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1
Paduch, Jan-Hendrik, Johanna Lücking, Elisabeth Mansion-de Vries, Claudia Zinke, Nicole Wente, and Volker Krömker. "Prevention of Intramammary Infections by Prepartum External Application of a Teat Dip Containing Lactic Acid Bacteria with Antimicrobial Properties in Dairy Heifers." Pathogens 9, no. 4 (April 16, 2020): 288. http://dx.doi.org/10.3390/pathogens9040288.
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The aim of the current study was to investigate the effects of the prepartum external treatment of teats with a combination of four lactic acid bacteria strains viz. Lactobacillus (Lb.) rhamnosus ATCC 7469, Lactococcus lactis subsp. lactis ATCC 11454, Lb. paracasei 78/37 (DSM 26911), and Lb. plantarum 118/37 (DSM 26912) on the postcalving udder health of dairy heifers. The study used a split-udder design. Two weeks before the expected calving date, one of two contralateral teats of a teat pair was dipped with an aqueous suspension of lactic acid bacteria (final bacterial counts 8.40–8.47 log10-transformed CFU/mL) once in a week until calving; the other teat of the pair was not treated. After calving, quarter foremilk samples were taken and investigated cyto-microbiologically. In total, 629 teat pairs of 319 heifers were included. There was an association between the treatment and intramammary infections caused by the major udder-pathogenic bacteria Staphylococcus aureus, Streptococcus dysgalactiae, and enterococci, as well as clinical mastitis in the first 100 days after calving. The present study indicates that intramammary infections with major pathogens and clinical mastitis may be prevented by regular prepartum external application of lactic acid bacteria in dairy heifers.
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Kadhim, Ali S. "Antimicrobial Resistance Patterns and Extended Spectrum Beta-lactamases Producing by Proteus mirabilis Isolated from Different Sources." Al-Mustansiriyah Journal of Science 28, no. 1 (November 19, 2017): 47. http://dx.doi.org/10.23851/mjs.v28i1.311.
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A total of 801 samples included 179 clinical samples and 622 animal samples were collected from Baghdad province. All samples were cultured on blood agar and MacConkey agar plates to isolate proteus mirabilis bacteria. Results showed that rate isolates of P. mirabilis from clinical and animal samples were 25.89% (51/179) and 5.95% (37/622) respectively. Antibiotic susceptibility test showed that lowest resistance rates for clinical P. mirabilis isolates were 3.9% for ciprofloxacin, 7.8% for norfloxacin, 9.8% for imipenem, 13.7% for levofloxacin and 15.7% for cefotaxime, and highest resistance rates were 82.4% for cefepime, 78.4% for piperacillin, 56.9% for ceftazidime and 54.9% for cefoxitin. In regards to animal isolates, they were 100% sensitive to cefoxitin and 100% resistance to piperacillin. Their resistance rates were 2.7% to amikacin, 5.4% to ciprofloxacin and 8.1% to cefepime, imipenem and levofloxacin. The results revealed that all P. mirabilis isolates were 100% multidrug resistance for 2-8 antibiotics. Extended spectrum β-lactamases produced were detected in 52.94% of clinical P. mirabilis isolates and in 48.65% of animal isolates.
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Carlton, Edward Watts, Jenny Ingram, Hazel Taylor, Joel Glynn, Rebecca Kandiyali, Sarah Campbell, Lucy Beasant, et al. "Limit of detection of troponin discharge strategy versus usual care: randomised controlled trial." Heart 106, no. 20 (May 5, 2020): 1586–94. http://dx.doi.org/10.1136/heartjnl-2020-316692.
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IntroductionThe clinical effectiveness of a ‘rule-out’ acute coronary syndrome (ACS) strategy for emergency department patients with chest pain, incorporating a single undetectable high-sensitivity cardiac troponin (hs-cTn) taken at presentation, together with a non-ischaemic ECG, remains unknown.MethodsA randomised controlled trial, across eight hospitals in the UK, aimed to establish the clinical effectiveness of an undetectable hs-cTn and ECG (limit of detection and ECG discharge (LoDED)) discharge strategy. Eligible adult patients presented with chest pain; the treating clinician intended to perform investigations to rule out an ACS; the initial ECG was non-ischaemic; and peak symptoms occurred <6 hours previously. Participants were randomised 1:1 to either the LoDED strategy or the usual rule-out strategy. The primary outcome was discharge from the hospital within 4 hours of arrival, without a major adverse cardiac event (MACE) within 30 days.ResultsBetween June 2018 and March 2019, 632 patients were randomised; 3 were later withdrawn. Of 629 patients (age 53.8 (SD 16.1) years, 41% women), 7% had a MACE within 30 days. For the LoDED strategy, 141 of 309 (46%) patients were discharged within 4 hours, without MACE within 30 days, and for usual care, 114 of 311 (37%); pooled adjusted OR 1.58 (95% CI 0.84 to 2.98). No patient with an initial undetectable hs-cTn had a MACE within 30 days.ConclusionThe LoDED strategy facilitates safe early discharge in >40% of patients with chest pain. Clinical effectiveness is variable when compared with existing rule-out strategies and influenced by wider system factors.Trial registration numberISRCTN86184521.
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Nagy, Ildikó, Anita Katalin Varga, Norbert Balázsfalvi, and Balázs Nemes. "A kadáverdonor-vesék elfogadási gyakorlatának vizsgálata a debreceni transzplantációs centrumban." Orvosi Hetilap 162, no. 26 (June 27, 2021): 1022–28. http://dx.doi.org/10.1556/650.2021.32253.
