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1
Nitschke, Tobias, Philipp Groene, Alice-Christin Acevedo, Tobias Kammerer, and Simon T. Schäfer. "Coagulation under Mild Hypothermia Assessed by Thromboelastometry." Transfusion Medicine and Hemotherapy 48, no. 4 (2021): 203–9. http://dx.doi.org/10.1159/000513922.
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<b><i>Introduction:</i></b> While previous studies have shown a significant impact of extreme hypo- and hyperthermia on coagulation, effects of much more frequently occurring perioperative mild hypothermia are largely unknown. This study therefore aimed to analyze the effects of mild hypothermia using rotational thromboelastometry in vitro. <b><i>Materials and Methods:</i></b> Twelve healthy volunteers were included in this study. Standard thromboelastometric tests (EXTEM, INTEM, FIBTEM) were used to evaluate coagulation in vitro at 39, 37, 35.5, 35, and 33°C. Beyond standard thromboelastometric tests, we also evaluated the effects of mild hypothermia on the TPA-test (ClotPro, Enicor GmbH, Munich, Germany), a new test which aims to detect fibrinolytic capacity by adding tissue plasminogen activator to the sample. Data are presented as the median with 25/75th percentiles. <b><i>Results:</i></b> Extrinsically activated coagulation (measured by EXTEM) showed a significant increase in clot formation time (CFT; 37°C: 90 s [81/105] vs. 35°C: 109 s [99/126]; <i>p</i> = 0.0002), while maximum clot firmness (MCF) was not significantly reduced. Intrinsically activated coagulation (measured by INTEM) also showed a significant increase in CFT (37°C: 80 s [72/88] vs. 35°C: 94 s [86/109]; <i>p</i> = 0.0002) without significant effects on MCF. Mild hypothermia significantly increased both the lysis onset time (136 s [132/151; 37°C] vs. 162 s [141/228; 35°C], <i>p</i> = 0.0223) and lysis time (208 s [184/297; 37°C] vs. 249 s [215/358; 35°C]; <i>p</i> = 0.0259). <b><i>Conclusion:</i></b> This demonstrates that even under mild hypothermia coagulation is significantly altered in vitro. Perioperative temperature monitoring and management are greatly important and can help to prevent mild hypothermia and its adverse effects. Further investigation and in vivo testing of coagulation under mild hypothermia is needed.
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Visser, Philip, Alison Dwyer, Juli Moran, Mary Britton, Melodie Heland, Filomena Ciavarella, Sandy Schutte, and Daryl Jones. "Medical emergency response in a sub-acute hospital: improving the model of care for deteriorating patients." Australian Health Review 38, no. 2 (2014): 169. http://dx.doi.org/10.1071/ah13245.
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Objective To assess the frequency, characteristics and outcomes of medical emergency response (MER) calls in a sub-acute hospital setting. Methods The present study was a retrospective observational study in a sub-acute hospital providing aged care, palliative care, rehabilitation, veteran’s mental health and elective surgical services. We assessed annual MER call numbers between 2005 and 2011 in the context of contemporaneous changes to hospital services. We also assessed MER calls over a 12-month period in detail using standardised case report forms and the scanned medical record. Results There were 2285 multiday admissions in the study period where 141 MER calls were triggered in 132 patients (61.7 calls per 1000 admissions). The median patient age was 83.0 years, and 55.3% of patients were men. Most calls occurred on weekdays and during the daytime, and were triggered by altered conscious state, low oxygen saturations and hypotension. Documentation of escalation of care before the MER call was not present in 99 of 141 (70.2%) calls. Following the call, in 70 of 141 (49.6%) cases, the patient was transferred to the acute campus, where 52 (74.2%) and 14 (20%) patients required ward and intensive care level treatment, respectively. Thirty-seven of 132 (28%) patients died. A palliative care physician adjudicated that most of these patients who died (24/37; 64.9%) were appropriate for a call, but that 19 (51.4%) should have received palliation at the time of the call. Compared with survivors, patients who died after the MER call were more likely originally admitted from supported accommodation. Conclusions MER calls in our sub-acute hospital occurred in elderly patients and are associated with an in-hospital mortality of 28%. A small proportion of patients required intensive care level treatment. There is a need to improve processes involving escalation of care before MER call activation and to revise advance care directives. What is known about this topic? Rapid response team (RRT) activation has been well described in the acute hospital setting. Although the impact on survival benefit to patients remains controversial, it has been widely adopted as a model of care to respond to deteriorating ward patients. This is particularly relevant in Australia at present with the implementation of the new National Safety and Quality Health Service Standards. What does this paper add? There have not been any previous papers published on rapid response systems in a sub-acute hospital. This paper describes some of the changes and challenges associated with increasing RRT activations in a sub-acute health care facility. What are the implications for practitioners? For clinicians in a sub-acute setting, the study reinforces the importance of pre-emptively documenting and communicating advance care directives. In addition, it is important to identify patients with reversible pathology likely to benefit from transfer and acute care, and to avoid the transfer of those who will not and, instead, provide appropriate palliation. For practitioners involved in models of care for deteriorating patients, the study provides information on where problems occurred in our system and the strategies used to address these issues.
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Awada, Hassan, Jibran Durrani, Tariq Zuheir Kewan, Ashwin Kishtagari, Valeria Visconte, and Reda Z. Mahfouz. "Comprehensive Characterization of Cytogenetic and Mutational Analysis of Acute Promyelocytic Leukemia: Is PML-Rara Everything?" Blood 134, Supplement_1 (November 13, 2019): 1404. http://dx.doi.org/10.1182/blood-2019-131724.
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Acute promyelocytic leukemia (APL) is characterized by PML-RARA fusion caused by the t(15;17)(q24;q21) translocation. Although PML-RARA fusion explains the dedifferentiation in most of APL patients, it still does not entirely represent the unique cause of all the clinical manifestations of the disease failing to determine the full leukemic phenotype. Up to 40 % of APL patients have an additional chromosomal abnormality other than PML-RARA. Murine studies have reported that additional cytogenetic abnormalities and secondary somatic mutations (for instance FLT3-ITD) might contribute to leukemia progression. Indeed, mice expressing mutant PML-RARA develop definitive leukemia after one year, suggesting that additional hits are required for transformation. Moreover, no distinct genetic signature has been characterized by next generation sequencing (NGS). This confirms that no gene has been reproducibly identified. APL respond to all-trans retinoic acid (ATRA) in the great majority of patients. However, one quarter of APL develop ATRA resistance suggesting that additional secondary chromosomal abnormalities might be evolving resistance. Combination of low dose arsenic, modify certain epigenetics, with ATRA decreased resistance potential and improved response. In the line with other possible factors involved in ATRA resistance, is the broad nature of the targets of ATRA. A molecular core network of ATRA's targets has been clustered in differentiation, growth factors and nuclear receptors possibly cooperating with PML-RARA and additional chromosomal abnormalities. Herein, we aimed to characterize the gene mutations and chromosomal abnormalities playing key roles in cellular differentiation and epigenetic regulation and to correlate the occurrence of these alterations with treatment response and survival outcomes in APL. We took advantage of a large cohort of APL patients (n=145). Median age of the cohort was 50 yrs (19-85); equal gender distribution; median blood counts were: [WBC 6.2 x 109/L (0.4-155); 37% had leukopenia], hemoglobin [9.8 g/dL (2.7-16.2); 32% had anemia] and platelets [29 x 109/L (range of 0-228); 93% had thrombocytopenia]. In terms of karyotype, 15% of the patients carried +8, 7% had complex karyotyping (≥3 cytogenetic abnormalities), 2% had -7/del (7q) or del (12p), 1% had -17/del(17p), and 1 patient had -5. Mutational analysis of 30 genes panel, identified 141 mutations carried by 65% (94/145) of APL patients. The most frequent mutations were observed in FLT3-ITD (61/143; 43%), WT1 (26/139; 23%), and ASXL1 (7/136; 5%) genes. Less frequent mutations were found in 3.7% of CEBPA, KRAS, and NRAS genes as well as in CBL, EZH2, TET2 (3% each) genes. Additionally, we noted that all mutations were recurrent in specific functional pathways and patients carried mutations in more than 1 gene of the same pathway. Of note, cell signaling and proliferation genes (CBL, NRAS, KRAS, KIT, FLT3) were the most frequently mutated (77/141, 55%) and impacted OS (HR: 1.7, P=0.02). Moreover, transcriptional factors which are often mutated in AML (e.g. CEBPA, TP53, NPM1, RUNX1, WT1) as well as major determinants of cell's fate were markedly mutated (38/141, 27%) suggesting that genetic impairment of signaling and transcription might contribute to the lack of differentiation observed in APL phenotypes. Mutations in epigenetic genes and histone methyltransferases (ASXL1, BCORs, DNMT3A, EZH2, IDH1/2, TET2) were also found in 18/141 (13%) while genes regulating cell proliferation and RAS family (CBL, NRAS, KRAS, NPM1) were enriched in 16/132 (12%) of APL cohort. We then analyzed the genetic picture of remission (APLRm, n=131, 90%) and relapsed (APLR, 1sr relapsed to ATRA, n=14, 10%) patients. Acknowledging the low number of APLR, we observed that molecular mutations did not make a key difference in APLRvs. APLRm [except for a complete lack of mutations in epigenetic pathways (0% vs. 13%)]. Contrarily, specific cytogenetic abnormalities were more common in APLR compared to APLRm as the case of +8 (36% vs. 11%; P= .02) and -17/del(17p) (2/14 vs. 0/131; P= .008). In sum, our study demonstrates that PML-RARA might be accompanied by additional acquired chromosomal change with a variety of genetic mutations in key pathways driving cellular differentiation. These molecular/ cytogenetic associations could determine resistance to ATRA and overall APL patients' survival. Disclosures No relevant conflicts of interest to declare.
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Kyriazakis, I., and J. D. Oldham. "Diet selection in sheep: the ability of growing lambs to select a diet that meets their crude protein (nitrogen × 6.25) requirements." British Journal of Nutrition 69, no. 3 (May 1993): 617–29. http://dx.doi.org/10.1079/bjn19930064.
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To test the proposition that sheep are able to select a diet that meets their crude protein (N × 6.25; CP) requirements, feeds L, A, B, C and H with the same energy content (11 MJ metabolizable energy/kg feed) but different CP contents (78, 109, 141, 172 and 235 g CP/kg fresh feed respectively) were formulated. In addition, feed U, which was feed L plus 21.4 g urea/kg (CP content 132 g/kg), was also made. The feeds were offered ad lib. either singly (n 4 per treatment) or as a choice between feed H and another feed (pairs LH, AH, BH, CH and UH; n 9 per feed pair) to individually penned Suffolk × Scottish mule wether lambs, over the live-weight range 25–45 kg. On the single feeds the rates of live-weight gain were 273, 326, 412, 418, 396 and 407 g/day (SE of difference (SED) 34; P < 0.01) and protein (excluding wool) gain were 27, 32, 44, 45, 41 and 39 g/d (SED 4; P < 0.001) for feeds L, A, B, C, H and U respectively. When sheep were given a choice between a feed below (L or A) and a feed above their CP requirements (H; as judged by the single-feeding treatments) the CP concentration selected was not different between the two pairs: 131 (SE 4) v. 133 (SE 4) g CP/kg feed for pairs LH and AH respectively. On the choices BH and CH (a choice between two feeds above requirements) the feed lower in CP was constantly preferred (874 (SE 33) and 910 (SE 33) g feed B and C respectively per kg total feed intake; CP selected was 157 and 178 g CP/kg respectively). However, this was not the case with the UH choice on which sheep consumed only 599 (SE 61) g feed U/kg total feed intake, resulting in a selection of a higher CP in their diet (173 g CP/kg). The live-weight gains of the animals given a choice between two feeds were 416, 387, 415, 410 and 383 g/d (SED 37) and protein gains were 45, 40, 46, 50 and 43 (SE 7) for pairs LH, AH, BH, CH and UH respectively, which were comparable with the best performance achieved on a single feed. The results suggest that sheep were able to select a diet that meets their CP requirements and avoid, at least to a certain extent, excess of protein intake. It is also possible that sheep discriminate against a property of feed U, such as an excess of urea, when this feed is paired with a feed high in CP.
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Beck, Julia, Markus Schirmer, Margret Rave-Fraenk, Howard Urnovitz, Kirsten Bornemann-Kolatzki, William Marvin Mitchell, Michael Oellerich, Ekkehard Schütz, and Martin Canis. "Cell-free DNA for treatment monitoring and outcome predictor in head and neck cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6055. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6055.
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6055 Background: Copy number instability (CNI) signatures of cancers can be readily detected by Next Generation Sequencing of plasma cell-free DNA (cfDNA). HPV detected in oropharyngeal carcinomas is currently the only prognostic biomarker available. We report here CNI scores for disease monitoring of Head and Neck Cancers (HNC) with potential predictive value for personalized therapeutic options. Methods: A total of 132 plasma samples were collected from 54 HNC patients under informed consent and IRB approval. cfDNA was extracted from plasma, ~20M paired-end NGS mappable reads (reference: HG19) per sample were generated and CNI scores were calculated by read counting statistics. After unblinding CNI scores were evaluated as diagnostic parameter for association with disease characteristics and progression. Survival analysis was conducted after dichotomization of baseline CNI scores at a value of 31 corresponding to the 97.5thpercentile of a normal reference group (RG, n = 141). Results: CNI scores above the 97.5th RG percentile were detected in 40 out of 54 (74%) treatment naïve baseline samples. 29 patients with tumors ≤ T3 (62%, n = 42) and 11 out of 12 (92%) with T4 tumors had CNI scores > 31, with significantly higher CNI scores (p = 0.04) seen for T4 tumors. Higher CNI scores were also found in patients with tumor lymph node invasion (n = 37; median: 381, Q25-Q75: 57-1573) compared to negative lymph nodes (pN0, n = 17; 27, 19-64, p= 0.0004). A steep decline of CNI scores was detected after surgical resection, with increasing CNI scores in later disease progression. The pre-operative CNI scores were a stronger predictor of time to recurrence (p = 7*10-5) than the pN status (p = 0.05) (Cox regression). High baseline CNIs ( > 31) strongly correlated with time to recurrence (Kaplan-Meier log-rank p = 0.018) with a median of 20 months and median overall survival of 30 months in the high CNI group, neither reached in the low CNI-score group (60 m follow-up). Conclusions: Chromosomal instability within HNC was quantified from plasma cfDNA as CNI score. The CNI score may serve as better predictor for the time to recurrence interval than pN status. The data suggests that cfDNA analysis as CNI score may serve as real-time marker of treatment efficacy and outcome.
