaine de médecins généralistes ont été inclus en qualité de prestataires de soins. L’étude a été menée au moyen de questionnaires évaluant des composantes de la théorie de l’autodétermination, telles que la compétence, l’affiliation et l’autonomie. Nous avons également évalué les attitudes des patients vis-à-vis de l’insulinothérapie à l’aide du questionnaire de l’échelle d’évaluation de l’insulinothérapie (Insulin Treatment Appraisal Scale). Les attitudes des médecins généralistes vis-à-vis de l’insulinothérapie ont été évaluées au moyen d’un questionnaire différent.La compétence des patients a été jugée acceptable (14,44/20). Le score se rapportant à l’affiliation était faible, à environ 15,63/30. Les résultats suggèrent que la motivation intrinsèque des patients était inférieure à leur motivation extrinsèque (8,41/15 contre 15,03/20). Du côté des patients, le rejet de la gravité de la maladie (67,5 %) constituait le principal obstacle à la mise en place de l’insulinothérapie. Selon les médecins généralistes, une faible observance (96,7 %) était la principale cause de retard dans la prescription d’insuline.Nous avons observé que les patients ont une mauvaise compréhension de leur maladie. En raison de la faiblesse du score concernant l’affiliation, en tant qu’élément représentant la relation entre les patients et les prestataires de soins, nous soulignons l’importance d’une meilleure sensibilisation des malades et soignants à l’insulinothérapie et de la manière de mettre en place une relation efficace. more...
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- 2020
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25. A Collaborative Survey of Nurse Practitioner Colorectal Cancer Screening Practice
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Michael J. Steinberg, Jaimee Reiley, Roseann Velez, and Beverly Lang
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Advanced and Specialized Nursing ,medicine.medical_specialty ,Crc screening ,Colorectal cancer ,Practice patterns ,Nurse practitioners ,business.industry ,Early detection ,030204 cardiovascular system & hematology ,medicine.disease ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Colorectal cancer screening ,Slow progression ,Family medicine ,medicine ,Survey data collection ,030212 general & internal medicine ,business - Abstract
Colorectal cancer (CRC) is the second leading cause of cancer death in men and women in the United States. The opportunity for nurse practitioners (NPs) to initiate preventive measures to guide early detection of CRC is great given its slow progression. We present a collaborative project between a state NP association and colleagues from the Medical Affairs Division of a pharmaceutical company to develop an electronic survey to assess NP knowledge, beliefs, and practice patterns for CRC screening. Survey data identified that NP knowledge of CRC screening guidelines is variable and may contribute to low screening rates. more...
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- 2020
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26. Benefit versus risk associated with the use of brominated flame retardants
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Matthew S. Blais, Wiebke Droege, Sam Kacew, Thomas G. Osimitz, and A. Wallace Hayes
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0301 basic medicine ,Waste management ,Acrylonitrile butadiene styrene ,010501 environmental sciences ,Toxicology ,01 natural sciences ,Toxicology studies ,03 medical and health sciences ,chemistry.chemical_compound ,030104 developmental biology ,chemistry ,Slow progression ,Fire protection ,Environmental monitoring ,Biomonitoring ,Environmental science ,Tetrabromobisphenol A ,Risk assessment ,0105 earth and related environmental sciences - Abstract
Flame retardants are widely used in electronic equipment, construction materials, and furniture to prevent fires from starting and to slow progression. Environmental monitoring studies show their presence in house dust, biomonitoring studies occasionally detect the chemicals in biological samples, and animal toxicology studies show high-dose effects. Yet laboratory studies and real-world fire statistics confirm that flame retardants have benefits that need to be weighed against possible risks to human health. Tetrabromobisphenol A (TBBPA), is used to make brominated epoxy printed wiring boards, and to a lesser extent, flame retarded acrylonitrile butadiene styrene (ABS) plastic is often used to make electronic casings. Evaluating available toxicology data and using conservative exposure assumptions, the risks of using TBBPA in these applications is exceedingly low. Given the benefits of TBBPA and flame retardants, it is essential that carefully conducted, chemical- and use-specific risk assessment be used to inform regulatory action which could possibly undermine public fire protection. more...
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- 2020
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27. Predictors and Functional Outcomes of Fast, Intermediate, and Slow Progression Among Patients With Acute Ischemic Stroke
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Reza Jahan, Mersedeh Bahr Hosseini, Viktor Szeder, David S Liebeskind, Gary Duckwiler, Bryan Yoo, Latisha K Sharma, Satoshi Tateshima, Jeffrey L. Saver, Woo-Keun Seo, May Nour, Geoffrey P. Colby, Neal M Rao, and Sidney Starkman more...
