Introduction: Cancer diagnosis and treatment frequently involves physical and psychological sympt... more Introduction: Cancer diagnosis and treatment frequently involves physical and psychological symptoms, including anxiety, depression, fatigue, and sleep disturbances. The young adult population with cancer face unique struggles including poignancy in relation to self-concept, identity formation, independence, role development, loss of independence, and time away from school and peers. Mindfulness-based interventions are increasingly being evaluated for individuals with a cancer diagnosis. Mindfulness-Based Cognitive Therapy (MBCT) combines Mindfulness-Based Stress Reduction with aspects of cognitive behavioural therapy. This paper aims to briefly describe MBCT and its benefits and challenges in the young adult population with cancer. Method: An analysis of themes was conducted of post-intervention semi-structured interviews that were conducted with a subsample of 14 participants to gain more detailed information regarding their perception. Findings: Participants reported positive tra...
Many conditions affect the production of mature apothecia of Ciboria acerina in culture. In this ... more Many conditions affect the production of mature apothecia of Ciboria acerina in culture. In this investigation four factors were studied: age of isolate, temperature at which the cultures were grown, host from which the cultures were isolated, and the absence or presence of light. It was found that no apothecia were produced when the isolate was more than 18 months old. The temperature at which the stroma of C. acerina developed was significant in apothecium production. Stroma grown at 14 °C produced apothecia while stroma grown at 5 °C did not. However, apothecia matured over a temperature range of 5–22 °C. Apothecia were produced in cultures isolated from Acer, Alnus, and Populus. The quality of light received did not affect apothecium production. The absence of light at all stages of the growth of this fungus from the time of inoculation to the appearance of mature fruit bodies was not a limiting factor. Mature apothecia of Ciboria acerina were formed under artificial conditions in darkness.
Patients with type 2 diabetes have increased cardiovascular risk. PCSK9 monoclonal antibodies hav... more Patients with type 2 diabetes have increased cardiovascular risk. PCSK9 monoclonal antibodies have been shown to reduce LDL cholesterol and other lipids, but specific efficacy for patients with diabetes is unknown. We compared the effect of the PCSK9 inhibitor evolocumab on lipid parameters in patients with and without type 2 diabetes. We did a random-effects meta-analysis of randomised clinical trials comparing the efficacy of evolocumab, placebo, and ezetimibe to improve lipid parameters in adult patients (age 18-80 years) with or without type 2 diabetes. We searched MEDLINE and Embase to identify eligible 12-week, phase 3 trials published between Jan 1, 2012, and Feb 28, 2015. We excluded trials that included patients who had homozygous familial hypercholesterolaemia. All analyses were based on individual participant data. We used DerSimonian and Laird random-effects meta-analyses to compare the mean changes from baseline in concentrations of LDL cholesterol, non-HDL cholesterol, total cholesterol, triglycerides, lipoprotein(a), and HDL cholesterol at 12 weeks for evolocumab, placebo, and ezetimibe. We also assessed the effect of evolocumab therapy compared with placebo across subgroups of patients based on glycaemia, insulin use, renal function, and cardiovascular disease status at baseline. Three trials met our inclusion criteria, and included 413 patients with type 2 diabetes and 2119 patients without type 2 diabetes. In patients with type 2 diabetes evolocumab caused mean reductions in LDL cholesterol concentration that were 60% (95% CI 51-69) versus placebo and 39% (32-47) versus ezetimibe. In patients without type 2 diabetes, evolocumab caused mean reductions in LDL cholesterol that were 66% (62-70) versus placebo and 40% (36-45) versus ezetimibe. In patients with type 2 diabetes, evolocumab was associated with reductions in non-HDL cholesterol (55% [47-63] vs placebo and 34% [26-41] vs ezetimibe), total cholesterol (38% [32-44] vs placebo and 24% [16-31] vs ezetimibe), and lipoprotein(a) (31% [25-37] vs placebo and 26% [16-35] vs ezetimibe), and an increase in HDL cholesterol (7% [4-11] vs placebo and 8% [4-13] vs ezetimibe). Findings were similar across diabetes subgroups based on glycaemia, insulin use, renal function, and cardiovascular disease status. Evolocumab markedly reduces atherogenic lipoproteins in patients with type 2 diabetes, an effect that is consistent across subgroups and similar to that seen in patients without type 2 diabetes. Results from ongoing cardiovascular outcome trials of PCSK9 inhibitors will provide additional data to inform the use of these drugs in patients with type 2 diabetes. Amgen.
Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagon... more Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagonists.
Nursing standard (Royal College of Nursing (Great Britain) : 1987)
A new drug or the prevention of osteoporosis is both effective and convenient, only requiring an ... more A new drug or the prevention of osteoporosis is both effective and convenient, only requiring an injection every six months.
Pancreatic cancer is often resistant to conventional chemotherapy. In this study, we examined the... more Pancreatic cancer is often resistant to conventional chemotherapy. In this study, we examined the role of adenovirus-mediated overexpression of E2F-1 in inducing apoptosis and increasing the sensitivity of pancreatic cancer cells to chemotherapeutic agents. MIA PaCa-2 pancreatic head exocrine adenocarcinoma cells (mutant p53) were treated by mock infection or adenoviruses expressing beta-galactosidase or E2F-1 (Ad-E2F-1) alone or in combination with sublethal concentrations of each chemotherapeutic drug. Cell growth and viability were assessed at selected time points. Apoptosis was evaluated by flow cytometry, characteristic changes in cell morphology and poly (ADP-ribose) polymerase (PARP) cleavage. Western blot analysis was used to examine the expression of E2F-1 and Bcl-2 family member proteins and PARP cleavage. Western blot analysis revealed marked overexpression of E2F-1 at a multiplicity of infection (MOI) of 20 and 70. By 3 days after infection, Ad-E2F-1 treatment at an MOI of 70 resulted in approximately a 20-fold reduction in cell growth and 60% reduction in cell viability as compared to mock-infected cells. Cell cycle analysis, PARP cleavage and changes in cell morphology supported apoptosis as the mechanism of cell death in response to E2F-1. In order to test the efficacy of treatment with a combination of gene therapy and chemotherapy, we utilized concentrations of Ad-E2F-1 which reduced viability to 50% in combination with each chemotherapeutic agent. Cotreatment of the cells with E2F-1 virus and roscovitine (ROS) or etoposide resulted in an additive effect on cell growth inhibition and induction of apoptosis. Interestingly, 5-fluorouracil did not cooperate with Ad-E2F-1 in the mediation of tumor death or inhibition of cell growth. Immunoblotting for Bcl-2 family members revealed no significant changes in the expression levels of Bcl-2, Bcl X(L), Bax or Bak following gene or 'chemogene' therapy with E2F-1. However, a Bax cleavage product was noted which was substantially increased by cotreatment with ROS or etoposide. E2F-1 overexpression initiates apoptosis and suppresses growth in pancreatic MIA PaCa-2 cells in vitro. E2F-1-mediated apoptosis was not associated with significant changes in the expression of Bcl-2 family member proteins in these pancreatic cancer cells. ROS and etoposide, when combined with E2F-1 overexpression, induce apoptosis in an additive manner. This chemogene combination may provide a potentially useful therapeutic strategy for advanced pancreatic cancer.
Javal's rule and Grosvenor's simplification of it are commonly used formulas for ... more Javal's rule and Grosvenor's simplification of it are commonly used formulas for predicting spectacle astigmatism from keratometric measurements. We assessed the accuracy of these two rules. Spectacle astigmatism was estimated using both rules from measurements of corneal astigmatism on 100 eyes of 100 subjects. These estimates were then compared to the subjectively determined spectacle astigmatism. Grosvenor's simplification of Javal's rule gave slightly more accurate assessments than the original rule. However, only 66% of results gave estimates within 0.50 D, and 7% differed by more than 1.00 D. This can be compared to previous reports on the accuracy of autorefractors, where approximately 95% of cylinder results were within 0.50 D of the spectacle astigmatism. These results indicate that using Javal's rule or Grosvenor's simplification of it to determine spectacle astigmatism from corneal cylinder readings is of limited clinical value.
Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagon... more Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagonists.