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Franchini, K. G., I. A. Cestari, and E. M. Krieger. "Restoration of arterial blood oxygen tension increases arterial pressure in sinoaortic-denervated rats." American Journal of Physiology-Heart and Circulatory Physiology 266, no. 3 (March 1, 1994): H1055—H1061. http://dx.doi.org/10.1152/ajpheart.1994.266.3.h1055.
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The objective of the present study was to analyze whether the hypoxemia produced by chemoreceptor elimination influences the arterial pressure level after sinoaortic denervation (SAD) in rats. Hypoxemia and hypercapnia were observed in acute (1 day) and chronic (20 days) SAD rats [arterial PO2 (PaO2) = 65 +2- 1.6 and 71 +2- 2.2 mmHg and arterial PCO2 (PaCO2) = 46 +/- 1.3 and 37 +/- 1.8 mmHg, respectively] compared with control rats (PaO2 = 85 +/- 1.6 mmHg, PaCO2 = 31 +/- 1.07 mmHg). Increasing inspired PO2 (PIO2) from 138 mmHg (room air) to 155 mmHg restored the PaO2 of SAD rats to control levels (acute = 81 +/- 2.21 mmHg, chronic = 85 +/- 2.35 mmHg). PaO2. restoration produced pronounced elevation of mean arterial pressure (MAP) of acute (from 121 +/- 4 to 147 +/- 3.5 mmHg) and chronic (from 121 +/- 3 to 134 +/- 3.5 mmHg) SAD rats. Progressive stepwise increase of PIO2 (from 138 to 175, 210, and 235 mmHg) produced no additional elevation of MAP of acute (113 +/- 4, 137 +/- 5, 143 +/- 5, and 147 +/- 5 mmHg) and chronic (111 +/- 3.6, 131 +/- 7.4, 130 +/- 8.7, and 130 +/- 7 mmHg) SAD rats. Otherwise, the arterial pressure of control rats remained unchanged to progressive stepwise increase of PIO2 (118 +/- 5, 117 +/- 4, 118 +/- 4, 116 +/- 4 mmHg). These data suggest that the elimination of chemoreceptors in SAD rats produces hypoxemia responsible for hypotensive influences that counteract the pressor effects produced by baroreceptor elimination.
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Arobelidze, Salome, Abdo S. Haddad, Timothy Peter Spiro, and Hamed Daw. "Male breast cancer: Risk factors, treatment, and survival." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 110. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.110.
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110 Background: We conducted a retrospective study to investigate male breast cancer risk factors, treatment and survival. Methods: All patients with male breast cancer diagnosed between 1985 and 2014 at the Cleveland Clinic were retrospectively reviewed. Results: 131 patients were enrolled in the study. The median age at diagnosis was 66. Most of the tumors were invasive ductal carcinomas (85%, 111/131) and most were intermediate grade (47%, 41/87). Most patients had localized disease – stage 0-1 (45%, 48/107); stage 2 (35%, 37/107). Among the patients with data, 93% (94/101) were ER+, 73% (74/101) were PR+, 12% (10/80) were HER2 positive, and 6% were triple negative. Estimated median survival was 20.2 years (95% C.I. 19.0-29.4), and estimated 2 and 5-year survival were 96% + 2% and 87% + 3%. Grade was associated with outcome (p=.07). Conclusions: In our study only age at diagnosis was associated with overall survival. Further research is required to understand the treatment outcomes of this rare cancer. [Table: see text]
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Lin, Chin, Colin Edwards, Guy P. Armstrong, Anthony Scott, Hitesh Patel, Hamish Hart, and Jonathan P. Christiansen. "Prevalence and Prognostic Significance of Left Ventricular Dysfunction in Patients Presenting Acutely with Atrial Fibrillation." Clinical Medicine Insights: Cardiology 4 (January 2010): CMC.S4106. http://dx.doi.org/10.4137/cmc.s4106.
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The prevalence and prognostic importance of CM occurring as a consequence of AF is poorly defined. This study investigated the incidence of CM in patients with AF, its clinical features and long-term outcomes. We demonstrated that CM is common in patients presenting acutely with newly diagnosed rapid AF, and carries a worse long-term prognosis. Systolic dysfunction was reversible in an important proportion of patients, suggesting a greater prevalence of rate-related CM in AF than has previously been postulated. This underscores the importance of appropriate rhythm management strategies and repeat imaging studies. Background Atrial fibrillation (AF) may precipitate LV dysfunction, potentially leading to cardiomyopathy (CM). The prevalence and prognostic importance of CM occurring as a consequence of AF is poorly defined. We investigated the incidence of CM in patients with AF, its clinical features and long-term outcomes. Methods We reviewed 292 consecutive patients (average age 72 ± 13yrs) presenting acutely with AF and tachycardia over a 3 year period from June 2004. Clinical details were obtained from medical records. CM was defined as ejection fraction (EF) ≤ 50% on index admission. Results Echo was performed 93% of patients at index admission, and 69 (24%) had CM (average EF% = 37 ± 11), 60 of which were newly diagnosed. Patients with CM had significantly higher presenting heart rate (141 ± 19 vs. 132 ± 23 bpm), larger end-diastolic (5.7 vs. 5.2 cm) and end-systolic (4.5 vs. 3.2 cm) dimensions, and larger left atrial size (4.6 vs. 4.3 cm) ( P < 0.05 for all). They were also statistically more likely ( P < 0.05) to be male, present with breathlessness, have a history of coronary disease, and be treated with digoxin and warfarin. Follow-up echo between 6 and 12 months was performed in 46% of patients with new CM, and average EF rose to 53 ± 12%. At an average follow-up of 2.5 years, there was a significant increase in mortality in CM patients (16% vs. 9.5%, P < 0.05). Conclusion CM is common in patients presenting acutely with newly diagnosed rapid AF, and carries a worse long-term prognosis. Systolic dysfunction was reversible in an important proportion of patients, suggesting a greater prevalence of rate-related CM in AF than has previously been postulated. This underscores the importance of appropriate rhythm management strategies and repeat imaging studies.
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Michallet, Mauricette, Mohamad Sobh, Sandrine Leroy, Fiorenza Barraco, Xavier Thomas, Sophie Ducastelle, Bruno Lina, et al. "Impact of Single or Associated CMV, EBV and BK Virus Reactivation Early after Allogeneic Hematopoietic Stem Cell Transplantation on Relapse Incidence." Blood 124, no. 21 (December 6, 2014): 1428. http://dx.doi.org/10.1182/blood.v124.21.1428.1428.
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Abstract Background: Many recent studies have evaluated the impact of cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) showing a significant association with reduced risk of relapse. On the other hand, other frequent viral infections or reactivations like Epstein-Barr virus (EBV) and BK virus (BK-V) have not been evaluated in the same context and we do not know whether their association has an impact on transplantation outcomes or not. Objective: The aim of this study is to evaluate the impact of CMV, EBV and BK-V reactivation up to 3 months after allo-HSCT whether alone or associated on the relapse incidence of patients with hematological malignancies. Patients and methods: We evaluated 359 consecutive patients with hematological malignancies who received allo-HSCT and were followed in our center between January 2008 and June 2013; there were 218 (61%) males and 141 (39%) females with a median age of 48 years (range: 18-70), 182 (51%) had acute myeloid leukemia, 44 (12%) multiple myeloma, 34 (9%) myelodysplastic syndrome, 30 (8%) Non-Hodgkin lymphoma, 7 (2%) chronic lymphocytic leukemia, 21 (6%) myeloproliferative syndrome, 14 (4%) Hodgkin disease, 13 (4%) chronic myeloid leukemia and 14 (4%) aplastic anemia. At transplantation, 227 (63%) patients were in complete response (CR) or chronic phase (CP) and 132 (37%) were in less than CR or CP. For conditioning regimen, 171 (48%) were myeloablative and 188 (52%) were reduced intensity. DNA levels of CMV, EBV and BK-V in blood were detected by quantitative real-time polymerase chain reaction (RQ-PCR) after weekly monitoring up to 3 months after allo-HSCT. CMV-DNA, EBV-DNA or BK-V-DNA was considered positive when the copies exceeded 1000 copies/ml. Results: Among 359 patients, there were 102 patients who had CMV reactivation after a median time of 1.4 months (1.1-1.8) after allo-HSCT with a cumulative incidence of 25 % (24-26) at 3 months; 222 patients had EBV reactivation after a median time of 1.3 months (0.7-2.5) after allo-HSCT with a cumulative incidence of 48 % (47-50) at 3 months; and 38 patients had BK-V reactivation after a median time of 1.1 months (0.7-1.5) after allo-HSCT with a cumulative incidence of 10 % (9-11) at 3 months. The cumulative incidence of relapse at one and two years for the whole population was 27% (26-28) and 34% (33-35) respectively and the cumulative incidence of transplant-related mortality (TRM) was 22% (21-23) and 25% (24-26) respectively. The multivariate analysis took into account the type of disease, the type of conditioning, the disease status at transplantation, the presence of acute GVHD and single or the association of viral reactivation; this analysis showed that the presence of a single viral reactivation was associated with a significant lower relapse rate, for CMV: sdHR=0.34 [0.12-0.92], p=0.03, for EBV: sdHR= 0.52 [0.35-1], p=0.05 and for BK-V: sdHR=0.58[0.24-0.7], p=0.002; and that patients who have an associated CMV and EBV reactivation had significantly higher risk of relapse, sdHR= 5 [1.59-16], p=0.006. There was no significant impact of these reactivations on TRM. Conclusion: We confirmed the positive impact of CMV reactivation on relapse incidence, in addition we demonstrated that this impact exists also for EBV and BK-V, however we showed for the first time that the association of CMV and EBV was significantly associated with a higher risk of relapse. More investigations are ongoing to evaluate the immunological status of these patients and the different administered anti-viral treatments. Disclosures No relevant conflicts of interest to declare.
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Heimlich, Jonathan Brett, Godwin Chipoka, Portia Kamthunzi, Yuri D. Fedoriw, Nigel S. Key, Kenneth I. Ataga, and Satish Gopal. "Establishing Sickle Cell Diagnostics and Characterizing a Pediatric Sickle Cell Disease Cohort in Malawi." Blood 126, no. 23 (December 3, 2015): 2070. http://dx.doi.org/10.1182/blood.v126.23.2070.2070.
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Abstract Sickle cell disease (SCD) is highly prevalent in sub-Saharan Africa; however, there are relatively few studies describing the clinical profile for children with laboratory-confirmed SCD. Prior to December 2014, neither neonatal screening nor standardized methods for SCD diagnosis were routinely available in Malawi, as hemoglobin electrophoresis and alternative diagnostic methods were absent. We describe implementation of hemoglobin electrophoresis for children with clinically suspected SCD at Kamuzu Central Hospital, one of two national teaching hospitals in Malawi. Children with clinically suspected SCD were recruited January - May 2015 and underwent comprehensive clinical and laboratory characterization. 137 total patients were recruited and 117 were confirmed to have HbSS disease. Among children who were being cared for as SCD prior to enrollment, 86% had HbSS suggesting generally accurate clinical diagnosis by local providers. Baseline clinical parameters and self-reported SCD complications for the study population are displayed in Table 1. Of those with confirmed SCD, median age was 7.3 years (IQR 2.7-10.4) with 53% males. Prior malaria was reported by 39% of patients, and was higher in the 0-5 age group compared with the over 5 age group (46% vs. 31%, p=0.03). The most commonly reported SCD complications were anemia (72%), joint pain (56%), jaundice (52%), and acute pain episodes (50%). Children with confirmed SCD had median hemoglobin of 7.3 g/dL (IQR 6.9-7.9), total bilirubin of 1.7 mg/dL (IQR 1.1-2.6) and lactate dehydrogenase of 658 IU/L (IQR 527-773). Urinalysis demonstrated 26% of patients with blood and 7% with proteinuria by dipstick. As of May 2015, more than 250 samples for enrolled children as well as routine clinical care had been batch-processed weekly with an average turn-around time of 36 hours for results. Three Malawian laboratory technicians were trained to perform hemoglobin electrophoresis, all of whom have been performing the test independently since April 2015. Our findings highlight a need for wider implementation of resource-appropriate diagnostics as an essential foundation for care and research. Children had substantial clinical and laboratory evidence of SCD-related morbidity. Earlier diagnosis can improve care for this population by facilitating earlier therapeutic interventions, as well as providing a basis for research to better understand SCD-related morbidity in sub-Saharan Africa. These efforts can ultimately inform management strategies to improve outcomes and increase life expectancy among children with SCD in Malawi. Table 1. All (n=117) Male (n= 62) Female (n=55) p value Age years, median (IQR) 7.3 (2.7-10.4) 5.3 (2.3-9.4) 8.9 (4.2-11.9) 0.004 Height cm, median (IQR, n) 115 (88-131, 60) 111 (89-128, 36) 119.5 (93-140, 24) 0.21 Weight kg, median (IQR, n) 19 (13-27, 108) 16.5 (12-23.6, 58) 21 (14-30, 50) 0.01 Blood Pressure Systolic mmHg, median (IQR, n) 103 (98-110, 83) 101 (94-108, 43) 103 (99-110, 40) 0.37 Blood Pressure Diastolic mmHg, median (IQR, n) 60 (55-65, 83) 58 (53-65, 43) 61 (56-68, 40) 0.13 Heart Rate BPM, median (IQR, n) 104 (91-118, 114) 105 (94-123, 61) 104 (88-112, 53) 0.15 O2 Saturation %, median (IQR, n) 93 (88-97, 108) 91 (85-96, 59) 95 (91-98, 49) 0.004 % Hypoxemic (SPO2 < 90%), n (%) 36 (30.7) 26 (41.9) 10 (18.2) 0.005 Body Temperature Celsius, median (IQR, n) 37 (36.7-37.4, 91) 37 (36.7-37, 46) 37 (36.4-37.2, 45) 0.22 Positive History of: Malaria, n (%) 45 (38.5) 22 23 0.34 0-5 years, n (%) 25 (46.3) - - 0.03 6-18 years, n (%) 20 (31.7) - - Pneumonia, n (%) 29 (24.8) 10 (16.1) 19 (34.5) 0.02 HIV, n (%) 0 0 0 - Anemia, n (%) 84 (71.8) 49 (79.0) 35 (63.6) 0.06 Pallor, n (%) 16 (13.7) 7 (11.3) 9 (16.4) 0.43 Jaundice, n (%) 61 (52.1) 33 (53.2) 28 (50.9) 0.82 Received Blood Transfusion, n (%) 87 (74.4) 47 (75.8) 40 (72.7) 0.47 Days since last transfusion, median (IQR) 316 (133-1144) 240 (111-410) 577 (180-1784) 0.03 Pain episodes, n (%) 58 (49.6) 27 (43.5) 31 (56.4) 0.16 Joint pain, n (%) 66 (56.4) 33 (53.2) 33 (60.0) 0.34 Dactylitis, n (%) 41 (35.0) 19 (30.6) 22 (40.0) 0.29 Leg ulcers, n (%) 5 (4.3) 5 (8.1) 0 0.03 Stroke, n (%) 10 (8.5) 5 (8.1) 5 (9.1) 0.84 Nocturnal Enuresis, n (%) 24 (20.5) 12 (19.4) 12 (21.8) 0.74 Disclosures No relevant conflicts of interest to declare.
