Digoxin use after diagnosis of colorectal cancer and survival: a population-based cohort study.

BACKGROUND:

Digoxin has been shown to affect a number of pathways that are of relevance to cancer, and its use has been associated with increased risks of breast and uterus cancer and, more recently, a 40% increase in colorectal cancer risk. These findings raise questions about the safety of digoxin use in colorectal cancer patients, and, therefore, we investigated whether digoxin use after colorectal cancer diagnosis increased the risk of colorectal cancer-specific mortality.

METHODS:

A cohort of 10,357 colorectal cancer patients newly diagnosed from 1998 to 2009 was identified from English cancer registries and linked to the UK Clinical Practice Research Datalink (to provide digoxin and other prescription records) and to the Office of National Statistics mortality data (to identify 2,724 colorectal cancer-specific deaths). Using time-dependent Cox regression models, unadjusted and adjusted HRs and 95% confidence intervals (CI) were calculated for the association between postdiagnostic exposure to digoxin and colorectal cancer-specific mortality.

RESULTS:

Overall, 682 (6%) colorectal cancer patients used digoxin after diagnosis. Digoxin use was associated with a small increase in colorectal cancer-specific mortality before adjustment (HR, 1.25; 95% CI, 1.07-1.46), but after adjustment for confounders, the association was attenuated (adjusted HR, 1.10; 95% CI, 0.91-1.34) and there was no evidence of a dose response.

CONCLUSIONS:

In this large population-based colorectal cancer cohort, there was little evidence of an increase in colorectal cancer-specific mortality with digoxin use after diagnosis.

IMPACT:

These results provide some reassurance that digoxin use is safe in colorectal cancer patients.

Evolución de pacientes adultos en ventilación mecánica en modo ASV. UCI Hospital San Rafael Tunja agosto-diciembre 2014

Este es un estudio observacional descriptivo, longitudinal y prospectivo realizado con el fin de describir la evolución de de la mecánica ventilatoria, la gasometría y los tiempos de ventilación en los pacientes en ventilación mecánica en modo ASV en la UCI del Hospital San Rafael de Tunja durante los meses de Agosto a Diciembre de 2014 y encontrando que es un método seguro y eficiente para el manejo de la ventilación en pacientes sin mayores comorbilidades ni compromiso orgánico múltiple que bien podría ser utilizado desde el inicio de la ventilación hasta el destete de la misma con el beneficio adicional de menores requerimientos de sedación durante la ventilación pero teniendo en cuenta que factores como hipotensión sostenida, hiperlactatemia, falla renal e hipoxia severa pueden indicar la necesidad de cambio de modo ventilatorio.

La política comercial de Estados Unidos en el marco de la Organización Mundial del Comercio. Discurso vs. comportamiento con relación a prácticas anticompetitivas

El objetivo principal de esta monografía es identificar cuáles son las razones que justifican las contradicciones entre el discurso y el comportamiento de Estados Unidos en el marco de la Organización Mundial del Comercio, particularmente con relación a prácticas anticompetitivas derivadas del programa de protección a la agricultura del país. Para ello se analizan el interés nacional y los elementos de la seguridad nacional a partir de los cuales éste se ha construido. También se evalúan los procesos de formulación de política comercial y las interacciones entre los representantes políticos, las asociaciones de productores y el sector privado para mostrar como este comportamiento contradictorio corresponde a la legitimización de un interés particular.

Variação genética, herdabilidades e ganhos na seleção para caracteres de crescimento e forma, em teste de progênies de polinização aberta de Eucalyptus cloeziana, aos 24 anos de idade em Luiz Antônio-SP

Pós-graduação em Agronomia - FEIS

Ectopic third molar as a cause of sinusitis

Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Male, 19- years old, with an upper left ectopic third molar located in the maxillary sinus-infraorbital region. The patient reported a bad taste and recurrent sinusitis that had been resistant to treatment. Surgical excision was carried out of the third molar tooth using the Caldwell-Luc approach.

Grande sertão: veredas e sua adaptação para a televisão: uma análise das estruturas temporais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Geology of the Golden Sunlight Mine and Vicinity

The Golden Sunlight Mine is in the northern part of the Cardwell mining district on the eastern slope of a small range that rises by a series of benches to an elevation of 7,200 at a point five miles east of the town of Whitehall in Jefferson County.

