Over the past several years, the severity of Helicobacter pylori (H. pylori) infections has not significantly diminished. After successful eradication, the annual H. pylori recurrence rate is ...approximately 13% due to oral H. pylori infection. Established clinical diagnostic techniques do not identify an oral etiologic basis of H. pylori prior to gastric infection. There has been disagreement as to whether oral infection of H. pylori exists or not, with no definite conclusion. In medical practice, negative results with the urea breath test suggest that the stomach infection of H. pylori is cured in these patients. In fact, patients can present negative urea breath test results and yet exhibit H. pylori infection due to oral infection. The present paper provides evidence that H. pylori oral infection is nonetheless present, and the oral cavity represents a secondary site for H. pylori colonization.
Major issues in the implementation of screening for lung cancer by means of low-dose computed tomography (CT) are the definition of a positive result and the management of lung nodules detected on ...the scans. We conducted a population-based prospective study to determine factors predicting the probability that lung nodules detected on the first screening low-dose CT scans are malignant or will be found to be malignant on follow-up.
We analyzed data from two cohorts of participants undergoing low-dose CT screening. The development data set included participants in the Pan-Canadian Early Detection of Lung Cancer Study (PanCan). The validation data set included participants involved in chemoprevention trials at the British Columbia Cancer Agency (BCCA), sponsored by the U.S. National Cancer Institute. The final outcomes of all nodules of any size that were detected on baseline low-dose CT scans were tracked. Parsimonious and fuller multivariable logistic-regression models were prepared to estimate the probability of lung cancer.
In the PanCan data set, 1871 persons had 7008 nodules, of which 102 were malignant, and in the BCCA data set, 1090 persons had 5021 nodules, of which 42 were malignant. Among persons with nodules, the rates of cancer in the two data sets were 5.5% and 3.7%, respectively. Predictors of cancer in the model included older age, female sex, family history of lung cancer, emphysema, larger nodule size, location of the nodule in the upper lobe, part-solid nodule type, lower nodule count, and spiculation. Our final parsimonious and full models showed excellent discrimination and calibration, with areas under the receiver-operating-characteristic curve of more than 0.90, even for nodules that were 10 mm or smaller in the validation set.
Predictive tools based on patient and nodule characteristics can be used to accurately estimate the probability that lung nodules detected on baseline screening low-dose CT scans are malignant. (Funded by the Terry Fox Research Institute and others; ClinicalTrials.gov number, NCT00751660.).
Over the past twenty years, the existence of oral
infection has been controversial and is still disputed. It proposes that living
do not exist in the oral cavity. However, the progressive loss of ...efficacy of standard eradication therapies has made the treatment of
more challenging than ever due to oral
infection. We conducted a study to explore the existence of oral
infection among 4321 adults.
A total 4321 adults (age range, 20-89 years old) comprising 2849 men and 1472 women were recruited by annual physical exam and evaluated using the saliva
antigen test (HPS) to diagnose oral
infection and the urea breath test (UBT) to diagnose stomach
infection. According to the classification on age grouping of World Health Organization, patients were divided into three age groups: A group, the young age subgroup (<45 years); B group, the middle age subgroup (45 to 59 years); C group, the old age subgroup (60-74 years) and D group, the elder subgroup (75-89 years).
We found the positive rate of oral
was 59.59% in the 95% confidence interval (CI) ranges on A group. The lowest positive rate of
in D group was 25.48% in the 95% confidence interval CI ranges. There was a statistically significant difference (
<0.001) between A, B, C, and D groups but no significant difference between men and women.
HPS could identify oral
infection of individuals who have no risk for
gastric infection. The positive rate of oral
was 59.59% and this varies across different age groups. This information was not provided by UBT methods. It further identified that the prevalence of oral
infection is lower in the elder group that may be associated with fewer number of teeth.
A 16-month (July 2018–October 2019) dataset of size-resolved aerosol
composition is used to examine the sources and characteristics of five
organic acids (oxalate, succinate, adipate, maleate, ...phthalate) and
methanesulfonate (MSA) in Metro Manila, Philippines. As one of the most
polluted megacities globally, Metro Manila offers a view of how diverse
sources and meteorology impact the relative amounts and size distributions
of these species. A total of 66 sample sets were collected with a
Micro-Orifice Uniform Deposit Impactor (MOUDI), of which 54 sets were
analyzed for composition. Organic acids and MSA surprisingly were less
abundant than in other global regions that are also densely populated. The
combined species accounted for an average of 0.80 ± 0.66 % of total
gravimetric mass between 0.056 and 18 µm, still leaving 33.74 % of
mass unaccounted for after considering black carbon and water-soluble ions
and elements. The unresolved mass is suggested to consist of
non-water-soluble metals as well as both water-soluble and non-water-soluble
organics. Oxalate was approximately an order of magnitude more abundant than
the other five species (149 ± 94 ng m−3 versus others being
< 10 ng m−3) across the 0.056–18 µm size range. Both
positive matrix factorization (PMF) and correlation analysis are conducted
with tracer species to investigate the possible sources of organic acids
and MSA. Enhanced biomass burning influence in the 2018 southwest monsoon
resulted in especially high levels of submicrometer succinate, MSA, oxalate,
and phthalate. Peculiarly, MSA had negligible contributions from marine
sources but instead was linked to biomass burning and combustion. Enhanced
precipitation during the two monsoon seasons (8 June–4 October 2018 and
14 June–7 October 2019) coincided with a stronger influence from local
emissions rather than long-range transport, leading to notable concentration
enhancements in both the sub- and supermicrometer ranges for some species
(e.g., maleate and phthalate). While secondary formation via gas-to-particle
conversion is consistent with submicrometer peaks for the organic acids and
MSA, several species (i.e., phthalate, adipate, succinate, oxalate)
exhibited a prominent peak in the coarse mode, largely owing to their
association with crustal emissions (i.e., more alkaline aerosol type) rather
than sea salt. Oxalate's strong association with sulfate in the
submicrometer mode supports an aqueous-phase formation pathway for the study
region. However, high concentrations during periods of low rain and high
solar radiation suggest photo-oxidation is an important formation pathway.
