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Vignesh T. Packiam Craig V. Labbate Stephen A. Boorjian Robert Tarrell John C. Cheville Svetlana Avulova Vidit Sharma Matvey Tsivian Brittany Adamic Mohammad Mahmoud Ryan P. Werntz Norm D. Smith R. Jeffrey Karnes Matthew K. Tollefson Gary D. Steinberg Igor Frank 《Urologic oncology》2021,39(7):436.e1-436.e8
IntroductionWhile numerous current clinical trials are testing novel salvage therapies (ST) for patients with recurrent nonmuscle invasive bladder cancer (NMIBC) after bacillus Calmette-Guérin (BCG), the natural history of this disease state has been poorly defined to date. Herein, we evaluated oncologic outcomes in patients previously treated with BCG and ST who subsequently underwent radical cystectomy (RC).MethodsWe identified 378 patients with high-grade NMIBC who received at least one complete induction course of BCG (n = 378) with (n = 62) or without (n = 316) additional ST and who then underwent RC between 2000 and 2018. Oncologic outcomes were compared using the Kaplan-Meier method and Cox proportional hazards models. Sensitivity analyses were conducted stratifying by presenting tumor stage, matched 1:3 for receipt vs. no receipt of ST.ResultsPatients receiving ST were more likely to initially present with CIS (26% vs. 17%) and less likely with T1 disease (34% vs. 50%, P = 0.06) compared to patients not treated with ST. Receipt of ST was not associated with increased risk of adverse pathology (≥pT2 or pN+) at RC (31% vs. 41%, P = 0.14). Likewise, 5-year cancer-specific survival did not significantly differ between groups on univariable Kaplan-Meier analysis (73% for ST and 74% for no ST, P = 0.7). Moreover, on multivariable analysis, receipt of ST was not significantly associated the risk of death from bladder cancer (HR 1.12; 95% CI 0.60–2.09, P = 0.7). Results were unchanged on sensitivity analysis.ConclusionsThese data suggest that, in carefully selected patients, ST following BCG for high grade NMIBC does not compromise oncologic outcomes for patients who ultimately undergo RC. 相似文献
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L. Normén M. Johnsson H. Andersson Y. van Gameren P. Dutta 《European journal of nutrition》1999,38(2):84-89
Summary Plant sterols are known to have serum cholesterol lowering effects. A high dietary intake might therefore have a positive
impact on health. All food items of vegetable origin contain some amount of plant sterols. The aim of this study was to analyse
the plant sterol content of vegetables and fruits commonly consumed in Sweden, and to compare fresh and cooked samples of
the same items.
Altogether 20 different vegetables and 14 fruits were analysed. All vegetables and fruits were purchased in two shops in the
city of Gothenburg, Sweden. Lyophilization was performed within one month of the items being purchased. The samples were frozen
at −20 (C and analysed within six months, with a GLC method after acid hydrolysis, alkaline hydrolysis and silylation with
tri-methylsilylether. The acid hydrolysis was done in order to detect the fraction of glycosylated plant sterols, which are
split during boiling with HCl.
The median plant sterol content of vegetables was 14 (3.8–50) mg/100 g edible portion. The highest concentrations were found
in broccoli, Brussels sprouts, cauliflower and olives. The median plant sterol content of fruits was 16 (3–44) mg/100 g edible
portion. The highest concentrations were found in oranges and passion fruits.
The plant sterol concentrations were thus low in vegetables and fruits commonly consumed in Sweden. A serum cholesterol lowering
effect attributed to the plant sterols in vegetables and fruits would therefore be of limited significance.