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Liu, Yan, Xie Tong Wang, Hong Yan Li, Hai Yan Hou, Hong Wang, and Yan Tun Wang. "Safety and Efficacy of Higher Order Multifetal Pregnancy Reduction: A Single-Center Retrospective Study." American Journal of Perinatology Reports 10, no. 03 (July 2020): e228-e233. http://dx.doi.org/10.1055/s-0040-1715167.
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Abstract Objective This research was aimed to study the safety and efficacy of higher order multifetal pregnancy reduction (MFPR). Study Design This was a retrospective study of patients from an academic maternity center between 2005 and 2015. We evaluated outcomes of 131 consecutive patients who underwent higher order MFPR (quadruplets and greater). MFPR was performed at 11 to 18 weeks of gestation in all cases. In total, 122 of 131 cases of higher order multiple pregnancy were reduced to twins. We discuss the perinatal outcomes of patients who underwent higher order MFPR, followed by a comparative analysis between the 122 cases of MFPR that were reduced to twins and 101 cases of nonreduced twin pregnancies. Results The study included 104 sets of quadruplets, 20 sets of quintuplets, 5 sets of sextuplets, 1 set of septuplets, and 1 set of octuplets. The perinatal outcomes of the 131 cases were as follows: pregnancy loss, preterm deliveries at 28 to 33 (+6/7) weeks, and preterm deliveries at 34 to 36 (+6/7) weeks occurred in 23.66, 9, and 37% of cases, respectively. The mean time of delivery was 36.56 ± 1.77 weeks, and mean birth weight was 2,409.90 ± 458.16 g, respectively. A total of 122 cases that were reduced to twins were compared with nonreduced twins. The pregnancy loss rate for reduced twins was significantly higher than that for nonreduced twins. The preterm labor rate, mean delivery week, mean birth weight, birth-weight discordance, incidence of gestational diabetes mellitus, and pregnancy-induced hypertension were not significantly different between the groups (p > 0.05). Conclusion Perinatal outcomes were significantly improved by reducing the number of fetuses in higher order multifetal pregnancies. This study involved a large, diverse sample population, and the results can be used as a reference while conducting prenatal counseling.
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Pasadyn, Selena R., Eric E. Roselli, Amanda S. Artis, Cassandra L. Pasadyn, Dermot Phelan, and Eugene H. Blackstone. "From Court to Couch: Exercise and Quality of Life after Acute Type A Aortic Dissection." AORTA 09, no. 05 (October 2021): 171–79. http://dx.doi.org/10.1055/s-0041-1731403.
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Abstract Background Acute Type A aortic dissection can be physically and mentally stressful with little known about survivors' postrepair activity levels, exercise habits, and quality of life (QOL). This study was aimed to describe pre- and postdissection changes regarding exercise, understand physician recommendations, quantify use of cardiac rehabilitation, and assess QOL in dissection survivors. Methods A total of 295 acute Type A aortic dissection survivors were surveyed about exercise, cardiac rehabilitation, QOL, sexual activity, and posttraumatic stress disorder (PTSD) with 137 (46%) respondents. Results Respondents were less likely to participate in competitive athletics after than before dissection (1/131 [0.76%] vs. 26/131 [20%], p [McNemar test] < 0.0001) or lift heavy objects (11/111 [9.9%] vs. 41/111 [37%], p < 0.0001). Forty-eight of 132 respondents (36%) did not participate in cardiac rehabilitation. Compared with general population norms, respondents reported lower median QOL physical component scores (40 [26, 51; 15th, 85th percentile], p < 0.0001); these were lower in respondents who did not exercise (Hodges–Lehmann [HL; 95% confidence interval (CI)]: –6.8 [–11, –2.4], p = 0.002), limited sexual activity (–8.0 [–13, –4.3], p = 0.0002), or screened positive for PTSD (–10 [–14, –5.3], p = 0.0002). Median mental component scores were similar to general population norms (HL [95% CI]: 55 [34, 61], p = 0.24) but were lower among respondents who did not exercise (–4.2 [–7.8, –1.0], p = 0.01), limited sexual activity (–5.5 [–10, –1.8], p = 0.003), or screened positive for PTSD (–16 [–22, –10], p < 0.0001). Conclusion Physicians should prescribe cardiac rehabilitation, encourage appropriate exercise, promote resumption of sexual activity, and identify and treat PTSD after surgery for acute Type A aortic dissection.
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Aiano, Felicity, Samuel E. I. Jones, Zahin Amin-Chowdhury, Jessica Flood, Ifeanyichukwu Okike, Andrew Brent, Bernadette Brent, et al. "Feasibility and acceptability of SARS-CoV-2 testing and surveillance in primary school children in England: Prospective, cross-sectional study." PLOS ONE 16, no. 8 (August 27, 2021): e0255517. http://dx.doi.org/10.1371/journal.pone.0255517.
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Background The reopening of schools during the COVID-19 pandemic has raised concerns about widespread infection and transmission of SARS-CoV-2 in educational settings. In June 2020, Public Health England (PHE) initiated prospective national surveillance of SARS-CoV-2 in primary schools across England (sKIDs). We used this opportunity to assess the feasibility and agreeability of large-scale surveillance and testing for SARS-CoV-2 infections in school among staff, parents and students. Methods Staff and students in 131 primary schools were asked to complete a questionnaire at recruitment and provide weekly nasal swabs for SARS-CoV-2 RT-PCR testing (n = 86) or swabs with blood samples for antibody testing (n = 45) at the beginning and end the summer half-term. In six blood sampling schools, students were asked to complete a pictorial questionnaire before and after their investigations. Results In total, 135 children aged 4–7 years (n = 40) or 8–11 years (n = 95) completed the pictorial questionnaire fully or partially. Prior to sampling, oral fluid sampling was the most acceptable test (107/132, 81%) followed by throat swabs (80/134, 59%), nose swabs (77/132, 58%), and blood tests (48/130, 37%). Younger students were more nervous about all tests than older students but, after completing their tests, most children reported a “better than expected” experience with all the investigations. Students were more likely to agree to additional testing for nose swabs (93/113, 82%) and oral fluid (93/114, 82%), followed by throat swabs (85/113, 75%) and blood tests (72/108, 67%). Parents (n = 3,994) and staff (n = 2,580) selected a preference for weekly testing with nose swabs, throat swabs or oral fluid sampling, although staff were more flexible about testing frequency. Conclusions Primary school staff and parents were supportive of regular tests for SARS-CoV-2 and selected a preference for weekly testing. Children preferred nose swabs and oral fluids over throat swabs or blood sampling.
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van der Straaten, Hanneke M., Martine M. Paquay, Marcel G. J. Tilanus, Leo F. Verdonck, and Cynthia Huisman. "No Direct Effect of NOD2/CARD15 Variants On Clinical Outcome After Non-Myeloablative Allogeneic Stem Cell Transplantation." Blood 114, no. 22 (November 20, 2009): 4322. http://dx.doi.org/10.1182/blood.v114.22.4322.4322.
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Abstract Abstract 4322 Background Single nucleotide polymorphisms (SNPs) in the innate immunity receptor NOD2/CARD15 have been demonstrated to modulate the outcome of allogeneic haematopoietic stem cell transplantation. The effect of the NOD2/CARD15 polymorphism seems to be associated with donor source as well as type of conditioning regimen. Methods We reviewed NOD2/CARD15 mutations in all donor/recipient pairs of 192 consecutive patients who received non-myeloablative allogeneic stem cell transplantation(SCT) at our institution between 2002 and 2006. All patients were treated uniformly with fludarabine 30 mg/m2/day for 3 days followed by 200 cGy TBI (n=154) or TBI alone (n=38) and received grafts from HLA-matched related (n=132) or unrelated (n=60) donors. Results Mutated alleles were observed in 36 of 192 (19%) patients and in 35 of 192 (18%) donors. These SNPs, however, did not have a significant impact on clinical outcome data (P > 0.05, Kaplan Meier and Fine & Gray's test). Acute graft-versus-host disease (GVHD) occurred in 24 of 61 (39%) patients with the polymorphism and in 66 of 131 (50%) patients without the polymorphism. Chronic GVHD developed in 28 of 55 (51%) patients with SNP pairs and in 79 of 121 (65%) patients with the wild type. The incidence of transplant-related mortality was 21% in both groups, 13 of 61 patients in the group with the polymorphism and 27 of 131 without the polymorphism. Relapse was seen in 23 of 61 (38%) patients with the SNP pairs and in 48 of 131 (37%) wild type patients. Finally, overall survival was 43% (26/61) in patients with the polymorphism and 39% (51/131) in patients without the polymorphism. Conclusion These data indicate that mutations in the NOD2/CARD15 genes do not influence the clinical outcome of non-myeloablative allogeneic SCT directly. Since NOD2/CARD15 variants are not recognized as a single significant prognostic factor, screening for NOD2/CARD15 when selecting a donor does not seem to have additional value in patients undergoing non-myeloablative SCT. Disclosures: No relevant conflicts of interest to declare.
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Karikari, Akosua B., Kwasi Obiri-Danso, Enoch H. Frimpong, and Karen A. Krogfelt. "Antibiotic Resistance ofCampylobacterRecovered from Faeces and Carcasses of Healthy Livestock." BioMed Research International 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/4091856.
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Campylobacteris of major significance in food safety and human and veterinary medicine. This study highlighted resistance situation in the area of veterinary public health in Ghana. Using selective mCCDA agar, isolates were confirmed phenotypically on API CAMPY and genotypically by multiplex PCR ofIpxAgene. The susceptibility profile of species to common and relevant antibiotics was determined by the Kirby-Bauer disk diffusion method. Cattle, sheep, goat, and pig faecal samples analysed, respectively, yielded 13.2% (16/121), 18.6% (22/102), 18.5% (25/135), and 28.7% (29/101)Campylobacterspecies while 34.5% (38/110), 35.9% (42/117), 23.9% (32/134), and 36.3% (37/102) were, respectively, recovered from the carcasses. Species identified in faeces wereC. jejuni35.8% (33/92),C. jejunisubsp.doylei4.3% (4/92),C. coli47.8% (44/92), andC. lari12.0% (11/92). Species discovered in carcasses wereC. jejuni83.9% (125/149),C. jejunisubsp.doylei2.0% (3/149),C. coli6.0% (9/149), andC. lari8.1% (12/149). Resistance ranged from 92 to 97% to theβ-lactams, 7 to 69% to the quinolones, 0 to 44% to the aminoglycosides, 97 to 100% to erythromycin, 48 to 94% to tetracycline, 45 to 88% to chloramphenicol, and 42 to 86% to trimethoprim/sulfamethoxazole as 0% resistance was observed against imipenem.
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Haferlach, Claudia, Alexander Kohlmann, Wolfgang Kern, Torsten Haferlach, and Susanne Schnittger. "Cytogenetic and Molecular Genetic Characterization Of MLL-PTD Positive AML In Comparison To MLL-Translocated AML." Blood 122, no. 21 (November 15, 2013): 2557. http://dx.doi.org/10.1182/blood.v122.21.2557.2557.
