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Emu Oil and Saireito in combination reduce tumour development and clinical indicators of disease in a mouse model of colitis-associated colorectal cancer.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: Emu Oil (EO) previously demonstrated therapeutic potential in a mouse model of colitis-associated CRC (CA-CRC). Saireito, a traditional Japanese medicine, has not been investigated in CA-CRC.
Aim: To determine whether EO and Saireito could be therapeutic in an azoxymethane (AOM)/dextran sulphate sodium (DSS) model of CA-CRC.
Methods: Female C57BL/6 mice were assigned to groups (n = 10/group); 1) saline control, 2) saline+Saireito, 3) saline+EO, 4) saline+EO/Saireito, 5) AOM/DSS control, 6) AOM/DSS+Saireito, 7) AOM/DSS+EO and 8) AOM/DSS+EO/Saireito. Mice were intraperitoneally injected with saline or AOM (7.4 mg/kg) on day 0 and underwent three DSS/water cycles (2%w/v DSS for 7 days, 14 days water). Mice were orally-gavaged with either water (80 µL), Saireito (80 µL), EO (80 µL) or EO/Saireito (160 µL; 80 µL EO + 80 µL Saireito) thrice weekly. Daily bodyweight and disease activity index (DAI) were recorded and colonoscopies performed on days 20, 41 and 62. Mice were euthanized on day 63. p < 0.05 was considered statistically significant.
Results: AOM/DSS induced significant bodyweight loss throughout the trial (max -36%), which was attenuated by Saireito (max +7%), EO (max +5%) and EO/Saireito (max +14%; p < 0.05). AOM/DSS increased DAI compared to saline controls (p < 0.05), which was reduced by Saireito, EO and EO/Saireito (p < 0.05). All treatments reduced colonoscopically-assessed colitis severity (days 20 and 41; p < 0.05). EO/Saireito further decreased colitis severity compared to Saireito and EO alone (day 20; p < 0.05). Finally, EO and EO/Saireito resulted in fewer colonic tumours compared to AOM/DSS controls (p < 0.05).
Conclusion: Combined EO and Saireito reduced disease and tumour development in AOM/DSS mice, suggesting therapeutic potential in CA-CRC.
Keywords: Colorectal cancer; Emu Oil; Kampo medicine; Mouse model; Nutraceuticals; Ulcerative colitis.Australian Government
Department of Industry, Innovation and Science
AgriFutures Australi
Ablation of ganglionated plexi to treat symptomatic parasympathetic induced atrioventricular block
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadSamkvæmt klínískum leiðbeiningum er einkennagefandi gáttasleglarof
meðhöndlað með gangráðsmeðferð. Í ungum einstaklingum getur sú
meðferð reynst erfið til langframa vegna hættu á fylgikvillum, til að mynda
sýkingum, leiðsluvandamálum og hjartabilun af völdum gangráðsörvunar.
Hér er lýst tvítugum manni sem upplifði endurtekin yfirlið þar sem
uppvinnsla sýndi fyrstu gráðu gáttasleglarof ásamt breytilegu
gáttasleglarofi af gráðu 2, Mobitz 1. Sjúklingurinn var meðhöndlaður með
brennsluaðgerð á parasympatísk taugahnoð í hægri gátt. Við það varð PRbil eðlilegt. Meðferðinni hefur aldrei verið beitt áður á Íslandi og einungis
er fáum tilfellum lýst á heimsvísu.According to clinical guidelines a symptomatic atrioventricular block (AV
block) is treated with a pacemaker. For young individuals such a therapy can
be difficult due to possible long term complications such as infections, lead
disruptions and pacemaker induced cardiomyopathy. We describe a twenty
year old man with recurrent syncopes due to intermittent parasympathetic
caused AV block of grade 2. The patient underwent cardioneuroablation
where parasympathetic ganglia in the right atrium were ablated. After
the procedure the PR interval normalized. This procedure has never been
performed in Iceland before and there is a limited amount of case reports in
the literature
Endothelial dysfunction and thromboembolism in children, adolescents, and young adults with acute lymphoblastic leukemia.
