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Li, Juan, Hong-Zheng Li, Guang-Hui Zhu, Rui-Ke Gao, Ying Zhang, Wei Hou, and Jie Li. "Efficacy and safety of Kanglaite injection combined with first-line platinum-based chemotherapy in patients with advanced NSCLC: a systematic review and meta-analysis of 32 RCTs." Annals of Palliative Medicine 9, no. 4 (July 2020): 1518–35. http://dx.doi.org/10.21037/apm-20-616.
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Garcia-Rodriguez, Agustin, Alfredo Marin-Cardenas, Nelsy Herrera-Coello, Inocencia Diaz-Rodriguez, and Leandro Marrero-Suarez. "Produccion de biomasa proteica a partir de jugo de caña." Respuestas 4, no. 1 (June 18, 2016): 32–34. http://dx.doi.org/10.22463/0122820x.616.
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En el presente trabajo se analiza la utilizacion de una cepa de levadura aislada del jugo fermentado espontaneamente en la produccion de biomasa proteica para la alimentcion animal.El proceso se realiza con un sustrato no esteril constituido por jugo de caña suplementado con miel final.Como fuente de nitrogeno se emplea urea y se complementaron los nutrientes con sales minerales.La temperatura utilizada oscilo entre 32 y 35° C con una aireacion continua. El trabajo se realizo en tres escalas:laboratorio,piloto e industrial .El metodo empledo consistio en cultivo a batch incrementado. Los estudios realizados las diferentes escalas permitieron conformar una tecnologia de produccion de biomasa con alto contenido proteico (superior al 20% PV.b.s), a partir del jugo de caña por un proceso controlado, no esteril factible de introducir en instalaciones edañas los Centrales Azucareros.Se realizo ademas la evauacion zootecnica de cerdos alimentados con esta biomasa como suplemento del alimento base, en un centro genetico porcino cercano a la instalacion industrial.Palabras clave: Fermentación, Cepas, Rustica, Levadura, Alimentación.
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Safarov, Dzh A. "Behavioral risks of student dental health." Kazan medical journal 100, no. 4 (July 31, 2019): 616–21. http://dx.doi.org/10.17816/kmj2019-616.
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Aim. To increase the effectiveness of treatment and prevention of periodontal diseases in smoking students.
Methods. A comprehensive dental examination and survey was conducted among 380 students 180 of whom were smokers, and the other 200 students were not tobacco smokers. The students were comparable by age (mean age 21.1±0.09 and 21.4±0.10 years, p=0.1009) and the initial state of the oral cavity. To assess the effectiveness of treatment and preventive measures, smoking students with inflammatory changes in periodontium were divided into the groups. The first group (52 subjects) was divided into three subgroups: 1a (n=15) — removal of plaque by the piezoelectric ultrasound apparatus Vector; 2a (n=20) — use of the Air-Flo C2 air-abrasive apparatus; 3a (n=17) — use of Gracey curette. The second group (n=32) was divided into two subgroups: control (n=15) where only conventional therapy was applied, including professional oral hygiene (removal of supra- and subgingival dental deposits) and the main one (n=17), where, unlike the control group, additional supportive therapy was introduced with Antitobacco Chamomile-Sage conditioner. Repeated clinical examinations were carried out 1 and 6 months after the completion of treatment using periodontal and hygienic indices.
Results. Students were found to have caries and periodontal inflammation but it was more pronounced in patients with a bad smoking habit in history: 4.37±0.12 and 3.98±0.09 — the intensity of caries in smokers and non-smokers, respectively (p <0.05). Among the smoking students in relatively rare cases a healthy periodontium was detected: 2.78±1.22, versus 9.0±2.02 in the group of non-smoking students (p <0.05). With the inclusion of Antitobacco Chamomile-Sage conditioner in the complex therapy, the values of OHI-S and papillary marginal attachment indices were significantly lower than in the control group 1 and 6 months after treatment. A comparative analysis of the data obtained in another treatment group, divided into three subgroups, revealed that with the use of Gracey curette a more pronounced positive shift in the indices was observed.
Conclusion. Favorable dynamics in the reduction of hygienic and periodontal indices at all stages of the research, indicating improvement of oral hygiene and periodontal condition, was recorded when using periodontal Gracey curette and “Antitobacco Chamomile-Sage” herbal conditioner in the complex treatment.
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Guler, Hans-Peter, Kai-U. Eckardt, Jürgen Zapf, Christian Bauer, and E. Rudolf Froesch. "Insulin-like growth factor I increases glomerular filtration rate and renal plasma flow in man." Acta Endocrinologica 121, no. 1 (July 1989): 101–6. http://dx.doi.org/10.1530/acta.0.1210101.
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Abstract. Recombinant IGF-I was infused sc at a dose of 20 μg · kg−1 · h−1 to 2 healthy subjects during a total of 79 h. Serum levels of IGF-I rose from 93 and 177 to 502 and 616 μg/l, respectively. Fasting blood glucose remained normal. During the infusion, glomerular filtration rate increased by 31% in subject No. 1 and by 32% in subject No.2. Concomitantly, renal plasma flow increased by 26% and 22%, respectively. Proximal and distal tubular reabsorption of fluid and sodium as determined by lithium clearance was elevated to a similar extent. When determined again one week after the end of the IGF-I infusion, all parameters of renal function had returned to baseline. Sodium excretion, body weight and blood pressure did not change. We conclude that IGF-I infused at pharmacological doses has marked effects on kidney function. Future studies will be necessary to define the clinical potential of recombinant IGF-I in the treatment of diseases characterized by impaired renal perfusion and filtration.
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Kagemoto, Kaizo, Koichi Okamoto, Toshi Takaoka, Yasushi Sato, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, et al. "Detection of aberrant crypt foci with image-enhanced endoscopy." Endoscopy International Open 06, no. 08 (August 2018): E924—E933. http://dx.doi.org/10.1055/a-0621-8794.
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Abstract Background and study aims Conventional detection of aberrant crypt foci (ACF) with dye-spraying and magnifying observation is labor- and skill-intensive. We performed a prospective non-inferiority study to investigate the utility of image-enhanced endoscopy (IEE) for detection of ACF. Patients and methods Patients with a history of colorectal neoplasm were eligible. The number of ACF in the lower rectum was counted first using IEE magnification with narrow-band imaging (NBI) or blue-laser imaging (BLI), and subsequently using the methylene blue method. The primary endpoint was the ACF detection rate with IEE, i. e., the number of ACF detected with IEE relative to the number of ACF detected with methylene blue. The secondary endpoints were bowel preparation time, ACF detection time, and the detection rate with NBI or BLI. Results A total of 40 patients were enrolled (NBI 20 and BLI 20). The overall detection rate for ACF with IEE was 81.7 % (503/616; 95 %CI 78.8 – 84.6 %), meeting the primary endpoint. The detection rate for ACF with BLI (84.9 %, 258/304) was significantly higher than with NBI (78.5 %, 245/312; P < 0.05). Both bowel preparation time and ACF detection time were significantly shorter with IEE versus the methylene blue method (P < 0.01, respectively). The detection rates for dysplastic and non-dysplastic ACF with IEE were 84.4 % (27/32) and 80.3 % (469/584), respectively. Conclusion IEE is able to detect ACF during colonoscopy with sensitivity non-inferior to that of the conventional methylene blue method. IEE is simpler than the methylene blue method and is therefore a potentially useful new tool for ACF detection.
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Persky, Daniel, Julie Teruya-Feldstein, Tarun Kewalramani, Pauline D. Bonner, Alexia Iasonos, David Rice, Joachim Yahalom, Stephen D. Nimer, Andrew D. Zelenetz, and Craig H. Moskowitz. "High Dose Chemoradiotherapy and ASCT Can Overcome the Prognostic Importance of Bcl-2, Bim, and p53 in Relapsed/Refractory Hodgkin’s Lymphoma." Blood 106, no. 11 (November 16, 2005): 2073. http://dx.doi.org/10.1182/blood.v106.11.2073.2073.
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Abstract Introduction: Approximately twenty percent of patients with Hodgkin’s lymphoma (HL) relapse or have primary refractory disease. About 50% of these patients achieve long-term remissions after high-dose chemoradiotherapy and autologous stem cell transplantation (HDT/ASCT). At MSKCC, ICE (ifosfamide, carboplatin, etoposide) was incorporated as second-line chemotherapy prior to HDT/ASCT in a comprehensive treatment program. In addition to chemosensitive disease, a clinical prognostic model that emerged from this study identified 3 risk factors - B symptoms at relapse, extranodal disease, and complete remission duration of less than 1 year (Blood. 2001 Feb 1;97(3):616–23). This model was used to intensify treatment according to the number of risk factors, with stratification overcoming the significance of poor prognostic features (Blood. 2003 Nov 16;102(11), abstract #403). Methods: To further identify important prognostic factors, we evaluated pre-ICE biopsy specimens of patients enrolled on one of 3 IRB-approved clinical trials of HDT/ASCT. Prior studies showed that overexpression of bcl-2 and p53 have negative impact on outcome with primary therapy. We sought to determine if our comprehensive second-line program could overcome these poor prognostic features. We performed immunohistochemistry staining for bcl-2, bim (a bcl-2 family marker), and p53; samples were considered positive if any Reed-Sternberg (RS) cells stained for bcl-2 or bim, and if more than 50% stained for p53, at any staining intensity. Results: Seventy one patients had sufficient tissue available. Thirty five patients (49%) had disease progression and 28 (39%) died. Median PFS was 4.8 years, median OS was not reached, and median follow-up was 5.7 years. Bcl-2 was overexpressed in 19(27%), bim in 22 (32%), and p53 in 20 (29%) patients. Expression of bcl-2, bim, or p53 had no significant association with PFS or OS. Five-year PFS rates for positive vs. negative cases were 52.6% vs 50% for bcl-2, 54.5% vs 50% for bim, and 50% vs 51% for p53 (all p=NS). The 3 factor clinical model (B symptoms at relapse, extranodal disease and complete remission duration of less than 1 year) remained highly significant (0/1 vs 2/3 factors) for PFS and OS (p=0.002 and p=0.0003, respectively). Conclusion: Despite the evidence that p53 and bcl-2 overexpression may predict a worse prognosis with initial treatment, it appears that the approach of incorporating ICE and HDT/ASCT may overcome the significance of these biological markers at relapse. Further studies will focus on other pathways that are thought to play a role in relapsed/refractory HL outcomes. Bim is a novel pro-apoptotic marker from the bcl-2 family that is expressed on RS cells and suggests a role in the pathogenesis of HL. Future studies will focus on its role in both initial and relapsed/refractory setting.
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Sun, Xu Hui, Xi Yu, Lin Sun, and Lei Wang. "The Photocatalytic Activity of Bi20TiO32 for Degradation of Organic Pollutants in Different Water Quality." Advanced Materials Research 610-613 (December 2012): 586–89. http://dx.doi.org/10.4028/www.scientific.net/amr.610-613.586.
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In order to test the photocatalytic activity of Bi20TiO32under different conditions, experiments were done to compare its performance for degrading organic pollutants in water. The results are as following. Higher light intensity will increase the reaction rate. Ions in water will affect adversely the photoreaction. Temperature has little effect on the reaction. High concentration of H2O2helps to degrade organic pollutants in water.
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Janania Martinez, Michelle, Prathibha Surapaneni, Juan F. Garza, Tyler W. Snedden, Snegha Ananth, Jeremy Rawlings, David J. Gregorio, et al. "Hodgkin Lymphoma Outcomes: Can We Expect Ethnic Parity in a Hispanic Prevalent Population?" Blood 134, Supplement_1 (November 13, 2019): 4056. http://dx.doi.org/10.1182/blood-2019-129058.
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BACKGROUND It is estimated that 8110 persons will be diagnosed with Hodgkin Lymphoma (HL) in the US during 2019, but the advent of new treatment options has increased the cure rate to at least 80%. It has been reported that the rates of HL are lower in the adolescent and young adult (AYA) Hispanic population but significantly higher in the Hispanic population older than 65. The relative survival estimates are stated to be similar between AYA Hispanics (HI) and non-Hispanics (NH) but for ages 65-84, HI have a significantly higher mortality rate. Pediatric studies have suggested that ethnicity plays a role in outcomes in patients with HL but there is limited data in the adult population. There is an unmet need in the field, where dossiers on underrepresented ethnic minorities need to be carefully considered and compared to existing data. Therefore, our study aims to compare survival outcomes in Hispanics vs Non-Hispanics with HL, who were treated at the only NCI designated cancer center of South Texas. To our knowledge this is the largest cohort of HL patients from a single academic institution that serves primarily Hispanics. METHODS We located and retrospectively analyzed a total of 616 patients with diagnosis of Lymphoma (HL and NHL) by International Classification of Diseases (ICD) codes and identified 116 cases of HL; all the patients received care at UT Health San Antonio, between 2008-2018. Key variables for each patient included age, gender, race/ethnicity, comorbidities, insurance status, stage, BM and extranodal involvement, treatment received, outcome at 3 and 5 years and vitality status in 2018. Continuously distributed outcomes were summarized with the mean and standard deviation and categorical outcomes were summarized with frequencies and percentages. The significance of variation in the mean with disease category was assessed with one way ANOVA and the significance of associations between categorical outcomes was assessed with Pearson's Chi Square or Fisher's Exact test as appropriate. Multivariate logistic regression was used to model binary outcomes in terms of covariates and indicators of disease. All statistical testing was two-sided with a significance level of 5%. R1 was used throughout. The study was approved by the local Institutional Review Board. The findings will be available to patients, funders and medical community through traditional publishing and social media. RESULTS We identified 116 patients with HL, of which 73 were HI (63%), 43 NH (36%) and 1 not specified (1%). In regard to race, 92% identified as Caucasian, 4% as African American, 3% other and 1% Asian. The median age at diagnosis was 37.4, (SD 15.13). There were 49 females (42%) and 67 males (58%). The most common funding source was commercial insurance N=54 (47%), followed by a hospital payment plan N=30 (26%), Medicare N=16 (14%), unfunded N=13 (11%) and Medicaid N=3 (2%). Most prevalent co-morbidities were HTN N=28 (24%) and diabetes mellitus N= 23(20%); 50% of patients had no co-morbidities (N=63).At diagnosis ECOG of 0-1 was seen in 108 patients (93%); 8 were Stage I (7%), 39 stage II (33%), 32 stage III (28%), and 37 stage IV (32%). EBV was positive in 26 patients (22%). There were 15 patients that were HIV positive (13%), 54% with CD4 count <200, and 12 (75%) on antiretroviral therapy at diagnosis. Median PFS was 853.85 days (SD 912.92). We excluded patients who were lost to follow up or had not reached 3/5 years. At 3 year follow up there was: complete response in 37 HI (74%) vs 22 NH (92%); disease progression in 8 (16%) vs 0 (0%); death in 5 (10%) vs 2 (8%), respectively (p-value= 0.094). At 5 year follow up there was: complete response in 30 HI (77%) vs 17 NH (90%); progressive disease in 2 (5%) vs 0 (0); death 7 (18%) vs 2 (11%), respectively (p-value = 0.619). At the end of 2018, 41 HI (84%) were alive compared to 22 NH (88%) [p-value 0.74]. CONCLUSION Within the limitations of sample size, our study demonstrates that in the prevalently Hispanic population of our institution, HI patients with HL have no statistically significant difference in outcome when compared to NH patients. Disclosures No relevant conflicts of interest to declare.