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Male ,medicine.medical_specialty ,Time Factors ,Infarction ,030204 cardiovascular system & hematology ,Brain Ischemia ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Slow progression ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,Registries ,Acute ischemic stroke ,Aged ,Aged, 80 and over ,Advanced and Specialized Nursing ,business.industry ,Recovery of Function ,Middle Aged ,medicine.disease ,Stroke ,Treatment Outcome ,Disease Progression ,Cardiology ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background and Purpose: We aimed to delineate the determinants of the initial speed of infarct progression and the association of speed of infarct progression (SIP) with procedural and functional outcomes. Methods: From a prospectively maintained stroke center registry, consecutive anterior circulation ischemic stroke patients with large artery occlusion, National Institutes of Health Stroke Scale score ≥4, and multimodal vessel, ischemic core, and tissue-at-risk imaging within 24 hours of onset were included. Initial SIP was calculated as ischemic core volume at first imaging divided by the time from stroke onset to imaging. Results: Among the 88 patients, SIP was median 2.2 cc/h (interquartile range, 0–8.7), ranging most widely within the first 6 hours after onset. Faster SIP was positively independently associated with a low collateral score (odds ratio [OR], 3.30 [95% CI, 1.25–10.49]) and arrival by emergency medical services (OR, 3.34 [95% CI, 1.06–10.49]) and negatively associated with prior ischemic stroke (OR, 0.12 [95% CI, 0.03–0.50]) and coronary artery disease (OR, 0.32 [95% CI, 0.10–1.00]). Among the 67 patients who underwent endovascular thrombectomy, slower SIP was associated with a shift to reduced levels of disability at discharge (OR, 3.26 [95% CI, 1.02–10.45]), increased substantial reperfusion by thrombectomy (OR, 8.30 [95% CI, 0.97–70.87]), and reduced radiological hemorrhagic transformation (OR, 0.34 [95% CI, 0.12–0.94]). Conclusions: Slower SIP is associated with a high collateral score, prior ischemic stroke, and coronary artery disease, supporting roles for both collateral robustness and ischemic preconditioning in fostering tissue resilience to ischemia. Among patients undergoing endovascular thrombectomy, the speed of infarct progression is a major determinant of clinical outcome. more...
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- 2020
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28. Diagnostic Difficulties of Mucopolysaccharidosis Type I Mild Forms: Clinical Cases
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Nato D. Vashakmadze, Leyla S. Namazova-Baranova, Natalia V. Zhurkova, Ekaterina Yu. Zakharova, Elena J. Voskobaeva, Marina A. Babaikina, and Lyudmila M. Mikhaylova
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Pediatrics ,medicine.medical_specialty ,hurler-scheie syndrome ,business.industry ,Mucopolysaccharidosis ,Hurler–Scheie syndrome ,mucopolysaccharidosis ,medicine.disease ,RJ1-570 ,scheie syndrome ,Mucopolysaccharidosis type I ,Quality of life ,Slow progression ,Pediatrics, Perinatology and Child Health ,diagnostics ,Medicine ,business ,Iduronidase ,Scheie syndrome ,alpha-l-iduronidase - Abstract
Mucopolysaccharidosis type I mild forms include Scheie syndrome and Hurler-Scheie syndrome that are characterized by slow progression, intact intelligence, and primarily effect on visual organ, musculoskeletal and cardiovascular systems. Early diagnostics, multidisciplinary approach to examination and monitoring, timely management are crucial in maintenance of patients' quality of life, preventing complications development and early disability. The article provides the overview of published data and description of 3 clinical cases with mild course of mucopolysaccharidosis type I. more...
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- 2020
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29. Will the plant-based movement redefine physicians’ understanding of chronic disease?
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Maximilian Andreas Storz
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Diet, Vegan ,medicine.medical_specialty ,Disease ,Environment ,Professional Role ,Diabetic Neuropathies ,Slow progression ,Physicians ,medicine ,Humans ,Ethics, Medical ,Symptom control ,Bioethical Issues ,Practice Patterns, Physicians' ,Social Change ,Intensive care medicine ,Polypharmacy ,Informed Consent ,Ecology ,business.industry ,Plant based ,Health Care Costs ,Bioethics ,Diet ,Issues, ethics and legal aspects ,Chronic disease ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Chronic Disease ,Disease remission ,Treatment strategy ,Comprehension ,business ,Delivery of Health Care - Abstract
The world is experiencing a cataclysmically increasing burden from chronic illnesses. Chronic diseases are on the advance worldwide and treatment strategies to counter this development are dominated by symptom control and polypharmacy. Thus, chronic conditions are often considered irreversible, implying a slow progression of disease that can only be hampered but not stopped. The current plant-based movement is attempting to alter this way of thinking. Applying a nutrition-first approach, the ultimate goal is either disease remission or reversal. Hereby, ethical questions arise as to whether physicians' current understanding of chronic illness is outdated and morally reprehensible. In this case, physicians may need to recommend plant-based diets to every patient suffering from chronic conditions, while determining what other socioecological factors and environmental aspects play a role in the chronic disease process. This article provides insights to aspects of diet and chronic illness and discusses how the plant-based movement could redefine current understanding of chronic disease. The ethical justifications for recommending of a plant-based diet are analyzed. The article concludes that not advocating for plant-based nutrition is unethical and harms the planet and patients alike. more...
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- 2020
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30. Influence of early renoprotections on slow progression of chronic kidney disease in children
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S.V. Kushnirenko
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medicine.medical_specialty ,business.industry ,Slow progression ,Internal medicine ,medicine ,General Medicine ,medicine.disease ,business ,Gastroenterology ,Kidney disease - Published
- 2020
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31. Clinical study of apatinib combined with EGFR‐TKI in the treatment of chronic progression after EGFR‐TKI treatment in non‐small cell lung cancer (ChiCTR1800019185)
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Hongbing Zhang, Minghui Liu, Xin Li, Jun Chen, and Hongyu Liu
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Male ,0301 basic medicine ,Oncology ,Lung Neoplasms ,slow progression ,Pyridines ,EGFR‐TKIs ,Drug resistance ,Study Protocol ,chemistry.chemical_compound ,0302 clinical medicine ,Carcinoembryonic antigen ,Quality of life ,Carcinoma, Non-Small-Cell Lung ,Crown Ethers ,Antineoplastic Combined Chemotherapy Protocols ,Apatinib ,Prospective Studies ,Aged, 80 and over ,biology ,Gefitinib ,General Medicine ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,ErbB Receptors ,Research Design ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,Non small cell ,non‐small cell lung cancer ,Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,lcsh:RC254-282 ,Erlotinib Hydrochloride ,Young Adult ,03 medical and health sciences ,Egfr tki ,Internal medicine ,medicine ,Humans ,Lung cancer ,Aged ,business.industry ,medicine.disease ,respiratory tract diseases ,Clinical trial ,030104 developmental biology ,chemistry ,Drug Resistance, Neoplasm ,Mutation ,Quinazolines ,biology.protein ,business ,Follow-Up Studies - Abstract
This clinical trial (ChiCTR1800019185) is designed to be an open‐label, prospective, single‐center, single arm exploratory research study. The study will recruit non‐small cell lung cancer patients (NSCLC) with slow progression after first‐line treatment with EGFR‐TKI drugs. Slow progression will be confirmed by the presence of serum carcinoembryonic antigen or imaging evaluation. The primary aim is to assess progression‐free survival after EGFR‐TKIs treatment combined with apatinib 250 mg once daily. The secondary objectives are to evaluate objective efficacy, disease control rates, quality of life, overall survival, and safety. From September 2018 to September 2020, under specific entry and discharge standards, we plan to enroll 38 eligible patients until the end of the study. We hope that our study will help to explore a new way of combining the small molecular inhibitors of antiangiogenesis with EGFR‐TKIs to overcome acquired drug resistance. more...