Report on Pole Canyon Area and Area Three Miles Southeast of Jefferson Island

The primary purpose of the trip was to acquaint the students with some of the problems that occur in the field, and also how to make geologic maps of sections, outcrops, faults, and other geologic features of the earths surface.

What's in a name? Inflammatory airway disease in racehorses in training

The term 'inflammatory airway disease' (IAD) is often used to describe the syndrome of lower airway inflammation that frequently affects young racehorses in training around the world. In practice, this inflammation is generally diagnosed using a combination of endoscopic tracheal examination, including grading of amounts of mucus present and tracheal wash sampling. However, a recent consensus statement from the American College of Veterinary Internal Medicine concluded that bronchoalveolar lavage (BAL) sampling, rather than tracheal wash (TW) sampling, is required for cytological diagnosis of IAD and that tracheal mucus is not an essential criterion. However, as BAL is a relatively invasive procedure that is not commonly used on racing yards, this definition can only be applied routinely to a biased referral population. In contrast, many practitioners continue to diagnose IAD using endoscopic tracheal examination and sampling. We argue that, rather than restricting the use of the term IAD to phenotypes diagnosed by BAL, it is important to distinguish in the literature between airway inflammation diagnosed by BAL and that identified in the field using TW sampling. We suggest the use of the term brIAD for the former and trIAD for the latter. It is essential that we continue to endeavour to improve our understanding of the aetiology, pathogenesis and clinical relevance of airway inflammation identified in racehorses in training using tracheal examination and sampling. Future studies should focus on investigations of the component signs of airway inflammation.

The story of Community preference for food security

"Préférence communautaire" is an in-built notion of the CAP since its inception with the Treaty of Rome (1957). Its’ simple objective laid down at the Stresa Conference in 1958 is to prefer community produce over imports wherever possible, while at the same time promoting agricultural exports and FDI (“vocation exportatrice de l’Europe”). Does this contrast or correlate with the notion of “food sovereignty” which originated in 1996 as a notion of small farmer self-sufficiency (Via Campesina), and which now has found its way into the official EC discourse? Recent CAP reforms indeed seem to continue banking on border protection and on the occasional export subsidy. Nonetheless, coming together with claims to mitigate climate change, “food sovereignty” à la CAP fails to acknowledge efficiency losses at home and negative spillover effects on the right to food of food exporting developing countries. This chapter asks whether new non-tariff and domestic support measures are just new wine in the old cask of fortress Europe, together with the FDI promotion instruments of the FED and others. Might the increasing dynamics and new challenges of agricultural trade and investment lead to lower market and production shares for European farms? It concludes that in the medium term the WTO Green Box has the only legal and effective tools to promote EU agriculture and food.

Inflammatory Airway Disease of Horses-Revised Consensus Statement

The purpose of this manuscript is to revise and update the previous consensus statement on inflammatory airway disease (IAD) in horses. Since 2007, a large number of scientific articles have been published on the topic and these new findings have led to a significant evolution of our understanding of IAD.

Mechanical characterization of GdBCO/Ag and YBCO single grains fabricated by top-seeded melt growth at 77 and 300 K

YBaCuO and GdBaCuO + 15 wt% Ag large, single-grain, bulk superconductors have been fabricated via the top-seeded, melt-growth (TSMG) process using a generic NdBCO seed. The mechanical behavior of both materials has been investigated by means of three-point bending (TPB) and transversal tensile tests at 77 and 300 K. The strength, fracture toughness and hardness of the samples were studied for two directions of applied load to obtain comprehensive information about the effect of microstructural anisotropy on the macroscopic and microscopic mechanical properties of these technologically important materials. Splitting (Brazilian) tests were carried out on as-melt-processed cylindrical samples following a standard oxygenation process and with the load applied parallel to the growth-facet lines characteristic of the TSMG process. In addition, the elastic modulus of each material was measured by three different techniques and related to the microstructure of each sample using optical microscopy. The results show that both the mechanical properties and the elastic modulus of both YBCO and GdBCP/Ag are improved at 77 K. However, the GdBCO/Ag samples are less anisotropic and exhibit better mechanical behavior due to the presence of silver particles in the bulk, superconducting matrix. The splitting tensile strength was determined at 77 K and both materials were found to exhibit similar behavior, independently of their differences in microstructure.

Acute toxicity of selected toxicants to six species of fish /

Mode of access: Internet.