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Background Partial tandem duplications within the MLL gene (MLL-PTD) are a recurrent molecular alteration in acute myeloid leukemia (AML). MLL-PTD occurs with a frequency of 6-8% in de novo AML. Data on additional cytogenetic and molecular alterations in MLL-PTD+ AML is scarce. Beside partial tandem duplications within the MLL gene, the MLL gene is also a target of balanced translocations leading to the fusion of MLL with a large variety of partner genes. Aims 1. Evaluate the spectrum of additional cytogenetic and molecular genetic alterations. 2. Analyze whether additional aberrations impact prognosis. 3. Compare the spectrum of additional abnormalities between MLL-PTD+ AML and AML with MLL-translocations. Patients and Methods We selected a cohort of 225 de novo AML patients harboring a MLL-PTD. These were compared to a cohort of 130 de novo AML with MLL-translocation (MLL-t). Mutation screening for the following genes was performed in pts with MLL-PTD and MLL-t, respectively: ASXL1 (132; 85), CEBPA (184; 67), FLT3-ITD (225; 125), FLT3-TKD (208; 112), IDH1R132 (145; 88), IDH2R140 (141; 63), IDH2R172 (137; 73), KRAS (59; 82), NRAS (98; 82), RUNX1 (213; 97), NPM1 (221; 123), TP53 (104; 89), and WT1 (159; 86). EVI1 expression was assessed in 55 MLL-PTD+ pts and in 77 pts with MLL-t. Results The frequency of MLL-PTD and MLL-translocations differed significantly with respect to age. While MLL-PTD were more frequent in elderly pts, MLL-t were more frequent in younger pts (<10 yrs: 0%/2.3%; 10-19 yrs: 0%/3.8%, 20-29 yrs: 0.9%/13.1%, 30-39 yrs: 3.1%/9.2%, 40-49 yrs: 8.9%/23.1%; 50-59 yrs: 11.1%/13.1%; 60-69 yrs: 35.1%/13.8%; 70-79 yrs: 29.3%/13.8%; ≥80 yrs: 11.6%/7.7%; p<0.001). FAB subtype distribution differed significantly between of MLL-PTD+ and MLL-t AML. While in MLL-PTD+ AML most frequently subtypes M1 (33.8%) and M2 (43.6%) were observed, AML with MLL-t most frequently showed M4 (30%) and M5a (23.1%). The most frequent cytogenetic abnormalities in MLL-PTD+ cases were gains of 11q (n=37), followed by 8q (n=14), and 13q (n=7) and losses of 5q (n=14), 7q (n=14) and 17p (n=5). In contrast, in MLL-t patients the most frequent gains were trisomies 6 (n=7) and 8 (n=33), as well as gains of 1q (n=10), 19p (n=10), 19q (n=8) and 21q (n=21). There were many significant differences in co-occurring mutations between MLL-PTD+ and MLL-t: DNMT3Amut: 44.7% vs 0% (p<0.001), FLT3-ITD: 33.3% vs 3.2% (p<0.001), IDH1R132 14.5% vs 0% (p<0.001), IDH2R140: 19.9% vs 0% (p<0.001), IDH2R172 9.5% vs 0% (p=0.005), and RUNX1 25.8% vs 2.1% (p<0.001). On the other hand KRASmut (3.4% vs 23.2%, p=0.001) and NRASmut (8.2% vs 25.6%, p=0.002) were less frequent in MLL-PTD+ as compared to MLL-t AML. TP53 mutations were observed in comparable frequencies (3.8% vs 5.6%). NPM1 mutations were not detected in either entity. The mean EVI1 expression was significantly higher in MLL-t pts compared to MLL-PTD+ pts (167.1+/-259.1vs 0.4 +/- 0.47, p<0.001). Overall, chromosome abnormalities in addition to the MLL alteration were more frequent in MLL-t AML as compared to MLL-PTD+ AML (mean number of alterations: 1.2 vs 0.7, p=0.004). This goes along with more additional molecular mutations in MLL-PTD+ AML as compared to MLL-t AML (mean number of molecular mutations: 1.5 vs 0.6, p=0.004). Overall survival at 5 yrs was comparable in both subgroups (MLL-PTD+: 27.9% vs MLL-t: 39.8%). In both subgroups age was significantly associated with OS (<60 yrs vs ≥60 yrs: MLL-PTD+: 56.9 vs 16.3 months, MLL-t: 47.8 vs 9.7 months, for both p<0.001). Neither in MLL-PTD+ AML nor in MLL-t AML the presence of additional chromosome aberration had an impact on outcome. With respect to molecular mutations only IDH2R140 was significantly associated with shorter OS (HR: 2.2, p=0.007) and IDH2R172 with longer OS (HR: 0.2, p=0.04) in MLL-PTD+ AML. Conclusions Although both MLL-PTD+ and MLL-translocations disrupt the same gene AML harboring one or the other MLL abnormality differ significantly with respect to age distribution, the pattern of additional cytogenetic abnormalities and the frequency of accompanying molecular mutations. MLL-PTD is more frequent in older patients, presents most frequently as FAB M1 and M2, and harbors more additional molecular genetic events and less additional cytogenetic events. However, both AML subtypes are associated with adverse outcome, particularly in elderly patients. Disclosures: Haferlach: MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Kohlmann:MLL Munich Leukemia Laboratory: Employment. Kern:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Schnittger:MLL Munich Leukemia Laboratory: Employment, Equity Ownership.
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Bravetti, Marine, Levi-Dan Azoulay, Fleur Cohen-Aubart, Jean-François Emile, Zahir Amoura, Philippe Cluzel, and Julien Haroche. "Correlation of BRAF V600E mutation with cardiac involvement assessed by heart imaging in a monocentric series of 205 patients with Erdheim-Chester disease." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 7019. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.7019.
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7019 Background: Erdheim–Chester disease (ECD), an inflammatory myeloid neoplasm, is an histiocytosis associated with multisystem infiltration. Cardiovascular involvement in ECD is under-diagnosed and associated with poor outcome. The targetable BRAFV600Emutation is present in up to 70% of all ECD. Methods: Retrospective study of 205 patients (pts) with ECD who had cardiac imaging (195 MRI, 10 CT when MRI was contraindicated). We identified the types of lesions (infiltration, tumor, and effusion), localization (pericardial, myocardial, valvular) and consequences on cardiac function (coronary stenosis, atrial wall dyskinesia, diastolic and systolic functions). Results: 141 (68.8%) pts were male. 30 (14.6%) had mixed histiocytosis (mainly ECD + langerhans cell histiocytosis). BRAF mutation ( BRAFm) was found in 112 (54.6%) cases, while 59 pts (28.8%) were Wild Type (WT) and 34 pts (7.6%) had unknown BRAF status. Among the 205 cardiac imaging, 101 (49.3%) were abnormal. Cardiac involvement was found in 93 pts (49%). Among these, 72 had an impairment of the right ventricular atrioventricular sulcus (74%), 65 of the right atrium (RA) enclosure (69%). Alteration of Tricuspid Annular Plane Systolic Excursion was found in 15% and correlated with the size of the tumor. Pericardial involvement (effusion, thickening or contrast enhancement) was found in 59 pts (29%). Among BRAFm pts, 75 (67%) had a heart abnormality while 37 (33%) had normal imaging; Among WT pts 14 (23.7%) showed heart abnormality, whereas 45 (76.3%) had normal imaging (RR 2.8 (CI: 1.8-4.5); p = 1.8*10-7). A RA tumor was present in 51 (45.5%) BRAFm but only 6 (10.2%) WT pts respectively (RR 4.5 (CI : 2.0-9.8); p = 7*10-6). BRAFm was also associated with aortic infiltration (RR 1.76 (CI: 1.2–2.5)) and pericardial involvement (RR 2.12 (CI: 1.1–3.9), p = 0.0017). Conclusions: Cardiac infiltration is frequent in ECD (49.3%), especially RA tumor. BRAFm is associated with RA, aortic and pericardial involvements.
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Osoba, Osonde, and Bart Kosko. "Corrigendum to “Noise enhanced clustering and competitive learning algorithms” [Neural Netw. 37 (2013) 132–140]." Neural Networks 48 (December 2013): 206. http://dx.doi.org/10.1016/j.neunet.2013.05.004.
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Wnorowska, Urszula, Katarzyna Niemirowicz, Melissa Myint, Scott L. Diamond, Marta Wróblewska, Paul B. Savage, Paul A. Janmey, and Robert Bucki. "Bactericidal Activities of Cathelicidin LL-37 and Select Cationic Lipids against the Hypervirulent Pseudomonas aeruginosa Strain LESB58." Antimicrobial Agents and Chemotherapy 59, no. 7 (April 13, 2015): 3808–15. http://dx.doi.org/10.1128/aac.00421-15.
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ABSTRACTPseudomonas aeruginosaLiverpool epidemic strain (LES) infections in cystic fibrosis (CF) patients are associated with transmissibility and increased patient morbidity. This study was designed to assess thein vitroactivities of cathelicidin LL-37 peptide (LL-37) and select cationic lipids againstPseudomonas aeruginosaLESB58 in CF sputum and in a setting mimicking the CF airway. We found that LL-37 naturally present in airway surface fluid and some nonpeptide cationic lipid molecules such as CSA-13, CSA-90, CSA-131, and D2S have significant, but broadly differing, bactericidal activities againstP. aeruginosaLESB58. We observed strong inhibition of LL-37 bactericidal activity in the presence of purified bacteriophage Pf1, which is highly expressed byP. aeruginosaLES, but the activities of the cationic lipids CSA-13 and CSA-131 were not affected by this polyanionic virus. Additionally, CSA-13 and CSA-131 effectively prevent LESB58 biofilm formation, which is stimulated by Pf1 bacteriophage, DNA, or F-actin. CSA-13 and CSA-131 display strong antibacterial activities against different clinical strains ofP. aeruginosa, and their activities againstP. aeruginosaLESB58 and Xen5 strains were maintained in CF sputum. These data indicate that synthetic cationic lipids (mimics of natural antimicrobial peptides) are suitable for developing an effective treatment against CF lungP. aeruginosainfections, including those caused by LES strains.
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BARABANOV, ANDREI V., and NATALIA B. ANANJEVA. "Catalogue of the available scientific species-group names for lizards of the genus Phrynocephalus Kaup, 1825 (Reptilia, Sauria, Agamidae)." Zootaxa 1399, no. 1 (January 29, 2007): 1–56. http://dx.doi.org/10.11646/zootaxa.1399.1.1.
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This paper is a review of the specific taxonomy of the lizard genus Phrynocephalus Kaup, 1825. From 1771 to 2002, 140 species were either described as members of this genus, or of other genera but subsequently reffered to this genus. We have tried to review all the available information on the taxonomic status of these 140 names and the status of their name-bearing types. As a result of this review, 114 types are known to be extant, including 22 lectotypes and 5 neotypes designated in the present paper. As a conclusion of this preliminary analysis, we provisionally distribute these 140 names in 37 valid species names in the genus Phrynocephalus, 102 invalid synonyms of the latter names, and 1 nominal species now referred to another genus. The new subgenus Oreosaura subgen. nov. is described to accomodate viviparous species from Qinghai-Tibetan Plateau.
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Vachlepi, Afrizal, Didin Suwardin, and A. Zainal Abidin. "SIMULASI PENETAPAN KARAKTERISTIK PENGERINGAN SEMPROT LATEKS BERDASARKAN TEKNIK KOMPUTASI DINAMIKA FLUIDA." Jurnal Penelitian Karet 31, no. 1 (June 1, 2013): 30. http://dx.doi.org/10.22302/jpk.v31i1.131.
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Tujuan dari penelitian ini adalah untuk mempelajari karakteristik proses pengeringan lateks karet alam dengan alat pengering semprot menggunakan pendekatan teknik komputasi dinamika fluida (computational fluid dynamic/CFD). Kegiatan penelitian ini meliputi penentuan model CFD untuk menggambarkan sistem pengeringan semprot, penentuan kondisi batas simulasi, penentuan parameter operasi, dan simulasi pengeringan. Variasi perlakuan berupa kadar air lateks terdiri atas 65%, 70%, 75%, dan 80%. Sedangkan suhu udara pengering terdiri atas 140°C, 150°C, 160°C, 170°C, dan 180°C. Dari penelitian yang sudah dilakukan dapat disimpulkan bahwa kadar air lateks dan suhu udara pengering berpengaruh terhadap proses pengeringan kaitannya dengan kecepatan udara-partikel, waktu pengeringan, diameter partikel, kadar air produk, dan perubahan suhu udara-partikel. Simulasi CFD memprediksi diameter partikel produk akhir sekitar 130-135 micrometer dengan kadar air sekitar 0,32-0,58%. Suhu produk akhir yang keluar dari ruang pengering sekitar 37-54 °C. Diterima : 1 November 2012; Disetujui : 7 April 2013 How to Cite : Vachlepi, A., Suwardin, D., & Abidin, A. Z. (2013). Simulasi penetapan karakteristik pengeringan semprot lateks berdasarkan teknik komputasi dinamika fluida. Jurnal Penelitian Karet, 31(1), 30-44. Retrieved from http://ejournal.puslitkaret.co.id/index.php/jpk/article/view/131
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Kamimura, Naoki. "La relación de identidad de los cristianos del norte de África con la ejercitación espiritual, en las cartas de Agustín." Augustinus 64, no. 1 (2019): 153–72. http://dx.doi.org/10.5840/augustinus201964252/25310.
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In contributing to the debate on the transformation of late Roman world, some scholars have claimed that the boundaries between religious groups were fluid with external and internal factors. Christian identity was not characterised by clear indications of religious belief, observance, and practice. Some intriguing surveys have shown that the difference between Christians and pagans can be seen as part of a discursive binary. While the North African evidence of their identity allows us to consider the question of what it means to be a Christian, it is noteworthy that there is a comprehensive framework for the understanding of human behavior and thought: the ‘spiritual exercises’ in the Greco-Roman tradition. In the fourth and fifth centuries, Christian thinkers began to pursue the matter in question as being linked with the context of his concern for Christianness in late North Africa, the correlation still remains in question. In this article, therefore, first I examine how he referred to the Christian code of behavior in his letters. In particular, focusing my attention on epistolary correspondence of Augustine with two seemingly ‘pagans’, I show how he tried to impose the idea of ehe Christian norms of behavior on his correspondence –with Dioscorus (epp. 117 and 118) and with Volusianus (epp. 132, 135, and 137). Then I ask what Augustine understood by spiritual training. For the sake of clarity, I have divided the letters along he thematic line into three groups –the intellectual and therapeutic (ep. 26, 37, 56, 102, 162, 193, 202A, and 2*), the religious and eschatological (ep. 92, 130, 131, 137, and 157), and the exegetical aspect (ep. 28, 137, 149, 199, and 213). In each group I consider them chronologically as far as possible. Finally, I consider the principal feature of spiritual training, thereby coming to the enhancement of spiritual affinities, and mutual relationships of which he made use in speaking about Christian identity.
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Eberhard, Jakob, Olof Ståhl, Magdalena Cwikiel, Eva Cavallin-Ståhl, Yvonne Giwercman, Eva Cecilia Salmonson, and Aleksander Giwercman. "Risk factors for post-treatment hypogonadism in testicular cancer patients." European Journal of Endocrinology 158, no. 4 (April 2008): 561–70. http://dx.doi.org/10.1530/eje-07-0684.
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ObjectivesTesticular germ-cell cancer (TGCC) patients are at risk of developing hypogonadism but no risk factors have yet been defined.MethodsBlood was collected from 143 TGCC patients (after orchidectomy, prior to further therapy (T0) and 6, 12, 24, 36 and 60 months (T6, T12, T24, T36 and T60) after therapy). Biological hypogonadism (BH) was defined as: serum testosterone below 10 nmol/l and/or LH >10 IU/l; odds ratios (ORs) for BH with BH at T0, age, stage of disease, testicular characteristics, and androgen receptor polymorphism as predictors were calculated as well as the OR for developing BH post-treatment (one to two cycles of adjuvant chemotherapy (ACT) versus three to four cycles of higher dose chemotherapy (HCT) versus adjuvant radiotherapy (RT)).ResultsHCT increased the OR for BH at T6 (OR 22, 95% confidence interval (CI) 4.4–118) and T12 (OR 5.8, 95% CI 1.5–22). RT increased the OR at T6 (OR 10, 95% CI 2.1–47) and at T12 (OR 3.9, 95% CI 1.1–14). Microlithiasis predicted BH at T0 (OR 11, 95% CI 1.2–112), T12 (OR 3.9, 95% CI 1.1–13), T24 (OR 3.0, 95% CI 1.0–8.8), T36 (OR 5.4, 95% CI 1.7–17) and T60 (OR 4.4, 95% CI 1.2–16). BH at T0 was a risk for BH at T6 (OR 53, 95% CI 19–145), T12 (OR 125, 95% CI 37–430), T24 (OR 88, 95% CI 26–300) and T36 (OR 121, 95% CI 32–460).ConclusionsIt is clinically relevant that BH at T0 and testicular microlithiasis were predictive factors for post-treatment BH. HCT and RT gave temporary BH.