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Összefoglaló. Bevezetés: A magyarországi vesetranszplantáció 2013 óta az Eurotransplant (ET) keretein belül zajlik. A debreceni vesetranszplantációs centrumhoz évente kb. 200 kadáverdonorvese-felajánlás érkezik, melyek 37%-a kerül a megismert adatok alapján elfogadásra. Nem minden elfogadott vese kerül beültetésre, aminek számos oka lehet. Célkitűzés: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán. Módszer: A debreceni centrumhoz 2016. november és 2020. március között 624 vesefelajánlás érkezett. A felajánlott vesék 37%-a (n = 229) került előzetesen elfogadásra, később az elfogadott vesék 63%-a (n = 144) került beültetésre. Centrumunkban az ún. ’standard criteria’, azaz tökéletes minőségű donorvesék szignifikánsan magasabb arányban kerültek elfogadásra, majd beültetésre, mint az ’extended criteria’, azaz kompromisszummal vállalhatók. Az elfogadott és nem elfogadott veséket vizsgálva a KDPI (kidney donor profile index) és a KDRI (kidney donor risk index) értéke szignifikánsan magasabb volt az elutasított donorok esetében (p<0,001). Eredmények: Elemeztük, hogy a felajánlott, de a centrum által nem beültetett donorveséket más ET-centrumban elfogadták-e. Látható, hogy a felajánlott 624 donorvese közül 144 Debrecenben, 313 pedig más ET-centrumban került beültetésre, viszont 167 vese beültetése egyik ET-centrumban sem történt meg (discarded organ). A 36–85 KDPI-értékkel rendelkező csoportból került beültetésre a legtöbb donorvese (180 vese) más ET-centrumban. A Debrecenben beültetett kadáverdonor-vesék KDPI- és KDRI-értéke szignifikánsan alacsonyabb volt a nekünk felajánlott, majd máshol beültetett vesékhez képest. Következtetés: Összességében elmondható, hogy a debreceni centrumban a magas rizikócsoportba tartozó donorszervek elutasításra kerültek, miközben más centrumban a nagy részüket beültették. Ez alapján a 36–85 KDPI-értékű csoport a transzplantációs esetszám bővítésének lehetséges forrása a recipiens ismeretében. Orv Hetil. 2021; 162(26): 1022–1028. Summary. Introduction: Kidney transplantation in Hungary is carried out via Eurotransplant (ET). Our centre in Debrecen receives around 200 kidney offers a year, of which 37% are accepted. Not all accepted kidneys are transplanted, which can be a result of a number of causes. Obejctive: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán. Method: Between November 2016 and March 2020, the centre of Debrecen received 624 kidney offers. 37% (n = 229) of the offered kidneys got preliminarily accepted, of which 63% (n = 144) were transplanted later. In our centre, standard criteria donor kidneys were accepted and transplanted in significantly higher rate, than extended criteria donor kidneys. Looking at accepted and rejected kidneys, KDPI and KDRI values were significantly higher in the case of the refused ones (p<0.001). Results: Part of our assessment is to analyze whether kidneys offered to and refused by us got accepted in other transplant centres. In the examined period, of the 624 kidneys offered to our centre 144 were transplanted in Debrecen, 313 were transplanted in other ET centres, while 167 were not transplanted at all (discarded organ). The majority of transplanted kidneys in other ET centres had KDPI values between 36 and 85 (180 kidneys.) KDPI and KDRI values of kidneys transplanted in our centre were significantly lower than those that were offered to us, but got transplanted elsewhere. Conclusion: To summarize, we can say that high-risk donor organs are refused in the transplant centre of Debrecen, while the majority of them are being transplanted in other centres. Based on this, kidneys of KDPI value between 36 and 85 are a possible source of expanding the number of transplantations, with regards to the recipient. Orv Hetil. 2021; 162(26): 1022–1028.
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Katrib, K., H. A. Adlouni, and G. Férard. "Presence of nonesterified and acylcarnitine in human polymorphonuclear leukocytes and mononuclear cells." Clinical Chemistry 33, no. 4 (April 1, 1987): 533–35. http://dx.doi.org/10.1093/clinchem/33.4.533.
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Abstract We demonstrate the presence of nonesterified carnitine and acylcarnitine in leukocytes, but not in erythrocytes, from 16 healthy adults. After carefully separating the different kinds of blood cells we measured significant amounts of nonesterified carnitine and acylcarnitine in polymorphonuclear leukocytes (28.5 +/- 6.1 and 18.5 +/- 6.3 mumol/10(9) cells) and mononuclear cells (25.4 +/- 5.2 and 14.8 +/- 4.5 mumol/10(9) cells). We also measured nonesterified carnitine, long-chain acylcarnitine, and short-chain acylcarnitine in plasma after fractionation with perchloric acid and obtained the following values (mean +/- SD): 41.4 +/- 2.6, 3.9 +/- 1.2, and 6.0 +/- 1.6 mumol/L, respectively. The mean percentages of total carnitine (n = 6) in polymorphonuclear leukocytes, mononuclear cells, and plasma were approximately 62%, 27%, and 13% of whole-blood carnitine, respectively (mean recovery was 102%). The percentage of acylated carnitine was 37% in leukocytes, as compared with 19% in plasma.
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Tsitsiashvili, A. M., A. M. Panin, Ye N. Nikolayeva, A. A. Arutyunyan, M. S. Podporin, and V. N. Tsarev. "Microbial contamination dynamics in surgical treatment of patients using dental implants in a limited bone tissue volume." Stomatology for All / International Dental review, no. 2019 4 (89) (December 2019): 52–58. http://dx.doi.org/10.35556/idr-2019-4(89)52-58.
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The aim of the study was to evaluate the effectiveness of antibiotic chemotherapy regimens and the dynamics of the nature of microbial associations of the operating area at the surgical stages of treatment of patients using dental implants in conditions of limited bone tissue. The study involved 37 patients (17 m and 20 w, from 32 to 68 years). According to the tactics of the treatment and the type of antibacterial effect, the patients were divided into 3 groups. Per os was prescribed antibiotics as a step therapy: amoxicillin (flemoxin 500 mg 1 tablet 2 per day for 7 days) and amoxicillin / clavulanate (flemoclav 625 mg 1 table 2 per day 7 days), doxycycline (unidox 100 mg 1 table 1 per day 5 days). The 1st group of patients (n1=12; 31.9%) — a multi-stage approach (MA), where the 1st operation is bone grafting (BG) (Flemoxin 500 mg), after 6—9 months, the 2nd dental implantation (DI) (flemoklav 625 mg), after 3—6 months the 3rd — installation of gingival formers (GF) (unidox 100 mg). The 2nd group of patients (n2=14; 36.2%) — a one-stage approach (OA), where the 1st operation is BG with simultaneous DI (flemoxin 500 mg), after 6—9 months — the 2nd — installation of GF (flemoklav 625 mg). 3rd group — narrow/short implants (N/S) without BG were installed (n3=11; 31.9%). The 1st operation — DI (Flemoxin 500 mg), the 2nd — installation of GF (Flemoklav 625 mg). A bacteriological study with the identification of pure cultures of bacteria and determination of sensitivity to antibacterial drugs was performed for all patients before treatment and in dynamics. In MA, there was a suppression of the growth of certain types of bacteria and an increase in the number of species resistant to this antibiotic. In the framework of the OA, when prescribing antibiotics, the results were comparable. With N/S implants, growth inhibition of a number of species present at the beginning of treatment was noted. In multi-stage operations, we consider it reasonable to use beta-lactamase-protected drugs, or drugs of another group that include representatives of parodontopathogenic species and potential carriers of multiple resistance genes in their spectrum of action.