No full textTo access publisher's full text version of this article click on the hyperlink belowEndothelial dysfunction has not previously been investigated as a thrombogenic risk factor among patients with acute lymphoblastic leukemia (ALL), known to be at high risk of thromboembolism. We retrospectively explored the association between three circulating biomarkers of endothelial dysfunction (thrombomodulin, syndecan-1, VEGFR-1) measured in prospectively collected blood samples and risk of thromboembolism in 55 cases and 165 time-matched controls, treated according to the NOPHO ALL2008 protocol. In age-, sex-, and risk group-adjusted analysis, increasing levels of thrombomodulin and VEGFR-1 were independently associated with increased odds of developing thromboembolism (OR 1.37 per 1 ng/mL [95% CI 1.20‒1.56, P 30 days before thromboembolic diagnosis. Thrombomodulin levels were on average 3.2 ng/mL (95% CI 2.6-8.2 ng/mL) higher in samples with measurable asparaginase activity (P < 0.0001). Among single nucleotide variants located in or neighboring coding genes for the three biomarkers, none were significantly associated with odds of thromboembolism. If results are validated in another cohort, thrombomodulin and VEGFR-1 could serve as predictive biomarkers, identifying patients in need of preemptive antithrombotic prophylaxis.Danish Childhood Cancer Foundation
Interreg grant for the Interregional Childhood Oncology Precision Medicine Exploration (iCOPE) projec
The Future of Sleep Measurements: A Review and Perspective.
No full textTo access publisher's full text version of this article click on the hyperlink belowThis article provides an overview of the current use, limitations, and future directions of the variety of subjective and objective sleep assessments available. This article argues for various ways and sources of collecting, combining, and using data to enlighten clinical practice and the sleep research of the future. It highlights the prospects of digital management platforms to store and present the data, and the importance of codesign when developing such platforms and other new instruments. It also discusses the abundance of opportunities that data science and machine learning open for the analysis of data.
Keywords: Codesign; Data management platform; Data science; Machine learning; Objective data; Sleep diary; Sleep measurement; Subjective data.Sleep Revolution from the European Union's Horizon 2020 research and innovation program 965417
NordForsk (NordSleep project) via the Icelandic Centre for Researc
Changes in prescriptions on opioids in primary health care during the years 2008-2017
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBAKGRUNNUR
Undanfarna áratugi hefur ávísunum á ópíóíðalyf fjölgað mikið á
Vesturlöndum. Aukinni notkun fylgir hætta á aukaverkunum, fíkn í
ópíóíðalyf og andlátum tengdum ópíóíðum. Aukning ávísana á ópíóíðalyf
hefur meðal annars verið rakin til breyttra viðhorfa til verkjameðferðar.
Rannsóknir hafa sýnt að verkir eru meðal algengustu ástæðna þess að
fólk leitar til lækna og langvinnir verkir eru algengir. Samanborið við
önnur norræn lönd eru ávísanir á ópíóíða hlutfallslega flestar á Íslandi.
Tilgangurinn var að kanna þróun ávísana á ópíóíðalyf í heilsugæslunni
fyrir alla aldurshópa á tímabilinu 2008–2017.
EFNIVIÐUR OG AÐFERÐIR
Rannsóknin náði til allra ávísana á ópíóíðalyf hjá öllum
heilsugæslustöðvum á höfuðborgarsvæðinu á tímabilinu 2008–2017.
Íbúafjöldi á höfuðborgarsvæðinu var á þessu tímabili um 201 til
222 þúsund. Gögn voru fengin úr Sögukerfi heilsugæslunnar og
rúmlega 68.000 einstaklingar höfðu fengið ávísun á ópíóíðalyf á
rannsóknartímabilinu.
NIÐURSTÖÐUR
Á rannsóknartímabilinu varð 17,2% (p<0,01) aukning á skilgreindum
sólarhringsskömmtum/1000 íbúa/dag á ópíóíðum. Um þriðjungur
þeirra sem fengu ávísun voru karlar og var hlutfallið óbreytt milli ára.
Hlutfallslega varð mest aukning í SSS/1000 íbúa/dag í aldurshópnum 90
ára og eldri, eða 40,5% (p<0,01). Hlutfallslega fjölgaði mest einstaklingum
sem fengu ópíóíðalyf í aldursflokknum 30–39 ára, eða um 25,5% (p<0,01).
Ávísunum fjölgaði í öllum lyfjaflokkum, mælt í SSS/1000 íbúa/dag, um
15,3% (p<0,01) á parkódín, 20,7% (p<0,01) á parkódín forte, 4,7% (p<0,01)
á tramadól og 85,6% (p<0,01) á mjög sterk ópíóíðalyf.
ÁLYKTANIR
Þróun lyfjaávísana á allar tegundir ópíóíðalyfja til skjólstæðinga
heilsugæslustöðva á höfuðborgarsvæðinu á árunum 2008–2017, þar
sem ávísunum á mjög sterk ópíóíðalyf fjölgaði mest hlutfallslega, ætti
að hvetja til endurskoðunar á verkjameðferð innan heilsugæslunnar
og gæðaþróunar á því sviði. Jafnframt ættu niðurstöðurnar að hvetja til
endurmats á vinnulagi við endurnýjum ávísana á ópíóíðalyf í heilsugæslu.INTRODUCTION: In recent decades there has been a notable increase in the prescription of
opioids in western countries. With this rise in use of opioids the risk of side effects, opioid
abuse and deaths linked to opioids have become more apparent. The increase in opioid
prescription may partly stem from a change in attitude in relation to pain management.
