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111.
Christine A. M. Smith Karine Toupin-April Jeffrey W. Jutai Ciarán M. Duffy Prinon Rahman Sabrina Cavallo Lucie Brosseau 《PloS one》2015,10(9)
Objectives
The objectives of this review are to: 1) appraise the methodological quality of clinical practice guidelines (CPGs) in juvenile idiopathic arthritis (JIA) providing pharmacological and/or non-pharmacological intervention recommendations, and 2) summarize the recommendations provided by the included CPGs and compare them where possible.Methods
A systematic search was performed. Three trained appraisers independently evaluated the methodological quality of the CPGs using a validated and reliable instrument, the Appraisal of Guidelines in Research and Evaluation II. Six domains were considered: 1) score and purpose; 2) stakeholder involvement; 3) rigor of development; 4) clarity of presentation; 5) applicability; and 6) editorial independence. The domains consist of a total of 23 items each scored on a 7-point scale. High quality CPGs were identified if they had a domain score above 60% in rigor of development, and two other domains.Results
Of the three included CPGs, the Royal Australian College of General Practitioners (RACGP) and American College of Rheumatology (ACR) CPGs were considered to be of high quality, but the German Society for Pediatric Rheumatology was of lower quality. Domains one to four had high domain scores across the guidelines (mean (standard deviation)): 72.76 (13.80); 66.67 (9.81); 64.67 (7.77); and 87.00 (9.64), respectively. Lower scores were obtained for applicability (14.00 (5.57)) and editorial independence (43.44 (7.02)). Recommendations varied across CPGs due to differences in context, target audience (general practitioners, rheumatologists, and other multidisciplinary healthcare professionals) and patients’ disease presentations. Despite this variability, progression of pharmacological treatment did not conflict between CPGs. Recommendations for non-pharmacological interventions were vague and the interventions considered varied between CPGs.Conclusions
Overall, recommendations were based on a paucity of evidence and weak study designs. Further research is needed on interventions in JIA, as well as higher quality CPGs to facilitate implementation of the best evidence-based recommendations in clinical practice. 相似文献112.
Serena P. Koenig Alexandra Bornstein Karine Severe Elizabeth Fox Jessy G. Dévieux Patrice Severe Patrice Joseph Adias Marcelin Dgndy Alexandre Bright Ngoc Pham Pierre Cremieux Jean William Pape 《PloS one》2015,10(11)
Objective
We assessed the association between gender and mortality on antiretroviral therapy (ART) using identical models with and without sex-specific categories for weight and hemoglobin.Design
Cohort study of adult patients on ART.Setting
GHESKIO Clinic in Port-au-Prince, Haiti.Participants
4,717 ART-naïve adult patients consecutively enrolled on ART at GHESKIO from 2003 to 2008.Main Outcome Measure
Mortality on ART; multivariable analyses were conducted with and without sex-specific categories for weight and hemoglobin.Results
In Haiti, male gender was associated with mortality (OR 1.61; 95% CI: 1.30–2.00) in multivariable analyses with hemoglobin and weight included as control variables, but not when sex-specific interactions with hemoglobin and weight were used.Conclusions
If sex-specific categories are omitted, multivariable analyses indicate a higher risk of mortality for males vs. females of the same weight and hemoglobin. However, because males have higher normal values for weight and hemoglobin, the males in this comparison would generally have poorer health status than the females. This may explain why gender differences in mortality are sometimes observed after controlling for differences in baseline variables when gender-specific interactions with weight and hemoglobin are omitted. 相似文献113.
David Costantini Aurelie Goutte Christophe Barbraud Bruno Faivre Gabriele Sorci Henri Weimerskirch Karine Delord Olivier Chastel 《PloS one》2015,10(8)
One of the major challenges in ecological research is the elucidation of physiological mechanisms that underlie the demographic traits of wild animals. We have assessed whether a marker of plasma oxidative stress (TBARS) and plasma haptoglobin (protein of the acute inflammatory phase response) measured at time t predict five demographic parameters (survival rate, return rate to the breeding colony, breeding probability, hatching and fledging success) in sexually mature wandering albatrosses over the next four years (Diomedea exulans) using a five-year individual-based dataset. Non-breeder males, but not females, having higher TBARS at time t had reduced future breeding probabilities; haptoglobin was not related to breeding probability. Neither TBARS nor haptoglobin predicted future hatching or fledging success. Haptoglobin had a marginally positive effect on female survival rate, while TBARS had a marginally negative effect on return rate. Our findings do not support the role for oxidative stress as a constraint of future reproductive success in the albatross. However, our data point to a potential mechanism underlying some aspects of reproductive senescence and survival. Our results also highlight that the study of the consequences of oxidative stress should consider the life-cycle stage of an individual and its reproductive history. 相似文献
114.