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- 2020
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32. Contemporary diagnostic and therapeutic possibilities in patients with adenoid cystic carcinoma of the head and neck
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Elzbieta Sarnowska, Katarzyna Śmiałek-Kania, Janusz A. Siedlecki, Beata Jagielska, Andrzej Kawecki, and Tomasz J. Sarnowski
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medicine.medical_specialty ,business.industry ,Adenoid cystic carcinoma ,Clinical course ,medicine.disease ,Asymptomatic ,Long latency ,Oncology ,Slow progression ,Carcinoma ,Medicine ,In patient ,Radiology ,medicine.symptom ,Head and neck ,business - Abstract
Adenoic cystic carcinoma (SACC, ACC) in the head and neck area, occurring in small and large salivary glands are relatively rare tumors, usually undergoing slow progression. ACC is characterized by a different clinical course compared to other cancers, with a long latency period, a tendency to form late, initially asymptomatic metastases and a small percentage of responses to systemic treatment. This article presents current recommendations for diagnostic procedures and treatment possibilities. more...
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- 2020
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33. Multinodular and Vacuolating Neuronal Tumors with Suggested Slow Progression
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Wakamiya Tomihiro, Abe Tatsuya, Masuoka Jun, Nakahara Yukiko, Inoue Kohei, Koguchi Motofumi, Ito Hiroshi, Yoshioka Fumitaka, and Ogata Atsushi
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Thesaurus (information retrieval) ,Slow progression ,business.industry ,Medicine ,Surgery ,Neurology (clinical) ,business ,Neuroscience - Published
- 2020
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34. An empirical pipeline for personalized diagnosis of Lafora disease mutations
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Pascual Sanz, Sheng Li, Craig W. Vander Kooi, Jeremiah Wayne, Andrea Kuchtová, Maria Machio-Castello, Zoe R. Simmons, Sarah Sternbach, M. Kathryn Brewer, Matthew S. Gentry, Maria Adelaida Garcia-Gimeno, Rosa Viana, Jose M. Serratosa, National Institutes of Health (US), National Science Foundation (US), Epilepsy Foundation, European Science Foundation, Ministerio de Ciencia e Innovación (España), Sanz, Pascual [0000-0002-2399-4103], and Sanz, Pascual more...
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History ,Polymers and Plastics ,Science ,Biophysics ,Disease ,Progressive myoclonus epilepsy ,Bioinformatics ,Biochemistry ,Article ,Industrial and Manufacturing Engineering ,Lafora disease ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Slow progression ,0502 economics and business ,Medicine ,Dementia ,Missense mutation ,Glycogen storage disease ,050207 economics ,Business and International Management ,Exome sequencing ,030304 developmental biology ,0303 health sciences ,Multidisciplinary ,050208 finance ,business.industry ,Metabolic disorder ,Disease progression ,05 social sciences ,medicine.disease ,3. Good health ,business ,Structural biology ,Laforin ,030217 neurology & neurosurgery - Abstract
Summary Lafora disease (LD) is a fatal childhood dementia characterized by progressive myoclonic epilepsy manifesting in the teenage years, rapid neurological decline, and death typically within ten years of onset. Mutations in either EPM2A, encoding the glycogen phosphatase laforin, or EPM2B, encoding the E3 ligase malin, cause LD. Whole exome sequencing has revealed many EPM2A variants associated with late-onset or slower disease progression. We established an empirical pipeline for characterizing the functional consequences of laforin missense mutations in vitro using complementary biochemical approaches. Analysis of 26 mutations revealed distinct functional classes associated with different outcomes that were supported by clinical cases. For example, F321C and G279C mutations have attenuated functional defects and are associated with slow progression. This pipeline enabled rapid characterization and classification of newly identified EPM2A mutations, providing clinicians and researchers genetic information to guide treatment of LD patients., Graphical abstract, Highlights • Lafora disease (LD) patients present with varying clinical progression • LD missense mutations differentially affect laforin function • An empirical in vitro pipeline is used to classify laforin missense mutations • Patient progression can be predicted based on mutation class, Disease; Biochemistry; Structural biology; Biophysics more...