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Emmett, Louise, Sarennya Pathmanandavel, Andrew Nguyen, Megan Crumbaker, Andrew On Wah Yam, Wai Ling Chan, Karen Fullard, Bao Ho, Arun Azad, and Anthony M. Joshua. "Results of a phase I/II prospective dose-escalation trial evaluating safety and efficacy of combination 177LuPSMA-617 and NOX66 in men with mCRPC post androgen signalling inhibition and two lines of taxane chemotherapy (LuPIN trial)." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 120. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.120.
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120 Background: Despite treatment advances, metastatic castrate resistant prostate cancer (mCRPC) remains a lethal disease. Trials in 177LuPSMA-617 have demonstrated good efficacy and safety, but synergistic combinations may further improve treatment responses. NOX66 inhibits external NADH oxidase type 2 with downstream pro-apoptotic actions including radio-sensitization. We present results of a prospective open label single arm phase 1/2 dose escalation/expansion trial of 177LuPSMA-617 and NOX66 in mCRPC. Methods: Men with progressive mCRPC post androgen signalling inhibition (ASI) and taxane chemotherapy were eligible. Inclusion criteria included PSMA PET/CT intensity > SUV max 15, with no discordant disease on FDG PET/CT, Hb > 100 g/L, Platelets > 90 x 106/L and GFR > 40 mL/min. Protocol allowed up to 6 doses of 177 Lu-PSMA 617 (7.5Gbq) on day 1 with NOX66 (suppository) given day 1-10 at 6-weekly intervals; the first 8 men received 400mg NOX66. After safety review, dose was escalated to 800mg. Data regarding safety, efficacy, pain scores, and QOL were collected. Results: 32/43 (26% imaging screen failures) screened men were enrolled (November 2017 – June 2019), of whom 100% had prior docetaxel and ASI, and 94% (30/32) cabazitaxel. All men received ≥ 2 cycles, with 12/32 completing 6 cycles, and 16/32 2 - 5 cycles, while 4/32 remain on treatment. Any PSA response was seen in 84% (27/32), with a PSA response > 50% in 62.5% (20/32). Median PSA PFS was 6.5 months (95%CI 3.54-9.3). To date, 72% (23/32) of patients have progressed. 34% (11/32) men have died with median OS not reached. 50% (12/24) of men with baseline pain scores ≥3 (24/32) had significant reduction in pain. Adverse events are summarized below. Conclusions: Combination 177LuPSMA-617 with NOX66 appears safe and efficacious in men with heavily pre-treated mCRPC. Clinical trial information: ACTRN12618001073291. [Table: see text]
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Piqueras, C. M., D. Herrera, and B. A. Latorre. "First Report of High Boscalid Resistance in Botrytis cinerea Associated with the H272L Mutation in Grapevine in Chile." Plant Disease 98, no. 10 (October 2014): 1441. http://dx.doi.org/10.1094/pdis-05-14-0558-pdn.
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Gray mold (Botrytis cinerea Pers.) is a major disease of grapevine (Vitis vinifera L.) worldwide. Integrated control strategies, including canopy management and fungicide treatments, are needed to control gray mold. Chemical control relies on the use of single mode of action fungicides. The aim of this research was to study the sensitivity of B. cinerea to boscalid, which is a single mode of action fungicide of the succinate dehydrogenase inhibitor (SDHI) fungicide group. Fifty isolates were obtained in 2012 to 2013 from commercial vineyards in central Chile. Vineyards had received two boscalid applications at least for four consecutive years. Briefly, the percent mycelial growth inhibition (MGI) was determined on minimal medium (MM) (2) plus 50 μg m−1 of boscalid (Cantus 50 WP, BASF Chile). Each isolate was tested in triplicate, obtaining 2% highly resistant (HR, MGI ≤25%), 32% moderately resistant (MR, MGI 26 to 50%), 64% low resistant (LR, MGI 51 to 80%), and 2% sensitive (S, MGI ≥81%) phenotypes. Nine isolates were arbitrary selected and compared for MGI on MM plus 50 μg ml−1 of boscalid (1) and conidial germination inhibition (CGI) on yeast extract-bacto peptone-Na acetate (YBA) plus 5 μg ml−1 of boscalid (2,3). Isolates previously determined to be S and HR had the same phenotype for both MGI and CGI. However, all of the MR and LR isolates, determined based on the MGI tests, were identified as S isolates in the CGI tests. Using primer-introduced restriction analysis (PIRA)-PCR (4), the SdhB mutations were detected only in the HR isolate. The amplifications were performed with H272L-fw/H272-rev and were digested by the enzyme BglII, yielding 35- and 85-bp fragments and confirming a mutation at codon 272 (H272L) in the HR phenotype. The efficacy of the label-rate (0.4 g liter−1) boscalid in controlling gray mold was determined on ‘Granny Smith’ apples. The apples were surface-disinfested (75% ethanol, 30 s), wounded with a sterile syringe, and inoculated with a mycelium plug (5 mm in diameter) or 20 μl of a conidial suspension (106 conidia/ml) of one HR, MR, and S isolate. The inoculum was placed on the wounded sites after boscalid application. Apples were incubated for 7 days at 21°C. Each test had four replicates and the experiment was conducted three times. Boscalid slightly controlled (<6.7% efficacy) gray mold on the apples that were inoculated with mycelium or conidia of the HR phenotype isolate, while the sensitive isolate was highly controlled (>95% efficacy), and the MR isolate was moderately controlled (27 to 34% efficacy). These results demonstrate that mycelium or conidia assays using MM + 50 μg ml−1 boscalid or YBA+5 μg ml−1 boscalid consistently detected HR isolates. The S isolates detected using MGI were also S according with the CGI tests. The presence of the boscalid HR strains of B. cinerea associated with the H272L mutation in grapevine in Chile is reported for the first time in this study. This finding suggests that resistance to boscalid needs to be considered in the design of gray mold control strategies in commercial grapevine orchards. References: (1) D. Fernandez-Ortuño et al Plant Dis. 96:1198, 2012. (2) M.-J. Hu et al. J. Phytopathol. 159:616, 2011. (3) Y. K. Kim and C. L. Xiao. Plant Dis. 94:604, 2010. (4) T. Veloukas et al. Plant Dis. 95:1302, 2011.
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Bezerra, Fernanda Carvalho, Maria Irismar de Almeida, and Sílvia Maria Nóbrega-Therrien. "Estudos sobre envelhecimento no Brasil: revisão bibliográfica." Revista Brasileira de Geriatria e Gerontologia 15, no. 1 (2012): 155–67. http://dx.doi.org/10.1590/s1809-98232012000100017.
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O objetivo do presente trabalho foi realizar uma revisão bibliográfica dos estudos sobre envelhecimento no âmbito das ciências da saúde, a fim de apresentar um panorama do que tem sido pesquisado sobre o assunto na América Latina e no Brasil no período de 1982 a 2010. Utilizou-se a bases de dados LILACS disponível on line na Biblioteca Virtual em Saúde (BVS). Constatou-se um aumento expressivo do número de publicações a partir de 2006, principalmente nas categorias: estado de saúde (51%, n=318), avaliação cognitiva (12,72%, n=66), estudos sociodemográficos (6,16% n=32), medicamentos (3,27% n=17) e avaliação funcional (3,08% n=16). Na categoria estado de saúde, houve maior número de publicações relativas a atividade física (17,9% n=57), doenças cardiovasculares (11,95% n=38), dieta (7,6% n=24), saúde bucal (6,6% n=21), menopausa/andropausa (6,3% n=20), quedas (5,97% n=19), atividade sexual (5,03% n=16) e depressão (4,1% n=13). Concluiu-se que é importante estudar estes temas relacionados à senescência, para contribuir com a qualidade de vida nesta faixa etária.
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Pfister, Karin, Piotr Kasprzak, Kyriakos Oikonomou, Hanna Apfelbeck, Wojciech Derwich, Wibke Uller, Alexander Stehr, and Wilma Schierling. "Management von Viszeralarterienaneurysmen unter besonderer Berücksichtigung der Organperfusion – Erfahrungen über mehr als 20 Jahre." Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie 143, no. 05 (October 2018): 516–25. http://dx.doi.org/10.1055/a-0750-6016.
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Zusammenfassung Einleitung Viszeralarterienaneurysmen (VAA) sind selten und werden meist als Zufallsbefund entdeckt. Die Indikation zur Behandlung besteht bei symptomatischen Patienten, Pseudoaneurysmen sowie bei asymptomatischen Patienten bei einer Größe von mehr als 2,5 cm (Viszeralarterienaneurysmen) bzw. mehr als 3 cm (Nierenarterienaneurysmen), bei Schwangeren und vor einer Lebertransplantation. Neben der erfolgreichen, operativen oder endovaskulären Ausschaltung des Aneurysmas ist der Erhalt der Organperfusion wichtig. Die folgende Arbeit stellt das Management von Viszeralarterienaneurysmen und die Erfahrungen über einen Zeitraum von mehr als 20 Jahren dar und zeigt einen Behandlungsalgorithmus auf. Patienten Zwischen 1995 und 2018 wurden am Universitätsklinikum Regensburg 179 VAA diagnostiziert (84 Männer, 95 Frauen, medianes Alter 62 (18 – 87) Jahre). 113-mal (63%) lag ein Milzarterien-, 21- bzw. 22-mal (je 12%) ein Nieren- und Leberarterienaneurysma vor. 14-mal (8%) fand sich ein Aneurysma der gastropankreatikoduodenalen Arkade, 9-mal (5%) der A. mesenterica superior/inferior. 110 (62%) Patienten wurden bei fehlender Behandlungsindikation nachbeobachtet, 34 (19%) offen und 35 (19%) endovaskulär behandelt. Bei allen wurde präoperativ eine Bildgebung, meist mit CT-Angiografie durchgeführt. Ergebnisse Von den 69 therapierten Patienten mit VAA wurden 51 (74%) elektiv und 18 (26%) notfallmäßig wegen Blutung behandelt. 16 Notfallpatienten wurden endovaskulär, 2 offen chirurgisch behandelt. Postoperativ fand sich 2-mal eine partielle Minderdurchblutung der Leber, die folgenlos blieb. Einmal musste Dünndarm teilreseziert werden. 32/51 (63%) elektive VAA wurden offen, 19/51 (37%) endovaskulär therapiert. Leber und Darm blieben bei beiden Verfahren intakt. Bei den 21 Milz- und Nierenarterienaneurysmen wurde operativ 4-mal die Milz, 1-mal die Niere komplett entfernt, zusätzlich fanden sich postoperativ 3 Nierenteilinfarkte (gesamt 8/21 [38%]). Postinterventionell zeigte sich bei den 14 Milz- und Nierenarterienaneurysmen 2-mal ein Milz- und 3-mal ein Nierenteilinfarkt, 2-mal wurde die Milz später entfernt (gesamt 7/14 [50%]). Zum Nachweis der Organperfusion wurde die CT-Angiografie, vor allem aber der Kontrastmittelultraschall (CEUS) durchgeführt. Schlussfolgerung Bei Blutung und Pseudoaneurysmen ist die endovaskuläre Therapie das Vorgehen der ersten Wahl. Bei elektiven Eingriffen spielt die sorgfältige Planung im Hinblick auf die technische Machbarkeit der Aneurysmaausschaltung, aber auch der Erhalt der Organperfusion, vor allem bei Milz- und Nierenarterienaneurysmen, eine entscheidende Rolle. Eine bildgebende Nachsorge, vorzugsweise mit Ultraschall, wird dringend empfohlen. Vor bzw. nach Splenektomie oder bei funktioneller Asplenie sind entsprechende Impfungen vorgeschrieben.
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Emmett, Louise, Sarennya Pathmanandavel, Megan Crumbaker, Christopher Rofe, Andrew On Wah Yam, Bao Ho, Wai Ling Chan, et al. "Updated results of a phase I/II prospective dose escalation trial evaluating safety and efficacy of combination 177Lu PSMA 617 and idronoxil in men with mCRPC post androgen signalling inhibition and taxane chemotherapy (LuPIN trial)." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 5557. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.5557.