Introduction: Cancer diagnosis and treatment frequently involves physical and psychological sympt... more Introduction: Cancer diagnosis and treatment frequently involves physical and psychological symptoms, including anxiety, depression, fatigue, and sleep disturbances. The young adult population with cancer face unique struggles including poignancy in relation to self-concept, identity formation, independence, role development, loss of independence, and time away from school and peers. Mindfulness-based interventions are increasingly being evaluated for individuals with a cancer diagnosis. Mindfulness-Based Cognitive Therapy (MBCT) combines Mindfulness-Based Stress Reduction with aspects of cognitive behavioural therapy. This paper aims to briefly describe MBCT and its benefits and challenges in the young adult population with cancer. Method: An analysis of themes was conducted of post-intervention semi-structured interviews that were conducted with a subsample of 14 participants to gain more detailed information regarding their perception. Findings: Participants reported positive tra...
Many conditions affect the production of mature apothecia of Ciboria acerina in culture. In this ... more Many conditions affect the production of mature apothecia of Ciboria acerina in culture. In this investigation four factors were studied: age of isolate, temperature at which the cultures were grown, host from which the cultures were isolated, and the absence or presence of light. It was found that no apothecia were produced when the isolate was more than 18 months old. The temperature at which the stroma of C. acerina developed was significant in apothecium production. Stroma grown at 14 °C produced apothecia while stroma grown at 5 °C did not. However, apothecia matured over a temperature range of 5–22 °C. Apothecia were produced in cultures isolated from Acer, Alnus, and Populus. The quality of light received did not affect apothecium production. The absence of light at all stages of the growth of this fungus from the time of inoculation to the appearance of mature fruit bodies was not a limiting factor. Mature apothecia of Ciboria acerina were formed under artificial conditions in darkness.
Patients with type 2 diabetes have increased cardiovascular risk. PCSK9 monoclonal antibodies hav... more Patients with type 2 diabetes have increased cardiovascular risk. PCSK9 monoclonal antibodies have been shown to reduce LDL cholesterol and other lipids, but specific efficacy for patients with diabetes is unknown. We compared the effect of the PCSK9 inhibitor evolocumab on lipid parameters in patients with and without type 2 diabetes. We did a random-effects meta-analysis of randomised clinical trials comparing the efficacy of evolocumab, placebo, and ezetimibe to improve lipid parameters in adult patients (age 18-80 years) with or without type 2 diabetes. We searched MEDLINE and Embase to identify eligible 12-week, phase 3 trials published between Jan 1, 2012, and Feb 28, 2015. We excluded trials that included patients who had homozygous familial hypercholesterolaemia. All analyses were based on individual participant data. We used DerSimonian and Laird random-effects meta-analyses to compare the mean changes from baseline in concentrations of LDL cholesterol, non-HDL cholesterol, total cholesterol, triglycerides, lipoprotein(a), and HDL cholesterol at 12 weeks for evolocumab, placebo, and ezetimibe. We also assessed the effect of evolocumab therapy compared with placebo across subgroups of patients based on glycaemia, insulin use, renal function, and cardiovascular disease status at baseline. Three trials met our inclusion criteria, and included 413 patients with type 2 diabetes and 2119 patients without type 2 diabetes. In patients with type 2 diabetes evolocumab caused mean reductions in LDL cholesterol concentration that were 60% (95% CI 51-69) versus placebo and 39% (32-47) versus ezetimibe. In patients without type 2 diabetes, evolocumab caused mean reductions in LDL cholesterol that were 66% (62-70) versus placebo and 40% (36-45) versus ezetimibe. In patients with type 2 diabetes, evolocumab was associated with reductions in non-HDL cholesterol (55% [47-63] vs placebo and 34% [26-41] vs ezetimibe), total cholesterol (38% [32-44] vs placebo and 24% [16-31] vs ezetimibe), and lipoprotein(a) (31% [25-37] vs placebo and 26% [16-35] vs ezetimibe), and an increase in HDL cholesterol (7% [4-11] vs placebo and 8% [4-13] vs ezetimibe). Findings were similar across diabetes subgroups based on glycaemia, insulin use, renal function, and cardiovascular disease status. Evolocumab markedly reduces atherogenic lipoproteins in patients with type 2 diabetes, an effect that is consistent across subgroups and similar to that seen in patients without type 2 diabetes. Results from ongoing cardiovascular outcome trials of PCSK9 inhibitors will provide additional data to inform the use of these drugs in patients with type 2 diabetes. Amgen.
Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagon... more Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagonists.
Nursing standard (Royal College of Nursing (Great Britain) : 1987)
A new drug or the prevention of osteoporosis is both effective and convenient, only requiring an ... more A new drug or the prevention of osteoporosis is both effective and convenient, only requiring an injection every six months.
Pancreatic cancer is often resistant to conventional chemotherapy. In this study, we examined the... more Pancreatic cancer is often resistant to conventional chemotherapy. In this study, we examined the role of adenovirus-mediated overexpression of E2F-1 in inducing apoptosis and increasing the sensitivity of pancreatic cancer cells to chemotherapeutic agents. MIA PaCa-2 pancreatic head exocrine adenocarcinoma cells (mutant p53) were treated by mock infection or adenoviruses expressing beta-galactosidase or E2F-1 (Ad-E2F-1) alone or in combination with sublethal concentrations of each chemotherapeutic drug. Cell growth and viability were assessed at selected time points. Apoptosis was evaluated by flow cytometry, characteristic changes in cell morphology and poly (ADP-ribose) polymerase (PARP) cleavage. Western blot analysis was used to examine the expression of E2F-1 and Bcl-2 family member proteins and PARP cleavage. Western blot analysis revealed marked overexpression of E2F-1 at a multiplicity of infection (MOI) of 20 and 70. By 3 days after infection, Ad-E2F-1 treatment at an MOI of 70 resulted in approximately a 20-fold reduction in cell growth and 60% reduction in cell viability as compared to mock-infected cells. Cell cycle analysis, PARP cleavage and changes in cell morphology supported apoptosis as the mechanism of cell death in response to E2F-1. In order to test the efficacy of treatment with a combination of gene therapy and chemotherapy, we utilized concentrations of Ad-E2F-1 which reduced viability to 50% in combination with each chemotherapeutic agent. Cotreatment of the cells with E2F-1 virus and roscovitine (ROS) or etoposide resulted in an additive effect on cell growth inhibition and induction of apoptosis. Interestingly, 5-fluorouracil did not cooperate with Ad-E2F-1 in the mediation of tumor death or inhibition of cell growth. Immunoblotting for Bcl-2 family members revealed no significant changes in the expression levels of Bcl-2, Bcl X(L), Bax or Bak following gene or 'chemogene' therapy with E2F-1. However, a Bax cleavage product was noted which was substantially increased by cotreatment with ROS or etoposide. E2F-1 overexpression initiates apoptosis and suppresses growth in pancreatic MIA PaCa-2 cells in vitro. E2F-1-mediated apoptosis was not associated with significant changes in the expression of Bcl-2 family member proteins in these pancreatic cancer cells. ROS and etoposide, when combined with E2F-1 overexpression, induce apoptosis in an additive manner. This chemogene combination may provide a potentially useful therapeutic strategy for advanced pancreatic cancer.
Javal's rule and Grosvenor's simplification of it are commonly used formulas for ... more Javal's rule and Grosvenor's simplification of it are commonly used formulas for predicting spectacle astigmatism from keratometric measurements. We assessed the accuracy of these two rules. Spectacle astigmatism was estimated using both rules from measurements of corneal astigmatism on 100 eyes of 100 subjects. These estimates were then compared to the subjectively determined spectacle astigmatism. Grosvenor's simplification of Javal's rule gave slightly more accurate assessments than the original rule. However, only 66% of results gave estimates within 0.50 D, and 7% differed by more than 1.00 D. This can be compared to previous reports on the accuracy of autorefractors, where approximately 95% of cylinder results were within 0.50 D of the spectacle astigmatism. These results indicate that using Javal's rule or Grosvenor's simplification of it to determine spectacle astigmatism from corneal cylinder readings is of limited clinical value.
Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagon... more Review Article from The New England Journal of Medicine Angiotensin Receptors and Their Antagonists.
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