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- 2021
35. Faecal Diagnostic Biomarkers for Colorectal Cancer
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Andrea Cruz, Anais Crespo, Alexandra Cunha, Águeda Iglesias, Paulo P. Freitas, Carla A. O. C. M. Carvalho, Laura García-Nimo, and Joaquín Cubiella
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Oncology ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,diagnosis ,faecal haemoglobin ,Colonoscopy ,colorectal cancer ,Article ,Metastasis ,Slow progression ,Internal medicine ,Medicine ,Diagnostic biomarker ,M2-PK ,neoplasms ,RC254-282 ,Cause of death ,medicine.diagnostic_test ,business.industry ,Advanced stage ,Cancer ,biomarkers ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,digestive system diseases ,advanced adenoma ,business - Abstract
Simple Summary Colorectal cancer (CRC) is a significant public health problem, being a major cause of cancer death worldwide. Hence, the identification of biomarkers able to support CRC detection is crucial. This work analyses a panel of six biomarkers, namely interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-2, MMP-9, haemoglobin (Hb) and M2-pyruvate kinase (M2-PK), in stool samples from patients with CRC, advanced adenomas, other lesions and healthy individuals. Our results indicate that the levels of Hb and M2-PK were increased in CRC patients in comparison to the controls. Moreover, the combination of these biomarkers increased the specificity or sensitivity for CRC detection and thus present potential for diagnosis of CRC. Abstract Background: Colorectal cancer (CRC) is a major cause of cancer-related death worldwide. Cancer progression, including invasion and metastasis, is a major cause of death among CRC patients. Current methods for CRC screening commonly consist of a combination of faecal immunochemical test (FIT) for stool occult blood detection and invasive procedures such as colonoscopy. Considering the slow progression of CRC, and that symptoms usually emerge at advanced stages, its early diagnostic can limit cancer’s spread and provide a successful treatment. Biomarkers have a high potential for the diagnosis of CRC in either blood or stool samples. Methods: In this study, we analysed the diagnostic value of six different biomarkers in stool samples of patients with CRC, advanced adenomas, other lesions and healthy individuals. We have also assessed the overall performance of the combination of these biomarkers for CRC detection. Results: The results indicate that haemoglobin (Hb) and M2-pyruvate kinase (M2-PK) levels were increased in CRC patients in comparison to the controls. Conversely, the concentrations of matrix metalloproteinase (MMP)-2, MMP-9, and tumour necrosis factor-alpha (TNF-α) were not significantly different between the tested groups. Conclusion: The combination of FIT-Hb with the M2-PK levels increased the specificity or sensitivity for CRC detection and thus present potential as faecal diagnostic biomarkers for CRC. more...
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- 2021
36. The open membrane database: Synthesis-structure-performance relationships of reverse osmosis membranes
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Rhea Verbeke, Timothée Stassin, Cody L. Ritt, Zhiqing Yang, Ryan M. DuChanois, Guy Z. Ramon, Menachem Elimelech, Naama Segev-Mark, Adi Ben-Zvi, Ines Nulens, Ivo F.J. Vankelecom, Douglas M. Davenport, and Chuyang Y. Tang more...
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Technology ,Engineering, Chemical ,Computer science ,Polymer Science ,Filtration and Separation ,PRESSURE ,computer.software_genre ,Biochemistry ,Desalination ,ENERGY ,Engineering ,Slow progression ,General Materials Science ,CONCENTRATION POLARIZATION ,PERMEABILITY ,Physical and Theoretical Chemistry ,Reverse osmosis ,Structure (mathematical logic) ,Permeability-selectivity trade-off ,Science & Technology ,Database ,Product data ,Transport theory ,Interactive database ,DIFFUSION ,Membrane ,Physical Sciences ,COMPOSITE MEMBRANES ,Membrane performance ,NANOFILTRATION MEMBRANES ,CROSS-FLOW ,computer ,COEFFICIENTS - Abstract
Since the advent of thin-film composite polyamide membranes brought forth a breakthrough in desalination and water purification membranes nearly half a century ago, recent years have only witnessed marginal improvements in the water-salt selectivity of these membranes. The slow progression is partly attributable to limited understanding of membrane synthesis–structure–performance relationships. A centralized archive of reverse osmosis membrane (RO) characterization data may lead to a shared understanding of features that maximize RO performance and unify research efforts. The Open Membrane Database (OMD), which can be found at www.openmembranedatabase.org , is a growing database of over 600 water purification and desalination membranes that are sourced from peer-reviewed journals, patents, and commercial product data. Here, we outline the detailed functionality of the database, the transport theory underlying the membrane performance calculations, and best practices for membrane performance testing and reporting. The user-sourced, open-access database may be used to benchmark novel RO membranes against the state of the art, conduct meta-analyses, and develop synthesis–structure–performance relationships, each of which will be critical to advancing membrane development. more...
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- 2021
37. Treatment of rheumatoid arthritis by phototherapy: advances and perspectives
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Yunxia Dong, Jie Cao, and Wei Cao
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Oncology ,medicine.medical_specialty ,Necrosis ,business.industry ,medicine.medical_treatment ,Light irradiation ,Photodynamic therapy ,Apoptosis ,Disease ,Phototherapy ,medicine.disease ,Arthritis, Rheumatoid ,Pharmacotherapy ,High dosage ,Photochemotherapy ,Slow progression ,Internal medicine ,Rheumatoid arthritis ,medicine ,Humans ,General Materials Science ,medicine.symptom ,business - Abstract
Rheumatoid arthritis (RA) is an inflammatory disease that is prevalent worldwide and seriously threatens human health. Though traditional drug therapy can alleviate RA symptoms and slow progression, high dosage and frequent administration would cause unfavorable side effects. Phototherapy including photodynamic therapy (PDT) and photothermal therapy (PTT) has demonstrated distinctive potential in RA treatment. Under light irradiation, phototherapy can convert light into heat, or generate ROS, to promote necrosis or apoptosis of RA inflammatory cells, thus reducing the concentration of related inflammatory factors and relieving the symptoms of RA. In this review, we will summarize the development in the application of phototherapy in the treatment of rheumatoid arthritis. more...