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5557 Background: There is no established standard of care post cabazitaxel in men with mCRPC. Ongoing trials in 177LuPSMA-617 have demonstrated good efficacy and safety, but synergistic combinations may further improve treatment responses. Idronoxil (NOX66) inhibits external NADH oxidase type 2 with downstream pro-apoptotic actions including radio-sensitization. Herein we present updated results and an additional cohort of a prospective single arm phase I/II dose escalation/expansion trial of LuPSMA-617 and NOX66 in mCRPC. Methods: Men with progressive mCRPC post androgen signalling inhibition (ASI) and 2 lines of taxane chemotherapy were considered eligible. Key inclusion criteria included PSMA PET/CT intensity SUV max > 15 with no discordant disease on FDG PET/CT, Hb >10, Platelets >100 and GFR >40mls/min. Enrolled patients received up to 6 doses of 177 Lu-PSMA 617 (7.5Gbq) day 1 every 6 weeks in combination with NOX66 days 1-10 each cycle. Cohort 1 (n=8) received 400mg NOX66. Cohorts 2 and 3 subsequently received 800mg and 1200mg of NOX66, respectively, following safety reviews. Data regarding safety, efficacy, pain scores, and QOL were collected. Results: 32 men were enrolled in cohorts 1&2 (November 2017 – June 2019) and 24 in cohort 3 (August 2019-February 2020). To date there have been no dose-limiting toxicities. Data for cohort 3 are immature. For cohorts 1 & 2: 31/32 men received ≥2 cycles, with 12/32 (47%) completing 6 cycles. Any PSA response was seen in 84% (27/32), with a PSA response > 50% in 62.5% (20/32). Median PSA PFS is 6.1 months Of men with increased baseline pain scores ≥3 (24/32), 50% (12/24) had a clinically significant reduction in pain indicators. Adverse events are summarized below. Updated results for cohorts 1 and 2 and preliminary results of cohort 3 will be presented. Conclusions: Combination LuPSMA-617 + NOX 66 appears safe and efficacious in men with heavily pre-treated end stage mCRPC. Clinical trial information: ACTRN12618001073291 .
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Doty, Samuel, Ryan W. Dickson, and Michael Evans. "Evaluation of a Novel Shallow Aggregate Ebb-and-flood Culture System and Transplant Size Effects on Hydroponic Basil Yield." HortTechnology 30, no. 5 (October 2020): 585–92. http://dx.doi.org/10.21273/horttech04635-20.
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Ornamental bedding plant operations transitioning to leafy greens and herb production must decide whether to invest in new hydroponic equipment or modify existing culture systems for edible crops. In addition, common practices used to increase space-use and production efficiencies during bedding plant production may be modified for hydroponic leafy greens and herbs, such as purchasing large seedlings for transplant. The objective of the first experiment was to evaluate plant growth in a modified and novel shallow aggregate ebb-and-flood (SAEF) system intended for bedding plant growers with an emphasis on comparing yield across four basil (Ocimum basilicum) cultivars grown in the SAEF system to those grown using the traditional nutrient film technique (NFT) and deep water culture (DWC) hydroponic systems. The second experiment objective was to evaluate basil seedling size and the time of transplant to NFT hydroponic systems to determine effects on the final yield. ‘Genovese’ basil seedlings were grown in trays with cell counts of 32, 50, 72, 105, and 162 cells with corresponding root volumes per plant of 98.1, 50.2, 38.5, 19.6, and 16.3 cm3, respectively. Seedlings were transplanted to NFT systems at 14, 21, and 28 days after sowing and were harvested at 35 days. In the first experiment, overall basil shoot fresh and dry weights per plant were intermediate in the SAEF system (90.4 and 8.3 g) compared with the DWC (102.6 and 9.1 g) and NFT (75.8 and 6.6 g) hydroponic systems. In the second experiment, final shoot fresh and dry weight per plant increased as seedling root volume increased from 16.3 cm3 [72.8 and 5.5 g (162-cell tray)] to 98.1 cm3 [148.5 and 12.2 g (32-cell tray)]. Transplanting seedlings at later dates decreased yield across tray size and root volume treatments. Differences in yield between culture systems may have resulted from differences in nutrient supply and availability for plant uptake. Transplant of large seedling plugs to hydroponic culture was not shown to increase space-use efficiency after transplant without compromising yield, likely because root zone factors limited growth during seedling production. Further investigation into maximizing plant growth during seedling production and evaluating the effects of seedling size and transplant practices are needed to determine the potential for increasing space-use and production efficiencies.
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Kadia, Tapan, Jorge E. Cortes, Farhad Ravandi, Guillermo Garcia-Manero, Michael Andreeff, Koichi Takahashi, Gautam Borthakur, et al. "Clinical and Molecular Characterization of p53-Mutated Acute Myeloid Leukemia." Blood 126, no. 23 (December 3, 2015): 564. http://dx.doi.org/10.1182/blood.v126.23.564.564.
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Abstract P53 is a multifunctional tumor suppressor protein encoded by the TP53 gene, located on the short arm of chromosome 17. Among its functions, it plays a role in maintaining genomic stability by reacting to DNA damage, activating DNA repair programs, and triggering cell cycle arrest. Over half of human malignancies contain mutations or deletions in TP53 that compromise its function. Mutations in TP53 have been described in 8-10% of cases of acute myeloid leukemia (AML) and are associated with an adverse prognosis. We examined a cohort of 293 patients (pts) with newly diagnosed, non-CBF, non-APL AML treated at our institution in whom mutation screening was performed. Mutation testing was performed using a validated 28-gene, whole-exome sequencing panel. Our aim was to characterize the clinico-pathologic characteristics of AML pts with TP53 mutations (mut-P53), their response to different therapies, and their survival compared to those with wild-type TP53 (wt-P53). Pts were treated with several different therapies that could be classified has high-dose cytarabine-based (HDAC), hypomethylating agent (HYPO), or low-intensity therapy other than single-agent HYPO (LOW-INT). Of the 293 pts studied, 97 (33%) and 196 (67%) were < 60 years and ≥ 60 years, respectively. Overall, 53 (18%) had TP53 mutations, 17 (18%) pts < 60 years and 36 (18%) pts ≥ 60 years. 95% of the mutations were found in exons 5-8 of TP53, the DNA-binding domain. Patient characteristics by age and TP53 mutation status are summarized in Table 1. In pts < 60 years, those with mut-P53 had significantly lower peripheral blasts, bone marrow (BM) blasts, and fibrinogen compared to those with wt-P53. For pts ≥ 60 years, those with mut-P53 were older, had lower WBC counts, lower platelet counts, and significantly lower BM blast counts than those with wt-P53. Significantly more pts with mut-P53 had complex karyotype (p<0.001), abnormalities of chromosomes 5 and/or 7 (p<0.001), abnormalities of chromosome 17 (p<0.001), and a diagnosis of therapy-related AML (p=0.004) compared to pts with wt-P53. 81% of pts with mut-P53 had a complex karyotype and 55% of pts with a complex karyotype had mut-P53. A 28-gene mutation screen that was performed detected concomitant mutations and delineated the molecular landscape of AML pts with mut-P53 (Figure 1A). Mutations in FLT3 (p=0.023), RAS (p=0.037), and NPM1 (p=0.029) were significantly underrepresented in pts with mut-P53 compared to wt-P53. Rates of CR were lower in pts with mut-P53 compared to those with wt-P53 in the younger and older cohorts (Table 1). The OS of pts younger and older than 60 years by p53 status is shown in Figure 1B. Among pts with mut-P53, the CR rates for HDAC, HYPO, and LOW-INT were 60%, 29%, and 50%, respectively compared with 72%, 35%, and 63% in wt-P53 pts, respectively. When divided into cohorts by age < and ≥ 60yrs, there was no difference in OS for patients with mutated TP53 treated with HDAC, HYPO, or LOW-INT. TP53 mutations in AML are associated with low blast counts, low WBC counts, complex karyotype, therapy-related disease, and inferior outcomes compared to those with wt-P53. In our cohort there was no difference in outcome among different intensity therapies. Newer therapies are needed to improve outcome in this difficult cohort of pts. Table 1. Age <60 (N=97) Characteristic mut-p53 wt-p53 p-value Median Age 49 (20-59) 51 (22-59) 0.8 Median WBC 2.7 (0.9 - 30) 4.9 (0.5 - 103) 0.46 Median Platelet 32 (4 - 153) 39 (1 - 708) 0.35 Median periph blasts 6 (0 - 63) 27 (0 - 97) 0.03 Median LDH 937 (392 - 10298) 717 (231 - 11952) 0.25 Median Fibrinogen 330 (43 - 558) 413 (67 - 1117) 0.06 Median BM Blasts 27 (12 - 91) 54 (1 - 96) 0.008 CR Rate (%) 53 70 0.255 Age >60 (N=196) Characteristic mut-p53 wt-p53 p-value Median Age 74 (62-90) 71 (60-92) 0.02 Median WBC 2.3 (0.7-17.5) 2.9 (0.2-164.5) 0.09 Median Platelet 34 (8-321) 45 (1-1069) 0.07 Median periph blasts 10 (0-86) 8 (0-96) 0.8 Median LDH 535 (286-3616) 616 (284-17486) 0.4 Median Fibrinogen 407 (213-753) 388 (102-923) 0.5 Median BM Blasts 32 (3-97) 47 (4-93) 0.009 CR Rate (%) 36 50 0.196 Disclosures Cortes: Novartis: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Teva: Research Funding; BerGenBio AS: Research Funding; Ariad: Consultancy, Research Funding; Astellas: Consultancy, Research Funding; Ambit: Consultancy, Research Funding; Arog: Research Funding; Celator: Research Funding; Jenssen: Consultancy. Konopleva:Novartis: Research Funding; AbbVie: Research Funding; Stemline: Research Funding; Calithera: Research Funding; Threshold: Research Funding. DiNardo:Novartis: Research Funding.
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Oxner, Christopher Ryan, Rebecca A. Nelson, Wendy Lee, Marjun Philip Duldulao, Rebecca Lynn Wiatrek, Steven Chen, Alessio Pigazzi, Joseph Kim, and Julio Garcia-Aguilar. "Accuracy of computed tomography in staging colon cancer patients." Journal of Clinical Oncology 30, no. 4_suppl (February 1, 2012): 614. http://dx.doi.org/10.1200/jco.2012.30.4_suppl.614.
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614 Background: Though adjuvant chemotherapy is well-established for treating patients with AJCC Stage III colon cancer, there is growing interest in giving chemotherapy neoadjuvantly for these patients. Since clinical staging to determine eligibility requires accurate preoperative imaging, our objective was to determine whether computed tomography (CT) scans can be used to detect nodal disease in colon cancer patients. Methods: We identified patients with AJCC stage I-III colon cancer who underwent curative resection between 2006 and 2010 at our institution. Patient CT scans were obtained and final radiologic reports were recorded in a database. CT images underwent secondary prospective review by a blinded independent surgeon with the intent to identify mesenteric lymphadenopathy (N+). Clinical staging from the original radiologic report and secondary surgeon review of the CT images were then compared with pathologic staging. Results: Imaging and pathology were available for 67 colon cancer patients. Original radiologic review reported N+ disease in 10 of 67 patients (15%), but final pathology revealed 31 of 67 (46%) patients to be N+. Therefore, radiological review correctly predicted Stage III disease in 10 of 31 (32%) patients. On final pathology, 36 of 67 (54%) patients had no nodal disease (N0). Radiologic reports noted absence of lymphadenopathy in 29 of 67 (43%) patients, thus accurately predicting N0 disease in 29 of 36 (80%) patients. Of 67 studies, 14 (21%) had no mention of lymphadenopathy and were considered N0. Of these 14, 6 were N+ on final pathology. Surgeon review accurately identified N+ disease in 4 of these 6 patients. On surgeon review, sensitivity increased from 32% to 68% while specificity dropped from 80% to 61%, corresponding to a decrease in false negatives from 68% to 32% and an increase in false positives from 20% to 39%. Conclusions: Current clinical staging of colon cancer by CT has low accuracy. However, actively seeking nodal disease improves sensitivity but with minor loss of specificity. Improved radiologic criteria and technology may further increase accuracy in clinical staging of Stage III colon cancer patients who will receive neoadjuvant treatment.
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Finney, W., SN Wiener, and F. Catanzariti. "Treatment of Morton's neuroma using percutaneous electrocoagulation." Journal of the American Podiatric Medical Association 79, no. 12 (December 1, 1989): 615–18. http://dx.doi.org/10.7547/87507315-79-12-615.
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A new modality for treating Morton's neuroma was introduced and performed by the authors, using a nerve lesion generator. Seventy-nine lesions were evaluated by obtaining the patients' responses to three questions. By rating their symptoms on a 0-5 scale both before and after the neurectomy, the patients showed a 56% reduction in symptoms. With a gone-improved-same-worse rating, the patients responded with 25%, 46%, 24%, and 5% in each respective category. The overall assessment of the procedure by the patients yielded 68% pleased and 32% not pleased. An average of 4 hr was missed from work following the neurectomy, and only 20% of the patients required mild analgesics.
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Radics-Johnson, Jennifer B., Daniel W. Chacon, and Li Zhang. "617 Who Benefits the Most from Burn Camps?" Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S162—S163. http://dx.doi.org/10.1093/jbcr/irab032.267.
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Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.
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Demetrio, D., A. Magalhaes, M. Oliveira, R. Santos, and R. Chebel. "11 Invivo-derived embryo pregnancy rates at Maddox Dairy from 2008 to 2018." Reproduction, Fertility and Development 32, no. 2 (2020): 130. http://dx.doi.org/10.1071/rdv32n2ab11.