Gaetane Nocturne Stephan Pavy Saida Boudaoud Raphaèle Seror Philippe Goupille Philippe Chanson Désirée van der Heijde Floris van Gaalen Francis Berenbaum Xavier Mariette Karine Briot Antoine Feydy Pascal Claudepierre Philippe Dieudé Joanne Nithitham Kimberly E. Taylor Lindsey A. Criswell Maxime Dougados Christian Roux Corinne Miceli-Richard 《PloS one》2015,10(8)
Objectives
To investigate DKK-1 and SOST serum levels among patients with recent inflammatory back pain (IBP) fulfilling ASAS criteria for SpA and associated factors.Methods
The DESIR cohort is a prospective, multicenter French cohort of 708 patients with early IBP (duration >3 months and <3 years) suggestive of AxSpA. DKK-1 and SOST serum levels were assessed at baseline and were compared between the subgroup of patients fulfilling ASAS criteria for SpA (n = 486; 68.6%) and 80 healthy controls.Results
Mean SOST serum levels were lower in ASAS+ patients than healthy controls (49.21 ± 25.9 vs. 87.8 ± 26 pmol/L; p<0.0001). In multivariate analysis, age (p = 5.4 10−9), CRP level (p<0.0001) and serum DKK-1 level (p = 0.001) were associated with SOST level. Mean DKK-1 serum levels were higher in axial SpA patients than controls (30.03 ± 15.5 vs. 11.6 ± 4.2 pmol/L; p<0.0001). In multivariate analysis, DKK-1 serum levels were associated with male gender (p = 0.03), CRP level (p = 0.006), SOST serum level (p = 0.002) and presence of sacroiliitis on radiography (p = 0.05). Genetic association testing of 10 SNPs encompassing the DKK-1 locus failed to demonstrate a significant contribution of genetics to control of DKK-1 serum levels.Conclusions
DKK-1 serum levels were increased and SOST levels were decreased among a large cohort of patients with early axial SpA compared to healthy controls. DKK-1 serum levels were mostly associated with biological inflammation and SOST serum levels. 相似文献115.
Mariem Ben Khelifa Charles Coutton Raoudha Zouari Thomas Karaouzène John Rendu Marie Bidart Sandra Yassine Virginie Pierre Julie Delaroche Sylviane Hennebicq Didier Grunwald Denise Escalier Karine Pernet-Gallay Pierre-Simon Jouk Nicolas Thierry-Mieg Aminata Touré Christophe Arnoult Pierre F. Ray 《American journal of human genetics》2014
116.
Accuracy of patient-reported height loss and risk factors for height loss among postmenopausal women
Background
Since loss of height may indicate vertebral fracture, the accuracy of the information on height is relevant for clinical practice. We undertook this study to compare reported and measured loss of height among post-menopausal women in a primary care setting. We also analyzed the determinants of this height loss.Methods
In an observational study conducted between December 2007 and May 2008, we asked 1779 randomly selected general practitioners to recruit the first five female patients who were more than 60 years of age, regardless of the reason for the consultation. Using a questionnaire, physicians collected data on demographic and clinical variables, history of osteoporosis and current anti-osteoporotic treatment. We used three assessments of height: tallest height in early adulthood recalled by the patient, estimated current height reported by the patient at the visit and current measured height. We defined loss of height as the difference between the patient’s tallest recalled height and her current measured height.Results
A total of 8610 patients were included in the analysis; the mean age was 70.9 (standard deviation [SD] 7.2) years. The mean loss of height was 4.5 cm. The mean current reported height was 2.1 (SD 2.5) cm lower than the tallest recalled height and 2.4 (SD 2.6) cm lower than the measured current height. The best predictors of a loss of height of 3 cm or more were age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.08–1.10), previous vertebral fracture (OR 1.49, 95% CI 1.16–1.91), previous nonvertebral fracture (OR 1.26, 95% CI 1.06–1.51), thoracic kyphosis (OR 2.07, 95% CI 1.69–2.55), scoliosis (OR 1.35, 95% CI 1.12–1.63), back pain (OR 1.22, 95% CI 1.07–1.39) and osteoporosis (OR 1.39, 95% CI 1.20–1.60).Interpretation