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- 2021
38. Necrotizing Soft Tissue Infections, the Challenge Remains
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Femke Nawijn, Andrew B. Peitzman, Luke P. H. Leenen, and Falco Hietbrink
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necrotizing soft tissue infections ,medicine.medical_specialty ,Erythema ,RD1-811 ,business.industry ,Critically ill ,necrotizing fasciitis ,presentation NSTIs ,Treatment delay ,Soft tissue ,Fast onset ,medicine.disease ,outcomes ,mortality ,Sepsis ,Slow progression ,Perspective ,medicine ,Surgery ,Presentation (obstetrics) ,medicine.symptom ,Intensive care medicine ,business - Abstract
Background: Necrotizing Soft Tissue Infections (NSTIs) are uncommon rapidly spreading infection of the soft tissues for which prompt surgical treatment is vital for survival. Currently, even with sufficient awareness and facilities available, ambiguous symptoms frequently result in treatment delay.Objectives: To illustrate the heterogeneity in presentation of NSTIs and the pitfalls entailing from this heterogeneity.Discussion: NSTI symptoms appear on a spectrum with on one side the typical critically ill patient with fast onset and progression of symptoms combined with severe systemic toxicity resulting in severe physical derangement and sepsis. In these cases, the suspicion of a NSTI rises quickly. On the other far side of the spectrum is the less evident type of presentation of the patient with gradual but slow progression of non-specific symptoms over the past couple of days without clear signs of sepsis initially. This side of the spectrum is under represented in current literature and some physicians involved in the care for NSTI patients are still unaware of this heterogeneity in presentation.Conclusion: The presentation of a critically ill patient with evident pain out of proportion, erythema, necrotic skin and bullae is the classical presentation of NSTIs. On the other hand, non-specific symptoms without systemic toxicity at presentation frequently result in a battery of diagnostics tests and imaging before the treatment strategy is determined. This may result in a delay in presentation, delay in diagnosis and delay in definitive treatment. This failure to perform an adequate exploration expeditiously can result in a preventable mortality. more...
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- 2021
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39. Συσχέτιση φυσικής δραστηριότητας και ποιότητα ζωής σε ομάδες ασθενών με χρόνιες παθήσεις
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Maria Chania
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Gerontology ,medicine.medical_specialty ,business.industry ,Significant difference ,Organic disorders ,Disease ,Mental health ,Health problems ,Quality of life ,Slow progression ,Dialysis unit ,Physical therapy ,Medicine ,business - Abstract
The World Health Organization describes the chronic disease as “disease of long duration and generally slow progression” and the chronic conditions as “health problems requiring continuous management for years or even decades”. The aim of this research was to explore the correlation of physical activity and quality of life relating to health (QoLrH), in groups of patients with chronic diseases, with mellitus diabetes, with B-thalasaimia and with renal failure. Α tool consisted of: a) short form of the international physical activity questionnaire (IPAQ) and b) short form of the quality of life questionnaire (SF-36) during the period 2010-2011,was filled in by 133 patients from the Renal Dialysis Unit in 4 general hospitals of the Health District of Peloponnese. 51.1% of the participants were women, 33.8% were graduates from Colleges/ Universities, and 59.4% are married. 53.0% of them were working for 6-8 hours daily and 68.9% consider their income to be insufficient for their living and personal needs. Furthermore, some seem to be affected from various other organic disorders, comorbidities. Apart from the body disorders known from the bibliography, we statistically remark a significant negative influence of all levels – dimensions of the quality of life in all three groups of patients. In particular: (52.6%)had low physical activity. Men had considerably higher marks in the synoptic scale of physical health a fact that indicates better physical health in comparison to women. Additionally, there was a significant difference in the marks of the participants at the synoptic scale of physical health in accordance with their level of education, both of the high school graduates and the graduates of Universities. Moreover, the participants that used to work 6-8 hours daily had considerably higher marks in the synoptic scale of physical health from other participants. Women got considerably higher marks in the synoptic scale of mental health. From the results’ analysis it arose that for all three groups of patients there was significant correlation between all the dimensions of quality of life. Therefore, the higher it gets the quality of life regarding one dimension, the better it becomes regarding all the others too. more...
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- 2021
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40. Comparative Analysis of Serial Union Patterns After Opening-Wedge High Tibial Osteotomy with and without Bone-Void Fillers
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Jae Ik Lee, Yong Seuk Lee, Dong Hyun Kim, Tae Woo Kim, and Seong Chan Kim
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Male ,Scoring system ,Knee Joint ,High tibial osteotomy ,Slow progression ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Aged ,Retrospective Studies ,Orthodontics ,Gap filling ,Bone Transplantation ,Tibia ,business.industry ,Anteroposterior radiograph ,Bone union ,General Medicine ,Middle Aged ,Osteoarthritis, Knee ,Opening wedge ,Osteotomy ,Bone Substitutes ,Surgery ,Female ,Level iii ,Hydroxyapatites ,business - Abstract
Background Opening-wedge high tibial osteotomy produces opening gaps; however, there is little consensus on bone graft necessity and the material that would produce a superior union. The purposes of the present study were (1) to compare the serial union patterns associated with various bone-void fillers, (2) to determine whether bone-void filler is necessary to achieve bone union of the opening gap, and (3) to determine whether bone union is different according to the correction degree during opening-wedge high tibial osteotomy. Methods In this retrospective study, 97 knees were randomly assigned to treatment with hydroxyapatite chip bone (Group A), allogenic chip bone (Group B), or no bone graft (Group C) and were analyzed after a minimum 1-year follow-up. To compare the bone union pattern, the area of callus filling located at the most medial side on an anteroposterior radiograph of the knee was recorded, and a modified van Hemert scoring system was used in the mediolaterally divided 5 zones. The correlations between the correction degree and bone union scores were evaluated. Results There were no significant differences in the extent of mediolateral bone-healing at 6 weeks or 3 months postoperatively (p = 0.172 and p = 0.228). However, Group C showed more prominent progression of the gap filling to the medial side compared with Groups A and B at 6 months postoperatively (p = 0.002). Group C showed slow progression of bone union up to 6 weeks but surpassed the other groups at 6 months. The union pattern was not different between Groups A and B, and the correction degree was not correlated with bone union beyond 3 months postoperatively. Conclusions Despite the different gap-healing patterns, opening-wedge high tibial osteotomy without bone graft achieved bone union comparable with allogenic and synthetic graft materials. Group C (no bone graft) showed slower progression of bone union but surpassed the other groups at around 6 months. Based on the union pattern, there was no difference depending on the correction degree and the use of bone-void fillers. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. more...
