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- Lalitkumar, PGL, et al.
(författare)
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Effects of Estradiol/Micronized Progesterone vs. Conjugated Equine Estrogens/Medroxyprogesterone Acetate on Breast Cancer Gene Expression in Healthy Postmenopausal Women
- 2023
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Ingår i: International journal of molecular sciences. - : MDPI AG. - 1422-0067. ; 24:4
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies suggest estradiol (E2)/natural progesterone (P) confers less breast cancer risk compared with conjugated equine estrogens (CEE)/synthetic progestogens. We investigate if differences in the regulation of breast cancer-related gene expression could provide some explanation. This study is a subset of a monocentric, 2-way, open observer-blinded, phase 4 randomized controlled trial on healthy postmenopausal women with climacteric symptoms (ClinicalTrials.gov; EUCTR-2005/001016-51). Study medication was two 28-day cycles of sequential hormone treatment with oral 0.625 mg CEE and 5 mg of oral medroxyprogesterone acetate (MPA) or 1.5 mg E2 as percutaneous gel/day with the addition of 200 mg oral micronized P. MPA and P were added days 15–28/cycle. Material from two core-needle breast biopsies in 15 women in each group was subject to quantitative PCR (Q-PCR). The primary endpoint was a change in breast carcinoma development gene expression. In the first eight consecutive women, RNA was extracted at baseline and after two months of treatment and subjected to microarray for 28856 genes and Ingenuity Pathways Analysis (IPA) to identify risk factor genes. Microarray analysis showed 3272 genes regulated with a fold-change of >±1.4. IPA showed 225 genes belonging to mammary-tumor development function: 198 for CEE/MPA vs. 34 for E2/P. Sixteen genes involved in mammary tumor inclination were subject to Q-PCR, inclining the CEE/MPA group towards an increased risk for breast carcinoma compared to the E2/P group at a very high significance level (p = 3.1 × 10−8, z-score 1.94). The combination of E2/P affected breast cancer-related genes much less than CEE/MPA.
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- Amin, Kawa, et al.
(författare)
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Autoantibody profiles in autoimmune hepatitis and chronic hepatitis C identifies similarities in patients with severe disease
- 2017
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Ingår i: World Journal of Gastroenterology. - : Baishideng Publishing Group Inc.. - 1007-9327 .- 2219-2840. ; 23:8, s. 1345-1352
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine how the auto-antibodies (Abs) profilesoverlap in chronic hepatitis C infection (CHC) andautoimmune hepatitis (AIH) and correlate to liverdisease.METHODS: Levels of antinuclear Ab, smooth muscle antibody (SMA)and liver/kidney microsomal-1 (LKM-1) Ab and markersof liver damage were determined in the sera of 50 patients with CHC infection, 20 AIH patients and 20healthy controls using enzyme linked immunosorbentassay and other immune assays. RESULTS: We found that AIH patients had more severe liverdisease as determined by elevation of total IgG,alkaline phosphatase, total serum bilirubin and serumtransaminases and significantly higher prevalence ofthe three non-organ-specific autoantibodies (auto-Abs)than CHC patients. Antinuclear Ab, SMA and LKM-1 Abwere also present in 36% of CHC patients and relatedto disease severity. CHC cases positive for auto-Abswere directly comparable to AIH in respect of mostmarkers of liver damage and total IgG. These caseshad longer disease duration compared with auto-Abnegative cases, but there was no difference in gender,age or viral load. KLM-1+ Ab CHC cases showed bestoverlap with AIH. CONCLUSION: Auto-Ab levels in CHC may be important markers ofdisease severity and positive cases have a diseasesimilar to AIH. Auto-Abs might have a pathogenic roleas indicated by elevated markers of liver damage.Future studies will unravel any novel associationsbetween these two diseases, whether genetic or other.
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- Diwan, V, et al.
(författare)
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Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India
- 2015
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Ingår i: Journal of infection in developing countries. - : Journal of Infection in Developing Countries. - 1972-2680. ; 9:5, s. 505-511
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In low- and middle-income countries such as India, private pharmacies play an important role in medical treatments, offering advice for common illnesses such as diarrhea and respiratory tract infections. There is a need to explore the details of the dispensing practices at the private pharmacies in low- and middle-income countries. Methodology: The present study used simulated client methodology to assess the actual dispensing practices for patients with pediatric diarrhea at private pharmacies in an urban setting of an Indian province. Results: This study identified 164 private pharmacies (84.10%) in the study setting that engaged in the practice of dispensing prescription drugs without prescriptions. Only about 40% asked clients if they had a prescription from a doctor. The average duration of consultations at the pharmacies was 1.3 minutes (range, 0.5–6 minutes). The dispensing of drugs was not in compliance with the recommended guidelines and regulations. The most commonly dispensed drugs were antibiotics (40.24%); of these, quinolones either alone or in combination with imidazoles were the most frequently dispensed. The other commonly dispensed drugs were antimotility drugs (31.10%) and Lactobacillus acidophilus (probiotics; 23.17%). The drugs were dispensed in inappropriate doses due to the absence of indications. Conclusions: Overuse and misuse of all these prescription drugs dispensed by pharmacies pose significant issues, such as resistance, dangerous side effects, and high costs. At the same time, the pharmacies did not dispense recommended drugs such as oral rehydration solution and zinc, which they are authorized to dispense without a prescription.
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- Godoy-Ramirez, K., et al.
(författare)
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Exploring childhood immunization among undocumented migrants in Sweden - following qualitative study and the World Health Organizations Guide to Tailoring Immunization Programmes (TIP)
- 2019
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 171, s. 97-105
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: National vaccination coverage in Sweden is high. Recurrent outbreaks of measles and rubella however highlight some immunity gaps in the population. Current knowledge about immunization status of undocumented migrant children is scant. The World Health Organization/Europe has developed the Guide to Tailoring Immunization Programmes (TIP) to assist countries in diagnosing barriers and motivators to vaccination in communities with low vaccination coverage. Based on the TIP guide, the objective of this study was to explore determinants to vaccination among undocumented immigrants, using qualitative approach. Study design: The study consisted of three steps: (i) an initial workshop for problem statement; (ii) qualitative research for increased understanding of the vaccination practices of children in the undocumented community; and (iii) a second workshop to incorporate the qualitative interview findings together with data from key stakeholders into a conceptual framework. Methods: This was a qualitative study featuring interviews of seven undocumented parents recruited at non-governmental clinics, three nurses at Child Health Centers, and information from key stakeholders retrieved at workshops as part of the TIP process. Results: The content analysis revealed two main themes: parental fear of being questioned and parental acceptance of child immunization. Undocumented parents had a positive view and attitude toward childhood immunization but expressed strong fear of being asked for identification papers at healthcare facilities. Owing to lack of knowledge on entitlements of the undocumented among health personnel, parents were incorrectly rejected when seeking care for their children. Frequent mobility among undocumented may limit access to complete the immunization schedule. Undocumented parents mistrust healthcare providers and avoid health facilities, further delaying childrens' access to health care, including immunization services. Conclusions: The findings of this study confirm the complexity of barriers that undocumented parents face regarding childhood immunization. The TIP guide offers a valuable process for a deeper understanding of the determinants of immunization challenges among undocumented migrants. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
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