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Maddox Dairy, located in Riverdale, CA, USA, is a Holstein herd that milks 3500 cows with a 305-day mature-equivalent milk production of 12 800 kg, and they have been producing high genetic animals by embryo transfer (ET) since the early 1980s. Invivo-derived embryos from Holstein donors were transferred fresh (grade 1 or 2) or frozen (grade 1), at morula (4), early blastocyst (5), or blastocyst (6) stage, to virgin heifers (VH, natural oestrus, 13-15 months old) or lactating cows (LC, Presynch-Ovsynch, 86 days in milk, first or second lactation) 6 to 9 days after oestrus. Pregnancy diagnosis was done by transrectal ultrasonography at 32-46 days in VH and by the IDEXX PAG test at 30 days in LC. June, July, August, September, and October were called critical months (first service AI conception rate drops below 44%) and compared with the other months. The data from 32 503 ETs between January 2008 and December 2018 are summarised on Table 1. Pregnancy rates (PR) are lower for LC recipients than for VH. Embryo transfers performed 7 or 8 days after oestrus had higher PR in both types of recipients and embryos, but Day 6 and 9 oestrus are also used with fair results. The season does not seem to affect PR. There is not enough difference in the combination of stage and days from oestrus for invivo-derived embryos. These numbers do not belong to a planned experiment. Several management changes during the years were made, which make it very difficult to apply statistical methods to analyse the data correctly. They are used as a tool to make decisions in an attempt to improve future results. Table 1.Pregnancy rate (PR) of virgin heifers (top) and lactating cows (bottom)-fresh (SH) and frozen (OZ) invivo-derived embryo transfer1 Heat-months SH-ST4 SH-ST5 SH-ST6 SH-All OZ-ST4 OZ-ST5 OZ-ST6 OZ-All PR% n PR% n PR% n PR% n PR% n PR% n PR% n PR% n Heifers 6 d-CM 62 934 66 243 68 69 63 1246 56 473 58 219 62 42 57 734 6 d-OM 62 1623 67 489 69 211 64 2323 56 600 55 296 48 137 55 1033 6 d-T 62 2557 67 732 69 280 63 3569 56 1073 57 515 51 179 56 1767 7 d-CM 64 1506 68 495 67 221 65 2222 60 822 62 340 63 156 61 1318 7 d-OM 66 2723 68 1021 69 510 67 4254 57 1120 59 581 57 231 58 1932 7 d-T 66 4229 68 1516 69 731 67 6476 58 1942 60 921 60 387 59 3250 8 d-CM 65 1348 64 518 67 322 65 2188 59 595 64 258 63 108 61 961 8 d-OM 66 2166 68 886 70 510 67 3562 61 770 60 364 51 130 60 1264 8 d-T 66 3514 67 1404 69 832 66 5750 60 1365 62 622 56 238 60 2225 9 d-CM 60 109 56 43 70 20 60 172 60 5 33 6 50 4 47 15 9 d-OM 58 129 63 57 60 40 60 226 63 16 50 18 75 4 58 38 9 d-T 59 238 60 100 63 60 60 398 62 21 46 24 63 8 55 53 All-CM 64 3897 66 1299 67 632 65 5828 58 1895 61 823 63 310 60 3028 All-OM 65 6641 67 2453 69 1271 66 10 365 58 2506 58 1259 53 502 58 4267 All-T 65 10 538 67 3752 69 1903 66 16 193 58 4401 60 2082 57 812 59 7295 Lactating cows 6 d-CM 54 265 48 86 50 12 53 363 38 141 31 77 50 10 36 228 6 d-OM 49 463 52 203 45 56 50 723 46 101 48 54 59 27 48 182 6 d-T 51 728 51 289 46 68 51 1086 41 242 38 131 57 37 42 410 7 d-CM 54 755 59 274 56 103 55 1137 43 928 48 450 43 192 45 1570 7 d-OM 55 914 66 367 54 109 58 1393 46 1052 45 564 47 353 46 1969 7 d-T 55 1669 63 641 55 212 57 2530 45 1980 46 1014 46 545 45 3539 8 d-CM 63 252 68 82 76 33 65 368 48 219 56 80 42 33 50 332 8 d-OM 61 257 64 161 53 47 61 466 50 191 53 77 56 16 51 284 8 d-T 62 509 65 243 63 80 63 834 49 410 55 157 47 49 50 616 All-CM 56 1272 58 442 60 148 57 1868 44 1288 47 607 43 235 45 2130 All-OM 55 1634 62 731 51 212 56 2582 47 1344 46 695 48 396 47 2435 All-T 55 2906 60 1173 55 360 57 4450 45 2632 47 1302 46 631 46 4565 1ST=stage; CM=critical months (June, July, August, September, and October); OM=other months.
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Deng, Wen Yi, Xiao Lei Wang, Wei Chao Yu, and Ya Xin Su. "Hydrogen-Rich Gas Production from Microwave Pyrolysis of Sewage Sludge at High Temperature." Advanced Materials Research 610-613 (December 2012): 2302–6. http://dx.doi.org/10.4028/www.scientific.net/amr.610-613.2302.
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Microwave pyrolysis of sewage sludge was conducted in a single-mode microwave oven. The influencing effects of experimental factors, including particle size and moisture content of sewage sludge, pyrolysis temperature, and shape of microwave adsorber, on concentration of pyrolysis gas products were studied. The results indicated that with the decrease of particle size, the H2 concentration increased from 31 vol.% to 34 vol.%, and CO concentration increased from 17 vol.% to 22 vol.%. When the moisture content of sewage sludge increased from 0 to 83 wt.%, the H2 concentration increased from 32 vol.% to 42 vol.%, and the CO concentration increased from 20 vol.% to 31 vol.%. Compared with microwave adsorber in powder phase, the microwave adsorber in fixed structure can transform more volatile compounds to uncondensable gas, and the concentrations of H2 and CO were also slightly increased.
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Morsheda, Hamima Umme, Md Nahid Uz Zaman, and Nahid Afroze. "Assessment of job satisfaction among the senior staff nurses working at Sadar Hospital, Naogaon, Bangladesh." Asian Journal of Medical and Biological Research 2, no. 4 (January 23, 2017): 611–15. http://dx.doi.org/10.3329/ajmbr.v2i4.31004.
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This study aimed to examine nurses? job satisfaction at Sadar Hospital, Naogaon, Bangladesh. It also examines the relationships between nurses? assessment, satisfaction, attitude, and practice with respect to job satisfaction. The descriptive cross sectional study design was used to explore the job satisfaction among the staff nurses. Total number of nurses working in this hospital was 121. A total number of fifty nurses were recruited into this study in order to overcome non-response subjects. The age group 30-39 years were 40%, 40-49 years were 46% and 50+ above were 14% nurses. Male nurses were only 6% and the female were 94%. Marital status single 12%, married 80%, widow 8%. Muslim nurses were 58%, Hindu 38% and Christian 4%. Academic qualification of them was SSC 66% and H.S.C 34%. Professional qualification was Diploma in Nursing /Diploma in Midwifery 92%, B.Sc. in public Health Nursing 6% and MPH 2%. Length of service 1 to 10 years 22%, 11 to 20 years 50%, 21 to 25 years 24%, 31+ years 4%. Regarding maintaining therapeutic relationship; facing problem in duty; keeping records; receiving complicated patient; attend in duty time; maintaining aseptic techniques; maintaining work; carryout admission and discharge the results for all above questions were 100% yes. But regarding satisfy to give care 30% respondent were not satisfied; whole for job salary 68% nurses were not feel enough and remaining 32% were satisfied. Again in case of promotion to the next post most of the respondent 16% were satisfied and 84% were not satisfied.Asian J. Med. Biol. Res. December 2016, 2(4): 611-615
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Baltrūnaitė, Jūratė, and Kęstutis Trainavičius. "Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas." Lietuvos chirurgija 14, no. 1 (March 31, 2015): 38–45. http://dx.doi.org/10.15388/lietchirur.2015.1.5330.
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Darbo tikslasSkrandžio ar dvylikapirštės žarnos opos perforacija yra reta, tačiau gyvybei pavojinga vaikų būklė. Darbo tikslas – išanalizuoti vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų kliniką, diagnostiką ir gydymą.Tyrimo medžiaga ir metodaiAtlikta retrospektyvi ligonių, 1994–2012 m. gydytų Vaikų ligoninės VUL SK filialo Vaikų chirurgijos skyriuje, duomenų analizė. Vertinta ligonių amžius, lytis, anamnezė, klinika, fizinio ir instrumentinio ištyrimo duomenys, operacijos radiniai, metodai ir trukmė, medikamentinė terapija ir ankstyvosios komplikacijos. Statistinė duomenų analizė atlikta MS Excel programa.RezultataiBuvo tirta 15 vaikų: 14 (93,3 %) berniukų ir 1 (6,6 %) mergaitė. Vidutinis ligonių amžius buvo 16,3±1,3 metų. Dvylikai (80 %) ligonių diagnozuota skrandžio, 3 (20 %) – dvylikapirštės žarnos opos perforacija. Iki perforacijos pilvo skausmais skundėsi 11 (73,3 %) ligonių, iš jų keturiems buvo diagnozuota opaligė. Dauguma ligonių (46,6 %) atvyko į ligoninę per 6 valandas nuo simptomų pradžios. Visi vaikai skundėsi labai stipriu skausmu pakrūtinio srityje, 8 (53,3 %) – pykinimu ir vėmimu. Tik 1 (6,6 %) vaikui buvo melena. Vienas (6,6 %) skundėsi pakrūtinio skausmu, plintančiu į kairį petį. 86,6 % tiriamųjų nustatyti pilvaplėvės dirginimo požymiai. Apžvalginėje pilvo rentgenogramoje 12 (80 %) ligonių rasta laisvo oro po diafragma. Ligoniai iki operacijos vidutiniškai sirgo 34,47 ± 57,41 valandas (nuo 2 iki 178). Laparotomija buvo atlikta 13 (86,6 %) ligonių, laparoskopija – 2 (20 %). Net 12 (80 %) vaikų perforavusios opos rastos skrandžio prepiliorinės dalies priekinėje sienoje. Aštuoniems ligoniams (53,4 %) skirta H. pylori eradikacinė terapija. Vaikai ligoninėje gydyti vidutiniškai 10,6 ± 6,3 dienas (nuo 4 iki 32). Pooperacinė eiga buvo sklandi 14 (93,3 %) ligonių, 1 (6,6 %) vaikui nustatyta nefrozinio lygio proteinurija. Visi ligoniai pasveiko.IšvadosSkrandžio ir dvylikapirštės žarnos opos turėtų būti įtariamos paaugliams berniukams, kurie kreipiasi dėl ūminių stiprių pakrūtinio skausmų ir kuriems nustatytas pilvaplėvės dirginimas. Laisvas oras po diafragma apžvalginėje pilvo rentgenogramoje – itin svarbus požymis diagnozuojant ligą. Ulcerorafija ir H. pylori eradikacija (kai infekcija patvirtinta) yra būtini, kad pacientas visiškai pasveiktų.
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Uddin, Mohammed Jalal, Stojanovic Velimir, Abdul Latif Salama, Babu Othman, Lulu Othman, Enamul Haque, and Hani Shuhaiber. "Surgical Repair of Complete Atrioventricular Septal Defect." Asian Cardiovascular and Thoracic Annals 6, no. 1 (March 1998): 37–40. http://dx.doi.org/10.1177/021849239800600108.
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Between January 1988 and March 1996, 40 patients underwent repair of complete atrioventricular septal defect with a two-patch technique and routine atrioventricular valve cleft closure. The mean age of the patients was 10.8 ± 6.9 months and the mean weight was 6.6 ± 2.6 kg. Twenty-three had Down's syndrome and 13 had coexisting cardiac anomalies. Preoperative angiography and echocardiography revealed mild atrioventricular valve regurgitation in 22 patients, moderate regurgitation in 16, and severe regurgitation in the other 2. The mortality was 12.5% (4 early and 1 late deaths). The major cause of death was pulmonary hypertensive crisis. Reoperation was necessary in 3 patients; 2 had atrioventricular valve annuloplasty and one had prosthetic valve replacement. All 3 survived reoperation. Echocardiography at a mean of 32 ± 20 months postoperatively showed mild left atrioventricular valve regurgitation in 32 patients and moderate regurgitation in 3. Management of postoperative pulmonary hypertensive crisis and repair of complete atrioventricular septal defect before the development of high pulmonary vascular resistance may reduce the mortality of this surgical procedure.
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Kim, Esther, Amily Koshy, Shannon Higgins, Andrew Lassman, and Fabio Iwamoto. "COVD-20. COVID-19 INFECTION DURING CHEMOTHERAPY FOR MALIGNANT GLIOMA: OUTCOMES AMONG 3 PATIENTS." Neuro-Oncology 22, Supplement_2 (November 2020): ii25. http://dx.doi.org/10.1093/neuonc/noaa215.103.
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Abstract BACKGROUND Chemotherapy may increase risk of SARS-COV-2 infection and COVID-19 severity. METHODS A patient developed COVID-19 during chemotherapy for glioma. We retrospectively identified others diagnosed with COVID-19 during temozolomide or lomustine for glioma. RESULTS (1) A 64 year-old woman (index patient) with anaplastic oligodendroglioma received PCV 22 months previously. Baseline White Blood Cell (WBC) count was 4.2 and Absolute Neutrophil Count (ANC) was 2.7 K/uL. KPS was 90 without comorbidities. For recurrence she initiated temozolomide but developed fever on cycle 1 day 2. SARS-COV-2 PCR was positive. Further temozolomide was held. She is recovering as an outpatient. (2) A 27 year-old man with anaplastic astrocytoma received concurrent RT/temozolomide then 1 cycle of adjuvant temozolomide. Baseline WBC was 8.3, ANC 5.2, and KPS 90. Obesity, asthma, and pre-diabetes were comorbidities. Hyposmia/hypogeusia and low-grade fever began, in retrospect, during concurrent RT/temozolomide. PCR for SARS-COV-2 was negative 2 months after symptom onset; serology detected both IgG and IgM when WBC was 6.6 and ANC 4.0. Cycle 2 of adjuvant temozolomide was held until fever resolved (spontaneously); hyposmia/hypogeusia persist. (3) A 53 year-old man with glioblastoma previously received RT/temozolomide, then lomustine and bevacizumab for progression. WBC was 5.1, ANC 4.0, and KPS 60. He was obese. Fever, chills, and dyspnea developed on lomustine cycle 2 day 38. SARS-COV-2 PCR was positive. He was hospitalized and chemotherapy held; symptoms resolved 12 days after onset, but PCR continued to show detectable virus 32 days later. PCR became negative after 50 days total, and treatment resumed uneventfully. DISCUSSION All 3 patients recovered from SARS-COV-2 infection despite active temozolomide or lomustine chemotherapy. Normal ANC, high KPS, and early detection may have contributed to limited symptom severity and duration, despite obesity and other comorbidities in 2 cases. Detection changed management by delaying additional cycles of immunosuppressive chemotherapy until recovery.