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Asare, George Awuku, Daniel Afriyie, Robert A. Ngala, Alfred A. Appiah, Yvonne Anang, Iddi Musah, Samuel Adjei, et al. "Shrinkage of Prostate and Improved Quality of Life: Management of BPH Patients with Croton membranaceus Ethanolic Root Extract." Evidence-Based Complementary and Alternative Medicine 2015 (March 24, 2015): 1–10. http://dx.doi.org/10.1155/2015/365205.
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Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The study aimed at validating the use of freeze-dried Croton membranaceus ethanolic root extract for BPH management. Thirty-three patients were observed before and after 3-month administration of 20 mg t.i.d orally. The International Prostate Symptom Score (IPSS), and the International Index of Erectile Function (IIEF) questionnaires were used. Total/free PSA (tPSA, fPSA), renal, liver function, lipid tests, and ultrasonographic imaging were performed. Thirty (30) patients (66 ± 11 years) completed the study. IPSS results showed 37% had severe, 40% moderate, and 23% mild symptoms before; 57% and 43% had moderate and mild symptoms, respectively, after treatment. IIED of patients’ results showed 30% with severe, 40% moderate, 24% mild-moderate, 3% mild, and 3% no erectile dysfunction before treatment and 20% severe, 43% moderate, and 37% mild-moderate dysfunction, after treatment. Quality of life (QoL) improved (P=0.001). Significant but non-pathological increases in total and indirect bilirubin as well as apolipoprotein A occurred. Mean tPSA reduced from 27.9 ± 19.0 to 16.2 ± 11.8 ng/mL (P=0.002); fPSA from 6.1 ± 4.8 to 3.9 ± 2.9 ng/mL (P=0.045); and prostate volume from 101.8 ± 41.3 to 54.5 ± 24.8 cm3 (P=0.023). C. membranaceus shrinks the prostate and improves QoL.
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Patel, Brijesh, Paul Secheresiu, Mahek Shah, Lekha Racharla, Ahmad B. Alsalem, Manyoo Agarwal, Byomesh Tripathi, et al. "Trends and Predictors of Palliative Care Referrals in Patients With Acute Heart Failure." American Journal of Hospice and Palliative Medicine® 36, no. 2 (August 29, 2018): 147–53. http://dx.doi.org/10.1177/1049909118796195.
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Objective: To determine the rate and predictors of palliative care referral (PCR) in hospitalized patients with acute heart failure (AHF). Introduction: The PCR is commonly utilized in terminal conditions such as metastatic cancers. There is no data on trends and predictors from large-scale registry of general population regarding PCR in patients with AHF. Methods: For this retrospective study, data were obtained from National Inpatient Sample Database from 2010 to 2014. We used International Classification of Diseases, Ninth Revision diagnosis codes to identify cases with a principle diagnosis of AHF. These patients were divided into 2 groups: (1) PCR, (2) no PCR groups. We performed multivariate analysis to identify predictors of PCRs, as well as reported PCR trends from 2010 to 2014. Results: From the database, out of 37 312 324 hospitalizations, 621 947 unweighted cases with primary diagnosis of AHF were selected for further analysis. About 2.8% received PCR. From 2010 to 2014, there was an uptrend from 2.0% to 3.6% for PCR. Metastatic cancer, ventilator-dependent respiratory failure, and cardiogenic shock were strongly associated with PCR. Those who underwent percutaneous coronary intervention and African American or other races were negative predictors for PCR. In the PCR group, 31.4% of patients died during hospitalization. Conclusion: Palliative care referrals were made in a very small proportion of patients with AHF. We observed steady rise in the PCR utilization. Chronic conditions, advancing age, and high-risk patients were major predictors of PCR.
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Regmi, Shrawan K., Kumar P. Dahal, and Jagadeesh Bhattarai. "Soil corrosivity to the buried-pipes used in Lalitpur, Kathmandu Valley, Nepal." Nepal Journal of Environmental Science 3 (December 7, 2015): 15–20. http://dx.doi.org/10.3126/njes.v3i0.22730.
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Six soil parameters (moisture content, pH, resistivity, oxidation-reduction potential, chloride and sulfate) of 23 samples were analyzed using standard methods for their corrosive nature towards the buried galvanized-steel and cast-iron pipes used to supply drinking water in three areas (Tikathali, Imadol- KA and Imadol-KHA) of Lalitpur district of Kathmandu Valley. Amounts of these six soil parameters in the collected 23 samples were found to be of 11–37% moisture content, 6.1–8.4 pH, 0.3330 x 104– 4.7620 x104 Ohm.cm resistivity, 317–553 mV (SHE) oxidation-reduction potential, 14–75 ppm chloride and 56–176 ppm sulfate contents. These findings indicated that most of soil samples collected from the study areas of Lalitpur district of Nepal are found to be mildly corrosive and less corrosive nature of soils on the buried galvanized-steel and cast-iron pipes used for the supply of drinking water. The use of non-conducting materials like gravel/sand around the buried-pipes, before burying them in the study areas seems to be effective to control such corrosion and to increase life time of the pipes.
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Ruddy, Kathryn J., Shari I. Gelber, Rulla M. Tamimi, Elizabeth S. Ginsburg, Lidia Schapira, Steven E. Come, Virginia F. Borges, Meghan E. Meyer, and Ann H. Partridge. "Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer." Journal of Clinical Oncology 32, no. 11 (April 10, 2014): 1151–56. http://dx.doi.org/10.1200/jco.2013.52.8877.
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Purpose Most research regarding fertility in young women with breast cancer has focused on long-term survivors. Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis. Patients and Methods As part of an ongoing prospective multicenter cohort study, we surveyed women with newly diagnosed early-stage breast cancer at age ≤ 40 years. The baseline survey included sociodemographic, medical, and treatment data as well as a modified Fertility Issues Survey, including fertility concern and preservation items. Univariable and multivariable modeling were used to investigate predictors of greater fertility concern. Results Among the first 620 eligible respondents included in this analysis, median age was 37 years (range, 17 to 40 years); 425 women (68%) discussed fertility issues with their physicians before starting therapy, and 319 (51%) were concerned about becoming infertile after treatment. Because of concerns about fertility, four women (1%) chose not to receive chemotherapy, 12 (2%) chose one chemotherapy regimen over another, six (1%) considered not receiving endocrine therapy, 19 (3%) decided not to receive endocrine therapy, and 71 (11%) considered receiving endocrine therapy for < 5 years; 65 (10%) used fertility preservation strategies. Greater concern about fertility was associated with younger age, nonwhite race, not having children, and receipt of chemotherapy. Conclusion Many young women with newly diagnosed breast cancer have concerns about fertility, and for some, these substantially affect their treatment decisions. Only a minority of women currently pursue available fertility preservation strategies in this setting.