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Petrova, E. Y. "TEACHING ACADEMIC WRITING: CHALLENGES AND SOLUTIONS." Belgorod State University Scientific bulletin. Series Humanities 37, no. 1 (2018): 131–41. http://dx.doi.org/10.18413/2075-4574-2018-37-1-131-141.
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Yang, David T., Michele M. Flanders, and George M. Rodgers. "Increased Risk of Cerebrovascular Events Is Associated with Elevated Factor XI Activity." Blood 106, no. 11 (November 16, 2005): 2626. http://dx.doi.org/10.1182/blood.v106.11.2626.2626.
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Abstract High levels of factor XI as measured by antigenic methods have been implicated as a risk factor for deep venous thrombosis, and there is limited evidence that increased factor XI activity as measured by a functional assay is associated with cardiovascular disease. In the current study, we evaluated factor XI antigen, factor XI functional activity and high-sensitivity C-reactive protein (hs-CRP) from 123 patients under the age of 55 with normal prothrombin and partial thromboplastin times undergoing evaluation for a hypercoagulable state. Of the 123 patients, 80 had a history suggestive of arterial thrombosis (65 with stroke symptoms, 13 with transient ischemic attack symptoms, and 2 with other arterial thrombi), 17 had a history of venous thrombosis, and 26 had indeterminate histories for arterial or venous thrombosis. 40 age- matched healthy subjects were used to determine the upper limit of normal for factor XI activity as defined by the 95th percentile value (141%). 17/80 (21%) of patients with arterial thrombosis and 3/17 (18%) of the patients with venous thrombosis had above normal factor XI activity levels. Based on this, those with elevated factor XI activity have a relative risk of 5.3 for a cerebrovascular event. Regression analysis demonstrates that factor XI activity appears to correlate with factor XI antigen level (slope=0.79 and R=0.67), but there is no correlation between factor XI activity or factor XI antigen levels and hs-CRP (R= −.003 and R=.096 respectively). Our findings suggest that elevated factor XI activity is associated with an increased risk for cerebrovascular events and confirms that elevated factor XI levels are also associated with increased risk for venous thrombosis. In addition, assessment of factor XI levels by two methods, both functional activity and antigenic level, appear to correlate with one another to a fair degree suggesting that increased activity is likely related to increased levels of the protein itself. Lastly, lack of correlation with hs-CRP suggests that factor XI is not an acute-phase reactant. Population Characteristics n Mean Age Median Age Range Male:Female Normals 40 39±9 41 23–55 15:25 Arterial Thrombosis 80 42±8 43 20–55 36:44 Venous Thrombosis 17 38±11 37 20–54 7:10 Factor XI ActivityLevels Normal Arterial Thrombosis Venous Thrombosis Factor XI Activity (%) Mean±SD 101±23 136±111 111±36 Median 100 117 113 Range 57–155 55–675 71–196 95th percentile 141 # Cases above 95th percentile 2/40 (5%) 17/80 (21.3%) 3/17 (17.6%)
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Masuoka, Kazuhiro, Kazuya Ishiwata, Masanori Tsuji, Shinsuke Takagi, Hisashi Yamamoto, Yuki Mori, Naofumi Matsuno, et al. "Comparative Single Institute Analysis of Cord Blood Transplantation From Unrelated Donors with Unrelated Bone Marrow or Related Peripheral Blood Stem-Cell Transplants in Adult Patients with Acute Myeloid Leukemia / Myelodysplastic Syndrome." Blood 114, no. 22 (November 20, 2009): 3382. http://dx.doi.org/10.1182/blood.v114.22.3382.3382.
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Abstract Abstract 3382 Poster Board III-270 Recently, unrelated cord blood transplant (UCBT) has been widely applied to those who lack available related or unrelated donors. However, some results in those reports were conflicting, especially for transplantation-related mortality (TRM). The US study demonstrated a poor outcome for TRM in CBT recipients compared with human leukocyte antigen (HLA)–matched bone marrow transplant (BMT) recipients (NEJM. 2004; 351:2265). On the other hand, Takahashi et al showed excellent outcome (TRM 9% and disease free survival, DFS 70%) in CBT (Blood. 2007; 109:1322). Since there has been not much data available regarding this issue, we retrospectively extracted to adult patients with acute myeloid leukemia (AML) / myelodysplastic syndrome (MDS) and analyzed retrospectively the results of 245 recipients who underwent allogeneic stem cell transplantation (allo-SCT). We reviewed medical records of 290 patients with AML/MDS who had received allo-SCT from an unrelated donor between June 2000 and March 2009 at our institute, Tokyo, Japan. Since patients who had previous hematopoietic stem cell transplantations, active serious infection and performance status > 2, were excluded, 45 were subjected to the following analysis. Finally, the study includes 245 recipients of UCB (n = 140), UBM (n = 63), and related mobilized peripheral blood (RPB, n = 42) for de novo AML (n = 132), MDS overt AML (n = 79), refractory anemia (RA, n = 15), and refractory anemia with excess of blasts (RAEB, n = 19). Patient s median age for UCB, UBM, and RPB recipients were 59 (17 - 72), 55 (23 – 70), and 55 (22 – 67), respectively. UCB recipients had more serologically HLA-mismatched grafts (97% vs. 38% vs. 22%, P < .01), were conditioned more frequently with melphalan (75% vs. 27% vs. 20%, P < .01) and with total body irradiation (86% vs. 80% vs. 12%, P < .01 and used more tacrolimus (78% vs. 81% vs. 15%, P < .01) and less methotrexate (0% vs. 98% vs. 85%, P < .01) for graft-versus-host disease (GVHD) prophylaxis. Disease status consisted of standard (CR1 or CR2 of AML and RA, n = 62) and advanced groups(other status, n = 183). UCB recipients had significantly advanced status relative to UBM and RPB recipients (84% vs. 57% vs. 69%, P < .01) at the time of transplantation. Other characteristics such as sex, diagnosis, and body weight were balanced among three groups. Median follow-up time of survivors was 787 days (119 – 2314), 1050 days (244 – 3059), and 1287 days (141 – 3004) for UCB, UBM, and RPB recipients, respectively. The incidence of grade II–IV acute GVHD among evaluable UCB recipients was lower than those of UBM and RPB recipients (32% vs. 54% vs. 59%, P < .01). Similarly, the incidences of chronic GVHD for evaluable UCB, UBM, and RPB recipients were 36%, 69%, and 66%, respectively (P < .01). The estimated overall survival (OS) and DFS rates at 5 years post-transplantation were 36% (95% confidence interval Åm95%CIÅn; 25 - 47%) and 35% (95%CI; 26 - 44%) for UCB, 55% (95%CI; 40 - 69%) and 51% (95%CI; 37 - 64%) for UBM, and 39% (95%CI; 22 - 55%) and 25% (95%CI; 8 - 41%) for RPB (OS, P < .01 and DFS, P < .01). In the standard group, OS and DFS rates were not significantly different in the three groups (OS, UCB 63% vs. UBM 70% vs. RPB 49%, P = .39 and DFS, UCB 63% vs. UBM 70% vs. RPB 39%, P = .10). Similarly, in the advanced group, there were not significantly difference in the three groups (OS, UCB 30% vs. UBM 41% vs. RPB 35%, P = .23 and DFS, UCB 29% vs. UBM 38% vs. RPB 24%, P = .27). Compared with UBM and RPB recipients, UCB recipients had delayed hematopoietic recovery at 60 day (UCB 85% vs. UBM 97% vs. RPB 100%, Hazard ratio ÅmHRÅn= 0.49; 95%CI: 0.40 0.59; P < .01). Five-year estimated TRM and relapse rate (RR) were not significantly different in the three groups (TRM, UCB 34% vs. UBM 29% vs. RPB 50%, P = .39 and RR, UCB 30% vs. UBM 20% vs. RPB 28%, P = .28). < Conclusion> In this analysis, there was no apparent difference in the risks of TRM and RR between the UCB and UBM/RPB recipient groups. OS and DFS in both groups were also comparable among standard and advanced groups. Finally, our clinical results suggest that UCBT could be as safe and effective a stem-cell source as UBMT or RPB transplant for adult AML/MDS patient. Disclosures: No relevant conflicts of interest to declare.
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Prasad, Divya R., and Neelima V. Nair. "Study of perinatal outcomes in normal and borderline oligamnios." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 1 (December 26, 2019): 279. http://dx.doi.org/10.18203/2320-1770.ijrcog20196034.
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Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.
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RODRIGUES-LIMA, Fernando, Claudine DELOMÉNIE, Geoffrey H. GOODFELLOW, Denis M. GRANT, and Jean-Marie DUPRET. "Homology modelling and structural analysis of human arylamine N-acetyltransferase NAT1: evidence for the conservation of a cysteine protease catalytic domain and an active-site loop." Biochemical Journal 356, no. 2 (May 24, 2001): 327–34. http://dx.doi.org/10.1042/bj3560327.
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Arylamine N-acetyltransferases (EC 2.3.1.5) (NATs) catalyse the biotransformation of many primary arylamines, hydrazines and their N-hydroxylated metabolites, thereby playing an important role in both the detoxification and metabolic activation of numerous xenobiotics. The recently published crystal structure of the Salmonella typhimurium NAT (StNAT) revealed the existence of a cysteine protease-like (Cys-His-Asp) catalytic triad. In the present study, a three-dimensional homology model of human NAT1, based upon the crystal structure of StNAT [Sinclair, Sandy, Delgoda, Sim and Noble (2000) Nat. Struct. Biol. 7, 560–564], is demonstrated. Alignment of StNAT and NAT1, together with secondary structure predictions, have defined a consensus region (residues 29–131) in which 37% of the residues are conserved. Homology modelling provided a good quality model of the corresponding region in human NAT1. The location of the catalytic triad was found to be identical in StNAT and NAT1. Comparison of active-site structural elements revealed that a similar length loop is conserved in both species (residues 122–131 in NAT1 model and residues 122–133 in StNAT). This observation may explain the involvement of residues 125, 127 and 129 in human NAT substrate selectivity. Our model, and the fact that cysteine protease inhibitors do not affect the activity of NAT1, suggests that human NATs may have adapted a common catalytic mechanism from cysteine proteases to accommodate it for acetyl-transfer reactions.
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Jetty, V., G. Duhon, P. Shah, M. Prince, K. Lee, M. Goldenberg, A. Kumar, CJ Glueck, and P. Wang. "ID: 86: SAFETY OF 50,000-100,000 UNITS OF VITAMIN D3 PER WEEK IN VITAMIN D DEFICIENT, HYPERCHOLESTEROLEMIC PATIENTS, WITH STATIN INTOLERANCE." Journal of Investigative Medicine 64, no. 4 (March 22, 2016): 929.2–930. http://dx.doi.org/10.1136/jim-2016-000120.39.
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BackgroundIn ∼85–90% of statin intolerant patients, vitamin D deficiency (serum 25 (OH) D <32 ng/ml) is a reversible cause of statin intolerance, usually requiring 50,000 to 100,000 units of vitamin D/week continuously to normalize serum vitamin D, and thus successfully allow reinstitution of statins which previously could not be tolerated because of myalgia-myositis.Specific AimIn 274 statin intolerant patients, all with low entry serum vitamin D (<32 ng/ml, median 21 ng/ml), we assessed safety and efficacy of vitamin D supplementation (50,000–100,000 units/week) over treatment periods of 3 months (n=274), 3 and 6 months (n=161), 3, 6, and 9 months (n=58), and 3, 6, 9, and 12 months (n=22).ResultsIn the 385 patients with 3 month follow-up, taking mean 61,000 and median 50,000 IU of vitamin D3/week, median serum vitamin D rose from 20 to 42 ng/ml (p<0.0001); vitamin D became high (>100 ng/ml) but not toxic-high (>150 ng/ml) in 4 patients (1.0%) (101, 102, 106, 138 ng/ml). Median serum calcium was unchanged from entry (9.6 mg/dl) to 9.6 at 3 months. On vitamin D supplementation, the trend of change in serum calcium from normal-to-high or from high-to-normal did not significantly differ (McNemar S=1.0, p=0.32), and there was no significant trend in change of the calculated glomerular filtration rate (eGFR) from entry to follow-up (McNemar S=2.6, p=0.11).In the 161 patients with 3 and 6 month follow-up, taking mean 67,000 and median 50,000 IU of vitamin D3/week, median entry serum vitamin D rose from 21 to 42 to 44 ng/ml (p<0.0001), serum vitamin D was high (>100 but <150 ng/ml) in 2 patients at 3 months (1.2%, 101, 102 mg/ml) and in 3 (1.9%) at 6 months (101, 140, 140 ng/ml). Median serum calcium was unchanged from entry (9.7 mg/dl), at 3 and 6 months (9.7, 9.6 mg/dl, p>0.05). On vitamin D supplementation, the change in serum calcium from normal-to-high or high-to-normal was no significant trend (McNemar S=0.7, p=0.41), and no trend in change of eGFR (McNemar S=1.3, p=0.26).In the 58 patients with 3, 6, and 9 month follow-up on mean and median 71,000 and 100,000 IU of D3/week, median entry vitamin D rose from 20 to 37, 41, and 44 ng/ml (p<0.0001), with 1 (1.7%, 102 ng/ml), 2 (3.5%, 140, 140 ng/ml), and 0 (0%) patients high. Median serum calcium was unchanged from entry, median 9.7, 9.8, 9.6, and 9.6 mg/dl. On vitamin D supplementation, the trend of change in serum calcium from normal-to-high or high-to-normal was not significant (McNemar S=1.8, p=0.18), and no trend in change of eGFR (McNemar S=2, p=0.16).In the 22 patients with follow-up at 3, 6, 9, and 12 months on mean and median 70,000 and 75,000 IU of D3/week, median serum vitamin D rose from 20 to 37, to 41, to 44, and to 43 ng/ml (p<0.0001), with 1 (5%, 102 ng/ml) high, 2 (9%, 140, 140) high, 0 (0%) high, and 1 (5%, 126 ng/ml) high. Serum calcium was unchanged, median at entry 9.6, and then at 3, 6, 9, and 12 months 9.7, 9.7, 9.5, and 9.7 mg/ml. At entry serum calcium was normal in 21, none high, and one became high at 12 month follow-up. The trend of change in eGFR was insignificant, McNemar S=1.0, p=0.32.When serum D rose above 100 ng/ml in the few cases, as above, it fell into the normal range within 2 weeks by reducing the vitamin D dose by 50%.ConclusionsWhen 50,000–100,000 units of vitamin D/week are given to reverse statin intolerance in statin intolerant patients with low entry vitamin D (<32 ng/ml), it appears to be safe over up to 1 year follow-up, without toxic high serum vitamin D levels >150 ng/ml, and levels rarely >100 ng/ml, and without changes in serum calcium or eGFR.