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- 2021
41. Gorham–Stout disease of the mandible: case report and review of literature of a rare type of osteolysis
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Rohan Jagtap, John Hardeman, D. Kashtwari, Benjamin Schlott, Abdullah Lamfon, Axel Ruprecht, and Swati Gupta
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Osteolysis ,business.industry ,Mandible ,nutritional and metabolic diseases ,030206 dentistry ,Disease ,Oral and maxillofacial radiology ,medicine.disease ,Dermatology ,030218 nuclear medicine & medical imaging ,Gorham-Stout Disease ,03 medical and health sciences ,0302 clinical medicine ,Slow progression ,medicine ,Etiology ,Oral and maxillofacial surgery ,Radiology, Nuclear Medicine and imaging ,Dentistry (miscellaneous) ,business - Abstract
Gorham–Stout disease (GSD) is a rare form of osteolysis, the aetiology and pathogenesis of which remains controversial to this date. Although more than 200 cases of GSD have been reported so far, this disease continues to go undiagnosed in the initial stages owing to its varied clinical presentations and rarity. Through this case report of GSD in a 3-year-old boy, we discuss the slow progression of the disease over a period of 13 years. The literature review is also done with an emphasis on the role of an oral and maxillofacial radiologist in understanding the disease at its incipient stage. more...
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- 2019
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42. Clear Cell Type of Hepatocellular Carcinoma with a Slow Progression Accompanied by Natural Necrosis
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Anna Kobayashi, Takashi Yamagishi, Toshihiko Yoshida, Masahiro Tominaga, Hisoka Yamane, Sachiko Yoshida, Taku Matsumoto, and Yasuhiro Fujino
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Necrosis ,business.industry ,Slow progression ,Hepatocellular carcinoma ,Gastroenterology ,Cancer research ,Medicine ,Surgery ,medicine.symptom ,business ,medicine.disease ,Clear cell type - Published
- 2019
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43. Imaging and clinicopathologic features of myxoid meningiomas
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Mahlon D. Johnson and Ali Hussain
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Pathology and Forensic Medicine ,Meningioma ,03 medical and health sciences ,0302 clinical medicine ,Stroma ,Slow progression ,Meningeal Neoplasms ,otorhinolaryngologic diseases ,medicine ,Humans ,neoplasms ,Aged ,medicine.diagnostic_test ,business.industry ,Histology ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,nervous system diseases ,Neurology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
AIMS Due to their rarity, the natural history and imaging of myxoid meningiomas are not completely characterized. We analyzed clinical, imaging, and pathologic features of myxoid meningioma seen neurosurgically or in consultation between 1999 and 2018. MATERIALS AND METHODS Archival material was searched for meningiomas designated "myxoid meningioma" at Vanderbilt University School of Medicine (1997 - 2004) and the University of Rochester School of Medicine and Dentistry (1994 - 2018). RESULTS Our cases were predominantly in females and presented with a slow progression of symptoms. Each tumor was in the hemispheres. Magnetic resonance imaging (MRI) found most were hyperintense on T2-weighted images. Each meningioma had foci of limited meningothelial amongst extensive myxoid histology with Alcian-blue-staining stroma and EMA-immunoreactive cells. CONCLUSION Myxoid meningiomas present with atypical imaging and histologic characteristics but are not truly metaplastic, i.e., are not differentiated to a different cell type. more...
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- 2019
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44. Multiple sclerosis relapses contribute to long‐term disability
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Carol J. Schramke, Edward Gettings, Daniel Diehl, Chris Hackett, Thomas F. Scott, and Wisam Elmalik
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Multiple Sclerosis ,Newly diagnosed ,Cohort Studies ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Slow progression ,Humans ,Medicine ,Disabled Persons ,030212 general & internal medicine ,Retrospective Studies ,Expanded Disability Status Scale ,business.industry ,Multiple sclerosis ,Retrospective cohort study ,General Medicine ,Middle Aged ,Long term disability ,medicine.disease ,Neurology ,Cohort ,Disease Progression ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Treatments affect both relapse-related disability and short-term disability change, but measurements of their impact on long-term outcomes remain a challenge. Objective To ascertain the contribution of relapse-associated disability to overall disability in relapse-onset multiple sclerosis (RMS) using long-term data collected in our clinic. Materials and methods Retrospective study of a cohort of newly diagnosed patients with RMS, (n = 176) was undertaken, measuring all confirmed changes in disability up to 15 years after onset. Worsening was assessed yearly and in 5-year epochs and was attributed to either relapse (RW) or slow progression (PW). Results At data lock, 139/176 (81%) of patients were still actively followed, with Expanded Disability Status Scale (EDSS) available for 10 years post-onset in 145/176 (82%) patients and 15 years post-onset EDSS in 83 patients (mean follow-up entire group 12.7 years post-onset). RW accounted for a large amount of worsening seen in the first 15 years of RMS. RW was less frequent over time, but accounted for most EDSS changes in the first decade of MS (167/267, 63% of EDSS changes), and remained important even in years 11-15 (17/50, 34% of EDSS changes). Median change in disability due to RW vs PW was similar over the entire 15 years. Conclusions Worsening of treated MS was associated with relapses in many RMS patients throughout the first 15 years after onset, suggesting an opportunity for long-term benefit through relapse reduction. more...