Research has shown that pain is among the most common reasons people seek medical
care and chronic pain is prevalent. Iceland is leading the Nordic countries in opioid
prescriptions.
OBJECTIVE: To examine prescriptions of opioids in primary car in Iceland for all age group
from 2008 to 2017.
METHODS: The research included all opioid prescription in every health clinic in the
capital area in Iceland the between 2008 and 2017. Population in the capital area in this
time period was between 201 and 222 thousand people. Data was collected from medical
records database of the primary health care and approximatley 68.000 individuals had
received a prescription for opioids during the research period.
RESULTS: During the research period there was a 17,2% (p<0,01) increase in DDD/1000
inhabitants/day (Defined daily dose) for opioids. About a third of those who got the
prescription were men and that ratio did not change during the period. proportionately,
the biggest change in DDD/1000 inhabitants/day was in the age group made of people 90
years old and older, about 40,5% (p<0,01). The biggest increase in number of people getting
a prescription for opioids was in the age group 30-39, about 25,5% (p<0,01). Number of
prescriptions increased in every category of opioids, measured in DDD/1000 inhabitants/
day,15,3% (p<0,01) in parkódin, 20,7% (p<0,01) in parkódín forte, 4,7% (p<0,01) in tramadol
and 85,6% (p<0,01) in the strongest opioids.
Discussion: the evolution of prescriptions for every type of opioid to the clients of
the health clinics in the capital area that occured in the years from 2008 to 2017,
proportionately highest for the strongest opioids, should encourage a review of pain
treatment within the health clinics and development within that field
Cascade of care during the first 36 months of the treatment as prevention for hepatitis C (TraP HepC) programme in Iceland: a population-based study.
No full textTo access publisher's full text version of this article click on the hyperlink belowBackground: WHO has set targets to eliminate hepatitis C virus (HCV) infection as a global health threat by 2030 through a 65% reduction in HCV-related deaths and 80% reduction in HCV incidence. To achieve these goals, WHO set service coverage targets of 90% of the infected population being diagnosed and 80% of eligible patients being treated. In February, 2016, Iceland initiated a nationwide HCV elimination programme known as treatment as prevention for hepatitis C (TraP HepC), which aimed to maximise diagnosis and treatment access. This analysis reports on the HCV cascade of care in the first 3 years of the programme.
Methods: This population-based study was done between Feb 10, 2016, and Feb 10, 2019. Participants aged 18 years or older with permanent residence in Iceland and PCR-confirmed HCV were offered direct-acting antiviral (DAA) therapy. The programme used a multidisciplinary team approach in which people who inject drugs were prioritised. Nationwide awareness campaigns, improved access to testing, and harm reduction services were scaled up simultaneously. The number of infected people in the national HCV registry was used in combination with multiple other data sources, including screening of low-risk groups and high-risk groups, to estimate the total number of HCV infections. The number of people diagnosed, linked to care, initiated on treatment, and cured were recorded during the study. This study is registered with ClinicalTrials.gov, NCT02647879.
Findings: In February, 2016, at the onset of the programme, 760 (95% CI 690-851) individuals were estimated to have HCV infection, with 75 (95% CI 6-166) individuals undiagnosed. 682 individuals were confirmed to be HCV PCR positive. Over the next 3 years, 183 new infections (including 42 reinfections) were diagnosed, for a total of 865 infections in 823 individuals. It was estimated that more than 90% of all domestic HCV infections had been diagnosed as early as January, 2017. During the 3 years, 824 (95·3%) of diagnosed infections were linked to care, and treatment was initiated for 795 (96·5%) of infections linked to care. Cure was achieved for 717 (90·2%) of 795 infections.
Interpretation: By using a multidisciplinary public health approach, involving tight integration with addiction treatment services, the core service coverage targets for 2030 set by WHO have been reached. These achievements position Iceland to be among the first nations to subsequently achieve the WHO goal of eliminating HCV as a public health threat.Icelandic Government
Gilead Science
Angiotensin Receptor Blockers in cyclodextrin nanoparticle eye drops: Ocular pharmacokinetics and pharmacologic effect on intraocular pressure.
No full textTo access publisher's full text version of this article click on the hyperlink belowPurpose: Orally administered angiotensin II receptor blockers (ARBs) decrease intraocular pressure (IOP). Topical administration may reduce systemic side effects and result in a useful glaucoma drug. The aim of this study is to test the ocular delivery and pharmacologic effect of nanoparticle eye drops containing ARBs (e.g. irbesartan and candesartan).
