78 resultados para MacRitchie, Finlay


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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NEWEST (Neoadjuvant Endocrine Therapy for Women with Estrogen-Sensitive Tumors) is the first study to compare biological and clinical activity of fulvestrant 500 versus 250 mg in the neoadjuvant breast cancer setting. We hypothesized that fulvestrant 500 mg may be superior to 250 mg in blocking estrogen receptor (ER) signaling and growth. A multicenter, randomized, open-label, Phase II study was performed to compare fulvestrant 500 mg (500 mg/month plus 500 mg on day 14 of month 1) versus fulvestrant 250 mg/month for 16 weeks prior to surgery in postmenopausal women with ER+ locally advanced breast cancer. Core biopsies at baseline, week 4, and surgery were assessed for biomarker changes. Primary endpoint: change in Ki67 labeling index (LI) from baseline to week 4 determined by automated computer imaging system (ACIS). Secondary endpoints: ER protein expression and function; progesterone receptor (PgR) expression; tumor response; tolerability. ER and PgR were examined retrospectively using the H score method. A total of 211 patients were randomized (fulvestrant 500 mg: n = 109; 250 mg: n = 102). At week 4, fulvestrant 500 mg resulted in greater reduction of Ki67 LI and ER expression versus 250 mg (-78.8 vs. -47.4% [p < 0.0001] and -25.0 vs. -13.5% [p = 0.0002], respectively [ACIS]); PgR suppression was not significantly different (-22.7 vs. -17.6; p = 0.5677). However, H score detected even greater suppression of ER (-50.3 vs. -13.7%; p < 0.0001) and greater PgR suppression (-80.5 vs. -46.3%; p = 0.0018) for fulvestrant 500 versus 250 mg. At week 16, tumor response rates were 22.9 and 20.6% for fulvestrant 500 and 250 mg, respectively, with considerable decline in all markers by both ACIS and H score. No detrimental effects on endometrial thickness or bone markers and no new safety concerns were identified. This provides the first evidence of greater biological activity for fulvestrant 500 versus 250 mg in depleting ER expression, function, and growth.

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BACKGROUND Predicting long-term survival after admission to hospital is helpful for clinical, administrative and research purposes. The Hospital-patient One-year Mortality Risk (HOMR) model was derived and internally validated to predict the risk of death within 1 year after admission. We conducted an external validation of the model in a large multicentre study. METHODS We used administrative data for all nonpsychiatric admissions of adult patients to hospitals in the provinces of Ontario (2003-2010) and Alberta (2011-2012), and to the Brigham and Women's Hospital in Boston (2010-2012) to calculate each patient's HOMR score at admission. The HOMR score is based on a set of parameters that captures patient demographics, health burden and severity of acute illness. We determined patient status (alive or dead) 1 year after admission using population-based registries. RESULTS The 3 validation cohorts (n = 2,862,996 in Ontario, 210 595 in Alberta and 66,683 in Boston) were distinct from each other and from the derivation cohort. The overall risk of death within 1 year after admission was 8.7% (95% confidence interval [CI] 8.7% to 8.8%). The HOMR score was strongly and significantly associated with risk of death in all populations and was highly discriminative, with a C statistic ranging from 0.89 (95% CI 0.87 to 0.91) to 0.92 (95% CI 0.91 to 0.92). Observed and expected outcome risks were similar (median absolute difference in percent dying in 1 yr 0.3%, interquartile range 0.05%-2.5%). INTERPRETATION The HOMR score, calculated using routinely collected administrative data, accurately predicted the risk of death among adult patients within 1 year after admission to hospital for nonpsychiatric indications. Similar performance was seen when the score was used in geographically and temporally diverse populations. The HOMR model can be used for risk adjustment in analyses of health administrative data to predict long-term survival among hospital patients.

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Campanian-Maestrichtian planktonic foraminifers were examined from Sites 698 (2128 m water depth) and 700 (3611 m water depth) on the Northeast Georgia Rise (southern South Atlantic, 51°S). Site 698 penetrated 72.5 m of Campanian-Maestrichtian chalk and limestone with only 18.2% recovery, whereas Site 700 recovered 66.8% of a 152.7-m section of Coniacian-Maestrichtian limestone. Preservation of planktonic foraminifers from both sites is moderate in Maestrichtian samples, but worsens with increasing depth in the Campanian. The Northeast Georgia Rise planktonic foraminifers are typical of Late Cretaceous Austral Province faunas described from other southern high-latitude sites; species diversity is low and the assemblages are dominated by species of Heterohelix, Globigerinelloides, Hedbergella, and Archaeoglobigerina. Five species, including Globigerinelloides impensus Sliter, Archaeoglobigerina australis Huber, Archaeoglobigerina mateola Huber, Hedbergella sliteri Huber, and Rugotruncana circumnodifer (Finlay), are considered to be endemic to the Austral Province. Formation of a cool temperate water mass in the circum-Antarctic region, resulting from the final breakup of the Gondwana continents, may have led to increased provincialism of the Austral Province planktonic foraminifers during Campanian-Maestrichtian time. Magnetobiostratigraphic correlation of eight planktonic foraminifer datum events at Hole 700B with ages determined for datums at ODP Leg 113 Holes 689B and 690C (Maud Rise, 65°S) demonstrates regional synchroneity of first and last occurrences within the Austral Province. As was observed at the Maud Rise, several keeled and nonkeeled species previously thought to have been restricted to warmer low-latitude regions first occur later at the Northeast Georgia Rise than at the low-latitude sites. The causes for high-latitude diachroneity among these immigrant species are not clear; neither oxygen and carbon isotope data from the Maud Rise sites nor calcareous nannoplankton distributions for the southern South Atlantic region show conspicuous changes that correlate to the delayed first occurrences.