Our study showed that the patients’ estimated current height was not correct, with a mean difference of −2.5 cm from the current measured height. The mean height loss was 4.5 cm. Previous vertebral fracture and thoracic kyphosis were strong determinants of the height loss.Loss of height is common with advancing age.1,2 Causes include changes in curvature of the spine, narrowing of intervertebral discs and vertebral fractures. Height loss is associated with back pain and thoracic hyperkyphosis.3,4 Two-thirds of adults have back pain at any time. Controversies exist about the need for radiographs of the spine: Does the benefit of detecting treatable disorders of the spine such as vertebral fracture outweigh the harm of unnecessary radiographs? Loss of height is usually recorded as one of the clinical signs to help identify postmenopausal women with vertebral fractures.5 The use of this parameter to decide whether radiography is needed depends on the threshold for height loss associated with a strong risk of vertebral fracture. The thresholds useful in clinical practice to detect prevalent vertebral fracture range from 3 cm to 6 cm,6–9 with the risk of prevalent fracture increasing with the magnitude of the height loss. Thus, the accuracy of the information on height is relevant for clinical practice.We conducted this study to compare reported and measured loss of height in a large population of women more than 60 years old in a primary care setting and to analyze the determinants of this height loss. 相似文献117.
Membrane-bound carbonic anhydrases are key pH regulators controlling tumor growth and cell migration
Johanna Chiche Karine Ilc M. Christiane Brahimi-Horn Jacques Pouyssgur 《Advances in enzyme regulation》2010,50(1):20-3376
Hypoxia and acidosis are common features of the tumor microenvironment. Under hypoxic conditions increased lactic acid secretion together with carbonic acid production contributes to a high acid load in the tumor. Multiple isoforms of carbonic anhydrase (CA) (EC 4.2.1.1) are expressed in normal and neoplastic tissues. The expression of membrane-bound CAs, such as CA IX and CA XII is increased in hypoxic tumors and is tightly controlled by oxygen levels via the hypoxia-inducible factor (HIF). In this article we have reviewed recent findings that implicate the hypoxia-inducible CAs in pH homeostasis and in controlling cell viability and tumor growth. We then presented some preliminary, original in vitro data that point to the implication of hypoxia-inducible CAs in cell migration. In addition, we reviewed the clinical data that exploit the immunohistochemical detection of the hypoxia-inducible CAs as a marker for patient prognosis in different types of cancer and finally, we mentioned briefly approaches to therapeutic inhibition of CA. 相似文献
118.
119.
120.
The 3D structure of methanogen chromosomal protein 1 (MC1), determined with heteronuclear NMR methods, agrees with its function in terms of the shape and nature of the binding surface, whereas the 3D structure determined with homonuclear NMR does not. The structure features five loops, which show a large distribution in the ensemble of 3D structures. Evidence for the fact that this distribution signifies internal mobility on the nanosecond time scale was provided by using (15)N-relaxation and molecular dynamics simulations. Structural variations of the arm (11 residues) induced large shape anisotropy variations on the nanosecond time scale that ruled out the use of the model-free formalism to analyze the relaxation data. The backbone dynamics analysis of MC1 was achieved by comparison with 20 ns molecular dynamics trajectories. Two β-bulges showed that hydrogen bond formation correlated with ? and ψ dihedral angle transitions. These jumps were observed on the nanosecond time scale, in agreement with a large decrease in (15)N-NOE for Gly17 and Ile89. One water molecule bridging NH(Glu87) and CO(Val57) through hydrogen bonding contributed to these dynamics. Nanosecond slow motions observed in loops LP3 (35-42) and LP5 (67-77) reflected the lack of stable hydrogen bonds, whereas the other loops, LP1 (10-14), LP2 (22-24), and LP4 (50-53), were stabilized by several hydrogen bonds. Dynamics are often directly related to function. Our data strongly suggest that residues belonging to the flexible regions of MC1 could be involved in the interaction with DNA. 相似文献