University of Wales

About: University of Wales is a education organization based out in Cardiff, United Kingdom. It is known for research contribution in the topics: Population & Poison control. The organization has 12462 authors who have published 16873 publications receiving 700173 citations. The organization is also known as: Prifysgol Cymru.

Dopamine agonists and pituitary tumor shrinkage

Abstract: The primary aim of this review has been to clarify the tumor shrinking effects of dopamine agonists on pituitary macroadenomas of different cell types. Shrinkage is most dramatic for macroprolactinomas and is due to cell size reduction. Seventy-nine percent of 271 definite macroprolactinomas were reduced in size by at least 25%, and 89% shrank to some degree. Most shrinkage occurs during the first 3 months of treatment, although in a minority shrinkage is delayed. Dopamine agonist resistance during long-term therapy is exceptional. Drug withdrawal nearly always leads to a return of hyperprolactinemia, even after several years treatment, although early tumor reexpansion is unusual. About 10% of true macroprolactinomas do not shrink with dopamine agonists; the molecular mechanisms of such resistance have yet to be determined. Alternative formulations of BC and new dopamine agonists (CV 205-502 and cabergoline) are useful for the minority of patients unable to tolerate oral BC, but do not seem to further improve overall shrinkage rates. The risks of pregnancy have probably been overstated, and BC is suitable primary treatment for women with prolactinomas of all sizes; the drug can be used safely during pregnancy in the event of clinically relevant tumor expansion. The interpretation of different degrees of hyperprolactinemia is discussed and management strategies suggested. Most patients with macroprolactinomas now avoid surgery, but drug-induced, time-dependent tumor fibrosis should be remembered if surgery is contemplated. Nonfunctioning pituitary tumors are mostly of gonadotroph cell origin and may be associated with significant disconnection hyperprolactinaemia. Seventy-six of 84 well-characterized tumors showed no tumor shrinkage during dopamine agonist therapy. Possible explanations include abnormalities of dopamine receptor number and function. Preliminary evidence suggests that dopamine agonists may restrain the growth of some functionless tumors; most of these tumors, however, can be satisfactorily debulked using transsphenoidal surgery. In contrast to macroprolactinomas, other functioning pituitary tumors (GH-, TSH-, and ACTH-secreting) rarely shrink during dopamine agonist therapy, although the number of tumors studied is small.

Metabolic footprinting and systems biology: the medium is the message

Abstract: One element of classical systems analysis treats a system as a black or grey box, the inner structure and behaviour of which can be analysed and modelled by varying an internal or external condition, probing it from outside and studying the effect of the variation on the external observables. The result is an understanding of the inner make-up and workings of the system. The equivalent of this in biology is to observe what a cell or system excretes under controlled conditions - the 'metabolic footprint' or exometabolome - as this is readily and accurately measurable. Here, we review the principles, experimental approaches and scientific outcomes that have been obtained with this useful and convenient strategy.

10 years experience of the Dermatology Life Quality Index (DLQI).

Abstract: The Dermatology Life Quality Index, the first dermatologyspecific health-related quality of life (HRQoL) questionnaire, was published in 1994 (Finlay and Khan, 1994). There is now 10 years experience with over 85 peer reviewed research articles and 52 published abstracts describing its use: there are also many current studies worldwide using the DLQI as an outcome measure. The aim of this review article is to provide detailed information about where to find any published aspect of the DLQI so that the reader can readily decide whether the DLQI may be appropriate for their use. The DLQI was designed to be simple and easy to use in a busy clinical setting: wide experience of its use has confirmed the appropriateness of this concept. There are other well-validated similar outcome measures: these include Skindex (Chren et al, 1996), Dermatology Quality of Life Scales (Morgan et al, 1997), and Dermatology-specific Quality of Life Instrument (Anderson and Rajagopalan, 1997). de Korte et al (2002) and de Tiedra et al (1998) have compared the characteristics of various HRQoL outcome measures used in dermatology. Many concepts to be considered when choosing quality of life measures in dermatology have been reviewed (Finlay, 1997).

Randomised controlled trial of psychological debriefing for victims of acute burn trauma

Abstract: BACKGROUND Psychological debriefing (PD) is widely used following major traumatic events in an attempt to reduce psychological sequelae. METHOD One hundred and thirty-three adult burn trauma victims entered the study. After initial questionnaire completion, participants were randomly allocated to an individual/couple PD group or a control group who received no intervention; 110 (83%) were interviewed by an assessor blind to PD status three and 13 months later. RESULTS Sixteen (26%) of the PD group had PTSD at 13-month follow-up, compared with four (9%) of the control group. The PD group had higher initial questionnaire scores and more severe dimensions of burn trauma than the control group, both of which were associated with a poorer outcome. CONCLUSION This study seriously questions the wisdom of advocating one-off interventions post-trauma, and should stimulate research into more effective initiatives.