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Filgueiras, Andreza Maria De Oliveira, Helene Santos Carvalho Pereira, Ruth Tramontani Ramos, Bruna Lavinas Sayed Picciani, Thays Teixeira de Souza, Lívia Maria Dos Santos Izahias, Geraldo Oliveira Silva-Junior, and Marília Heffer Cantisano. "Prevalence of oral lesions caused by removable prosthetics." Revistas 73, no. 2 (June 30, 2016): 130. http://dx.doi.org/10.18363/rbo.v73n2.p.130.
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The present study aimed to investigate the prevalence of injuries caused by removable prostheses in patients of clinical specialization in dentistry. Of 598 patients, 175 (29%) had some type of associated injury. The lesions found included erythematous candidiasis, inflammatory fibrous hyperplasia, inflammatory papillary hyperplasia, traumatic ulcer, angular cheilitis, irritative keratosis, and denture stomatitis. Inflammatory fibrous hyperplasia was the most prevalent lesion, found in 88 patients (50%), followed by erythematous candidiasis in 75 patients (43%). Of the total number of injured patients, 141 (81%) were women and 34 (19%) were men, and 101 patients (58%) were Caucasian and 37 (21%) were black. Most lesions were located in the upper alveolar ridge and the hard palate. The most widely used type of prosthesis was full upper prosthesis with 84 users (48%). The average usage time for all prostheses was 17 years (SD ± 13). Average patient age was 62 years (SD ± 14). The prevalence of injuries caused by removable prostheses is high, and prolonged use of the device and the presence of oral lesions are strongly associated. Moreover, women represent the largest number of users of the prostheses and therefore carry the majority of the injuries.
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Smith, Christiana, Adriana Weinberg, Jeri E. Forster, Myron J. Levin, Jill Davies, Jennifer Pappas, Kay Kinzie, Emily Barr, Suzanne Paul, and Elizabeth J. McFarland. "Maternal Lopinavir/Ritonavir Is Associated with Fewer Adverse Events in Infants than Nelfinavir or Atazanavir." Infectious Diseases in Obstetrics and Gynecology 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/9848041.
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Combination antiretroviral therapy (cART) is successfully used for prevention of perinatal HIV transmission. To investigate safety, we compared adverse events (AE) among infants exposed to different maternal cART regimens. We reviewed 158 HIV-uninfected infants born between 1997 and 2009, using logistic regression to model grade ≥1 AE and grade ≥3 AE as a function of maternal cART and confounding variables (preterm, C-section, illicit drug use, race, ethnicity, infant antiretrovirals, and maternal viremia). Frequently used cART regimens included zidovudine (63%), lamivudine (80%), ritonavir-boosted lopinavir (37%), nelfinavir (26%), and atazanavir (10%). At birth, anemia occurred in 13/140 infants (9%), neutropenia in 27/107 (25%), thrombocytopenia in 5/133 (4%), and liver enzyme elevation in 21/130 (16%). Corresponding rates of AE at 4 weeks were 59/141 (42%), 54/130 (42%), 3/137 (2%), and 3/104 (3%), respectively. Serious AE (grade ≥ 3) exceeded 2% only for neutropenia (13% at birth; 9% at 4 weeks). Compared with infants exposed to maternal lopinavir/ritonavir, infants exposed to nelfinavir and atazanavir had a 5-fold and 4-fold higher incidence of AE at birth, respectively. In conclusion, hematologic and hepatic AE were frequent, but rarely serious. In this predominantly protease inhibitor-treated population, lopinavir/ritonavir was associated with the lowest rate of infant AE.
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Kiraly, A., G. Suto, E. H. Livingston, P. H. Guth, S. St Pierre, and Y. Tache. "Central vagal activation by TRH induces gastric hyperemia: role of CGRP in capsaicin-sensitive afferents in rats." American Journal of Physiology-Gastrointestinal and Liver Physiology 267, no. 6 (December 1, 1994): G1041—G1049. http://dx.doi.org/10.1152/ajpgi.1994.267.6.g1041.
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The role of calcitonin gene-related peptide (CGRP) in the vagal cholinergic-mediated increase in gastric mucosal blood flow (GMBF) induced by the stable thyrotropin-releasing hormone (TRH) analogue RX-77368 injected intracisternally (ic, 30 ng) was investigated in urethan-anesthetized rats using the hydrogen gas clearance technique. alpha-CGRP (14 micrograms.kg-1.h-1) or bethanechol (150 micrograms.kg-1.h-1) infused close intra-arterially to the stomach or RX-77368 injected intracisternally increased GMBF by 76, 102, and 131%, respectively, 30 min after administration. The CGRP antagonist, human CGRP-(8-37) [hCGRP-(8-37)], injected intravenously (15 micrograms/kg bolus and 3 micrograms.kg-1.h-1) inhibited by 100, 97, and 73% the gastric hyperemic response to alpha-CGRP, TRH analogue, and bethanechol, respectively, whereas the substance P antagonist CP-96,345 (3 mg/kg iv) had no effect. In capsaicin-pretreated rats, hCGRP-(8-37) no longer blocked the increase in GMBF induced by intracisternal RX-77368. These results suggest that the gastric hyperemic response to central vagal activation induced by intracisternal TRH analogue at 30 ng is mediated by local effector function of capsaicin-sensitive afferent fibers releasing CGRP.
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Islam, Md Khairul, Pratyay Hasan, Md Murad Hossain, Fahima Sharmin Hossain, Tazdin Delwar Khan, Rifat Hossain Ratul, Motlabur Rahman, et al. "Prevalence of hypokalemia in COVID-19 and its association with clinical and common laboratory parameters." Journal of Dhaka Medical College 29, no. 2 (January 5, 2021): 131–37. http://dx.doi.org/10.3329/jdmc.v29i2.51187.
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Importance: Hypokalemia is a neglected common manifestation in COVID-19 patients admitted in hospital though it has serious consequences. Coronavirus may cause hypokalemia through disruptions of rennin-angiotensin system, gastrointestinal loss or other unknown mechanisms.
Objective: To investigate the prevalence of hypokalemia among patients with moderate to severe COVID-19 and its association with other clinical and laboratory parameters.
Design, Setting, and Participants: This was cross sectional observational study conducted at Dhaka medical College Hospital of Bangladesh from June, 2020, to August 2020. Participants were included who were positive for rt-PCR for COVID-19 according to the national guideline. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L).
Results: Prevalence of hypokalemia among patients with COVID-19 was 20.2%, severe hypokalemia (2 patients [1.5%]) and hypokalemia (25 patients [18.7%]). One thirty four (134) patients with positive COVID-19 were included. The mean [SD] age of these 134 patients according to different potassium levels appear to be : 68 [2.83] years for severe hypokalemia , 51.93[11.68] years for hypokalemia and 50.73[14.7] years for normokalemia. Among them, 46 patients were females [34.32%]) and rest were males [65.68%]. Within the total sum of 134 patients, 107 were identified having normokalemia, [79.9%]. 25 patients [18. 7%] had hypokalemia and only two patients [1.5%] were found having normokalemia. Among 134 patients, three commonest symptoms were fever (132 patients [98.5%]), dry cough (123 patients (91.79%) and shortness of breath (122 patients [91.04%]), followed by less common symptoms like fatigue (89 patients [66.410%]), sore throat (60 patients [44.77%]), and diarrhea (44 patients, [32.83%]). Shortness of breath was associated with grades of hypokalemia (P=0.022). Only 26 patients (19.4%) manifested having vomiting/Nausea. The predominant comorbidities found among these 134 participants were Hypertension (68 patients [64.2%]), Diabetes (54 patients [52.9%]), Ischemic heart disease (37 patients [38.1%]) and Asthma (27 patients [31.0%]). The prevalence of comorbidities was not associated with Hypokalemia.
Conclusions Prevalence of hypokalemia among patients with COVID-19 is high (20.2%) and appropriate treatment is highly required.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 131-137
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Cheng, B. F., G. Séguin-Swartz, and D. J. Somers. "Cytogenetic and molecular characterization of intergeneric hybrids between Brassica napus and Orychophragmus violaceus." Genome 45, no. 1 (February 1, 2002): 110–15. http://dx.doi.org/10.1139/g01-131.
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Twenty-two intergeneric hybrids from a cross between Brassica napus (AACC, 2n = 38) cultivar Oro and the ornamental crucifer Orychophragmus violaceus (OO, 2n = 24) were produced without embryo rescue. The plants were classified into three groups based on morphological and cytological observations and RAPD banding patterns. Plants of Group I had morphological traits of both parents and 2n = 29 chromosomes. In these plants, 62.1% of the pollen mother cells (PMCs) had the pairing configuration 1 III + 9 II + 8 I; the remaining PMCs had 10 II + 9 I. The plants possessed 97.698.8% B. napus specific and 9.211.7% O. violaceus specific RAPD fragments. Plants of Group II exhibited novel morphological traits and possessed 2n = 35, 36, or 37 chromosomes. Plants of Group III were morphologically similar to B. napus and possessed 2n = 19, 37, 38, or 39 chromosomes. Plants of Group II and Group III had 94.199.4% B. napus specific RAPD fragments and no O. violaceus specific RAPD fragments. Chromosome fragments were observed in PMCs of most of the F1 plants in all groups. Based on the cytological results and RAPD analysis, it is suggested that genome doubling and chromosome elimination occurred in the intergeneric hybrids of B. napus × O. violaceus.Key words: Brassica, intergeneric hybridization, meiosis, RAPD, chromosome elimination.
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Stengel, Anna, Rabia Shahswar, Torsten Haferlach, Wencke Walter, Stephan Hutter, Manja Meggendorfer, Wolfgang Kern, and Claudia Haferlach. "Whole transcriptome sequencing detects a large number of novel fusion transcripts in patients with AML and MDS." Blood Advances 4, no. 21 (November 4, 2020): 5393–401. http://dx.doi.org/10.1182/bloodadvances.2020003007.
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Abstract Fusion transcripts are frequent genetic abnormalities in myeloid malignancies and are often the basis for risk stratification, minimal residual disease (MRD) monitoring, and targeted therapy. We comprehensively analyzed the fusion transcript landscape in 572 acute myeloid leukemia (AML) and 630 myelodysplastic syndrome (MDS) patients by whole transcriptome sequencing (WTS). Totally, 274 fusion events (131 unique fusions) were identified in 210/572 AML patients (37%). In 16/630 MDS patients, 16 fusion events (15 unique fusions) were detected (3%). In AML, 141 cases comprised entity-defining rearrangements (51% of all detected fusions) and 21 (8%) additional well-known fusions, all detected by WTS (control group). In MDS, only 1 fusion was described previously (NRIP1-MECOM, n = 2). Interestingly, a high number of so-far unreported fusions were found (41% [112/274] in AML, 88% [14/16] in MDS), all validated by cytogenetic and/or whole genome sequencing data. With 1 exception (CTDSP1-CFLAR, n = 2), all novel fusions were observed in 1 patient each. In AML, cases with novel fusions showed concomitantly a high frequency of TP53 mutations (67%) and of a complex karyotype (71%), which was also observed in MDS, but less pronounced (TP53, 26%; complex karyotype, 21%). A functional annotation of genes involved in novel fusions revealed many functional relevant genes (eg, transcription factors; n = 28 in AML, n = 2 in MDS) or enzymes (n = 42 in AML, n = 9 in MDS). Taken together, new genomic alterations leading to fusion transcripts were much more common in AML than in MDS. Any novel fusions might be of use for developing markers (eg, for MRD monitoring), particularly in cases without an entity-defining abnormality.
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Riley, Christopher B., Kirsty L. Chidgey, Janis P. Bridges, Emma Gordon, and Kevin E. Lawrence. "Isolates, Antimicrobial Susceptibility Profiles and Multidrug Resistance of Bacteria Cultured from Pig Submissions in New Zealand." Animals 10, no. 8 (August 14, 2020): 1427. http://dx.doi.org/10.3390/ani10081427.
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Data on the scope of bacterial pathogens present and the frequency of antimicrobial resistance (AMR) in New Zealand’s pigs are limited. This study describes bacterial isolates, antimicrobial susceptibility data, and multidrug resistance (MDR; resistance to ≥3 antimicrobial classes) from New Zealand pig submissions. Porcine test data from June 2003 to February 2016 were obtained from commercial veterinary pathology laboratory records. In total, 470/477 unique submissions resulted in bacterial growth, yielding 779 isolates. Sample type was recorded for 360/477 (75.5%); lung (79/360; 21.9%), faecal (61/360; 16.9%) and intestinal (45/360; 12.5%) were most common. The most common isolates were Escherichia coli (186/779, 23.9%), Actinobacillus pleuropneumoniae (43/779; 5.5%), Streptococcus suis (43/779; 5.5%), unidentified Campylobacter spp. (38/779; 4.9%), alpha haemolytic Streptococci (32/779; 4.1%), coagulase negative Staphylococcus spp. (26/779; 3.3%), and Pasteurella multocida (25/779; 3.2%). Susceptibility results were available for 141/779 (18.1%) isolates from 62/470 (13.2%) submissions. Most were susceptible to trimethoprim-sulphonamide (75/81; 92.6%), but fewer were susceptible to penicillin (37/77; 48.1%), tilmicosin (18/43; 41.9%), or tetracyclines (41/114; 36.0%). No susceptibility data were available for Salmonella spp., Campylobacter spp., or Yersinia spp. isolates. MDR was present in 60/141 (42.6%) isolates. More data on sample submission drivers, antimicrobial drug use, and susceptibilities of important porcine bacterial isolates are required to inform guidelines for prudent antimicrobial use, to reduce their prevalence, human transmission, and to minimise AMR and MDR.