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Haferlach, Claudia, Sandra Weissmann, Sabrina Kuznia, Susanne Schnittger, Wolfgang Kern, Alexander Kohlmann, and Torsten Haferlach. "TP53 Mutations Are Present In 15.7% Of ALL, Are Especially Frequent In ALL With MYC-Rearrangement and In ALL With Low Hypodiploid Chromosome Status and Are Associated With Poor Prognosis." Blood 122, no. 21 (November 15, 2013): 827. http://dx.doi.org/10.1182/blood.v122.21.827.827.
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Abstract Background TP53 is the most frequently mutated gene in cancer. The prognostic impact of TP53 mutations has been demonstrated in CLL, AML, and MDS. However, data on the frequency and prognostic impact of TP53 mutations in ALL is scarce. Aims We aimed at determining the TP53 mutation frequency, the association with cytogenetic subgroups and age, as well as the impact on survival. Patients and Methods In total, a large cohort of 625 patients with ALL was analyzed for TP53 mutations by deep-sequencing allowing to simultaneously quantify the mutation load. In all patients chromosome banding analyses have been performed. In addition, in 341 patients the copy number state of TP53 was determined by FISH. Results The cohort comprised 353 male and 272 female patients, median age was 49.5 years (range: 0.1-91.4 years). The cohort included the following groups: normal karyotype (n=101; 16.2%), t(9;22)(q34;q11) (n=162; 25.9%), MLL-translocations (n=37; 5.9%), MYC-translocations (n=40; 6.4%), t(12;21)(p13;q22) (n=15; 2.4%), low hypodiploidy (<40 chromosomes) (n=24; 3.8%), high hyperdiploidy (51-68 chromosomes) (n=38; 6.1%), complex karyotype (n=69; 11.0%), other cytogenetic abnormalities (n=139; 22.2%). Detailed data on immunophenotyping was available for 408 patients (T-lineage: n=105; B-lineage: n=267, Burkitt: n=36). In the total cohort, the frequency of TP53 mutations was 15.7% (98/625). TP53 mutations were most frequent in ALL with low hypodiploidy (22/24; 91.7%) and MYC-translocated ALL (25/40; 62.5%) and also quite frequent in ALL with complex karyotype (16/69; 23.2%), ALL with normal karyotype (13/101; 17.4%), and in MLL-translocated ALL (6/37; 16.2%). TP53 mutations were rare in t(9;22)(q34;q11) (7/162; 4.3%), high hyperdiploidy (3/38; 6.1%), and other cytogenetic abnormalities (6/139; 4.3%) and absent in ALL with t(12;21)(p13;q22) (0/15; 0%). Furthermore, TP53 mutations were less frequent in T-lineage ALL (8/105; 7.6%) as compared to B-lineage and Burkitt ALL (41/267; 15.4% and 21/36; 58.3%). TP53 mutation frequency increased with age (TP53mut <60 years vs ≥ 60 years 10.8% (45/417) vs 25.5% (53/208), p<0.0001). 25/64 (39.1%) TP53 mutated patients with available TP53 deletion status showed a deletion of the second allele, while in 17/319 (5.3%) TP53wt patients with available TP53 deletion status a TP53 deletion was detected (p<0.001). 11/98 (11.2%) TP53 mutated patients showed two TP53 mutations. Median overall survival (OS) was significantly shorter in TP53mut vs TP53wt patients (18.8 months vs 75.5 months, p<0.0001). OS at 4 years in patients <60 years was 80.1% in TP53wt compared to 56.8% in TP53mut (p=0.012) and 59.3% vs 22.6% in patients ≥ 60 years (p<0.0001). Also within the cytogenetic categories MYC-translocated and complex karyotype TP53 mutations had a significant adverse impact on overall survival. Further, patients with either two TP53 mutations or one TP53 mutation and an accompanying TP53 deletion had a significantly shorter OS as compared to patients with only one altered TP53 allele (median OS 11.5 vs 63.1 months, p=0.009). In contrast, OS in patients with a TP53 deletion without a TP53 mutation did not differ from patients without TP53 alterations. In addition, the TP53 mutation load was investigated by next-generation sequencing and varied between 2% and 98% (median: 41%). Within the subset of patients with TP53 mutation, patients with a mutation load >20% showed a significantly shorter OS as compared to patients with a lower mutation load (median OS 11.5 months vs not reached, p=0.003). Interestingly, OS in patients with a TP53 mutation load ≤ 20% did not differ from TP53wt patients. In multivariate Cox regression analysis including parameters significantly associated with shorter OS in univariate analysis the following factors retained an independent adverse impact on OS: age (<60 years vs ≥ 60 years, HR=2.2; p=0.01), MLL-translocation (HR=2.8; p=0.03), and TP53mut >20% (HR: 3.1, p=0.01). Conclusions 1. TP53 is mutated in 15.7% of ALL with the highest frequency in ALL with low hypodiploidy (91.7%) and MYC-translocated ALL (62.5%). 2. The TP53 mutation frequency increases with age. 3. TP53 mutations are associated with short survival independent of age and specific cytogenetic alterations. 4. TP53 mutations had a significant impact on OS only if the mutation load was >20%. Disclosures: Haferlach: MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Weissmann:MLL Munich Leukemia Laboratory: Employment. Kuznia:MLL Munich Leukemia Laboratory: Employment. Schnittger:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Kern:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Kohlmann:MLL Munich Leukemia Laboratory: Employment. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership.
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Xu, Yumei, Daniel Leduc, Weimin Ye, and Zengqi Zhao. "Description of Tripylella jianjuni sp. n. (Nematoda: Tripylidae) from New Zealand." Nematology 20, no. 8 (2018): 795–810. http://dx.doi.org/10.1163/15685411-00003176.
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Summary Tripylella jianjuni sp. n. (Tripylidae) is described from New Zealand. Females are characterised by a relatively long body (1743 (1675-1860) μm in the female and 1747 (1576-1979) μm in the male), outer labial setae (8-9 μm long) and cephalic setae (4-5 μm long) in a single circle, two large subventral teeth in two adjacent stomatal chambers, relatively short pharynx (b = 5.5 (5.4-5.6) in the female and 5.7 (5.3-6.1) in the male), vulva located slightly anterior to mid-body (V = 44 (43-46)), protuberant lips, and long filiform tail (461 (398-531) μm, c = 3.8 (3.3-4.2) and c′ = 23.2 (18-29) in the female, and 450 (362-511) μm, c = 3.9 (3.6-4.4) and c′ = 19.0 (16.0-20.8) in the male), tail with three ventromedian caudal setae. Males have arcuate spicules 37 (35-41) μm long, gubernaculum straight, 14 (12-16) μm long, three ventromedian supplementary papillae located anterior to the cloacal aperture, and a single plus four pairs of subventral caudal setae located posterior to the cloacal aperture on the tail. Preliminary analyses of phylogenetic relationships within the Triplonchida were done using the SSU and D2-D3 region of LSU DNA sequences.