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Xu, Xiao Ling, Zuo Wan Zhou, and Wen Jun Zhu. "Studies on the Active Oxygen in Zinc Oxides with Different Morphologies." Materials Science Forum 610-613 (January 2009): 229–32. http://dx.doi.org/10.4028/www.scientific.net/msf.610-613.229.
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Active oxygen species generated from semiconductor under irradiation play an important role in decomposing and mineralizing pollutants and undesirable compounds in the air and waste water. The production of superoxide anion (O2－) and hydroxyl radical (•OH) generated in the suspension of zinc oxides with different morphologies and particle sizes were studied in the present paper. Three kinds of zinc oxides, which named tetra-needle like ZnO (T-ZnO) whisker with length of 10~20 μm and basal diameter of 1~3 μm, nanosized ZnO (n-ZnO) with particle size of 20~30 nm and commercial ZnO powder (p-ZnO) with particle size of ~1 μm, respectively, were used in this work. Nitroblue tetrazolium (abbr. NBT) was used to determine the amount of super oxide anion generated from the related zinc oxides, in which NBT can be reduced to insoluble purple formazan by super oxide anion. The amount of hydroxyl radicals was determined by detecting the decreased absorption intensity of Fe(phen)32+ (complex of iron (II) with 1,10-phenanthroline) at 510 nm with UV-Vis spectrophotometer. The results indicated that the most amounts of superoxide anion and hydroxyl radical were detected in T-ZnO whiskers and n-ZnO respectively. The difference between the production amount of superoxide anion and hydroxyl radical can be attributed to the different mechanisms for both of the production and transportation of these two kinds of active oxygens.
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Can Bostan, Özge, Mehmet Erdem Çakmak, Saltuk Buğra Kaya, Ebru Damadoğlu, Gül Karakaya, and Ali Fuat Kalyoncu. "The Role of Skin Tests and Premedication in Radiocontrast Media Hypersensitivity: A Clinical Dilemma." Asthma Allergy Immunology 19, no. 2 (August 23, 2021): 78–83. http://dx.doi.org/10.21911/aai.606.
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ABSTRACT Objective: Controversies continue over the diagnostic approach, prediction, and premedication in radiocontrast media (RCM) hypersensitivity. One of the most important problems encountered in daily clinical practice is that patients do not recall which contrast agent has been used in previous exposures. Also, in most cases, the details of the reaction have not been recorded. Therefore, difficulties are experienced in decision-making about skin testing and premedication in patients who are suspected of RCM hypersensitivity. To assess the clinical value of skin tests and premedication in RCM hypersensitivity. Materials and Methods: A retrospective evaluation was made of the medical records of patients between October 2014 and December 2019. The skin tests were performed with the culprit agent if it was known, otherwise, with iohexol, one of the most commonly used RCM in Turkey. As premedication, oral methylprednisolone 40 mg 13-7-1 hours before the procedure and oral pheniramine 22.7 mg 1 hour before the procedure were prescribed. Results: A total of 41 patients were evaluated (32 females and 9 males). Of the reactions, 35 (85.4%) were immediate and 6 (14.6%) were non-immediate. Three (7.3%) had a positive intradermal test result. It was determined that 20 patients (17 immediate, 3 non- immediate), required imaging with RCM again. Of these, 18 received premedication and two did not, although it was recommended. Of the patients who received premedication, one (5.5%) had an urticarial reaction of the same grade, while both patients (100%) who did not receive premedication developed an immediate allergic reaction that was of a similar grade to that of the previous reaction. Conclusion: Skin test positivity for RCM was observed at low rates. In cases with negative skin tests and when the culprit drug cannot be identified, re-exposure to alternative RCM under premedication may reduce the risk of the reaction. Keywords: Allergy, iodinated contrast media, iobitridol, iohexol, premedication
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Beck, T. M., P. J. Hesketh, S. Madajewicz, R. M. Navari, K. Pendergrass, E. P. Lester, J. A. Kish, W. K. Murphy, J. D. Hainsworth, and D. R. Gandara. "Stratified, randomized, double-blind comparison of intravenous ondansetron administered as a multiple-dose regimen versus two single-dose regimens in the prevention of cisplatin-induced nausea and vomiting." Journal of Clinical Oncology 10, no. 12 (December 1992): 1969–75. http://dx.doi.org/10.1200/jco.1992.10.12.1969.
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PURPOSE This study compares the efficacy and safety of two single-dose regimens with the approved three-dose regimen of ondansetron in the prevention of cisplatin-induced emesis. PATIENTS AND METHODS This multicenter study was a stratified, randomized, double-blind, and parallel group design. Chemotherapy-naive inpatients were randomized to receive intravenous (IV) ondansetron (Zofran; Glaxo Inc, Research Triangle Park, NC) 0.15 mg/kg times three doses, every 4 hours or a single 8-mg or 32-mg dose followed by two saline doses that began 30 minutes before cisplatin administration. Cisplatin (high-dose > or = 100 mg/m2 or medium-dose 50 to 70 mg/m2) was given as a single infusion (< or = 3 hours). Patients were monitored for emetic episodes, adverse events, and laboratory safety parameters for 24 hours after cisplatin administration. RESULTS A total of 699 patients (359 high-dose, 340 medium-dose) were enrolled. Of these, 618 were assessable for efficacy (15 ineligible, 66 protocol deviations). The 32-mg dose was superior to the 8-mg single dose with regard to total number of emetic episodes (high-dose, P = .015; medium-dose, P < .001), complete response (no emetic episodes: high-dose, 48% v 35%; P = .048; medium-dose, 73% v 50%; P = .001) and failure rate (> 5 emetic episodes, withdrawn or rescued: high-dose, 20% v 34%; P = .018; medium-dose, 9% v 23%; P = .005). The 32-mg single dose was also superior to the 0.15 mg/kg times three dose regimen with regard to total number of emetic episodes (medium-dose, P = .033) and failure rate (high-dose, 20% v 36%; P = .009; medium-dose, 9% v 22%; P = .011). Ondansetron was well tolerated. The most common adverse event was headache. An approximate 10-fold increase in the incidence of clinically significant transaminase elevations was observed in the high-dose versus medium-dose cisplatin strata (aspartate aminotransferase [AST], 6.5% v 0.7%; serum alanine aminotransferase [ALT], 5.0% v 0.3%). CONCLUSION A 32-mg single dose of ondansetron is more effective than a single 8-mg dose and is at least as effective as the standard regimen of 0.15 mg/kg times three doses in the prevention of cisplatin-induced acute emesis.
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Joshi, Shabin M., Richard Jonathan David Hewitt, Helen L. Storr, Kia Rezajooi, Habib Ellamushi, Ashley B. Grossman, Martin O. Savage, and Fary Afshar. "Cushing's Disease in Children and Adolescents: 20 Years of Experience in a Single Neurosurgical Center." Neurosurgery 57, no. 2 (August 1, 2005): 281–85. http://dx.doi.org/10.1227/01.neu.0000166580.94215.53.
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ABSTRACT OBJECTIVE: This is a retrospective analysis of 25 consecutive pediatric patients with Cushing's disease who underwent transsphenoidal surgery performed by a single neurosurgeon in a specialist center during a 20-year period. This article discusses the presentation of Cushing's disease, the endocrinological investigation with particular reference to bilateral inferior petrosal sinus sampling (BIPSS), the operative management with reference to specific pediatric difficulties of the transsphenoidal approach and the use of intraoperative image guidance, and the analysis of these cases as regards postoperative complications and outcomes of this rare condition in young patients. METHODS: All patients underwent detailed endocrine investigation and imaging in the form of computed tomography and/or magnetic resonance imaging. BIPSS was performed in 19 patients (76%), with successful lateralization of the side of the microadenoma in 14 (74%) and prediction of a central tumor in four (94% total prediction rate). Surgical removal was via the sublabial, paraseptal, transsphenoidal route. RESULTS: There were 15 male and 10 female patients, with a mean age of 13.4 years (range, 6.6–17.8 yr). Weight gain was the most common presentation (100%), and then growth impairment (96%), fatigue and skin changes (64%), and hypertension (32%). Postoperative complications included growth hormone deficiency (36%), transient diabetes insipidus (12%), panhypopituitarism (4%), and transient cerebrospinal fluid rhinorrhea (4%). The median follow-up period was 59.5 months (range, 6–126 mo). Overall, 15 patients (60%) achieved surgical cure or remission, of which 14 outcomes were obtained using the results of BIPSS. Ten patients (40%) required postoperative radiotherapy to achieve “remission.” There were no cases of meningitis, no neurological deficits, no reoperations, and no mortality. CONCLUSION: Cushing's disease in children and adolescents is a rare illness. The accurate preoperative localization of the adenoma is essential for achieving good results. In this series, BIPSS was far more accurate in localizing the adenoma than computed tomography or magnetic resonance imaging. Imaging, however, is useful for the exclusion of other intracranial problems. Transsphenoidal surgery was safe and efficacious in achieving cure in the majority of cases. The challenge of transsphenoidal surgery in this age group is the small pituitary fossa and the absence of sphenoid sinus aeration in some cases. We found the use of intraoperative neuronavigation to be an excellent aid in overcoming such anatomic difficulties.
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Ajeigbe, Hakeem A., Folorunso M. Akinseye, Alpha Y. Kamara, AbdulAzeez Tukur, and Abubakar Hassan Inuwa. "Productivity, Water- and Nitrogen-Use Efficiency, and Profitability of Pearl Millet (Pennisetum glaucum) under Different Nitrogen Applications in Semiarid Region of Nigeria." International Journal of Agronomy 2020 (August 27, 2020): 1–12. http://dx.doi.org/10.1155/2020/1802460.
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An experiment was conducted to examine the performance of pearl millet under different nitrogen (N) fertilizer rates in two locations in the semiarid zone of Nigeria. The objective was to evaluate the effects of different N rates on pearl millet yields, water- and nitrogen-use efficiency, and profitability. Grain yield increased by 23, 26, 32, 32, and 27% and by 38, 41, 54, 58, and 56% compared to unfertilized plots when applying 20, 40, 60, 80, and 100 kg Nha−1 in Minjibir and Gambawa, respectively. Similarly, stalk yield increased by 4, 3, 9, 9, and 9% and by 16, 24, 36, 40, and 37% compared to unfertilized plot when applying 20, 40, 60, 80, and 100 kg Nha−1 in Minjibir and Gambawa, respectively. The variations in GY that could be explained by TWU and NUE were 28% and 26% in Minjibir and 46% and 41%, respectively, in Gambawa. There was a strong and positive correlation (R = 0.81 and R = 0.95) between WUE and GY across N-fertilizer rates and pearl millet varieties in both locations. An increase in N-fertilizer levels increased WUE, confirming the optimal application of 60 kg Nha−1 in Minjibir and of 80 kg Nha−1 in Gambawa. Similarly, the highest net economic return (NER) of US$610 ha−1 was obtained at 60 kg Nha−1 in Minjibir and the highest NER of US$223 ha−1 was obtained at an application rate of 80 kg Nha−1 in Gambawa. Break-even yield was above 1000 kg ha−1, signifying that average farmer with a mean yield of less than 1000 kg ha−1 produces millet at a loss.
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Huang, Weidong, Jonathan F. Lara, Richard Michaelson, Xiu Sun, Pierfranco Conte, Valentina Guarneri, Elena Barbieri, et al. "Quantitative HER2 measurement and PI3K mutation profile in matched primary and metastatic breast cancer tissues." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 614. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.614.
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614 Background: HER2 status of primary breast cancer (PBC) is routinely used to determine systemic treatment for metastatic breast cancer (MBC) patients. Discordance rates of HER2 status between PBC and MBC range from 5.5% to 29% based on published meta-analyses. The clinical benefit of re-assessing HER2 in MBC tissues remains controversial. In this study, we measured quantitative HER2 expression in matched PBC and MBC tissues and correlated changes of HER2 with mutations in the catalytic domain of PI3 kinase(PIK3CA). Methods: Total HER2 protein expression (H2T) was quantified by the HERmark assay in 41 matched PBC and MBC formalin-fixed, paraffin-embedded specimens. PIK3CA mutation status in exons 9 (E545K and E542K) and 20 (H1047R) was determined using a validated pyrosequencing assay. Results: MBC samples included 5 lymph node, 13 viscera, 6 brain, and 17 soft tissue lesions (N=41). 27 (66%) cases showed higher H2T in MBC than in matched PBC; and 14 (34%) cases had higher H2T in PBC than in matched MBC, indicating an overall increase of H2T in matched MBC lesions (fold change 0.25-17.57; p=0.005, paired Wilcoxon rank sum test). HER2 positive conversion (HERmark negative/equivocal in PBC, but positive in matched MBC) was found in 6 (15%) cases, while HER2 negative conversion (HERmark positive in PBC, but negative/equivocal in matched MBC) was seen in 2 (5%) cases. HER2 status was unchanged in 33 (80%) cases. PIK3CA mutations were detected in 13 (32%) of PBC and 19 (46%) of MBC samples. Among the HER2 positive conversion cases, PIK3CA mutation was identified in 50% (3/6) PBC and 67% (4/6) MBC, compared to 0% (0/2, PBC or MBC) in the HER2 negative conversion cases. Among cases with unchanged HER2 status, PIK3CA mutation was observed in 30% (10/33) PBC and 42% (14/33) MBC. Conclusions: Quantitative HER2 assessment revealed a 20% discordance in HER2 status between matched PBC and MBC tissues, with more frequent conversion from low HER2 in PBC to high HER2 in MBC. PIK3CA mutation was observed more frequently in patients who converted from HER2 negative PBC to HER2 positive MBC. These results suggest that re-assessment of biomarkers in MBC tissues may better inform the selection of therapeutic options for patients with MBC.