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- 2019
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45. Benefit from mechanical thrombectomy in acute ischemic stroke with fast and slow progression
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Arturo Renú Jornet, Ramon Torné, Jordi Blasco, Laura Llull, Ángel Chamorro, Juan Macho, Sergio Amaro, Carlos Laredo, Xabier Urra, Carmen Montejo, Salvatore Rudilosso, and Victor Obach
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medicine.medical_specialty ,Perfusion scanning ,030204 cardiovascular system & hematology ,Risk Assessment ,Brain Ischemia ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Slow progression ,Internal medicine ,medicine.artery ,Humans ,Medicine ,Prospective Studies ,Acute ischemic stroke ,Stroke ,Aged ,Thrombectomy ,Aged, 80 and over ,Medical treatment ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Mechanical thrombectomy ,Treatment Outcome ,Cohort ,Middle cerebral artery ,Disease Progression ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveThe rate of progression of the ischemic lesion is variable in patients with stroke. We tested the hypothesis that the tissue saving effect of mechanical thrombectomy (MT) is greater in fast progressors.MethodsA single-center cohort of consecutive patients (n=242) with occlusions of the terminal internal carotid or M1 segment of the middle cerebral artery treated with MT (n=195) or best medical treatment (n=47), known time from onset, and full imaging (baseline CT perfusion and follow-up MRI) available was studied. The estimated infarct progression rate (eIPR) was calculated at baseline and patients were categorized as fast/slow progressors according to the median eIPR of 4.8 mL/hour. The primary outcome measure was the interaction between eIPR category and MT on infarct growth. The secondary outcomes assessed the effect of MT on final infarct volume and functional status in relation to the eIPR category. The safety outcomes were mortality and symptomatic intracranial hemorrhage.ResultsThe eIPR category had a modifying effect (Pi=0.017) of MT on infarct growth that was significantly reduced with MT only in fast progressors (median (IQR) 3.8 mL (−11–55) vs 41 mL (11–107) with medical treatment; p=0.009, adjusted p=0.045). There was also a significant interaction on final infarct volume (Pi=0.005), with a greater reduction after MT in fast progressors. The functional status improved with MT both in fast and slow progressors, with no significant modifying effect of eIPR category (Pi=0.201). There were also no significant interactions on safety outcomes.ConclusionMT in stroke patients with large vessel occlusion limits infarct growth more significantly in fast progressors. more...
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- 2019
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46. Heritage Failure and Its Public
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Trinidad Rico
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History ,Civil society ,Scope (project management) ,Museology ,Subject (philosophy) ,Historiography ,Environmental ethics ,06 humanities and the arts ,Conservation ,Growth model ,060104 history ,Work (electrical) ,Slow progression ,Political science ,0601 history and archaeology ,Discipline - Abstract
The work and historiography of heritage studies and preservation rely significantly on a growth model. They present disciplinary engagements with their subject of study as a slow progression towards a more effective and sustainable involvement of diverse voices, values, and methodological approaches. In this paper, however, I address the role of failure in this field using the particular example of a heritage civil society in Doha, Qatar. How does the field of heritage studies address negative results and what does this reveal about the scope and aims of an expanding discipline? more...
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- 2019
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47. Data evidencing slow anaerobic digestion in emergency treatment and disposal of infectious animal carcasses
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Heekwon Ahn, Jacek A. Koziel, Lam T. Nguyen, Timothy S. Frana, J. (Hans) van Leeuwen, and Thomas D. Glanville
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0303 health sciences ,Multidisciplinary ,Waste management ,business.industry ,Context (language use) ,Emergency treatment ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,Visual evidence ,Anaerobic digestion ,0302 clinical medicine ,Volatile fatty acids ,Agricultural and Biological Science ,Slow progression ,Digestate ,lcsh:R858-859.7 ,Environmental science ,Livestock ,lcsh:Science (General) ,business ,030217 neurology & neurosurgery ,lcsh:Q1-390 ,030304 developmental biology - Abstract
Burial of infectious and potentially infectious livestock and poultry animals is the most common response to an emergency situation. The data set summarizes 22-week-long experiment that simulates the environment found within conventional burial trenches for emergency disposal of animal carcasses, worldwide, sometimes with a topical application of quicklime as it is required in the Republic of Korea. This data set shows the rarely presented evidence of the extremely slow decay of animal carcasses. Besides visual evidence of no visible breakdown of carcass material, i.e., carcass (or carcass quarters and coarse cuts) still resembled the initial material at the end of the study, we present data characterizing the process. Specifically, temporal variations of digestate quality (pH, ammonia, volatile fatty acids), biogas production, and the persistence of odorous volatile organic compounds are summarized. The data provide important evidence of undesirable, slow progression of the digestion process. The evidence of failure to achieve practical endpoints with the anaerobic digestion provides the impetus for seeking alternative, improved methods of disposal that will be feasible in emergency context, such as aerated burial concept (Koziel et al., 2018 [1]). more...