Current chemotherapeutic regimens have only modest benefit for non-small cell lung cancer (NSCLC) patients. Cumulative toxicities/drug resistance limit chemotherapy given after the first-line ...regimen. For personalized chemotherapy, clinically relevant NSCLC models are needed for quickly predicting the most effective regimens for therapy with curative intent. In this study, first generation subrenal capsule xenografts of primary NSCLCs were examined for (a) determining responses to conventional chemotherapeutic regimens and (b) selecting regimens most effective for individual patients.
Pieces (1x3x3 mm(3)) of 32 nontreated, completely resected patients' NSCLCs were grafted under renal capsules of nonobese diabetic/severe combined immunodeficient mice and treated with (A) cisplatin+vinorelbine, (B) cisplatin+docetaxel, (C) cisplatin+gemcitabine, and positive responses (treated tumor area <or=50% of control, P < 0.05) were determined. Clinical outcomes of treated patients were acquired.
Xenografts from all NSCLCs were established (engraftment rate, 90%) with the retention of major biological characteristics of the original cancers. The entire process of drug assessment took 8 weeks. Response rates to regimens A, B, and C were 28% (9 of 32), 42% (8 of 19), and 44% (7 of 16), respectively. Certain cancers that were resistant to a particular regimen were sensitive to others. The majority of responsive tumors contained foci of nonresponding cancer cells, indicative of tumor heterogeneity and potential drug resistance. Xenografts from six of seven patients who developed recurrence/metastasis were nonresponsive.
Models based on first generation NSCLC subrenal capsule xenografts have been developed, which are suitable for quick assessment (6-8 weeks) of the chemosensitivity of patients' cancers and selection of the most effective regimens. They hold promise for application in personalized chemotherapy of NSCLC patients.
Over the past twenty years, the existence of oral
(
) infection has been controversial and is still disputed. It proposes that living H. pylori do not exist in the oral cavity. However, the ...progressive loss of efficacy of standard eradication therapies has made the treatment of
more challenging than ever due to oral
infection. We conducted a study to explore the existence of oral
infection in preschool children.
A total of 178 children were recruited and evaluated using the saliva
antigen test (HPS) and the urea breath test (UBT C
) to diagnose oral and stomach
infections, respectively. The treatments of oral
infection included toothpaste only, and toothpaste combined with mouth washing morning and night daily for two months. Group A: Children live with parents who have a stomach disease history. Group B: Children live with parents who have no stomach disease history. Group C: Children with toothpaste treatment. Group D: Children with combined toothpaste and mouth rinse treatments. Group E: Control group with no treatments.
The positive rate of HPS and C
were 76.4% and 15.73% in the 95% confidence interval (95% CI) range, respectively, among the 178 children. The positive rate of HPS was significantly higher (
<0.001) with the parents who suffered from stomach
infections which had been diagnosed by C
. After two-month treatments, Group D and Group E provided 26.87% and 26.44% (95% CI) range efficient rates of the oral
infection, respectively. The difference between the C, D, and E groups was significant (
<0.001).
Oral
exists in the oral cavity of preschool children. The positive rate of HPS was higher with parents suffering from stomach disease, and treatment was effective in reducing oral infection.
Manufacturing industry has been facing tremendous pressure on environmental regulations like the reduction of pollutants, e.g., carbon dioxide. Limited natural resources have driven manufacturing ...companies to seek ways to reduce energy consumption for daily production. Manufacturing industry needs to consider sustainability for green manufacturing during the entire product life cycle. Conventional product life cycle management has not considered energy consumption with respect to product manufacturing. This paper proposes a new product life cycle management information model by considering the sustainability aspects. And a framework is presented to conduct energy simulation for analyzing the impact of sustainability on manufacturing. Analysis results show that the energy simulation using the sustainability-enabled product life cycle management information model could assist the manufacturing industry to save energy.