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Nakamura, Tsujiguchi, Hara, Kambayashi, Miyagi, Thu Nguyen, Suzuki, et al. "Dietary Calcium Intake and Hypertension: Importance of Serum Concentrations of 25-Hydroxyvitamin D." Nutrients 11, no. 4 (April 23, 2019): 911. http://dx.doi.org/10.3390/nu11040911.
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The relationship among dietary calcium, hypertension and vitamin D status currently remains unclear. This population-based cross-sectional study examined the association between dietary calcium intake and hypertension and the influence of serum concentrations of 25-hydroxyvitamin D [25(OH)D] in Japanese subjects. A total of 619 subjects aged from 40 years were recruited. Dietary intake was measured using a validated brief self-administered diet history questionnaire. Hypertension was defined as the use of antihypertensive medication or a blood pressure of 140/90 mmHg. Serum concentrations of 25(OH)D were used as the biomarker of vitamin D status. The prevalence of hypertension and low serum 25(OH)D levels (<20 ng/mL) were 55 and 32%, respectively. Dietary calcium intake inversely correlated with hypertension in subjects with serum 25(OH)D levels higher than 20 ng/mL (OR: 0.995; 95% CI: 0.991, 0.999) but it was not significant in those with serum 25(OH)D levels of 20 ng/mL or lower. Furthermore, dietary vitamin D intake correlated with serum concentrations of 25(OH)D after adjustments for various confounding factors. The present results demonstrate that the regular consumption of calcium may contribute to the prevention and treatment of hypertension in subjects with a non-vitamin D deficiency and also that dietary vitamin D intake may effectively prevents this deficiency.
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Péterffy, Árpád. "The starting period and development of heart surgery in Debrecen; The consequence of Professor József Schnitzler’s initiative." Orvosi Hetilap 150, no. 40 (October 1, 2009): 1861–64. http://dx.doi.org/10.1556/oh.2009.28721.
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A debreceni szívsebészet Schnitzler József professzor kezdeményezésére és folyamatos támogatásával az Auguszta Szanatórium mellkassebészeti osztályán, Eisert Árpád, nyíregyházi sebész főorvos együttműködésével vette kezdetét az 1960-as évek első felében. Az első 5 év folyamán (1963–68) összesen 44 zárt szívműtétet végeztek (ductuslekötés, pulmonalis és mitralis commissurotomia, pericardectomia). Az első nyitott szívműtétet vendégoperatőrként Kovács Gábor szegedi szívsebészprofesszor végezte 1968-ban, miután megérkezett Clevelandből Köteles Béla, és az ottani református egyház ajándéka, egy Pemco típusú szív-tüdő motor. Gömöry András szívsebészprofesszor Debrecenben 1972-től 1983-ig irányította a szakmai tevékenységet. Az első 20 év során 310 nyitott, 220 zárt szívműtét, 612 pacemaker-beültetés, összesen mintegy 1200 beavatkozás történt. Schnitzler professzor nyugdíjba vonulása után (1983) Péterffy Árpád lett a klinika igazgatója, és vette át a szívsebészet irányítását is. Az azóta eltelt 25 év alatt 18 000 nyitott, 1500 zárt és 8500 pacemakerműtét, összesen 32 000 beavatkozás történt. 2008-tól Szerafin Tamás egyetemi docens – Péterffy professzor tanítványa – lett a szívsebészet vezetője.
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Piechota, M., B. Kot, E. Zdunek, J. Mitrus, J. Wicha, and M. K. Wolska. "Distribution of classical enterotoxin genes in staphylococci from milk of cows withand without mastitis and the cowshed environment." Polish Journal of Veterinary Sciences 17, no. 3 (September 1, 2014): 407–11. http://dx.doi.org/10.2478/pjvs-2014-0058.
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AbstractThe aim of this study was to analyze by PCR 185 isolates of Staphylococcus from milk of cows with- and without mastitis and from the cowsheds environment for their potential ability to produce five classical staphylococcal enterotoxins. Among S. aureus isolates 8 (32%) carried enterotoxin genes and only 2 of them had more than one gene. The enterotoxin genes were detected in 22 (13.7%) coagulase-negative staphylococci (CNS) isolates, among them in 9 (11.4%) isolates of S. xylosus, 5 (16.7%) S. sciuri, 3 (10.3%) S. epidermidis and in 5 (22.7%) Staphylococcus spp. In some CNS 2 or 3 genes were detected simultaneously. Among the investigated enterotoxin genes, sec was the most prevalent (70%). The genes encoding enterotoxin B and D were detected in 5 (16.7%) and 6 (20%) isolates, respectively. The lowest number of isolates had sea and see genes.The genes encoding enterotoxins were often identified in staphylococci from milk of cows with mastitis (73.4% of detected genes), while only 6 (20%) isolates from milk of cows without mastitis and 2 (6.6%) isolates from cowshed environment were positive for enterotoxin genes.The results showed that CNS from bovine milk, like S. aureus, carried enterotoxin genes and may pose a risk for public health.
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Cortes, Nelson, Andrew E. Lincoln, Gregory D. Myer, Lisa Hepburn, Michael Higgins, Margot Putukian, and Shane V. Caswell. "Video Analysis Verification of Head Impact Events Measured by Wearable Sensors." American Journal of Sports Medicine 45, no. 10 (May 25, 2017): 2379–87. http://dx.doi.org/10.1177/0363546517706703.
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Background: Wearable sensors are increasingly used to quantify the frequency and magnitude of head impact events in multiple sports. There is a paucity of evidence that verifies head impact events recorded by wearable sensors. Purpose: To utilize video analysis to verify head impact events recorded by wearable sensors and describe the respective frequency and magnitude. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Thirty male (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.06 m; mean weight, 73.4 ± 12.2 kg) and 35 female (mean age, 16.2 ± 1.3 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) players volunteered to participate in this study during the 2014 and 2015 lacrosse seasons. Participants were instrumented with GForceTracker (GFT; boys) and X-Patch sensors (girls). Simultaneous game video was recorded by a trained videographer using a single camera located at the highest midfield location. One-third of the field was framed and panned to follow the ball during games. Videographic and accelerometer data were time synchronized. Head impact counts were compared with video recordings and were deemed valid if (1) the linear acceleration was ≥20 g, (2) the player was identified on the field, (3) the player was in camera view, and (4) the head impact mechanism could be clearly identified. Descriptive statistics of peak linear acceleration (PLA) and peak rotational velocity (PRV) for all verified head impacts ≥20 g were calculated. Results: For the boys, a total recorded 1063 impacts (2014: n = 545; 2015: n = 518) were logged by the GFT between game start and end times (mean PLA, 46 ± 31 g; mean PRV, 1093 ± 661 deg/s) during 368 player-games. Of these impacts, 690 were verified via video analysis (65%; mean PLA, 48 ± 34 g; mean PRV, 1242 ± 617 deg/s). The X-Patch sensors, worn by the girls, recorded a total 180 impacts during the course of the games, and 58 (2014: n = 33; 2015: n = 25) were verified via video analysis (32%; mean PLA, 39 ± 21 g; mean PRV, 1664 ± 619 rad/s). Conclusion: The current data indicate that existing wearable sensor technologies may substantially overestimate head impact events. Further, while the wearable sensors always estimated a head impact location, only 48% of the impacts were a result of direct contact to the head as characterized on video. Using wearable sensors and video to verify head impacts may decrease the inclusion of false-positive impacts during game activity in the analysis.
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Hossain, SF, QT Islam, MR Siddiqui, A. Hossain, N. Jahan, YU Rahman, and MJ Iqbal. "A Study of Hypoalbuminaemia in Chronic Liver Disease and its Correlation with Development of Esophageal Varices." Bangladesh Journal of Medicine 22, no. 1 (February 2, 2013): 17–20. http://dx.doi.org/10.3329/bjmed.v22i1.13595.
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Background: The aim and objective of this study was to evaluate relationship of serum albumin and esophageal varices in chronic liver disease (CLD) admitted in the medicine unit and gastroenterology department of Dhaka Medical College Hospital. Method: In this cross-sectional study, a total number of 100 randomly selected, clinically diagnosed patients of chronic liver disease were studied from June 2010 to November 2010 (6 months). All patients were assessed as per Child-Pugh class and had full blood count, HBsAg, Anti-HCV antibodies by ELISA, abdominal ultrasound and Endoscopy of upper gastrointestinal tract. Patients were divided into Group A (serum albumin <3.5 gm%) and Group B (3.55). Result: Seventy-three male (73%) and twenty seven female patients (27%)] with age range of 16 to 75 years were evaluated. Out of 100 patients 24% were in between 46-55 years age group. 63% patient fall in child Pugh class A group, 32% fall in child Pugh class B & 5% fall in child Pugh class C. Mean Serum albumin was 3.8 gm%, (range 2.4-4.9). Esophageal varices (EV) were present in 32 patients (32%) and absent in 68 patients (68%). Group A had 29 patients (29% of the total) with 18 patients (62.06%) having EV. Group B had 71 patients (71% of the total) with 14 patients (19.71%) having EV. Sensitivity of hypoalbuminaemia as a marker of EV was 56% and specificity 83.8%, positive predictive value 62.06% and negative predictive value 80.2% and Odds ratio was 6.6. P value is <0.001. Conclusion: In Group A that is hypoalbuminaemia (<3.5 gm%), the incidence of Esophageal varices was more than Group B that is albumin level (>3.5gm%). Hypoalbuminemia is a good surrogate marker for the presence of esophageal varices in CLD. DOI: http://dx.doi.org/10.3329/bjmed.v22i1.13595 Bangladesh J Medicine 2011; 22: 17-20
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Martin, J. F., T. D. Daniel, and E. A. Trowbridge. "Acute and Chronic Changes in Platelet Volume and Count After Cardiopulmonary Bypass Induced Thrombocytopenia in Man." Thrombosis and Haemostasis 57, no. 01 (1987): 55–58. http://dx.doi.org/10.1055/s-0038-1651061.
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SummaryPatients undergoing surgery for coronary artery bypass graft or heart valve replacement had their platelet count and mean volume measured pre-operatively, immediately post-operatively and serially for up to 48 days after the surgical procedure. The mean pre-operative platelet count of 1.95 ± 0.11 × 1011/1 (n = 26) fell significantly to 1.35 ± 0.09 × 1011/1 immediately post-operatively (p <0.001) (n = 22), without a significant alteration in the mean platelet volume. The average platelet count rose to a maximum of 5.07 ± 0.66 × 1011/1 between days 14 and 17 after surgery while the average mean platelet volume fell from preparative and post-operative values of 7.25 ± 0.14 and 7.20 ± 0.14 fl respectively to a minimum of 6.16 ± 0.16 fl by day 20. Seven patients were followed for 32 days or longer after the operation. By this time they had achieved steady state thrombopoiesis and their average platelet count was 2.44 ± 0.33 × 1011/1, significantly higher than the pre-operative value (p <0.05), while their average mean platelet volume was 6.63 ± 0.21 fl, significantly lower than before surgery (p <0.001). The pre-operative values for the platelet volume and counts of these patients were significantly different from a control group of 32 young males, while the chronic post-operative values were not. These long term changes in platelet volume and count may reflect changes in the thrombopoietic control system secondary to the corrective surgery.
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Xiccato, G., A. Trocino, A. Sartori, and P. I. Queaque. "Effect of weaning diet and weaning age on growth, body composition and caecal fermentation of young rabbits." Animal Science 77, no. 1 (April 2003): 101–11. http://dx.doi.org/10.1017/s1357729800053704.
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AbstractTwo weaning diets (C and S) and three weaning ages (21, 25, and 28 days) were compared in a two factorial arrangement to evaluate their effect on growth performance, body composition and caecal fermentation activity of young rabbits. One hundred litters born the same day from multiparous does were used. Sixty litters were early weaned at 21, 25 and 28 days of age (20 litters per weaning age), put in collective cages (nine kits per cage) (W21, W25, and W28 litters) and offered the control diet C (crude protein (CP) : 175 g/kg dry matter (DM); ether extract : 20 g/kg DM; starch : 157 g/kg DM; acid-detergent lignin (ADL) : 60 g/kg DM; digestible energy (DE) : 11·08 MJ/kg DM) or the starter diet S (CP : 173 g/kg DM; ether extract : 41 g/kg DM; starch : 112 g/kg DM; ADL : 51 g/kg DM; DE : 11·31 MJ/kg DM). At 32 days of age, 180 early weaned rabbits (three rabbits from each of the 60 litters above) were selected : 60 animals were slaughtered; 120 animals were placed into individual cages and offered a fattening diet (CP : 166 g/kg DM; ether extract : 23 g/kg DM; starch : 177 g/kg DM; ADL : 49 g/kg DM; DE : 11·26 MJ/kg DM) from 32 to 56 days of age. At 56 days of age, another 60 representative rabbits were slaughtered. The administration of diet S to the early weaned rabbits increased litter weight at 32 days (6160 v. 6027 g;P<005) and gain to food ratio from weaning to 32 days (752 v 666 g/kg;P<0001) compared with diet C. Moreover, empty bodies (EB) of S rabbits were fatter (fat : 45 v. 41 g/kg; P = 001) and had greater energy content (5·92 v 5·71 MJ/kg;P<001). At 56 days of age, no residual effect of the diet was recorded. Weaning age affected growth performance, body composition and caecal fermentation at 32 days of age : EB weight (P<005) and EB protein concentration increased (from 164 to 168 g/kg,P<0·01) while caecal volatile fatty acid concentration decreased (from 71·7 to 53·8 mmol/l;P<0·01) when weaning age was increased from 21 to 28 days. At 56 days of age, no effect (P > 0·05) of weaning age was recorded on growth performance or caecal fermentation traits, but EB protein remained lower in the earliest weaned rabbits (P<0·05). In conclusion, feeding a high-fat low-starch diet to early weaned rabbits stimulated growth and body fat and energy retention of kits at 32 days of age with no effect on caecal fermentation. The early weaning successfully performed at 21 days of age strongly stimulated caecal fermentation but reduced body protein reserves.