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Young, Guy, Frauke Friedrichs, Anthony Chan, Gili Kenet, Paolo Simioni, Helen van Ommen, Anne Krumpel, et al. "Impact of Inherited Thrombophilia on Symptomatic Venous Thrombo-Embolism (VTE) in Children: A Systematic Review & Meta-Analysis of 37 Studies Including 2470 Pediatric Patients." Blood 110, no. 11 (November 16, 2007): 3189. http://dx.doi.org/10.1182/blood.v110.11.3189.3189.
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Abstract Background: Inherited thrombophilia (IT) has been described as a risk factor for venous thromboembolism (VTE) in children. So far the majority of studies performed in the field were either retrospective or prospective on small numbers of patients. Thus, the results are contradictory or inconclusive mainly due to lack of statistical power. The aim of this study was to better estimate the impact of IT on early VTE onset and recurrence in children as a prerequisite to develop primary and secondary treatment options. Methods: A systematic search of publications listed in the electronic databases (Pubmed, Medline, EMBASE, Web of Science, The Cochrane Library) up to August 2007 using key words in combination both as MeSH terms and text words, was conducted. Citations were screened by two independent group members and those meeting the inclusion criteria were retained. Articles were included if published after 1990, when pediatric VTE was started to be systematically investigated. Findings: Twenty case-control and 17 cohort studies from 13 countries met the inclusion criteria. In these studies > 70% of patients had at least one clinical risk factor. The summary odds ratios (OR) and 95% confidence intervals (CI) of included studies under a fixed-effects and random-effects model showed statistically significant associations between the IT traits investigated and VTE onset (table). For the rare event of VTE recurrence, 1227 patients (eight studies) were evaluated: at the present state due to high heterogeneity, a trend towards association with recurrent VTE was found for ≥2 IT traits in the fixed-effects model (0R/CI: 2.8/1.6–4.8). Interpretation: The present meta-analysis gives evidence that the detection of inherited thrombophilia is clincially meaningful in children with VTE and underlines the importance of a pediatric thrombophilia screening program. Summary of Data Risk Factors OR/CI:fixed model OR/CI:random model patients/controls 2470/4119 N/A FV G1691A 3.5/2.9–4.2 3.2/2.3–4.4 FII G20210A 2.2/1.5–3.3 2.2/1.5–3.4 Protein C defiiciency 9.8/5.9–16 9.9/6.1–16.1 Protein S deficiency 7.1/3.9–13.2 6.8/3.7–12.7 Antithrombin deficiency 7.9/3.8–16.6 7.3/3.4–15.3 Lipoprotein(a) 4.4/3,2–5.9 4/2.4–6.6 ≥ 2 risk factors 12.6/7.3–21.8 11.6/6.2–20.2
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Zhang, Y. H., H. G. Cao, Y. S. Li, H. Q. Yin, X. P. Sun, T. Gui, S. F. Ji, Y. Tao, Y. Liu, and X. R. Zhang. "316 INDUCTION OF PIG INDUCED PLURIPOTENT STEM CELLS BY RECOMBINANT PROTEINS ENCODED BY DEFINED FACTORS." Reproduction, Fertility and Development 23, no. 1 (2011): 254. http://dx.doi.org/10.1071/rdv23n1ab316.
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Pluripotent cells derived from any differentiated cell type through ectopic expression of transcription factors were designated as induced pluripotent stem (iPS) cells, exhibiting similar morphology and growth properties to embryonic stem (ES) cells besides expressing ES cell marker. Because iPS have the ability to differentiate into all types of cells, iPS cell technology is thought to have enormous potential for generating disease models, drug screening, toxicology, and regenerative medicine. However, for virus-mediated transfection of defined factors, the exogenous genes generally would be randomly inserted into the target cell’s genome, possibly bringing the potential hazard of insertional mutagenesis. Therefore, it is necessary to seek some new methods to induce somatic cell reprogramming without viruses. With instruction from the work of Zhou et al. (2009 Cell Stem Cell 4, 381–384), in the present study we attempted to use defined factors recombinant proteins-carried cell-penetrating peptide for the generation of porcine iPS cells, which would be a benefit for safe applications of iPS cells. Defined factors genes were amplified by PCR with specific primers of 9 arginines (R9) from recombinant plasmid pLL-hOCT4/pSox2/pMyc/pKlf4-EGFP (Yin et al. 2010 Prog. Biochem. Biophys. 37, 607–612) and inserted into prokaryotic expression vector pET-28a-EGFP. After DNA sequencing confirmation, the 4 recombinant plasmids were then transformed into BL21 strains, respectively. After IPTG induction, hOCT4/pSox2/pMyc/pKlf4-R9-EGFP fusion proteins were purified using Novagen His-Bind kit and confirmed by sodium dodecyl sulfate–polyacrylamide gel electrophoresis, respectively. Then, defined factors recombinant proteins were added into pig fetal fibroblasts (PFF) medium every 48 h to establish pig iPS cells. The results showed that purified hOCT4/pSox2/pMyc/pKlf4-R9-EGFP fusion proteins could enter into PFF efficiently, and most of them were located in nuclei. The PPF were subcultured in stem cell medium condition and treated with defined factors recombinant proteins for 6 cycles simultaneously; the clear-cut cell colonies were gradually derived. These cells had large translucent nuclei and a high nucleo:cytoplasmic ratio and were positive for AP, Oct4, and Nanog. Detailed characterisation of such induced cells is ongoing. This research would provide new ideas for the induction of porcine somatic cell reprogramming. Y. H. Zhang and H. G. Cao contributed equally. This work was supported by NSFC (30700574 30800784/c120103) and 973 (2009CB941004).
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Koval, M., S. T. Geist, E. M. Westphale, A. E. Kemendy, R. Civitelli, E. C. Beyer, and T. H. Steinberg. "Transfected connexin45 alters gap junction permeability in cells expressing endogenous connexin43." Journal of Cell Biology 130, no. 4 (August 15, 1995): 987–95. http://dx.doi.org/10.1083/jcb.130.4.987.