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Hayden, Mary K., Donald W. Blom, Elizabeth A. Lyle, Charity G. Moore, and Robert A. Weinstein. "Risk of Hand or Glove Contamination After Contact With Patients Colonized With Vancomycin-ResistantEnterococcusor the Colonized Patients' Environment." Infection Control & Hospital Epidemiology 29, no. 2 (February 2008): 149–54. http://dx.doi.org/10.1086/524331.
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Objective.To estimate the level of hand or glove contamination with vancomycin-resistant enterococci (VRE) among healthcare workers (HCWs) who touch a patient colonized with VRE and/or the colonized patient's environment during routine care.Design.Structured observational study.Setting.Medical intensive care unit of a 700-bed, tertiary-care teaching hospital.Participants.VRE-colonized patients and their caregivers.Methods.We obtained samples from sites on the intact skin of 22 patients colonized with VRE and samples from sites in the patients' rooms, before and after routine care, during 27 monitoring episodes. A total of 98 unique HCWs were observed during 131 HCW observations. Observers recorded the sites touched by HCWs. Culture samples were obtained from HCWs' hands and gloves before and after care.Results.VRE were isolated from a mean (±SD) of 55% ± 24% of patient sites (n= 256) and 17% ± 12% of environmental sites (n= 1,572). Most HCWs (131 [56%]) touched both the patient and the patient's environment; no HCW touched only the patient. Of 103 HCWs whose hand samples were negative for VRE when they entered the room, 52% contaminated their hands or gloves after touching the environment, and 70% contaminated their hands or gloves after touching the patient and the environment (P= .101). In a univariate logistic regression model, the risk of hand or glove contamination was associated with the number of contacts made (odds ratio, 1.1 [95% confidence interval, 1.01-1.19). In a multivariate model, the effect of the number of contacts could not be distinguished from the effect of type of contact (ie, touching the environment alone or touching both the patient and the environment). Overall, 37% of HCWs who did not wear gloves contaminated their hands, and 5% of HCWs who wore gloves did so (an 86% difference).Conclusion.HCWs were nearly as likely to have contaminated their hands or gloves after touching the environment in a room occupied by a patient colonized by VRE as after touching the colonized patient and the patient's environment. Gloves were highly protective with respect to hand contamination.
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Jarrousse, C., C. Carles-Bonnet, H. Niel, R. Sabatier, M. P. Audousset-Puech, P. Blache, A. Kervran, J. Martinez, and D. Bataille. "Inhibition of gastric acid secretion by oxyntomodulin and its 19-37 fragment in the conscious rat." American Journal of Physiology-Gastrointestinal and Liver Physiology 264, no. 5 (May 1, 1993): G816—G823. http://dx.doi.org/10.1152/ajpgi.1993.264.5.g816.
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Oxyntomodulin (Oxm) is a hormone, released from the intestine during digestion. Its target tissue is the gastric mucosa, where it inhibits acid secretion. It contains the 29-amino acid glucagon moiety, extended at its COOH-terminal end by an octapeptide. The glucagon moiety contains a basic doublet (Arg17-Arg18). Our working hypothesis was that the mode of action of Oxm may imply a processing of the molecule at the Arg-Arg doublet, releasing Oxm-(19-37). We compared the effect of Oxm with that of Oxm-(19-37) on gastric acid secretion in the conscious rat provided with a chronic gastric fistula. The acid secretion was plateau stimulated by a perfusion of either pentagastrin or histamine. Whereas Oxm or Oxm-(19-37) had no effect on basal acid secretion, both peptides inhibited pentagastrin (0.5 micrograms.kg-1.h-1)- and histamine (0.4 mg.kg-1.h-1)-stimulated acid secretion in a dose-dependent manner. When the metabolic clearance rate for each peptide was taken into account, the 19-37 fragment was as potent as the whole Oxm, regardless of the type of stimulant. When the dose of pentagastrin was increased from 0.175 to 1.1 micrograms.kg-1.h-1, the extent of inhibition induced by Oxm (40 pmol/kg) also increased. In contrast, when the dose of histamine was increased from 0.25 to 1.2 mg.kg-1.h-1, the extent of inhibition induced by Oxm (40 pmol/kg) decreased. Oxm-(19-37) (70-140 pmol/kg) displayed the same behavior as the whole molecule under both types of stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Groninger, John W., and Larry H. McCormick. "Effects of sulfometuron on hay-scented fern spore emergence." Canadian Journal of Forest Research 21, no. 6 (June 1, 1991): 942–43. http://dx.doi.org/10.1139/x91-131.
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A greenhouse experiment was conducted to examine the effects of the herbicide sulfometuron on hay-scented fern (Dennstaedtiapunctilobula (Michx.) Moore) spore emergence. Sulfometuron was applied at rates ranging from 0.025 to 0.21 kg active ingredient per hectare to forest soil inoculated with hay-scented fern spores. Emergence based on the occurrence of prothalli was evaluated 30, 37, 44, and 52 days after inoculation. Sulfometuron at all rates completely controlled spore emergence. The data suggest that applications of sulfometuron could be effective in preventing the sexual reproduction of ferns in forest stands following soil disturbance.
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Aoki, Naomi J., Kylie Venardos, Nick Andrianopoulos, Zoe K. Mcquilten, Amanda J. Zatta, Claire McLintock, Helen Savoia, and Erica M. Wood. "Use of Blood Components in Major Obstetric Hemorrhage: Preliminary Findings from the Australian and New Zealand Massive Transfusion Registry (ANZ-MTR)." Blood 124, no. 21 (December 6, 2014): 1563. http://dx.doi.org/10.1182/blood.v124.21.1563.1563.
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Abstract Introduction: Major obstetric hemorrhage (MOH) can develop rapidly and, due to the unique characteristics of maternity patients, early recognition and management can be challenging. Use of blood components in MOH can be life-saving however there is uncertainty about optimal use of these products and the role of adjunctive therapies. The ANZ-MTR generates observational data on current transfusion management and outcomes in critically bleeding patients receiving massive transfusion (MT) across all clinical settings. This study aimed to describe the transfusion strategies used in the MOH population and report their outcomes. Methods: Patients who had a MOH and received a MT (≥5 units of red blood cells [RBC] in 4h) between April 2011 and December 2013 at 15 Australian & NZ hospitals were identified. Data on the type and volume of blood products transfused as well as selected laboratory results and clinical outcomes were reviewed. Results: A total of 154 cases were identified and reviewed, representing 6% of the total ANZ-MTR cohort. Median age was 34 [IQR29-37] years and 99% of women had a Charlson Comorbidity Index score ≤ 1. Table 1 presents the blood products transfused. The median [IQR] fresh frozen plasma (FFP) to RBC ratio and platelets to RBC ratio was 0.6 [0.3-0.8] and 0.1 [0-0.2], respectively. FFP, platelets and cryoprecipitate were transfused in 87%, 66% and 49% of patients. Prothrombinex-HT was administered to 1 patient and 3 patients received rFVIIa. Table 2 presents the laboratory results taken prior to MT onset as well as the lowest and highest result reported within 24hours after the MT onset. Fibrinogen levels following MT onset was available for 121 (79%) patients. Of these, 46% women had a fibrinogen level <2 g/L of which 34% did not receive cryoprecipitate. Mean [SD] hemoglobin level 24h post-MT onset was 108g/L [19]. Regarding patient outcomes, median [IQR] hospital length of stay was 8 [4-43] days, 59 (38%) women were admitted to ICU, 40 (26%) underwent a subtotal or total hysterectomy and 3 (1.9%) died in-hospital. Table 1. Number of patients and median number of units transfused 24h post-MT onset (n = 154). Blood product n (%) Median units (IQR) Red blood cells 154 (100) 7 [6-10] Fresh frozen plasma 134 (87) 4 [2-6] Platelets 102 (66.2) 1 [0-1] Cryoprecipitate 76 (49.4) 0 [0-5] Table 2. Laboratory values* reported Value prior to MT onset Lowest value 0-24h post-MT onset Highest value 0-24h post-MT onset Hemoglobin (g/L) 102 [81-120], 84 77 [67-90]; 92 108 [95-119]; 92 INR 1.1 [0.9-1.2]; 33 1.1 [.9-1.2]; 72 1.3 [1.1-1.4]; 72 aPPT(s) 31 [28-35]; 39 31 [29-34]; 88 37 [33-46]; 88 Fibrinogen level (g/L) 3.2 [1.6-3.9]; 25 1.9 [1.4-2.6]; 79 2.9 [2.5-3.5]; 79 Platelet Count (109/L) 210 [158-249];84 102 [74-135]; 92 146 [110-190]; 92 pH 7.3 [7.3-7.4]; 22 7.3 [7.2-7.3]; 70 7.4 [7.4-7.5]; 70 *Data are Median [IQR]; % patients with laboratory test available Conclusion: Women with MOH requiring massive transfusion were generally healthier and younger than patients of other clinical contexts in the ANZ-MTR. Although there were few in-hospital deaths reported (1.9%), a large proportion of the cohort required a hysterectomy during their hospital admission. Further information on transfusion practice, including understanding optimal blood component ratios, is required to inform clinical practice and minimize risk in the obstetric setting. Disclosures McLintock: Novo Nordisk Australasia: Honoraria.
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Haas, Doris, Angela Kriso, Theresa Fritz, Herbert Galler, Juliana Habib, Mihaela Ilieva, Michael Kropsch, et al. "Background Concentrations of Cultivable, Mesophilic Bacteria and Dust Particles in the Air in Urban, Rural and Mountain Regions." International Journal of Environmental Research and Public Health 17, no. 24 (December 21, 2020): 9572. http://dx.doi.org/10.3390/ijerph17249572.
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Particulate air components can be of anthropogenic or natural origin. It is assumed that in different geographical areas varying concentrations of mesophilic bacteria are present in the ambient air. The aim of this study was to determine the background concentrations of airborne culturable mesophilic bacteria and particulate matter in the ambient air. Furthermore, the association between their concentrations and some environmental factors was analysed. In the period from July to October 2019, concentrations of mesophilic bacteria and dust particles were measured in urban, rural and mountain areas using the single-stage air sampler and the particle counter. The concentrations of bacteria and dust particles in the air were counted as number of Colony Forming Units per cubic metre (CFU/m3) and particles per cubic metre (pa/m3). Staphylococcus sp. were identified. The median values of the cultivated mesophilic bacteria at 30 °C and 37 °C were 7.1 × 102 CFU/m3 and 2.3 × 101 CFU/m3 in mountain regions, 1.3 × 102 CFU/m3 and 6.9 × 101 CFU/m3 in rural regions and 2.1 × 102 CFU/m3 and 6.5 × 101 CFU/m3 in urban regions. The median of Staphylococcus sp. was 2.5 × 100 CFU/m3 in alpine areas and 7.5 × 100 CFU/m3 in urban and rural areas. Higher bacterial concentrations were measured in sunshine and in windy weather. A relationship was observed between the concentrations of airborne mesophilic bacteria and the coarse particles in all three areas. The present study determined values between 5.0 × 100 and 4.6 × 102 CFU/m3 as natural background concentrations of airborne mesophilic bacteria and 1.2 × 107 pa/m3 and 6.5 × 104 pa/m3 for fine and coarse particles, respectively. These results can be proposed as baseline for the assessment of the emission sources of mesophilic bacteria for summer and early autumn.
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Crist, WM, AJ Carroll, JJ Shuster, FG Behm, M. Whitehead, TJ Vietti, AT Look, D. Mahoney, A. Ragab, and DJ Pullen. "Poor prognosis of children with pre-B acute lymphoblastic leukemia is associated with the t(1;19)(q23;p13): a Pediatric Oncology Group study." Blood 76, no. 1 (July 1, 1990): 117–22. http://dx.doi.org/10.1182/blood.v76.1.117.117.
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Abstract The prognostic significance of chromosomal translocations, particularly t(1;19) (q23;p13), was evaluated in children with pre-B and early pre-B acute lymphoblastic leukemia (ALL). Patients were treated on a risk- based protocol of the Pediatric Oncology Group (POG) between February 1986 and May 1989. An abnormal clone was detected in 46% (130 of 285) of pre-B cases and 56% (380 of 679) of early pre-B cases. Translocation of any type was associated with a worse treatment outcome than other karyotypic abnormalities: 15 of 66 versus 3 of 64 failed therapy in the pre-B group (P = .001), and 37 of 141 versus 23 of 239 failed in the early pre-B group (P less than .001). The t(1;19) (q23;p13) occurred significantly more often in cases of pre-B ALL with a clonal abnormality than in early pre-B ALL cases (29 of 130 v 5 of 380, P less than .001). Among the 285 pre-B cases in which bone marrow was studied cytogenetically, those with t(1;19) had a significantly worse treatment outcome than all others (11 of 29 v 27 of 256 have failed therapy, P less than .001). This difference is significant (P less than .001) after adjustment for leukocyte count, age, and other relevant features. Cases with the t(1;19) also had a worse prognosis than pre-B patients with other translocations (4 of 37 have failed, P less than .01) or with any other karyotypic abnormality (7 of 101 have failed, P less than .001). We conclude that chromosomal translocations confer a worse prognosis for non-T, non-B-cell childhood ALL, and that the t(1;19) is largely responsible for the poor prognosis of the pre-B subgroup.
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Crist, WM, AJ Carroll, JJ Shuster, FG Behm, M. Whitehead, TJ Vietti, AT Look, D. Mahoney, A. Ragab, and DJ Pullen. "Poor prognosis of children with pre-B acute lymphoblastic leukemia is associated with the t(1;19)(q23;p13): a Pediatric Oncology Group study." Blood 76, no. 1 (July 1, 1990): 117–22. http://dx.doi.org/10.1182/blood.v76.1.117.bloodjournal761117.