Methods: 1.5% irbesartan and 0.15% candesartan eye drops were applied to rabbits. The pharmacokinetics in cornea and aqueous humour after single eye drop application were studied in 49 rabbits. The effect of the eye drops on IOP was studied in 10 rabbits using an iCare (® TonoVet Plus, iCare, Finland) tonometer and compared with 0.5% timolol eye drops.
Results: Candesartan lowered IOP from 24.6 ± 5.1 mmHg at baseline to 19.0 ± 2.9 mmHg (mean ± SD, p = 0.030, n = 10) 4 hr after application. Irbesartan lowered IOP from 24.2 ± 1.7 mmHg to 20.2 ± 0.9 mmHg (p = 0.14, n = 10). Timolol decreased the IOP from 24.9 ± 4.2 mmHg to 20.4 ± 4.8 mmHg (mean ± SD, p = 0.036, n = 10). The pharmacokinetics data show that both formulations deliver effective amounts of drug into the intraocular tissues, with irbesartan and candesartan reaching concentrations of 121 ± 69 and 30.43 ± 13.93 ng/g (mean ± SD), respectively, in the aqueous humour 3 hr after a single-dose administration.
Conclusions: Topical application of irbesartan and candesartan eye drops delivers effective drug concentrations to the anterior segment of the eye in rabbits, achieving drug concentrations 100 times above the IC50 for angiotensin II receptor and showing an IOP-lowering effect. Angiotensin receptor blocker (ARB) eye drops have potential as a new class of glaucoma drugs.
Keywords: angiotensin receptor blockers; glaucoma; intraocular pressure; pharmacokinetics.European Union's programme Eurostar
European Union (EU
Frustrated Caring: Family Members' Experience of Motivating COPD Patients Towards Self-Management.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadAim: The aim of this phenomenological study was to explore principal family members' experience of motivating patients with chronic obstructive pulmonary disease (COPD) towards self-management.
Methods: Interviews were conducted with 10 family members (spouses and adult children) of COPD patients. The interviews were audio recorded, transcribed and analyzed thematically.
Results: Being a principal family member of a COPD patient is characterized by frustrated caring; wanting the best for him/her and yet carrying a heavier burden than the person feels equipped for, lacking both knowledge about the disease progress and information about available healthcare resources. The situation demands much energy, due to COPD patients' lack of stamina; family members' fear of the patient's possible breathlessness; willingness to help, though sometimes meeting with negative reactions from the patient; and feeling ignored by health professionals (HPs). Family members expressed a need for a formal connection between patient-family-HPs. The increasing burden experienced by patients' family members is characterized by a sequential process in three phases of the patient's declining self-management. In the early phase, family and patient are ignorant of COPD yet recognize the patient's smoking as a risky lifestyle. In the intermediary phase, signs of COPD become evident to the family. The first turning point is when the family first observes the patient's acute exacerbation. A second turning point is in the advanced phase, when family and patient recognize COPD as a progressive disease, possibly fatal. We also identified family members' views on COPD patients' needs, and their own roles, main frustrations and concerns.
Conclusion: Family members' experience of motivating COPD patients towards self-management is a sequential process where the family experiences advancing caring burden and declining self-management by the patient. We propose the establishment of COPD patients' teams consisting of patient-family-HP, aimed at the patients' best possible self-management.
Keywords: PR; chronic; family’s needs; obstructive; pulmonary rehabilitation; qualitative research; self-management
B Cells versus T Cells in the Tumor Microenvironment of Malignant Lymphomas. Are the Lymphocytes Playing the Roles of Muhammad Ali versus George Foreman in Zaire 1974?
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadMalignant lymphomas are a heterogeneous group of malignancies that develop both in nodal and extranodal sites. The different tissues involved and the highly variable clinicopathological characteristics are linked to the association between the lymphoid neoplastic cells and the tissues they infiltrate. The immune system has developed mechanisms to protect the normal tissue from malignant growth. In this review, we aim to explain how T lymphocyte-driven control is linked to tumor development and describe the tumor-suppressive components of the resistant framework. This manuscript brings forward a new insight with regard to intercellular and intracellular signaling, the immune microenvironment, the impact of therapy, and its predictive implications. A better understanding of the key components of the lymphoma environment is important to properly assess the role of both B and T lymphocytes, as well as their interplay, just as two legendary boxers face each other in a heavyweight title final, as was the case of Ali versus Foreman.
Keywords: B lymphocytes; T lymphocytes; lymphocyte inter-talk; malignant lymphomas; tumor microenvironment.Iuliu Hatieganu University, School of Doctoral Studies
RomanianMinistry of Research and Innovation, CCCDI-UEFISCDI within PNCDI III
European Economic Spac
Obesity of a Nation - what can we do?
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Downloa