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Many cells express multiple connexins, the gap junction proteins that interconnect the cytosol of adjacent cells. Connexin43 (Cx43) channels allow intercellular transfer of Lucifer Yellow (LY, MW = 443 D), while connexin45 (Cx45) channels do not. We transfected full-length or truncated chicken Cx45 into a rat osteosarcoma cell line ROS-17/2.8, which expresses endogenous Cx43. Both forms of Cx45 were expressed at high levels and colocalized with Cx43 at plasma membrane junctions. Cells transfected with full-length Cx45 (ROS/Cx45) and cells transfected with Cx45 missing the 37 carboxyl-terminal amino acids (ROS/Cx45tr) showed 30-60% of the gap junctional conductance exhibited by ROS cells. Intercellular transfer of three negatively charged fluorescent reporter molecules was examined. In ROS cells, microinjected LY was transferred to an average of 11.2 cells/injected cell, while dye transfer between ROS/Cx45 cells was reduced to 3.9 transfer between ROS/Cx45 cells was reduced to 3.9 cells. In contrast, ROS/Cx45tr cells transferred LY to > 20 cells. Transfer of calcein (MW = 623 D) was also reduced by approximately 50% in ROS/Cx45 cells, but passage of hydroxycoumarin carboxylic acid (HCCA; MW = 206 D) was only reduced by 35% as compared to ROS cells. Thus, introduction of Cx45 altered intercellular coupling between cells expressing Cx43, most likely the result of direct interaction between Cx43 and Cx45. Transfection of Cx45tr and Cx45 had different effects in ROS cells, consistent with a role of the carboxyl-terminal domain of Cx45 in determining gap junction permeability or interactions between connexins. These data suggest that coexpression of multiple connexins may enable cells to achieve forms of intercellular communication that cannot be attained by expression of a single connexin.
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Lakshman, Arjun, Jithma P. Abeykoon, Shaji Kumar, S. Vincent Rajkumar, Taxiarchis Kourelis, Francis Buadi, David Dingli, et al. "Daratumumab-based combination therapies (DCT) in heavily-pretreated patients (pts) with relapsed and/or refractory multiple myeloma (RRMM)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 8038. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.8038.
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8038 Background: Daratumumab-based Combination Therapies (DCT) with bortezomib (V)/ lenalidomide (R)/ pomalidomide (P) and dexamethasone (d) showed exceptional activity in RRMM in trials. Experience outside of trials since the approval of Daratumumab (D) in 2015 is limited. Methods: RRMM pts seen at Mayo Clinic, MN from 12/2015 -12/2016 were reviewed. Pts who received ≥ 1cycle of DCT were included. Time-to-event analyses were done from date of starting DCT. Common terminology criteria for adverse events v4.0 were used to grade toxicities. Results: Of 130 pts, 59% were males and median age at DCT initiation was 67 (43-93) years, ECOG performance score was ≥2 in 29%. Pts were classified as mSMART high (22%), intermediate (22%) or standard (56%) risk. Median time from diagnosis to initiation of DCT was 51.3 (5-156) months (m), and median number of prior therapies was 4 (1-14). 14% of pts were refractory to prior D monotherapy. Fifty-three (41%), 34 (26%) and 25 (19%) received DPd, DRd and DVd respectively. Eighteen (14%) pts received ‘other’ DCT. Median time to first response (≥ PR) was 3.1 m (95% CI 2.1-4.6). Overall response rate was 46%, [CR-2%, VGPR-18%, PR-26%]. Minimal response was seen in 17%, with clinical benefit rate of 62%. Median estimated follow up from initiation of DCT was 5.5 m (CI 4.2-6.1). The median duration of response was 6.1 m [CI 5.1- not reached (NR)]. Median progression free survival (PFS) was 5.5 m (CI 4.1-7.8) and median time to next therapy (TTNT) was 5.9 m (CI 4.6-9.4). Median PFS for DPd, DRd, DVd and other DCTs were 4.6 (CI 2.7-NR), 7.8 (CI 5-NR), 3.9 (CI 2.1-NR) and 3.9 (CI 2.8-8.2) m, respectively (p = 0.3). Median PFS for quadruple refractory (n = 28) MM was 2.8 m (CI 2.2-5.3) vs 5.9 m (CI 4.9-NR) for the rest (p < 0.01). Median overall survival (OS) from DCT was NR (CI 11.4-NR). Grade 3 or higher hematological toxicities were seen in 42% of pts. Other toxicities included infections (37%), fatigue (31%), infusion reactions (16%) and diarrhea (10%). Conclusions: DCT are effective in RRMM, but the PFS remains short particularly in quadruple refractory pts, reflecting the challenges encountered in managing heavily-pretreated, and often less fit patients, in routine practice.
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Choi-Kwon, S., and A. J. Baertschi. "Splanchnic osmosensation and vasopressin: mechanisms and neural pathways." American Journal of Physiology-Endocrinology and Metabolism 261, no. 1 (July 1, 1991): E18—E25. http://dx.doi.org/10.1152/ajpendo.1991.261.1.e18.
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Hypertonic (2 ml, 598 mosmol/kgH2O) solutions were infused over 4 min via a stomach tube in 12 groups (n = 5-10) of conscious rats with indwelling arterial catheters. Mean changes over 4–21 min of plasma arginine vasopressin (AVP) were 6.1 +/- 0.9 for NaCl (P less than 0.01), 9.3 +/- 3.0 for LiCl (P less than 0.01), 4.5 +/- 1.3 for sodium isethionate (P less than 0.01), 2.8 +/- 0.9 for sucrose (P less than 0.025), 3.9 +/- 2.8 for mannitol (P less than 0.01), and -0.1 +/- 0.1 (SE) pg/ml for urea. The AVP responses to NaCl and sucrose were proportional to the rate of gastrointestinal absorption of radiolabeled NaCl and sucrose, respectively. The AVP response to 598 mosmol/kgH2O NaCl was attenuated by 60.6% (P less than 0.001) in rats with lesion of the side branches of the major splanchnic nerves innervating the mesentery of the upper small intestine and the portal vein area, by 34–37% (P less than 0.05) in rats with right or left splanchnic nerve lesions, and was not affected by subdiaphragmatic vagotomy. Changes in systemic plasma osmolality were small and could not explain the AVP responses. Thus splanchnic receptors are osmosensitive, are situated in the mesentery of the upper small intestine and possibly the portal vein area, and project to the spinal cord via the right and left major splanchnic nerves.
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Pruna, Viorel Mihai, and M. R. Gorgan. "Particular aspects of cerebral metastases secondary to malignant melanoma in comparison with other brain metastases." Romanian Neurosurgery 29, no. 4 (December 1, 2015): 435–44. http://dx.doi.org/10.1515/romneu-2015-0059.
