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71.
The value of anal cytology and human papillomavirus typing in the detection of anal intraepithelial neoplasia: a review of cases from an anoscopy clinic 总被引:2,自引:0,他引:2 下载免费PDF全文
Fox PA Seet JE Stebbing J Francis N Barton SE Strauss S Allen-Mersh TG Gazzard BG Bower M 《Sexually transmitted infections》2005,81(2):142-146
BACKGROUND: Previous studies have reached differing conclusions about the utility of anal cytology as a screening tool for anal intraepithelial neoplasia (AIN). There is a need also to establish whether HPV typing offers a useful adjunct to screening. METHODS: We analysed data from 99 consecutive homosexual/bisexual male patients (89 HIV-1 positive) who underwent high resolution anoscopy. Follow up visits for these patients were also included, giving a total of 160 anoscopic procedures. Comparison was made between results of anal cytology using the sampling method of Palefsky, and histological findings of biopsies taken from abnormal areas seen on high resolution anoscopic examination of the anal canal. Swabs taken concurrently with the cytology were analysed for the presence of human papillomavirus (HPV) DNA and compared with the cytological and histological findings. RESULTS: The sensitivity of the cytology was 83%, and the specificity 38% when compared with histology. At screening of 34 asymptomatic men, 83% had anal cytological dysplasia and 78% had AIN. There were no significant differences in the prevalence of hrHPV genotypes between different cytological or histological grades of abnormalities. CONCLUSION: Anal cytology by the Palefsky method is simple to undertake, has a sensitivity and specificity comparable with cervical cytology, and can therefore be used as the basis of a pilot screening project in centres with large cohorts of HIV positive homosexual men who have a high risk of developing anal carcinoma. HPV genotyping is not a useful adjunct to cytological screening. 相似文献
72.
PURPOSE: Lutein and zeaxanthin are largely transported in plasma by high-density lipoprotein (HDL). The Wisconsin hypoalpha mutant (WHAM) chicken has a recessive sex-linked mutation in the ABCA1 transporter gene that results in a severe deficiency of HDL. In this study, the transport and tissue distribution of lutein and zeaxanthin were examined in newly hatched and 28-day-old WHAM chicks compared with control chicks. METHODS: One-day-old WHAM and control chicks were randomized to be fed a high-lutein or a control diet for 28 days. The plasma and tissues were analyzed for lutein, zeaxanthin, and lipoproteins on days 1 and 28. RESULTS: The WHAM chicks had very low plasma levels of HDL cholesterol (5.3% of normal). They also had very low concentrations of lutein in the plasma and all other tissues compared with control chicks. The plasma and retina were only 9% and 6% of control levels (P < 0.01), respectively. Zeaxanthin levels were similarly low (9% of control, P < 0.01). The high-lutein diet increased the content of lutein in the plasma and tissues of control chicks (P < 0.01). In contrast, in WHAM chicks, lutein increased greatly in the plasma, liver, and heart, but little in the retina (6% of control). CONCLUSIONS: HDL deficiency in the WHAM chicks was associated with a deficiency of lutein and zeaxanthin in the tissues, especially in the retina. The high-lutein diet increased the lutein content of some tissues via LDL and VLDL transport, but retinal lutein remained very low. These data support the prime role of HDL as the specific transporter of lutein and zeaxanthin into the retina. The WHAM chick provides an excellent model for the study of the role of HDL in the retinal uptake of lutein and zeaxanthin. 相似文献
73.
Non-union of the scaphoid: Russe graft vs Herbert screw 总被引:2,自引:0,他引:2
The results of treatment in 50 consecutive patients with established non-union of the scaphoid are presented. All patients were treated under the care of a single consultant, for the same indications. Russe bone graft is compared with wedge bone graft plus Herbert screw fixation, in terms of union and function. Overall, a higher success rate was obtained by wedge graft plus Herbert screw, and a significantly better range of movement. However, Russe bone graft appears equally satisfactory for fibrous non-union. 相似文献
74.
van Gaal WJ Arnold JR Porto I Jennings B Ashar V Schrale RG Banning AP 《International journal of cardiology》2008,128(2):272-274
Patients undergoing elective PCI are traditionally admitted overnight, however day case PCI cuts costs and has been proposed as a safe method for selected patients. We evaluated the success and long term clinical outcomes of day case percutaneous coronary intervention (PCI) for outpatients with stable angina.In total, 484 consecutive patients treated over a five year period with planned day case PCI were studied and followed up for 12 months. Successful PCI with same day discharge was performed in 463 patients (95.7%). There were 21 patients (4.3%) who required hospital admission. Reasons for failed discharge were hematoma formation (n = 7, 1.4%), coronary dissection (n = 4, 0.8%), post-procedural chest pain (n = 3, 0.6%), prolonged procedure (n = 2, 0.4%), and 1 each of acute stent thrombosis, coronary perforation, anaphylaxis, minor drug reaction and a functional study for untreated disease. One year follow up was complete for 439/484 (90.7%). At 12 months there were 6 hospitalizations for angina (1.2%, 95% CI 0.6–3.0%), 20 repeat revascularisations (4.1%, 95% CI 2.7–6.3%), 3 myocardial infarctions (0.6%, 95% CI 0.2–2.1%) and 2 deaths (0.4%, 95% CI 0.1–1.6%). Event free survival at 1 year follow up was 93.6% (95% CI 90.7–95.6%).Selecting patients for day case PCI is safe, and can achieve a high rate of success with excellent long term outcomes. 相似文献
75.