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- 2019
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48. State biomarkers for Machado Joseph disease: Validation, feasibility and responsiveness to change
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Laura Bannach Jardim, Gabriel Vasata Furtado, Camila Maria de Oliveira, Maria Luiza Saraiva-Pereira, Jonas Alex Morales Saute, and Gabriela Bolzan
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0106 biological sciences ,0301 basic medicine ,Oncology ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,lcsh:QH426-470 ,Machado-Joseph disease ,Clinical scale ,Neurophysiology ,Disease ,Biology ,01 natural sciences ,Biological fluid ,03 medical and health sciences ,Doença de Machado-Joseph ,Spinocerebellar ataxia type 3 ,Slow progression ,Internal medicine ,Genetics ,medicine ,Molecular Biology ,Poor responsiveness ,Articles ,medicine.disease ,spinocerebellar ataxia type 3 ,Clinical trial ,lcsh:Genetics ,Biomarcadores ,030104 developmental biology ,Spinocerebellar ataxia ,neurophysiology ,Machado–Joseph disease ,Biomarkers ,010606 plant biology & botany - Abstract
Machado-Joseph disease (SCA3/MJD) is the most common spinocerebellar ataxia worldwide, and particularly so in Southern Brazil. Due to an expanded polyglutamine at ataxin-3, SCA3/MJD presents a relentless course with no current disease modifying treatment. Clinical scales used to measure SCA3/MJD progression present moderate effect sizes, a major drawback for their use as main outcomes in clinical trials, given the rarity and slow progression of the disease. This limitation might be overcome by finding good surrogate markers. We present here a review of studies on peripheral and neurophysiological markers in SCA3/MJD that can be candidates for state biomarkers. Data on markers already studied were summarized, giving emphasis on validation against clinical scale, and responsiveness to change. While some biological fluid compounds and neurophysiological parameters showed poor responsiveness, others seemed to be good candidates. Some potential candidates that are waiting for responsiveness studies were serum levels of neuron specific enolase, vestibulo-ocular reflex and video-oculography. Candidates evaluated by RNA and microRNA expression levels need further studies to improve their measurements. Data on peripheral levels of Beclin-1 and DNAJB1 are promising but still incipient. We conclude that several potential candidates should follow onto validating studies for surrogate state biomarkers of SCA3/MJD. more...
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- 2019
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49. Dynamics of tuberculosis with fast and slow progression and media coverage
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Hong Xiang, Ya Dong Zhang, and Hai Feng Huo
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Tuberculosis ,Computer science ,Basic Reproduction Number ,Media coverage ,02 engineering and technology ,Models, Biological ,Sensitivity and Specificity ,Quantitative Biology::Other ,Stability (probability) ,Disease-Free Survival ,Slow progression ,0502 economics and business ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,Quantitative Biology::Populations and Evolution ,Applied mathematics ,Computer Simulation ,Mass Media ,Sensitivity (control systems) ,Bifurcation ,Communication ,Applied Mathematics ,05 social sciences ,General Medicine ,medicine.disease ,Computational Mathematics ,Modeling and Simulation ,Communicable Disease Control ,Disease Progression ,020201 artificial intelligence & image processing ,General Agricultural and Biological Sciences ,Basic reproduction number ,Algorithms ,Software ,050203 business & management ,Center manifold - Abstract
A new tuberculosis model with fast and slow progression and media coverage is formulated and analyzed. The basic reproductive number R0 is derived, and the existence and stability of all the equilibria are discussed. The occurrences of forward and backward bifurcation are obtained by using center manifold theory. Numerical simulations are also given to support our theoretical results. Sensitivity analysis on a few parameters is also carried out. Our results show that media coverage can encourage people to take measures to avoid potential infections and control the spread of tuberculosis. more...
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- 2019
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50. The EOLO (End-of-Life Ovarian Cancer) Study: Approach to Ovarian Cancer Patients at the End of Life
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Giusi Santangelo, Carolina Maria Sassu, Innocenza Palaia, Giorgia Perniola, Federica Tomao, Antonella Giancotti, Angela Musella, Violante Di Donato, Anna Di Pinto, and Pierluigi Benedetti Panici
- Subjects
end of life ,Adult ,Cancer Research ,medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,FIGO Stage IIIC ,Disease ,best supportive care ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Slow progression ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Ovarian Neoplasms ,Terminal Care ,Chemotherapy ,ovarian cancer ,palliative care ,quality of life ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Serous fluid ,Oncology ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,Ovarian cancer ,business - Abstract
Background: Chemotherapy at the end of life is a complex and challenging problem in medical oncology. Patients affected by ovarian cancer (OC) often experience a chronicization and slow progression of their disease, and chemotherapy is proposed until the end of life. Methods: We retrospectively analyzed data from patients affected by OC treated at our department and having died in the period between 2007 and 2017 and evaluated the frequency of antineoplastic treatments until the end of life, the chemotherapy-related toxicity, mortality, and the most frequent palliative care measure adopted. Results: A total of 110 OC deaths, after a median overall patient survival of 52.8 months (range 4–232), were analyzed. 77.3% of the patients presented with FIGO stage IIIC OC at diagnosis and 12.7% with FIGO stage IV OC. 89% of the histological types were serous papillary. The median age was 55 years (range 31–82) at diagnosis and 60 years (range 33–84) at death. Of the 110 patients analyzed, 85 (77%) had undergone chemotherapy over the last 3 months of life and 38% had chemotherapy even during the last month of life. The overwhelming majority of patients (81%) needed supportive therapies. Despite the treatments received, the majority of the patients died at home, 19% died in hospital, and only 4.5% died in hospice. The quality of life of these patients decreased dramatically in the last 30 days, but best supportive care improved the symptoms. Conclusions: End-of-life chemotherapy for OC patients is a thorny problem. More studies and a multidisciplinary approach are needed to better treat these patients. more...
- Published
- 2019
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