1,721,011 research outputs found
Novel xylan-controlled delivery of therapeutic proteins to inflamed colon by the human anaerobic commensal bacterium
No full textINTRODUCTION: Growth factors such as keratinocyte growth factor-2 (KGF-2) and transforming growth factor-beta (TGF-β) are important immunoregulatory and epithelial growth factors. They are also potential therapeutic proteins for inflammatory bowel disease. However, owing to protein instability in the upper gastrointestinal tract, it is difficult to achieve therapeutic levels of these proteins in the injured colon when given orally. Furthermore, the short half-life necessitates repeated dosage with large amounts of the growth factor, which may have dangerous side effects, hence the importance of temporal and spatial control of growth factor delivery.METHODS: The human commensal gut bacterium, Bacteroides ovatus, was genetically engineered to produce human KGF-2 or TGF-β1 (BO-KGF or BO-TGF) in a regulated manner in response to the dietary polysaccharide, xylan. The successful application of BO-KGF or BO-TGF in the prevention of dextran sodium sulphate induced murine colitis is presented here.RESULTS: This novel drug delivery system had a significant prophylactic effect, limiting the development of intestinal inflammation both clinically and histopathologically. The ability to regulate heterologous protein production by B ovatus using xylan is both unique and an important safety feature of this drug delivery system.CONCLUSIONS: The use of genetically engineered B ovatus for the controlled and localised delivery of epithelial growth promoting and immunomodulatory proteins has potential clinical applications for the treatment of various diseases targeting the colon.</p
Hepatic resection for colorectal metastasis: time to challenge the accepted doctrine
No full textThe selection of patients for resection of colorectal liver metastasis (CRLM) is based around a set of established rules and principles, some of which date back to and have changed little since the mid 1980's. In this paper the authors challenge this accepted doctrine and describe the criteria used for selection of patients for surgery in their own centre, criteria which permit the inclusion of many more patients for potentially curative surgery. They go on to describe methods used to increase resectability and discuss their own results achieved for the resection of CRLM.</p
892 Quality of life after pancreaticoduodenectomy
No full textAim: pancreaticoduodenectomy (PD) can severely impair quality of life (QOL) and alter normal activities. The European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C30) is an integrated system for assessing QOL in cancer patients. The aim was to evaluate the QOL outcomes for patients who undergo PD over a six-month period peri-operatively.Method: EORTC QLQ-C30 (v.3) and pancreas-specific (PAN26) questionnaires were offered to patients who underwent PD between July 2018 and March 2019. Patients were invited to complete the questionnaire three times (1–2 weeks pre-operatively, 2–6 weeks post discharge, and 6–8 months post-operatively. Patients were excluded if they did not complete >50% of the questions for at least two consecutive questionnaires. Scores were calculated in accordance with the EORTC QLQ-C30 (version 3) core questionnaire manual. Data was analysed using Cohen's effect size and one way analysis of variance (ANOVA).Results: a total of 21 patients were included. Overall QOL was reduced post-discharge (mean score 70.4 (±23.6) vs. 54.6 (±21.0), d=1.628, p=0.0412), however, there was no difference between QOL scores pre-operatively and after 6 months. There was a significant difference after 6 months for physical (mean score 98.4 (±9.6) vs. 85.2 (±14.6), d=1.068, p=0.0017) and role (mean score 92.1 (±17.2) vs. 63.9 (±28.7), d=1.1919, p=0.0005) function-related questions. Reduced appetite, diet restriction and pain were worse following discharge but improved significantly after six months.Conclusions: the results from this study suggest that whilst certain symptoms and functional impairment is common following PD, overall QOL returns to pre-operative levels for most patients
Surgical pathological second opinion in thyroid malignancy: impact on patients' management and prognosis
No full textOBJECTIVES: To evaluate the effect of inter-institutional surgical pathology review of thyroid cancer on patients' treatment and prognosis.METHODS: All cases referred to the Institute of Pathology at Leeds for thyroid pathology review between January 2001 and March 2003 were included. The referring pathologists reports were compared to those produced in the MDT meeting by the expert pathologist. Whenever there was disagreement a third expert opinion was sought who was blinded for both diagnoses. Effects on management and prognosis were evaluated if there was disagreement.RESULTS: Of the 66 patients reviewed, 12 (18%) had a different pathological diagnosis (kappa=0.33). Two had their diagnosis changed from malignant to benign and a further two from benign to malignant. Eight patients had their prognosis downgraded and four upgraded after histopathological review. Five patients had their management affected by the new pathological diagnosis.CONCLUSION: A second opinion of surgical pathology for thyroid tumours can result in major therapeutic and prognostic modifications. All cases of suspected thyroid cancers should be reviewed in a multidisciplinary meeting supported by pathologist with experience in thyroid pathology.</p
Impact of age on the short and long term outcomes following pancreaticodoudenectomy
No full textBackground: geriatric population is rapidly growing. Short and long-term survival following elective surgery in elderly patients is not clear.Methods: demography, operative and outcomes data were studied from a prospectively database undergoing pancreatico-duodenectomy (PD).Patients were divided into two groups according to the age: Age <75 (Group A), Age ≥75 years (Group B).Results: 444 patients were selected, there were 354 patients in group A and 90 patients in group B. Group B had more patients affected by heart disease compared to group A (p = 0.018). The two groups were similar in American Society of Anaesthesiology (ASA) score.Overall complication was similar in the two groups. However, post-operative cardiac events and perioperative mortality were significantly higher in the elderly group (p = 0.021 and 0.011 respectively). Hospital stay length was higher in the elderly group, 12.5 compared to 15.2 days (p = 0.021). On multivariate analysis ASA score 3 and not age was found to be an independent predictive factor for perioperative mortality (P = 0.04 HR = 4.327 95% CI = 1.083–18.033). The pathological finding was pancreatic ductal adenocarcinoma (PDAC) in 161 patients (45.5%) of group A and 35 patients (38.9%) of group B (P = 0.268). Interestingly, median survival was 23 months in group A compared to 18 months in group B (p = 0.1).Conclusion: age is not a limiting factor in patients undergoing PD however careful assessment is needed in elderly patients especially when age is associated with serious co-morbidities. The age does not appear to impact survival in patient undergoing a PD for PDAC
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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