Appropriate management requires timely and accurate confirmation of non-small cell lung cancer (NSCLC) recurrence in patients who have had curative-intent surgical resection. We assessed the ...association between circulating tumor DNA (ctDNA) identified using amplicon sequencing and evidence of recurrence on CT surveillance. A prospective cohort study of NSCLC patients with early-stage disease undergoing curative-intent resection was conducted. Surveillance was performed post-operatively at pre-defined intervals with both liquid biopsy and chest CT imaging. Amplicon panel next-generation sequencing was performed on DNA and RNA from tumor tissue and on plasma cell-free DNA for tumor-informed ctDNA detection. Resected tumors from 78 NSCLC patients were analyzed. Alterations were detected on the DNA assay for 65 tumors and only on the RNA assay for 4 tumors. Of the 65 patients with alterations detected on the tumor DNA assay, 29 completed post-operative liquid biopsy testing. Four of those 29 patients had evidence of recurrence on imaging, of whom two had biopsy confirmation of recurrence and detectable ctDNA at the 12-month follow-up. Molecular confirmation of NSCLC recurrence can be provided through amplicon sequencing of plasma cell-free DNA in cases with imaging evidence of recurrence. Invasive tissue diagnosis may be avoidable in patients with ctDNA confirmation of recurrence that is suspected based on imaging. Further study of ctDNA assessment technologies in the setting of suspected recurrence is necessary to inform post-operative lung cancer surveillance guidelines.
Empyema: an increasing concern in Canada Finley, Christian; Clifton, Joanne; Fitzgerald, J Mark ...
Canadian respiratory journal,
03/2008, Letnik:
15, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Empyema is a suppurative infection of the pleural space. Without prompt treatment, it can result in significant hospital stays, more invasive treatments as it progresses, and substantial morbidity ...and mortality.
The primary objective of the present study was to evaluate whether there has been an increasing incidence of empyema in Canada. A secondary objective was to investigate whether this increase disproportionately affects any age group.
The Discharge Abstract Database of the Canadian Institute for Health Information was used to evaluate national empyema data.
There were 11,294 patients identified with empyema over the nine-year period of the present study, of whom 31% were women. The mean (+/- SD) length of stay was stable throughout the study at 21.82+/-33.88 days, and 63.4% were discharged home. The incidence rate ratio (IRR) was defined as the ratio of the incidence rate of medical empyema in 2003 divided by the incidence rate in 1995. Medical empyema increased significantly (IRR 1.30, 95% CI 1.20 to 1.41; P<0.001), as did empyema of unknown cause (IRR 1.29, 95% CI 1.08 to 1.54; P=0.005), while surgical empyema did not appear to increase (IRR 1.17, 95% CI 0.97 to 1.43; P=0.114). A Poisson regression showed an increase in the indirect age-standardized IRR during the study period (IRR 1.025, 95% CI 1.018 to 1.032; P<0.001). The IRR for patients younger than 19 years of age from 1995 to 2003 was 2.20 (95% CI 1.56 to 3.10), while the IRR in patients older than 19 years was 1.23 (95% CI 1.14 to 1.34).
The present study demonstrates the increasing rate of empyema in Canada and shows a change in pattern of disease. The disproportionate rate change in the pediatric population suggests a high-risk group that needs to be addressed. In the adult population, while cause is unknown, it is necessary to continually educate front-line physicians to confront both the increased burden of this disease, caused by an aging population, and the underlying increasing rate of empyema in Canada.
The present study investigated the effects of curcumin on bone microstructure in non-tumor-bearing and Lewis lung carcinoma-(LLC)-bearing female C57BL/6 mice. Morphometric analysis showed that ...dietary supplementation with curcumin (2% or 4%) significantly reduced the bone volume to total volume ratio, connectivity density and trabecular number, and significantly increased the structure model index (an indicator of the plate- and rod-like geometry of trabecular structure) and trabecular separation in vertebral bodies compared to controls in both non-tumor-bearing and LLC-bearing mice. Similar changes in trabecular bone were observed in the femoral bone in curcumin-fed mice. Curcumin significantly reduced the cortical bone area to total area ratio and cortical thickness in femoral mid-shaft, but not in vertebral bodies, in both non-tumor-bearing and LLC-bearing mice. Curcumin feeding reduced plasma concentrations of osteocalcin and increased tartrate-resistant acid phosphate 5b in mice regardless of the presence of LLC, indicating that curcumin disrupts the balance of bone remodeling. Our results demonstrated that curcumin reduced the trabecular bone volume and cortical bone density. The skeleton is a favored site of metastasis for many types of cancers, and curcumin has been investigated in clinical trials in patients with cancer for its chemopreventive effects. Our results suggest the possibility of a combined effect of cancer-induced osteolysis and curcumin-stimulated bone loss in patients using curcumin. The assessment of bone structural changes should be considered for those who participate in curcumin clinical trials to determine its effects on skeleton health, particularly for those with advanced malignancies.
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