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Orlando, Laura, Francesco Giotta, Margherita Cinefra, Daniele Rizzi, Salvatore Pisconti, Salvatore Del Prete, Mariangela Ciccarese, et al. "When less is better: Safety and efficacy of combination of trastuzumab and continuous low oral dose chemotherapy (HEX) as first-line therapy for HER2-positive advanced breast cancer (ABC)—First early results from a phase II trial on behalf of Gruppo Oncologico Italia Meridionale (GOIM)." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 618. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.618.
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618 Background: Clinical activity of the combination of chemotherapy plus trastuzumab in HER2+ ABC has been well documented. We report the first results in terms of activity and safety of the combination of trastuzumab plus metronomic capecitabine and cyclophosphamide as first line therapy in HER-2 positive ABC. Methods: Patients (pts) at first relapse or with synchronous metastasis, were treated with trastuzumab (4 mg/kg, loading dose 6 mg/kg) plus oral capecitabine (1500mg/daily) and cyclophosphamide (50 mg/daily). Primary end-point was overall response rate (ORR), secondary end-points time to progression (TTP), clinical benefit rate (CBR; PR+ CR + prolonged SD for ≥ 24 weeks) and tolerability. The optimal two-stage design was applied. Results: A total of 31 pts with measurable ABC, tumors scored as +3 positive for HER-2 or FISH +, no pretreated with chemotherapy or trastuzumab for advanced disease have been enrolled, 28 actually valuable for response and toxicity. Median age was 59 years (range 42-87), visceral metastases were present in most patients (61%). Median number of cycles was 12 (range 1-37+). The ORR was 61 % (95% CI, 41-78%), with 1 CR (3.6 %) and 16 PR (57.1%). 9 patients had prolonged SD (32%). The CBR was 82.1% (95% CI , 63%-94%). Five progressions were observed (18%). Median TTP was 7 months (range 2- 19 + months). Ten pts received more than 20 courses. Worst toxicities were grade 2 hand-foot syndrome in 4 pts, grade 2 anemia in 4 pts, grade 2 nausea in 2 pts and diarrhea grade 3 in 1 pt. Cardiac toxicity grade 2 in 1 pts. Alopecia was not reported. Conclusions: Combination of trastuzumab and low dose metronomic oral chemotherapy in HER-2 + breast cancer has shown clinical activity. The tolerability was excellent and allowed the prolonged delivery of the combination. Thus, the patients accrual is ongoing to the pre-set target of 66 patients. Clinical trial information: 2009-017083-16.
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Le Roy, Florence, Eugénie Rigault, David Regnault, Nicole Hubert, Pascal Burtin, Antoine Hollebecque, David Malka, Valerie Boige, and Michel Ducreux. "Oxaliplatin desensitization after hypersensitivity reaction: A single-center experience on more than 300 procedures." Journal of Clinical Oncology 36, no. 4_suppl (February 1, 2018): 610. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.610.
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610 Background: Oxaliplatin is an essential drug in gastrointestinal oncology. Hypersensitivity reactions (HSR) occur frequently (incidence varying from 10% to 25%), leading to permanent treatment discontinuation. The present study aimed to report our experience of oxaliplatin desensitization in patients with history of HSR to oxaliplatin. Methods: We retrospectively reviewed all patients who received at least one infusion of oxaliplatin according to a desensitization protocol after prior history of HSR to oxaliplatin, from June 2011 until June 2017. HSRs were classified from NCI CTC-AE grade 1 (transient rash, fever < 38°C) to grade 4 (anaphylaxis). We applied in all cases a desensitization protocol in which the oxaliplatin infusion rate is gradually increased from 1mL/hr. to 150mL/hr., on an inpatient basis. Intravenous or hepatic arterial infusion was used depending on clinical setting. Results: Overall, 54 patients were included in this study, in whom HSR to oxaliplatin occurred after a median of 9 infusions (range, 1-31). The severity of HSRs was grade 1-2 in 33 patients (61%) and grade 3-4 in 21 patients (39%). A total of 305 oxaliplatin infusions according to a desensitization protocol were performed in these 54 patients (median, 5 infusions; range, 1-20). These infusions were by intravenous route in 42 patients (78%), by hepatic arterial route in 11 patients (18%), and both in 2 patients (4%). Infusions were well tolerated in 41 patients (76%), without new HSR. The remaining 13 patients (24%) experienced HSR recurrence (grade 2, 9 patients [69%]; grade 3, 4 patients [31%]). No anaphylaxis or oxaliplatin-related death occurred. In the 21 patients with a prior history of severe (grade 3-4) HSR, oxaliplatin desensitization procedure was effective and sustained in 16 patients (79%). Among 32 evaluable patients, 23 (72%) experienced disease control (14 partial responses, 9 stable diseases). Conclusions: Rechallenging Oxaliplatin desensitization procedure was successful in three out of four patients with prior history of HSR to oxaliplatin. Our retrospective study confirms that oxaliplatin desensitization is safe, and allows patients who developed HSR to continue an effective treatment.
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Podosokorskaya, O. A., I. V. Kublanov, A. L. Reysenbach, T. V. Kolganova, and E. A. Bonch-Osmolovskaya. "Thermosipho affectus sp. nov., a thermophilic, anaerobic, cellulolytic bacterium isolated from a Mid-Atlantic Ridge hydrothermal vent." International Journal of Systematic and Evolutionary Microbiology 61, no. 5 (May 1, 2011): 1160–64. http://dx.doi.org/10.1099/ijs.0.025197-0.
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A novel obligately anaerobic, extremely thermophilic, organotrophic bacterium, strain ik275marT, was isolated from a Mid-Atlantic Ridge deep-sea hydrothermal vent. Cells were rods surrounded by a sheath-like structure (toga), 0.4–0.9 µm in width and 1.2–6.0 µm in length. Strain ik275marT grew at 37–75 °C, pH 5.6–8.2 and at NaCl concentrations of 10–55 g l−1. Under optimum conditions (70 °C, pH 6.6, NaCl 20 g l−1), doubling time was 32 min. The isolate was able to ferment carbohydrates including starch, cellulose and cellulose derivatives. Acetate, H2 and CO2 were the main products of glucose fermentation. G+C content of DNA was 27 mol%. Phylogenetic analysis of 16S rRNA gene sequences showed that strain ik275marT is a member of the genus Thermosipho. 16S rRNA gene sequence identity with the other species of the genus Thermosipho ranged from 93.7 to 94.5 %. Based on the phylogenetic analysis and physiological properties of the novel isolate, we propose a novel species, Thermosipho affectus sp. nov., with type strain ik275marT ( = DSM 23112T = VKM B-2574T).
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Malinauskiene, Vilija, and Romualdas Malinauskas. "Lifetime Traumatic Experiences and Disordered Eating among University Students: The Role of Posttraumatic Stress Symptoms." BioMed Research International 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/9814358.
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The associations between lifetime traumatic events (TEs), posttraumatic stress (PTS) symptoms, and disordered eating (DE) were studied in a sample of 614 university students (mean age 20 years). An anonymous questionnaire included 32 lifetime TEs, IES-revised measured PTS symptoms, and EAT-26 evaluated DE symptoms. Statistical analyses included Pearson correlations and structural equation models (SEM) with bootstrapping method. Findings reveal the prevalence of DE in 8.1% of participants, while 73.9% of students experienced at least one lifetime TE. 52.0% of students with DE had PTS symptoms (p<0.0001) and 30.8% of students with lifetime TEs had PTS symptoms (p<0.001). In SEM, direct paths from lifetime TEs to PTS symptoms (0.38, p<0.0001) and from PTS symptoms to DE (0.40, p<0.0001) were observed. The final SEM confirmed the mediating role of PTS symptoms in the path between some TEs (traffic accident and seriously injured) and DE among the university students. If PTS symptoms are associated with DE, then addressing PTS symptoms in the context of DE treatment may improve treatment efficacy.
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Karásek, Petr, Dagmar Stejskalová, and Zbyněk Ulčák. "Analysis of Rural Social Aspects in the Context of Land Consolidations and Land Use Planning, the Case Study, Czech Republic." Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis 62, no. 3 (2014): 507–15. http://dx.doi.org/10.11118/actaun201462030507.
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Our project was focused on the investigation of attitudes and preferences of the rural population concerning landscape protection and use in the context of land use planning documentations – Land Consolidations (LC) and Land Use Planning (LUP). The survey was organized in the form of questionnaires distributed in four model localities. In total, we obtained 196 responses (almost 32%) out of 617 questionnaires distributed via elementary schools. The respondents are more familiar with the notion of land use planning (80% know the term of land plan) than land consolidations (known by 50% respondents only). The local population are not confident about the land-managing subjects (60% respondents do not believe that the subjects managing agricultural land e.g. protect arable land against erosion). Seventy % of respondents agree with restoration of balks, with reducing the acreages of agriculturally managed land tracts. More than 90% respondents perceive the landscape as a space for recreation, sports, and rest. Only 20% of inhabitants are employed in agriculture (over 60% respondents work in services or other specializations). The respondents prefer natural environment over the economic aspects of the rural areas.
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Kosugi, Chihiro, Hirohiko Kamiyama, Yoichiro Yoshida, Hiroshi Yoshida, Keiichiro Ishibashi, Keisuke Ihara, Makoto Takahashi, et al. "The combination of TAS-102 and bevacizumab as the third-line chemotherapy for metastatic colorectal cancer (TAS-CC3 Study)." Journal of Clinical Oncology 37, no. 4_suppl (February 1, 2019): 614. http://dx.doi.org/10.1200/jco.2019.37.4_suppl.614.
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614 Background: TAS-102 improved overall survival of metastatic colorectal cancer (mCRC) patients with median progression free survival (PFS) of 2.0 months (RECOURSE trial). Subsequently, the combination of TAS-102 and bevacizumab has been shown to extend median PFS with 3.7 months (C-TASK FORCE). However, this study included patients with 2nd line and 3rd line chemotherapy. Our study was planned exclusively for patients receiving this combination as a 3rd line chemotherapy to investigate clinical impact of this combination beyond cytotoxic doublet. Methods: This phase II study was conducted in investigator-initiated, open-label, single-arm, multicentered manner in Japan. Eligible patients were 20-80 years old, and had to have an ECOG performance status of 0 or 1; had confirmed unresectable mCRC with histologically diagnosed adenocarcinoma; were refractory or intolerant to fluoropyrimidine, irinotecan, and oxaliplatin in the 1st and the 2nd line chemotherapy. TAS-102 (35 mg/ m²) was given orally twice daily on days 1–5 and 8–12 in a 4-weeks cycle, and bevacizumab (5 mg/ kg) was administered by intravenous infusion for 30 minutes in every 2 weeks. The primary endpoint was progression free survival (PFS), and the secondary endpoints were time to treatment failure (TTF), response rate (RR), overall survival (OS), and safety. Results: Between June 2016 and August 2017, 32 pts were enrolled. The median PFS was 4.5 months, and the median OS was 9.3 months. Partial response was observed in 2 patients. The most common adverse events above grade 3 were neutropenia (15 patients) followed by thrombocytopenia (4 patients). Treatment-related serious adverse events were reported in 1 patient. There were no non-hematologic adverse events above grade 3. No treatment-related deaths occurred. Conclusions: This is the first study which involves the combination TAS-102 and bevacizumab as the 3rd line chemotherapy in the setting beyond cytotoxic doublet for the patients with mCRC. This study met its primary endpoint PFS, which is comparable to the results of C-TASK FORCE study. This combination has a potential to be one of therapeutic options of the 3rd line chemotherapy for mCRC. Clinical trial information: 000022438.
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Barata, Pedro C., Alfonso Gomez de Liano, Prateek Mendiratta, Valerie Crolley, Bernadett Szabados, Laura S. Wood, Beth Zanick, et al. "Clinical outcome of patients (Pts) with metastatic renal cell carcinoma (mRCC) progressing on front-line immune-oncology based combination (IO-COMBO) regimens." Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 613. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.613.
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613 Background: Several IO-COMBO regimens are under investigation in front-line mRCC. The clinical outcome of pts who progress on an IO-COMBO regimen and receive subsequent systemic therapy is unknown. Methods: A retrospective analysis of all pts with clear-cell mRCC enrolled in one of seven clinical trials investigating an IO-COMBO at Cleveland Clinic Taussig Cancer Institute and Barts Cancer Institute was conducted. Clinical outcome of subsequent therapy including best objective response according to RECIST v1.1, progression-free survival (PFS) and adverse events (AEs) using CTCAE v4.0, were collected. Results: From a total of 89 pts enrolled on an IO-COMBO trial, final analysis included 32 pts with PD who received ≥1 line of subsequent therapy, median age 57 (41-77), 83% male, 72% ECOG 0, 78% IMDC fav-/intm- risk. Prior IO-COMBO included atezolizumab/bevacizumab (n = 20), ipilimumab/nivolumab (n = 10) and axitinib/avelumab (n = 2). All except 1 pt received IO-COMBO in the front-line setting. All pts received 1 subsequent therapy (axitinib n = 15; pazopanib n = 9; sunitinib n = 4; cabozantinib n = 3; nivolumab n = 1) after progression on IO-COMBO, 12 pts were treated with a second subsequent therapy and 5 pts were treated with ≥3 subsequent lines of treatment. For pts with available response (n = 26), the overall best response to first subsequent therapy was 27% PR, 50% SD and 15% PD. Median PFS for the first subsequent therapy was 7.9 months (95% CI, 4.5-11.3) with 8 pts remaining on treatment. The median PFS for pts previously treated with a combination of IO plus anti-VEGF was 7.9 months (95% CI, 3.1-12.7) and was 9.3 months (95% CI, 3.5-15.0) for pts treated with a prior IO plus IO combination (p = 0.732). The most frequent G3/G4 treatment-related AEs observed with first subsequent therapy were LFT elevation (9%) and diarrhea (7%); 2 pts discontinued subsequent treatment due to toxicity. Conclusions: VEGF-TKIs have clinical activity in mRCC refractory to IO-COMBO therapy, possibly impacted by the inclusion of an anti-VEGF agent in prior IO-COMBO therapy. Subsequent therapy was in general well tolerated.