Received: 25 September 1998, Accepted: 10 February 1999 相似文献
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Aspects of control and substance use among middle‐aged and older adults with bipolar disorder 下载免费PDF全文
Marissa N. Stalman BSN Sarah L. Canham PhD Atiya Mahmood PhD David King PhD Norm O'Rourke PhD RPsych 《International journal of mental health nursing》2018,27(2):833-840
High prevalence rates of alcohol and substance use disorders have been reported among persons with bipolar disorder (BD). In the present study, we explored the daily experiences of middle‐aged and older adults living with BD who reported regular substance use and the ways in which participants expressed ‘control’ in relation to their use of alcohol and other substances. Semistructured, in‐depth interviews were conducted with 12 participants (nine women and three men), aged 36–57 years of age (mean = 49 years). Thematic analyses identified emergent themes and patterns in participants’ life histories. The theme of ‘control’ emerged as central to participants’ reports, and was organized into four categories: (i) substance use to control BD symptoms; (ii) substance use provides a sense of being in control; (iii) methods of controlled substance use; and (iv) not having control: overreliance on substances. Implications of the present study include the need for nurses to openly discuss the use of alcohol and other drugs with persons with BD, provide health information and screening, and determine whether persons with BD feel they have control over their substance use. Several lines of research with persons who have BD and use substances are suggested. 相似文献
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Norm R.C. Campbell Pedro Ordunez Gloria Giraldo Yenny A. Rodriguez Morales Cintia Lombardi Taskeen Khan Raj Padwal Ross T. Tsuyuki Cherian Varghese 《The Canadian journal of cardiology》2021,37(5):744-755
Globally, cardiovascular diseases (CVDs) are the leading cause of death. Viewed as a threat to the global economy, the United Nations included reducing noncommunicable diseases, including CVDs, in the 2030 sustainable development goals, and the World Health Assembly agreed to a target to reduce noncommunicable diseases 25% by the year 2025. In response, the World Health Organisation led the development of HEARTS, a technical package to guide governments in strengthening primary care to reduce CVDs. HEARTS recommends a public health and health system approach to introduce highly simplified interventions done systematically at a primary health care level and has a focus on hypertension as a clinical entry point. The HEARTS modules include healthy lifestyle counselling, evidence-based treatment protocols, access to essential medicines and technology, CVD risk-based management, team-based care, systems for monitoring, and an implementation guide. There are early positive global experiences in implementing HEARTS. Led by the Pan American Health Organisation, many national governments in the Americas are adopting HEARTS and have shown early success. Unfortunately, in Canada hypertension control is declining in women since 2010-2011 and the dramatic reductions in rates of CVD seen before 2010 have flattened when age adjusted and increased for rates that are not age adjusted, and there are marked increases in absolute numbers of Canadians with adverse CVD outcomes. Several steps that Canada could take to enhance hypertension control are outlined, the core of which is to implement a strong governmental nongovernmental collaborative strategy to prevent and control CVDs, focusing on HEARTS. 相似文献
7.
Normén L Shaw CA Fink CS Awad AB 《Current Medicinal Chemistry - Cardiovascular & Hematological Agents》2004,2(1):1-12
Phytosterols and omega-3 fatty acids (n-3) are natural food ingredients with potential cardiovascular benefits. Phytosterols inhibit cholesterol absorption, thereby reducing total cholesterol (TC) and LDL-cholesterol levels. Numerous clinical studies have shown that a daily intake of 1.5-2.0 g of phytosterols can result in a 10-15 % reduction in LDL levels, while consumption of n-3 is associated with a significant reduction in plasma triglyceride (TG) concentrations. Furthermore, n-3 may also beneficially modify a number of other risk factors of coronary heart disease (CHD). Thus, it is reasonable to suggest that combination of phytosterols and n-3 may further reduce cardiovascular risk factors. Esterification of phytosterols with non-n-3 fatty acids has substantially improved their incorporation into a variety of foods without affecting the efficacy of phytosterols. Therefore, it is assumed that esterification of phytosterols with n-3 may have advantages for both food industry and health. Evidence suggests that this combination is effective in reducing the levels of several cardiovascular risk factors including TC and TG concentrations, pro-aggregatory factors, arrhythmic eicosanoid and thromboxane A2 levels. In this mini-review, we have critically reviewed and summarized data from clinical and animal studies in which phytosterols and n-3, alone or in combination, were used. We have also provided information on structure-function relationship for these two natural compounds. Biological properties of several phytosterol derivatives including phytosterol-glucoside have been also discussed. Although the animal studies are supportive of this combination therapy, human studies are needed to address its long term effects. 相似文献
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Dean S. Picone Raj Padwal Norm R. C. Campbell Pierre Boutouyrie Tammy M. Brady Michael Hecht Olsen Christian Delles Cintia Lombardi Azra Mahmud Yaxing Meng Gontse G. Mokwatsi Pedro Ordunez Hoang T. Phan Giacomo Pucci Aletta E. Schutte KiChul Sung XinHua Zhang James E. Sharman for the Accuracy in Measurement of Blood Pressure Collaborative 《Journal of clinical hypertension (Greenwich, Conn.)》2020,22(12):2167
Hypertension guidelines recommend that blood pressure (BP) should be measured using a monitor that has passed validation testing for accuracy. BP monitors that have not undergone rigorous validation testing can still be cleared by regulatory authorities for marketing and sale. This is the situation for most BP monitors worldwide. Thus, consumers (patients, health professionals, procurement officers, and general public) may unwittingly purchase BP monitors that are non‐validated and more likely to be inaccurate. Without prior knowledge of these issues, it is extremely difficult for consumers to distinguish validated from non‐validated BP monitors. For the above reasons, the aim of this paper is to provide consumers guidance on how to check whether a BP monitor has been properly validated for accuracy. The process involves making an online search of listings of BP monitors that have been assessed for validation status. Only those monitors that have been properly validated are recommended for BP measurement. There are numerous different online listings of BP monitors, several are country‐specific and two are general (international) listings. Because monitors can be marketed using alternative model names in different countries, if a monitor is not found on one listing, it may be worthwhile cross‐checking with a different listing. This information is widely relevant to anyone seeking to purchase a home, clinic, or ambulatory BP monitor, including individual consumers for use personally or policy makers and those procuring monitors for use in healthcare systems, and retailers looking to stock only validated BP monitors. 相似文献
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