Avilajackson4022
Posttreatment circulating tumor DNA (ctDNA) heralded relapse in patients with large B-cell lymphoma.Omega-3 polyunsaturated fatty acids (PUFA) selectively killed cancer cells in acidic conditions.Macrophage embryonic lineage contributes to invasiveness and immune evasion at the onset of tumorigenesis.Melanoma cells exploit both genetic and nongenetic mechanisms of resistance to MAPK inhibition.The FDA has approved the FGFR2 inhibitor infigratinib for patients with locally advanced or metastatic cholangiocarcinoma who have already been treated for the disease. In a phase II study, the overall response rate for the drug was 23%, and the progression-free survival was 7.3 months. About 77% of patients developed hyperphosphatemia, the most common side effect of the drug.
This study explored the link between HLA polymorphisms that predispose to type 1 diabetes and birth size, infancy growth, and/or circulating IGF-I in a general population-based birth cohort.
The Cambridge Baby Growth Study is a prospective observational birth cohort study that recruited 2,229 newborns for follow-up in infancy. Of these, 612 children had DNA available for genotyping single nucleotide polymorphisms in the HLA region that capture the highest risk of type 1 diabetes rs17426593 for
, rs2187668 for
, and rs7454108 for
. Multivariate linear regression models at critical ages (cross-sectional) and mixed-effects models (longitudinal) were performed under additive genetic effects to test for associations between HLA polymorphisms and infancy weight, length, skinfold thickness (indicator of adiposity), and concentrations of IGF-I and IGF-binding protein-3 (IGFBP-3).
In longitudinal models, the minor allele of rs2187668 tagging
was associated with faster linear growth (
= 0.007), which wt distinct mechanisms involving endocrine pathways related to the HLA-conferred type 1 diabetes risk.
Multiple genome-wide association studies have identified a strong genetic linkage between the
locus and type 1 diabetes (T1D), but how this leads to disease remains obscure. Here, we characterized the functional consequence of a novel
coding mutation in a patient with T1D to gain further insight into how this impacts immune tolerance.
We identified a 24-year-old individual with T1D and other autoimmune and inflammatory conditions. find more The proband and first-degree relatives were recruited for whole-exome sequencing. Functional studies of the protein variant were performed using a cell line and primary myeloid immune cells collected from family members.
Sequencing identified a de novo
variant (c.457G>A, p.Gly153Arg) in the proband. Assays using monocyte-derived macrophages from the individual revealed enhanced activity of integrin pathways and a migratory phenotype in the absence of chemokine stimulation, consistent with SKAP2 p.Gly153Arg being constitutively active. The p.Gly153Arg variant, located in the well-conserved lipid-binding loop, induced similar phenotypes when expressed in a human macrophage cell line. SKAP2 p.Gly153Arg is a gain-of-function, pathogenic mutation that disrupts myeloid immune cell function, likely resulting in a break in immune tolerance and T1D.
SKAP2 plays a key role in myeloid cell activation and migration. This particular mutation in a patient with T1D and multiple autoimmune conditions implicates a role for activating
variants in autoimmune T1D.
SKAP2 plays a key role in myeloid cell activation and migration. This particular mutation in a patient with T1D and multiple autoimmune conditions implicates a role for activating SKAP2 variants in autoimmune T1D.
To determine the risk of diabetic ketoacidosis (DKA) and all-cause mortality among adolescents and young adults with type 1 diabetes with and without an eating disorder.
With use of population-level health care administrative data covering the entire population of Ontario, Canada, all people with type 1 diabetes aged 10-39 years as of January 2014 were identified. Individuals with a history of eating disorders were age- and sex-matched 101 with individuals without eating disorders. All individuals were followed for 6 years for hospitalization/emergency department visits for DKA and for all-cause mortality.
We studied 168 people with eating disorders and 1,680 age- and sex-matched people without eating disorders. Among adolescents and young adults with type 1 diabetes, 168 (0.8%) had a history of eating disorders. The crude incidence of DKA was 112.5 per 1,000 patient-years in people with eating disorders vs. 30.8 in people without eating disorders. After adjustment for baseline differences, the subdistribution hazard ratio for comparison of people with and without eating disorders was 3.30 (95% CI 2.58-4.23;
< 0.0001). All-cause mortality was 16.0 per 1,000 person-years for people with eating disorders vs. 2.5 for people without eating disorders. The adjusted hazard ratio was 5.80 (95% CI 3.04-11.08;
< 0.0001).
Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of DKA and nearly sixfold increased risk of death compared with their peers without eating disorders.
Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of DKA and nearly sixfold increased risk of death compared with their peers without eating disorders.Active commuting may hold a potential for preventing adverse health outcomes. However, evidence of the association of active commuting and the risk of health outcomes remains debatable. The current study systematically and quantitatively summarised research findings on the association between active commuting and the risk of the mentioned health outcomes. We comprehensively searched four databases (PubMed, EMBASE, Web of Science and Open Grey) from inception to 2 August 2020 for observational studies investigating the associations among adult population. Summary relative risks (RRs) and 95% CIs were estimated for the association. Heterogeneity was investigated using Cochran's Q test and the I 2 statistic. Restricted cubic splines were used to evaluate linear and nonlinear relations. The search yielded 7581 initial references. We included 28 articles in the meta-analysis. Compared with inactive commuting, active commuting reduced the risk of obesity (RR=0.88, 95% CI 0.83 to 0.94, I2=69.1%), hypertension (RR=0.95, 95% CI 0.87 to 1.04, I2=82.2%) and diabetes (RR=0.82, 95% CI 0.76 to 0.90, I2=44.5%). Restricted cubic splines showed linear associations between active commuting and obesity, hypertension and diabetes (P nonlinearity=0.640; P nonlinearity=0.886; P nonlinearity=0.099). As compared with the lowest active commuting group, the risk of obesity, hypertension and diabetes in the highest active commuting group were reduced by 13% (95% CI 0.82 to 0.93, I2=65.2%); 6% (95% CI 0.86 to 1.02, I2=75.2%) and 19% (95% CI 0.73 to 0.91, I2=49.8%) respectively. Active commuting seemed to be associated with lower risk of obesity, hypertension and diabetes. However, the results should be interpreted cautiously because this meta-analysis was based solely on observational studies.PROSPERO registration numberCRD42020202723.
We evaluated a classroom-based sensitisation intervention that was designed to reduce demand-side barriers affecting referrals to a school counselling programme. The sensitisation intervention was offered in the context of a host trial evaluating a low-intensity problem-solving treatment for common adolescent mental health problems.
We conducted a stepped-wedge, cluster randomised controlled trial with 70 classes in 6 secondary schools serving low-income communities in New Delhi, India.The classes were randomised to receive a classroom sensitisation session involving a brief video presentation and moderated group discussion, delivered by a lay counsellor over one class period (intervention condition, IC), in two steps of 4 weeks each. The control condition (CC) was whole-school sensitisation (teacher-meetings and whole-school activities such as poster displays). The primary outcome was the proportion of students referred into the host trial. Secondary outcomes were the proportion of students who met mentachological help-seeking for common mental health problems among secondary school pupils from urban, low-income communities in India.
NCT03633916.
NCT03633916.Although ovarian vein thrombosis (OVT) is classically considered a puerperal pathology, it can also occur in nonpuerperal settings such as endometritis, pelvic inflammatory disease, Crohn's disease, pelvic or gynaecological surgeries and thrombophilia. Hypercoagulation conditions such as antiphospholipid syndrome, systemic lupus erythematosus, factor V Leiden and protein C and S deficiency are all recognised risk factors. It is also a known complication during pregnancy often presenting with fever and lower abdominal pain within weeks after delivery. Its incidence is exceedingly rare, occurring in 0.05% of all pregnancies that result in live births and peaking around 2-6 days after delivery. Its preferential involvement of the right ovarian vein may be explained by the compression of the inferior vena cava and the right ovarian vein due to dextrorotation of the uterus during pregnancy. Furthermore, antegrade flow of blood and multiple incompetent valves in the right ovarian vein favours bacterial infection. Complications may include sepsis and thrombus extension to the inferior vena cava or left renal vein and rarely, pulmonary embolism. The authors present the case of a 27-year-old woman with lower abdominal pain 5 weeks after an elective caesarean section. Although the diagnosis of postpartum endometritis was initially considered, a CT suggested a right OVT. She commenced treatment with low-molecular weight heparin. A high index of clinical suspicion is required in order to establish the diagnosis of this rare cause of abdominal pain, which can mimic an acute abdomen.The most common cause of spontaneous intracranial hypotension headache is a cerebrospinal fluid (CSF) leakage, but the underlying mechanisms remain unknown. Intracranial hypotension is characterised by diffuse pachymeningeal enhancement on cranial MRI features, low CSF pressure and orthostatic headaches mostly caused by the dural puncture. We report a 31-year-old woman who presented to our services with reports of continuous severe bifrontal headache, which increased on sitting up and resolved on lying down. MRI of the cervical and lumbosacral spine showed signs of CSF leak; hence, patient was diagnosed with spontaneous intracranial hypotension headache. A CT-guided epidural blood patch was done at L4-5 with fibrin glue injected at the site of leak. The patient's signs and symptoms improved after the procedure.Xp11.2 translocation renal cell carcinoma (TRCC) is a rare and aggressive variant of renal cell carcinoma (RCC) when presenting in adults. We report a case of a man in his early 40s who was diagnosed with stage III Xp11.2 TRCC and underwent radical nephrectomy. Seven months following the surgery, an adrenal nodule and bilateral pulmonary nodules were discovered. He underwent cryoablation of the adrenal nodule and systemic treatment with daily pazopanib. He displayed stable disease for approximately 6 years. Following this period, multiple hospitalisations interrupted daily pazopanib therapy resulting in progression of disease. His regimen was then changed to ipilimumab and nivolumab, followed by current daily therapy with axitinib. The patient now shows stable disease in his 10th year after diagnosis. This case study demonstrates the efficacy of pazopanib for metastatic Xp11.2 TRCC and warrants further investigation to supplement the guidelines regarding the use of targeted therapy for TRCC.