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The prognostic significance of chromosomal translocations, particularly t(1;19) (q23;p13), was evaluated in children with pre-B and early pre-B acute lymphoblastic leukemia (ALL). Patients were treated on a risk- based protocol of the Pediatric Oncology Group (POG) between February 1986 and May 1989. An abnormal clone was detected in 46% (130 of 285) of pre-B cases and 56% (380 of 679) of early pre-B cases. Translocation of any type was associated with a worse treatment outcome than other karyotypic abnormalities: 15 of 66 versus 3 of 64 failed therapy in the pre-B group (P = .001), and 37 of 141 versus 23 of 239 failed in the early pre-B group (P less than .001). The t(1;19) (q23;p13) occurred significantly more often in cases of pre-B ALL with a clonal abnormality than in early pre-B ALL cases (29 of 130 v 5 of 380, P less than .001). Among the 285 pre-B cases in which bone marrow was studied cytogenetically, those with t(1;19) had a significantly worse treatment outcome than all others (11 of 29 v 27 of 256 have failed therapy, P less than .001). This difference is significant (P less than .001) after adjustment for leukocyte count, age, and other relevant features. Cases with the t(1;19) also had a worse prognosis than pre-B patients with other translocations (4 of 37 have failed, P less than .01) or with any other karyotypic abnormality (7 of 101 have failed, P less than .001). We conclude that chromosomal translocations confer a worse prognosis for non-T, non-B-cell childhood ALL, and that the t(1;19) is largely responsible for the poor prognosis of the pre-B subgroup.
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Ockerby, SE, DJ Lyons, GD Keefer, FPC Blamey, and DF Yule. "Irrigation frequency and nitrogen fertilizers modify cotton yield at Emerald, central Queensland." Australian Journal of Agricultural Research 44, no. 6 (1993): 1389. http://dx.doi.org/10.1071/ar9931389.
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Four irrigation frequencies and six nitrogen (N) fertilizer rates (0-300 kg ha-1) were applied to cotton (Gossypium hirsutum L.) grown on three Vertisols in the Emerald Irrigation Area, central Queensland. The purpose was to describe lint production responses to the plant available water before irrigation and N fertilizer, in terms of the crop N content and the efficiency of crop N use for lint production. Lint yield was greatest when the plant available water before irrigation was 50-80010 of the plant available water capacity (PAWC) of each soil. The rate of N fertilizer for maximum yield varied with plant available water and soil type. Plant available water before irrigation >60% and <37% PAWC, and rain after irrigation reduced the crop N content at the time of maximum leaf area index. Relative yield generally responded to 130 kg crop N ha-', although the range from 101 to 141 kg crop N ha-1 reflected differences in the maximum yield of each treatment. If the crop N was <130 kg ha-1, yield was mostly determined by the crop N content, whereas if the crop N content was >130 kg ha-1, yield and the efficiency of crop N use for lint production was determined by the plant available water before irrigation and soil type. Nitrogen fertilizer strategies to achieve the maximum yield of cotton (var. Deltapine 61) should focus on obtaining 130 kg crop N ha-1. This crop N content produced maximum yields for a range of plant available water contents before irrigation, and for three soil types.
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Batluk, T. I., D. V. Denisova, I. P. Berezovikova, L. V. Sherbakova, S. K. Malyutina, and Y. I. Ragino. "Associations of polyphenolic compounds consumption and the risk of dyslipidemia in the Siberian population." Russian Journal of Cardiology 25, no. 5 (June 8, 2020): 3773. http://dx.doi.org/10.15829/1560-4071-2020-3773.
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Aim. To identify associations of polyphenols consumption in general, as well as their classes with the risk of dyslipidemia in the population of Novosibirsk aged 45-69.Material and methods. In 2003-2005, in the frames of the HAPIEE international project “Determinants of cardiovascular diseases in Eastern Europe: a multicenter cohort study” the population sample aged 45-69 (9360 people, 4266 men and 5094 women, average age - 57.6 years) was examined in Novosibirsk. For the analysis of nutrition, a Food Frequency Questionnaire (FFQ) was used (141 product names). The content of polyphenolic compounds and their classes was evaluated using the European database Phenol-Explorer 3.6. The eating habits of the population and typically consumed foods were taken into account. The determination of total cholesterol and HDL cholesterol levels were carried out by enzymatic method. Hypercholesterolemia was diagnosed with cholesterol level greater than 5.0 mmol/l (190 mg/dL). Levels of HDL cholesterol <1.0 mmol/l in men and <1.2 mmol/l in women were considered as high-density lipoprotein hypocholesterolemia (hypoHDL-C). The concentration of low-density lipoprotein cholesterol was calculated with the Friedewald formula (1972). HyperLDL-C was diagnosed if level of LDL cholesterol was <3.0 mmol / l.Results. The chance of developing of hypercholesterolemia in the quartile with the highest consumption of “other polyphenols” was 20% less (OR 1.2 confidence interval (CI 1.01-0.14), p = 0.033), phenolic acids by 20% (OR 1.2 (CI 1.01-1.42), p = 0.04) and stilbenes by 37% (OR 1.37 (CI 1.15-1.64), p = 0.001) less than in the quartile of low consumption. The risk of developing hypoHDL-C was lower in the quartile of high polyphenols consumption in general by 18% (OR 1.18 (CI 1.002-1.4), p = 0.051), phenolic acids by 32% (OR 1.32 (CI 1.11-1.57), p = 0.001) and the groups of “other polyphenols” by 20% (OR 1.2 (CI 1.01-1.41), p = 0.04). The chance of hyperLDL-C in the high quartile of consumption of “other polyphenols” decreased by 16% (OR 1.16 (CI 1.002-1.355), p = 0.049) and lignans - by 33% (OR 1.33 (CI 1.14-1, 56), p <0.001) compared with low consumption.Conclusion. Thus, the consumption of polyphenols in general and in classes (phenolic acids, stilbenes, and “other polyphenols”) decreased the risk of dyslipidemia in Siberian population.
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Яременко, М. I. "Квазiлiнiйнi системи параболiчних диференцiальних рiв- нянь в дивергентнi формi з форм-обмеженими коефiцiєнтами." Науковий вісник Ужгородського університету. Серія: Математика і інформатика, no. 2(37) (November 25, 2020): 130–41. http://dx.doi.org/10.24144/2616-7700.2020.2(37).130-141.
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В роботi дослiджуються квазiлiнiйнi системи параболiчних диференцiальних рiвнянь в дивергентнi формi другого порядку з сингулярними коефiцiєнтами за умов форм-обмеженостi i лiнiйного росту нелiнiйного збурення. Встановлюється iснування розв’язку першої крайової задачi для квазiлiнiйної системи параболiчних диференцiальних рiвнянь за умов форм-обмеженостi i лiнiйного росту в просторi Соболева. Розглядаються умови за яких нелiнiйне збурення параболiчного диференцiального оператору обмежене лiнiйною функцiєю з коефiцiєнтами, якi можуть бути сингулярними за просторовою змiною, в лiнiйному випадку цi коефiцiєнти належать функцiональним класам Като та Неша
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Zunaira Javed, Syed Usman Masood, and Javed Laal. "Outcome of acute bacterial meningitis among children in Tertiary care hospital." Professional Medical Journal 29, no. 02 (January 31, 2022): 167–71. http://dx.doi.org/10.29309/tpmj/2022.29.02.6533.
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Objective: To determine the frequency of Hemophilus Influenzae type b, streptococcus pneumonia and Niesseria Meningitidis and outcome in culture proven meningitis in children 6 months to 24 months of age admitted in children ward. Study Design: Cross Sectional Analytical study. Setting: Pediatric Medical Unit of Bahawal Victoria Hospital, Bahawalpur. Period: January 2019 to December 2019. Material & Methods: A total of 220 children of either sex with culture proven meningitis, aged 6 months to 24 months, were included in the study. Demographic characteristics, duration of fever, history of seizures, weight of child, vaccination status and bacteria isolated from Cerebrospinal Spinal Fluid (CSF) and outcome were analyzed. Confidentiality of data was maintained and it was assured that no harm to the participants will be done. The outcome in the form of mortality was noted during the first 10 days of hospital stay. There was no conflict of interest among the authors and study was self-funded. Results: Amongst a total of 220 children, 123 (55.9%) were male. There were 130 (59.1%) children who were less than or equal to 1 year of age. There were 154 (70.0%) children who were having a weight of 7 to 10 kg. Vaccination status showed that, 111 (50.5%) were fully vaccinated, 59 (26.8%) partially vaccinated and 50 (22.7%) not vaccinated. Duration of fever revealed that, 141 (64.1%) had fever for more than 5 days. There were 139 (63.2%) children who had a history of seizures. Streptococcus pneumonia was the commonest bacteria found in 110 (50%) children followed by Neisseria meningitides 53 (24.1%), H. Influenza 37 (16.8%). Overall mortality was noted in 34 (15.5%) children. Conclusion: In children with bacterial meningitis, mortality was high and most common bacteria were found to be S.pneumoniae followed by H.influenzae.
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Schmolke, M., F. X. Beck, and W. G. Guder. "Effect of antidiuretic hormone on renal organic osmolytes in Brattleboro rats." American Journal of Physiology-Renal Physiology 257, no. 5 (November 1, 1989): F732—F737. http://dx.doi.org/10.1152/ajprenal.1989.257.5.f732.
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Homozygous Brattleboro rats were used to study the effect of antidiuretic hormone (ADH) on organic osmolytes, which have been shown to be involved in the cellular osmoadaptation in renal inner medulla. With the use of enzymatic spectrophotometric methods, glycerophosphorylcholine, sorbitol, and inositol were determined in kidney sections from papillary tip (IM3) to cortex. Compared with normal rat kidneys, IM3 of untreated Brattleboro rats (urine osmolality 132 mosmol/kg) were sorbitol depleted (16 +/- 1 vs. 371 +/- 37 mumol/g protein) and glycerophosphorylcholine was reduced to 20% (131 +/- 16 vs. 658 +/- 52 mumol/g protein). In contrast inositol was not changed (147 +/- 25 vs. 177 +/- 29 mumol/g protein). Similar effects were obtained in all medullary sections. Continuous treatment with ADH increased urine osmolality already after 5 h but renal glycerophosphorylcholine and sorbitol content only after 24 h. Normal osmolyte levels were reached after 3 days of ADH treatment when urine osmolality was 1,595 mosmol/kg. Inositol did not exhibit comparable changes during ADH treatment. The present results indicate that ADH, possibly by increasing interstitial tonicity, leads to increased glycerophosphorylcholine and sorbitol, but not inositol, contents.
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Masum, M. D., Rajee Mahmud Talukder, Shams Ibne Maksud, Enamul Haque, Jubaida Khanam, Sharif Hossain, and S. M. Talukder. "Evaluation of predictors of erectile dysfunction and hypogonadism in men with types 2 diabetes mellitus." International Journal of Advances in Medicine 7, no. 12 (November 23, 2020): 1767. http://dx.doi.org/10.18203/2349-3933.ijam20205038.
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Background: Now a day erectile dysfunction (ED) and hypogonadism of the patients with type 2 diabetes mellitus (T2DM) become two common complaints. The association among hypogonadism, erectile dysfunction and type 2 diabetes of man seem to be increased. The aim of this study was to evaluate the predictors of erectile dysfunction and hypogonadism in men with types 2 diabetes mellitus (T2DM). Methods: This was a cross-sectional study which was conducted in the Department of Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh Hospital, Bangladesh during the period from January 2019 to December 2019. In total 352 newly detected T2DM male patients, with complete data were finalized as the study population. All data were processed by using SPSS program version 23.0.Results: In this study, according to complement fixation test (cFT) and androgen deficiency in the aging male (ADAM) criteria, 119 (33.81%) participant had low cFT& ADAM positive under hypogonadal, 84 (23.86%) were with normal TT & ADAM negative (eugonadal), 37 (10.51%) were with low TT & ADAM negative (eugonadal), 112 (31.82%) were with normal TT & ADAM positive (eugonadal). On the other hand, according to the cFT and ADAM score in total 119 (33.81%) hypogonadal patients were with low cFT & ADAM positive. Besides this, 102 (43.78%) eugonadal patients were with normal cFT & ADAM negative and 131 (56.22%) eugonadal patients were with normal cFT & ADAM positive.Conclusions: Hence, universal screening of testosterone level and androgen deficiency symptoms is recommended in newly detected T2DM patients.
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Colombo Breda, Jéssica, Adriana Dalpicolli Rodrigues, Patrícia Wilmsen Dalla Santa Spada, and Tânia Torriani. "Hemoparasitoses em cães: análise de dados laboratoriais." Revista Acadêmica Ciência Animal 16 (November 26, 2018): 1. http://dx.doi.org/10.7213/1981-4178.2018.16016.
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AO objetivo desse trabalho foi avaliar a ocorrência de hemoparasitos em cães, consultando os laudos de análises sanguíneas de um laboratório de análises clínicas veterinárias do município de Bento Gonçalves, RS. Para tanto, foram avaliados 413 laudos emitidos de janeiro a junho do ano de 2013, cuja técnica utilizada foi a hematoscopia. Dos laudos avaliados com hemoparasitos, 45/53 (84,9%) apontaram eritrócitos parasitados por Babesia sp./Rangelia vitalli, 5/53 (9,4%) para leucócitos parasitados e níveis plaquetários diminuídos devido à Ehrlichia sp., e 3/53 (5,7%) parasitados simultaneamente por Babesia sp./R. vitalli e Ehrlichia sp. As amostras também foram caracterizadas pela evidência de anemia, sendo que 120/413 cães (29,1%) apresentavam quadro anêmico, 40 desses hemoparasitados; 293/413 (70,9%) não apresentaram anemia e 13/293 desses eram hemoparasitados. Na série vermelha, estavam laudados quadros de anisocitose, policromatofilia e/ou presença de eritroblastos para 129/413 (31,2%) cães, sendo 43/129 hemoparasitados; já 284/413 (68,8%) cães não apresentaram alterações da série vermelha, sendo 10/284 hemoparasitados. Para a série branca, 301/413 cães (72,9%) foram indicados com quadros de leucocitose, leucopenia, linfocitose e/ou neutrofilia, sendo que 50/301 desses (24,9%) eram hemoparasitados; 112/413 (27,1%) não apresentaram alterações da série branca, onde 3/112 eram hemoparasitados. Quanto às alterações plaquetárias, a trombocitopenia foi detectada em 131/413 (31,7%) cães, sendo 37/131 desses hemoparasitados; 282/413 (68,3%) não apresentaram alterações, dos quais 16/282 eram hemoparasitados. Mediante esses achados, pode-se constatar que as alterações hematológicas geralmente estão associadas à presença de hemoparasitos e os resultados servem para alertar sobre a importância do manejo adequado do local de vivência dos cães, certificando-se da ausência de carrapatos.