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Abstract Authors present a retrospective study of 427 patients with brain metastases admitted and treated in third and fourth neurosurgical departments of Emergency Clinical Hospital “Bagdasar-Arseni” Bucharest, from January, 2005 until December, 2014. 62.1% of all patients were men and 37.9% were women, with a medium age of 56.8 years, ranging between 17 and 85 years. 311 patients (72.8%) had a single metastasis, 79 patients (18.5%) developed 2 or 3 metastases and 37 patients (8.7%) had more than 3 metastases. The biggest four metastases in multiple cases were noted in database regarding location, either reported to left / right hemisphere, either related to site (frontal parietal etc.), and dimensions. In the case of malignant melanoma (22 men and 24 women) the status of the primary tumor was noted: the malignant melanoma was operated in 32 cases (69.6%) and in 7 patients (15.2%) the primary tumor was not operated. In another 7 cases the status of the primary tumor was not noted. The most frequent location for malignant melanoma was the legs in women and anterior thorax in men. In conclusion, cerebral metastases from malignant melanoma have most frequent intratumoral hemorrhages, comparative with other primary sources. Common primary sites founded in this study is legs in women and anterior thorax in men. Treatment of cerebral metastases is complex, multimodal, implying neurosurgeons, oncologists and radiotherapists.
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Gray, Diane M., Dorottya Czovek, Lauren McMillan, Lidija Turkovic, Jacob A. M. Stadler, Anessa Vanker, Bence L. Radics, et al. "Intra-breath measures of respiratory mechanics in healthy African infants detect risk of respiratory illness in early life." European Respiratory Journal 53, no. 2 (January 31, 2019): 1800998. http://dx.doi.org/10.1183/13993003.00998-2018.
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Lower respiratory tract illness (LRTI) is a leading cause of mortality and morbidity in children. Sensitive and noninvasive infant lung function techniques are needed to measure risk for and impact of LRTI on lung health. The objective of this study was to investigate whether lung function derived from the intra-breath forced oscillation technique (FOT) was able to identify healthy infants at risk of LRTI in the first year of life.Lung function was measured with the novel intra-breath FOT, in 6-week-old infants in a South African birth cohort (Drakenstein Child Health Study). LRTI during the first year was confirmed by study staff. The association between baseline lung function and LRTI was assessed with logistic regression and odds ratios determined using optimal cut-off values.Of the 627 healthy infants with successful lung function testing, 161 (24%) had 238 LRTI episodes subsequently during the first year. Volume dependence of respiratory resistance (ΔR) and reactance (ΔX) was associated with LRTI. The predictive value was stronger if LRTI was recurrent (n=50 (31%): OR 2.5, ΔX), required hospitalisation (n=38 (16%): OR 5.4, ΔR) or was associated with wheeze (n=87 (37%): OR 3.9, ΔX).Intra-breath FOT can identify healthy infants at risk of developing LRTI, wheezing or severe illness in the first year of life.
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Tan, Tow Shung, Angela Dispenzieri, Rajiv Pruthi, Martha Q. Lacy, Suzanne R. Hayman, Francis K. Buadi, Steven R. Zeldenrust, et al. "The Prevalence of Abnormal Coagulation Parameters in Patients with Newly Diagnosed Primary Systemic Amyloidosis and Its Impact on Outcome." Blood 112, no. 11 (November 16, 2008): 5114. http://dx.doi.org/10.1182/blood.v112.11.5114.5114.
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Abstract Background: Primary systemic amyloidosis (AL) is an incurable plasma cell disorder associated with varying degree of organ infiltration with light chain derived amyloid protein and consequent organ dysfunction. Various acquired coagulopathies, predominantly Factor X (FX) deficiency have been previously described in AL. The factor deficiencies are thought to be due to the direct binding of blood coagulation proteins to amyloid fibrils. Little is known regarding the prognostic significance of abnormal coagulation parameters in AL patients (pts). Methods: After Institutional Review Board approval, we performed a retrospective review of the medical records of 625 consecutive pts who had presented within 3 months of a diagnosis of AL to be evaluated at Mayo Clinic from June 2001 to June 2006. 540 pts had coagulation studies performed within 2 months of presentation. 51 of those pts were on oral anticoagulation and were excluded from the analysis. Results: Of the 489 pts included in the analysis, the median age was 62 years and 61% were male. The median overall survival (OS) of the entire cohort was 26.8 months. Table 1 lists the prevalence of abnormal coagulation tests in the remaining 489 patients. Prothrombin time (PT) was available in the majority of pts. 61 pts (12.6%) had elevated PT, and 63 pts (20.4%) had a decreased FX. 37 of the 61 pts with elevated PT had available FX levels, of which 31 (84%) of those had a decreased FX, suggesting that the cause of elevated PT was mostly due to a low FX. Indicators of hepatic involvement such as alkaline phosphatase and bilirubin levels were higher among the patients with prolonged PT and low FX. An elevated PT (more than 12.4 seconds) was strongly predictive of an adverse outcome, with a median OS of 8.7 months compared to a median OS of 29 months (p<0.0001) in pts with normal PT (Figure 1). Similarly, pts with decreased FX (less than 60% activity), was associated with significantly worse outcomes with a median OS of 14.9 months versus a median OS of 33 months (p<0.0001) in pts with normal FX (Figure 2). In a Cox proportional hazards model containing cardiac troponin (cTnT), NT-Pro BNP, serum alkaline phosphatase, and free light chain difference (involved minus uninvolved), prolonged PT or FX deficiency were independently prognostic for overall survival. Conclusion: Abnormalities of PT and FX are seen in a sizable proportion of pts with newly diagnosed AL. An elevated PT and or FX deficiency appear to adversely affect the outcome of these patients. It is likely that the elevated PT in these patients relate to FX deficiency in the majority which in turn may reflect the amyloid ‘burden’. The effect of other organ involvement like the hepatic involvement may also have an impact on FX and PT. Table 1. Prevalence of abnormal coagulation testing in patients with newly diagnosed primary systemic amyloidosis. Coagulation study N (Test results available) N of abnormal results (%) Elevated prothrombin time 486 61 12.6 Elevated activated partial thromboplastin time 312 48 15.4 Elevated thrombin time 315 84 26.7 Elevated fibrinogen 140 118 84.3 Decreased Factor II activity 62 26 41.9 Decreased Factor V activity 63 9 14.3 Decreased Factor VII activity 63 17 27 Decreased Factor X activity 309 63 20.4 Elevated D-dimer 130 72 55.4 Figure 1. Survival grouped by normal versus elevated Prothrombin time. Figure 1. Survival grouped by normal versus elevated Prothrombin time. Figure 2. Survival grouped by normal versus low Factor X levels. Figure 2. Survival grouped by normal versus low Factor X levels.