Osborne AH Vance D Rohling EJ Barton N Rogerson M Fello N 《Proceedings of the National Academy of Sciences of the United States of America》2008,105(43):16444-16447
It is widely accepted that modern humans originated in sub-Saharan Africa approximately 150-200 thousand years ago (ka), but their route of dispersal across the currently hyperarid Sahara remains controversial. Given that the first modern humans north of the Sahara are found in the Levant approximately 120-90 ka, northward dispersal likely occurred during a humid episode in the Sahara within Marine Isotope Stage (MIS) 5e (130-117 ka). The obvious dispersal route, the Nile, may be ruled out by notable differences between archaeological finds in the Nile Valley and the Levant at the critical time. Further west, space-born radar images reveal networks of-now buried-fossil river channels that extend across the desert to the Mediterranean coast, which represent alternative dispersal corridors. These corridors would explain scattered findings at desert oases of Middle Stone Age Aterian lithic industries with bifacial and tanged points that can be linked with industries further to the east and as far north as the Mediterranean coast. Here we present geochemical data that demonstrate that water in these fossil systems derived from the south during wet episodes in general, and penetrated all of the way to the Mediterranean during MIS 5e in particular. This proves the existence of an uninterrupted freshwater corridor across a currently hyperarid region of the Sahara at a key time for early modern human migrations to the north and out of Africa. 相似文献
76.
Kim CK McGorray SP Bartholomew BA Marsh M Dicken T Wassertheil-Smoller S Curb JD Oberman A Hsia J Gardin J Wong ND Barton B McMahon RP Sheps DS 《Archives of internal medicine》2005,165(11):1239-1244
BACKGROUND: Depressive symptoms have been associated with increased cardiac morbidity and mortality rates, but the pathophysiologic mechanism linking depressive symptoms to cardiovascular outcome has yet to be fully understood. Lower heart rate variability has also been associated with increased risk of cardiac events in healthy individuals and in patients with coronary artery disease. Findings regarding a relationship between depressive symptoms and heart rate variability that could explain increased cardiovascular risk have been inconsistent across studies. METHODS: As an ancillary study to the Women's Health Initiative Observational Study, 3372 postmenopausal women aged 50 to 83 years were enrolled for further evaluation using 24-hour ambulatory electrocardiographic monitoring. A shortened version of the Center for Epidemiological Studies Depression Scale and the Diagnostic Interview Schedule were administered. Women with adequate electrocardiographic data and depressive symptom information and without coronary artery disease were analyzed (n = 2627). RESULTS: Two hundred sixty-nine women (10.2%) had depressive symptoms as measured using the 2 instruments. Women with depressive symptoms had a higher mean +/- SD heart rate (77.4 +/- 9.6 vs 75.5 +/- 8.5 beats/min) and lower heart rate variability than women without depressive symptoms. All differences remained significant after adjusting for age (P<.01). CONCLUSIONS: Women with depressive symptoms had significant reductions in heart rate variability and higher heart rates, suggestive of increased sympathetic tone. These findings may contribute to the increased cardiac morbidity and mortality rates associated with depression in other studies. 相似文献
77.
Calley L. Hirsch Zeynep Coban Akdemir Li Wang Gowtham Jayakumaran Dan Trcka Alexander Weiss J. Javier Hernandez Qun Pan Hong Han Xueping Xu Zheng Xia Andrew P. Salinger Marenda Wilson Frederick Vizeacoumar Alessandro Datti Wei Li Austin J. Cooney Michelle C. Barton Benjamin J. Blencowe Jeffrey L. Wrana Sharon Y.R. Dent 《Genes & development》2015,29(12):1341
78.
79.
Paul Declerck Georgios Bakalos Elias Zintzaras Bettina Barton Thomas Schreitmüller 《Clinical therapeutics》2018,40(5):798-809.e2
Purpose
With the introduction of biosimilars of anticancer monoclonal antibodies (mAbs) in oncology, physicians are potentially confronted with the question whether it is clinically adequate to switch patients who are clinically stable on treatment with the reference product to a newly available biosimilar (or vice versa/from 1 biosimilar to another). For a proper impact assessment of switching, robust, product-specific, and clinically relevant evidence should be required, ideally including data from appropriately designed switching studies. In this article, we assess the current body of switching data available for approved or proposed biosimilars of anticancer mAbs.Methods
PubMed was systematically searched and ClinicalTrials.gov and abstract databases of selected congresses were hand-searched to identify all switching studies including biosimilars of anticancer mAbs.Findings
We identified 8 switching studies with biosimilars of rituximab (CT-P10, GP2013, PF-05280586, and BCD-020) and trastuzumab (ABP 980). Two were performed in oncology indications and the other 6 in rheumatoid arthritis (RA). Key elements of a well-designed switching study, such as randomization and blinding, were contained in several of the studies, but significant limitations were also present. The most frequent limitations were low statistical power because of small patient numbers, lack of an appropriate control arm, short follow-up, chosen outcome measures, and (for studies performed in RA) the concern whether switching data can be extrapolated to oncology indications. Accordingly, the data from these studies need to be interpreted with caution. Of note, all identified studies included a single switch only, whereas multiple switches may occur in the real-world setting. The scientific need to evaluate the impact of repeated switching has been recognized by the US Food and Drug Administration, who incorporated such a requirement in its draft guidance on interchangeability.Implications
From the scarce data available, the consequences of switching between reference product mAbs and their biosimilar(s) in the oncology setting are as yet unknown. Additional clinical evidence from well-designed switching studies is needed to guide switching decisions. 相似文献80.
Singh Jasvinder A. Richards John S. Chang Elizabeth Toupin-April Karine Barton Jennifer L. 《Clinical rheumatology》2021,40(2):693-700
Clinical Rheumatology - To assess rheumatologists’ views and practices related to shared decision-making (SDM) in gout treatment. We performed a cross-sectional electronic survey of... 相似文献