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Analogous to West- and North Africa, East Africa experienced more humid conditions between approximately 12 to 5 kyr BP, relative to today. While timing and extension of wet phases in the North and West are well constrained, this is not the case for the East African Humid Period. Here we present a record of benthic foraminiferal assemblages and sediment elemental compositions of a sediment core from the East African continental slope, in order to provide insight into the regional shallow Indian Ocean paleoceanography and East African climate history of the last 40 kyr. During glacial times, the dominance of a benthic foraminiferal assemblage characterized by Bulimina aculeata, suggests enhanced surface productivity and sustained flux of organic carbon to the sea floor. During Heinrich Stadial 1 (H1), the Nuttallides rugosus Assemblage indicates oligotrophic bottom water conditions and therefore implies a stronger flow of southern-sourced AAIW to the study site. During the East African Humid Period, the Saidovina karreriana Assemblage in combination with sedimentary C/N and Fe/Ca ratios suggest higher river runoff to the Indian Ocean, and hence more humid conditions in East Africa. Between 8.5 and 8.1 kyr, contemporaneous to the globally documented 8.2 kyr Event, a severe reduction in river deposits implies more arid conditions on the continent. Comparison of our marine data with terrestrial studies suggests that additional moisture from the Atlantic Ocean, delivered by an eastward migration of the Congo Air Boundary during that time period, could have contributed to East African rainfall. Since approximately 9 kyr, the gaining influence of the Millettiana millettii Assemblage indicates a redevelopment of the East African fringe reefs.

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Yersiniae, causative agents of plague and gastrointestinal diseases, secrete and translocate Yop effector proteins into the cytosol of macrophages, leading to disruption of host defense mechanisms. It is shown in this report that Yersinia enterocolitica induces apoptosis in macrophages and that this effect depends on YopP. Functional secretion and translocation mechanisms are required for YopP to act, strongly suggesting that this protein exerts its effect intracellularly, after translocation into the macrophages. YopP shows a high level of sequence similarity with AvrRxv, an avirulence protein from Xanthomonas campestris, a plant pathogen that induces programmed cell death in plant cells. This indicates possible similarities between the strategies used by pathogenic bacteria to elicit programmed cell death in both plant and animal hosts.

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Microbial pathogens have evolved many ingenious ways to infect their hosts and cause disease, including the subversion and exploitation of target host cells. One such subversive microbe is enteropathogenic Escherichia coli (EPEC). A major cause of infantile diarrhea in developing countries, EPEC poses a significant health threat to children worldwide. Central to EPEC-mediated disease is its colonization of the intestinal epithelium. After initial adherence, EPEC causes the localized effacement of microvilli and intimately attaches to the host cell surface, forming characteristic attaching and effacing (A/E) lesions. Considered the prototype for a family of A/E lesion-causing bacteria, recent in vitro studies of EPEC have revolutionized our understanding of how these pathogens infect their hosts and cause disease. Intimate attachment requires the type III-mediated secretion of bacterial proteins, several of which are translocated directly into the infected cell, including the bacteria's own receptor (Tir). Binding to this membrane-bound, pathogen-derived protein permits EPEC to intimately attach to mammalian cells. The translocated EPEC proteins also activate signaling pathways within the underlying cell, causing the reorganization of the host actin cytoskeleton and the formation of pedestal-like structures beneath the adherent bacteria. This review explores what is known about EPEC's subversion of mammalian cell functions and how this knowledge has provided novel insights into bacterial pathogenesis and microbe-host interactions. Future studies of A/E pathogens in animal models should provide further insights into how EPEC exploits not only epithelial cells but other host cells, including those of the immune system, to cause diarrheal disease.

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Enteropathogenic Escherichia coli (EPEC), a major cause of pediatric diarrhea, adheres to epithelial cells and activates host cell signal transduction pathways. We have identified five proteins that are secreted by EPEC and show that this secretion process is critical for triggering signal transduction events in epithelial cells. Protein secretion occurs via two pathways: one secretes a 110-kDa protein and the other mediates export of the four remaining proteins. Secretion of all five proteins was regulated by temperature and the perA locus, two factors which regulate expression of other known EPEC virulence factors. Amino-terminal sequence analysis of the secreted polypeptides identified one protein (37 kDa) as the product of the eaeB gene, a genetic locus previously shown to be necessary for signal transduction. A second protein (39 kDa) showed significant homology with glyceraldehyde-3-phosphate dehydrogenase, while the other three proteins (110, 40, and 25 kDa) were unique. The secreted proteins associated with epithelial cells, and EaeB became resistant to protease digestion upon association, suggesting that intimate interactions are required for transducing signals.

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Electronic text and image data.

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Mode of access: Internet.

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Mode of access: Internet.