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Koca, Esra, Christine Koch, Gabriele Husmann, and Jörg Bojunga. "Time from first symptoms to diagnosis in GEP-NET patients: Results from a large German tertiary referral center." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 610. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.610.
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610 Background: Patients with neuroendocrine tumors (NET) often go through a long phase between onset of symptoms and initial diagnosis. Methods: Retrospective analysis of 486 patients with GEP-NET (488 tumors) at tertiary referral center from 1984-2019; inclusion criteria: Patients > 18 years, diagnosis of GEP-NET; descriptive analysis using SPSS; Cox regression, Log rank test. Results: Demographics: Male 54% / 52.9% (all/GEP-NET), median age at first diagnosis 63y/58y (all /GEP-NET). Localizations: small intestine 145/488 (29.7%), pancreas 143/488 (29.3%), CUP 53/488 (10.9%), colon 49/488 (10%), stomach 45/488 (9.2%), rectum 27/488 (5.5%), other digestive organs 11/488 (2.3%), esophagus 5/488 (1%), other 10/488 (2%). Ki67 in 330/488 (67.6%) evaluable patients: < 3%: 155/330; 46.9%; ≥ 3%: 111/330; 33.6%; > 20%: 64/330;19.3%. 128/488 (26.2%) of patients had NET specific symptoms (abdominal pain 77/128; 60.2%, diarrhea 51/128; 39.8%, flush 19/128; 14.8%, carcinoid syndrome 8/128; 6.3% tachycardia 6/128; 4.7%). 122/488 (25%) patients showed other tumor-specific symptoms (weight loss 48/122; 39.3%, stool irregularity 21/122; 17.2%, hypoglycemia 10/122; 8.2%, painless jaundice 8/122; 6.6%). 154/ 488 (32%) of NET were incidental findings (imaging 39.6%, endoscopy 23.4%, surgery for other causes 18.8%, appendectomy 15.6%). 221/279 (initial diagnosis/any time; 79.2%) patients had distant metastases at initial diagnosis (187/221 liver metastases). Time from tumor manifestation to initial diagnosis: pNET 360 ± 116 days, siNET 309 ± 87 days, gastric NET 66 ± 47 days, colonic NET 98 ± 67 days. Time from onset of symptoms to diagnosis in symptomatic patients was significantly longer than in asymptomatic patients (388 ± 86 days vs. 174 ± 58 days, p = 0.001). No significant difference in patients with or without distant metastases (223 ± 78 days vs. 259 ± 57 days, p = 0.355). Conclusions: A large proportion of NET are incidental findings and only about half of all patients are symptomatic at the time of diagnosis. Diagnosis for symptomatic patients takes significantly longer than for asymptomatic, which might be due to mainly unspecific symptoms. Presence of metastases has no influence on time to diagnosis.
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Van Blarigan, Erin, Katherine Van Loon, Stacey A. Kenfield, June M. Chan, Emily Mitchell, Hilary Chan, Li Zhang, et al. "Self-monitoring and reminder text messages to increase physical activity after colorectal cancer (CRC): A pilot randomized controlled trial." Journal of Clinical Oncology 36, no. 4_suppl (February 1, 2018): 615. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.615.
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615 Background: Over 1.3 million people in the US are living with CRC. Physical activity is associated with lower risk of CRC mortality. Interventions are needed to increase physical activity after CRC diagnosis. Methods: We conducted a pilot RCT to determine the feasibility (adherence, attrition) and acceptability of a 12-wk intervention using a Fitbit Flex™ and daily text messages to increase physical activity after CRC. Eligible patients had to have colon or rectal cancer of any stage, be disease free or have stable disease, able to speak and read English, and access to Internet and a mobile phone. Individuals with contraindications to moderate-to-vigorous physical activity (MVPA) or exercising ≥30 min ≥5 d/wk were excluded. We explored the impact of the intervention (n = 20) vs. usual care (n = 21) on MVPA via ActiGraph GT3X+ accelerometers pre-/post-intervention. Results: The intervention was feasible and acceptable. On average, participants were 54 y, BMI 28 kg/m2 and enrolled 1.5 y after diagnosis; 59% were women, 73% were White, and 61% were stage III. The intervention arm wore their Fitbits a median of 74 d (89% of study days, IQR: 23-83 d) and responded to 74% (34) of the 46 text messages that asked for a reply (IQR: 28-82%). Older participants were more likely to wear the Fitbit ( r: 0.72; p < 0.001). Married participants were more likely to wear the Fitbit and respond to texts compared to unmarried (96% vs. 32% wear time, p: 0.02 and 85% vs. 46% response rate, p: 0.006). Most patients (88%) reported that the intervention motivated them to exercise and that they were satisfied with their experience. On average, the intervention arm increased MVPA by 14 min/d, while the control arm increased by only 1 min/d, but there was no statistically significant difference in change in MVPA between groups (mean difference comparing change in MVPA in the intervention vs. control: 13 min/d; 95% CI: -14, 40; p: 0.33). Conclusions: A 12-wk physical activity intervention with a Fitbit and text messages is feasible and acceptable among CRC patients after treatment. Larger studies are needed to determine whether the intervention increases physical activity. Clinical trial information: NCT02966054.
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Downar, J., and J. Mikhael. "60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 61. http://dx.doi.org/10.25011/cim.v30i4.2821.
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Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units.
Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care.
Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation.
In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units.
Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32.
Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610.
Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.
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Yoon, Sang Eun, Seok Jin Kim, and Kihyun Kim. "Review of 20 Years Outcome of Multiple Myeloma Novel Agent Era at Samsung Medical Center, a Korean Cancer Center." Blood 134, Supplement_1 (November 13, 2019): 5585. http://dx.doi.org/10.1182/blood-2019-127872.
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Introduction The present incidence of MM in Korea has increased approximately 50 times compared with the 1980s. Additionally, developing new anticancer drugs (cf, lenalidomide, pomalidomide, ixazomib, elotuzumab, selinexor and daratumumab) as well as advanced clinical trial of combination with classic and new agents has enabled a wide range of treatment options and improvement in overall survival. In Korean we also experience improvement in MM treatment, however, there are limitations in applying new agent due to delay in approval and reimbursement in compared with US and EU. Thus, we try to analyze the outcome of mm treatment for 20 years and to find unmet need of myeloma treatment in Korea. Methods We have conducted a registry study for multiple myeloma patients since 2000 in Samsung Medical Center. At the time of analysis, 957 patients included in this study. We excluded amyloidosis, plasma cell leukemia and POEMS syndrome. And, we also excluded patients without enough data or short follow up due to transfer to other medical center. Results The median follows up duration were 87 months (range 6-249) and the median overall survival of total patients were 55 months (95% CI 49.1-60.9). Among the 957 patients, the median age was 61 (22-92), 582 (60.8%) of those were aged younger than 65 years and 375 (39.2%) of those were aged older than 65 years. The overall survival of younger than 65 years was longer than older than 65 years old (66 months, 95% CI 59.3-72.7 vs. 35 months, 95% CI 30.3-39.7). Over the course of the decades, the patients who enrolled during from 2010-2018(n=614) were more than those who enrolled during from 2000 to 2009 (n=343). There was no difference in overall survival between the two groups. The majority of patients (n=746, 78%) received bortezomib-containing regimens followed by lenalidomide containing regimens (n=373, 39%). Before transplantation, VAD (n=132), T(C)D(n=187) and VTD(n=158) were used as conditioning regimens. Among of them, VTD regimen showed a slightly improvement in PFS (22months, 95% CI 19.3-34.4) than T(C)D or VAD (19 months, 95% CI 15.0-23.0 vs. 22 months 95% CI 17.0-27.0, P-value <0.00) but, no difference in survival rates according to type of regimen (p-value=0.46). The induction chemotherapy of the newly diagnosed auto-HSCT ineligible patients (n=307) was CP/MP/CD/MD (n=103), VMP (n=172), LD (n=32). There was a difference in ORR (55.4%, 79.7%, 84.4%, P-value<0.00) and PFS (13 months vs. 16 months vs. 20 months, P-value <0.00) according to the regimen, but no difference in survival. In present study, 489 patients (51.1%) received hematopoietic stem cell transplantation (HSCT), of which 403 (82.4%) patients received single auto-HSCT and 45 (9.2%) patients received tandem auto-HSCT. The survival of patients with auto-HSCT was 34 months (95% CI 29.0-39.0) in patients who were not treated with 75 months (95% CI 64.4-85.6, p-value < 0.00). The survival rate of patient who experienced second recurrence (n=613) was 29 months (95% CI 24.3-33.7), and those of the third recurrence (n=424) was 20 months (95% CI 16.1-23.9). Of the 239 patients who recurred after bortezomib and lenalidomide, 118 patients had received new agent including pomalidomide(n=109), carfilzomib(n=50), daratumumab and isatuximab (n=30). The overall survival of these patients was longer than not taking the new agents. (73 months, 95% CI 61.8-84.2 vs. 45 months, 95% CI 31.5-58.5, p-value<0.00). Conclusion In spite of shortcoming as a single center data, long duration and relatively large number we could see the overall outcome of MM treatment in the era of novel agent. We could see the improvement of outcome who experience novel drug treatment. However, we could not see overall survival improvement from the patients who were diagnosed later 10 years. We suspect that even the earlier patients experienced survival improvement due to salvage treatment of bortezomib and lenalidomide, but the exposure of second line novel drug is minimal for the latter group patients. In conclusion, we improved the outcome of MM treatment in Korea with novel drugs for past 20 years, but still we have unmet need to improve survival of MM patients and need to more active use of novel agent for MM patients. Figure Disclosures No relevant conflicts of interest to declare.
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Nilson, Göran. "Gloyd, H. K., Conant, R. (1990): Snakes of the Agkistrodon complex - a monographic review. 1-614, 32 coloured figs., 20 half-tone plates. Price $75. Society for the Study of Amphibians and Reptiles, Contributions to Herpetology no. 6, Oxford, Ohio." Amphibia-Reptilia 12, no. 4 (1991): 423–25. http://dx.doi.org/10.1163/156853891x00068.
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Hofman, Michael S., Louise Emmett, Shahneen Kaur Sandhu, Amir Iravani, Anthony M. Joshua, Jeffrey C. Goh, David A. Pattison, et al. "TheraP: A randomised phase II trial of 177Lu-PSMA-617 (LuPSMA) theranostic versus cabazitaxel in metastatic castration resistant prostate cancer (mCRPC) progressing after docetaxel: Initial results (ANZUP protocol 1603)." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 5500. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.5500.
Full textAbstract:
5500 Background: LuPSMA is a radiolabeled small molecule that delivers therapeutic β-radiation to PSMA-expressing tumors. Encouraging efficacy and safety has been shown in non-randomized studies of mCRPC. TheraP is a randomized phase II trial comparing LuPSMA vs cabazitaxel in men with mCRPC progressing after docetaxel. Methods: Men with mCRPC, and imaging with 68Ga-PSMA-11 and 18F-FDG PET/CT that confirmed high PSMA-expression and no sites of FDG-positive/PSMA-negative disease, were randomly assigned (1:1) to LuPSMA (6-8GBq q6weeks up to 6 cycles) vs cabazitaxel (20mg/m2 q3weeks up to 10 cycles); stratified by disease burden (>20 vs ≤20 sites), prior novel antiandrogens (NAA; abiraterone or enzalutamide), and study site. The primary endpoint was PSA response rate (PSA50-RR) defined by ≥50% reduction. Secondary efficacy endpoints included PSA-progression-free survival (PSA-PFS) and overall survival (OS). Data cut-off was 31DEC19 at this first pre-specified analysis. Results: 200 (median age 72 y, prior NAA 91%, >20 lesions 78%) of 291 PET screened men were randomised to LuPSMA (N=99) or cabazitaxel (N=101). 17 patients withdrew or died before receiving study treatment (1 LuPSMA vs 16 cabazitaxel). The PSA50-RR was higher in those assigned LuPSMA than cabazitaxel (65/99 [66%; 95%CI 56-75] vs 37/101 [37%; 95%CI 27-46]; P<0.001). At a median follow-up of 11.3 months, LuPSMA significantly improved PSA-PFS (HR 0.63, 95%CI 0.45-0.88, P=0.007; 143 events with next pre-specified analysis planned after 170 events). Efficacy results were similar when analyses were restricted to per-protocol treated men. OS data remains immature (57 deaths). Grade III-IV adverse events (AEs) occurred in 31/98 (32%) LuPSMA-treated men vs 42/85 (49%) in cabazitaxel-treated men. Discontinuations for toxicity occurred in 1/98 (1%) LuPSMA vs 3/85 (4%) cabazitaxel-treated. There were no treatment-related deaths. Conclusions: In men with docetaxel-treated mCRPC, LuPSMA was more active (PSA50-RR) than cabazitaxel with relatively fewer G3-4 AEs and PSA-PFS favoring LuPSMA. Clinical trial information: NCT03392428 .