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SOUZA, E. R. N., V. M. R. TEBALDI, and R. H. PICCOLI. "Adaptação e adaptação cruzada de Listeria monocytogenes aos compostos eugenol e carvacrol." Revista Brasileira de Plantas Medicinais 17, no. 4 (December 2015): 528–33. http://dx.doi.org/10.1590/1983-084x/13_098.
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RESUMOA evolução de certos microrganismos permite sua rápida adaptação aos ambientes em constante mudança, desenvolvendo assim, tolerância ou resistência ao aumento de determinados estresses. O uso de compostos bioativos provenientes da flora nativa tem sido apontado como uma possível solução para os problemas de controle da resistência e proliferação bacteriana. Este trabalho visou verificar a adaptação e adaptação cruzada de L. monocytogenes, frente aos compostos fenólicos eugenol e carvacrol. A concentração mínima inibitória (CMI) dos compostos fenólicos foi determinada pela técnica de microdiluição em placas de 96 cavidades, em caldo TSB + 0,5% de Tween 80. As concentrações finais (%) obtidas foram: 0,06; 0,12; 0,24; 0,49; 0,98; 1,95; 3,9; 6,25; 12,5; 25; 50. A suspensão bacteriana padronizada foi inoculada nas cavidades das placas, as quais foram incubadas a 37°C por 24 horas com posterior leitura da absorbância a 620 nm e determinação da CMI. A adaptação das células de L. monocytogenes ao eugenol e carvacrol foi realizada com o cultivo das células em TSB + 0,06% de eugenol ou carvacrol à 37°C por 2 horas. A cultura foi então centrifugada e as células ressuspendidas e padronizadas em TSB. A seguir, realizou-se novamente a técnica de microdiluição em caldo. Os resultados obtidos demonstraram que L. monocytogenes apresentou adaptação e adaptação cruzada frente ao carvacrol e eugenol. A CMI do eugenol e carvacrol foi de 24%. A pré-exposição de L. monocutogenes a concentração sub-letal de 0,06% de carvacrol ou de eugenol aumentou sua resistência. A pré-exposição ao carvacrol promoveu a adaptação de L.monocytogenes a ele aumentando a CMI para 12,5%. Já para o eugenol a CMI passou para 25%. Quando submetidas à concentração sub-letal de eugenol, este promoveu a adaptação das células tanto ao carvacrol quanto ao eugenol, sendo a CMI de 12,5%. Os resultados obtidos demonstraram que L. monocytogenes apresentou adaptação e adaptação cruzada ao carvacrol e eugenol. O presente trabalho sugere estudos futuros ainda mais abrangentes quanto à potencialidade antimicrobiana destes compostos.
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SAMIRA, KACHA, DJERBAOUI MALIKA, MARNICHE FAIZA, DE PRINS WILLY, RAMDANI MOHAMMED, ROGER FLOWER, and MOULAÏ RIADH. "Diversity and abundance of Lepidoptera populations in the Theniet El Had National Park (Algeria)." Zootaxa 4743, no. 1 (February 24, 2020): 35–46. http://dx.doi.org/10.11646/zootaxa.4743.1.3.
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An inventory of Lepidoptera in the Theniet El Had National Park (PNTEH), Algeria, revealed 86 taxa, both butterflies and moths. The specimens were collected in 68 localities distributed over ten cantons within the park in the period 2015–2017. A preliminary faunistic list is compiled as a base-line contribution to the study of adult Lepidoptera in this park. In total, 3139 specimens were collected. The moths are clearly well diversified, with 14 families and 49 species obtained from a total of 1485 adult specimens. The butterflies are represented by 5 families with 37 species and 1654 specimens. A total of 8 families are reported for the first time from this park, in order of abundance: Zygaenidae, Hesperiidae, Crambidae, Alucitidae, Heterogynidae, Sesiidae, Oecophoridae, and Cossidae. Also 61 species are recorded here for the first time for the park. The most diverse family is Nymphalidae with 15 taxa (23% of the total species). On the other hand, the Erebidae are represented by 894 specimens (28.5% of the total number of specimens. Within the Erebidae, the genus Catocala contains the highest number of individuals (794 specimens). The canton of Pré-Ben Chouhra is quantitatively the best represented with 625 specimens (19.9% of the total number of specimens collected) and the Nursery canton as the richest in lepidopteran species with 72 species observed. The diversity indices (H’ and Hmax.) and the equitability index (E), calculated for the 10 cantons indicate that lepidopteran species are diverse in each station.
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Minami, Hiroaki, Keiji Nogami, Takehisa Kitazawa, Kunihiro Hattori, and Midori Shima. "FVIII Heavy Chain Enhances Tenase Activity Induced By FVIIIa Mimicking Bispesific Antibody, ACE910." Blood 124, no. 21 (December 6, 2014): 1481. http://dx.doi.org/10.1182/blood.v124.21.1481.1481.
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Abstract Background: ACE910, asymmetric bispecific monoclonal antibodies to activated factor IX (IXa) and factor X, mimics the cofactor function of activated factor VIII (VIIIa) by modulating an optimal position on the tenase assembly. The estimated therapeutic range of ACE910 shows ~30% of thrombin generation in native tenase assembly, supporting that the structure on ACE910-mimicking tenase assembly is different from that on native tenase. Being close to physiological structure consisting from factor IXa, factor X, and factor VIIIa is important for potentiating the clotting function. We examined the effects of factor VIII subunits (light chain, heavy chain, A1 and A2, C2) on ACE910-tenase. Materials/Methods: The factor VIII light chain and heavy chain were isolated from EDTA-treated recombinant factor VIII following chromatography on SP- and Q- Sepharose columns. The A2 and A1 subunits were purified from thrombin-cleaved factor VIII heavy chain by Heparin-, SP- Sepharose columns. Purified factor Xa generation assays was examined with (i) factor VIII subunit (0-40 nM), ACE910 (10 µg/ml), phospholipid (PL) (40 µM), factor IXa (1 nM) and factor X (200 nM), (ii, iii) the A2 or heavy chain (40 nM), ACE910 (10 µg/ml), PL (40 µM), factor IXa and factor X (1 or 0-80 nM, and 0-300 or 200 nM, respectively). These mixtures were reacted for five minutes (i, ii) or one minute (iii). These assays were conducted at 37 °C. Results: (i) The factor Xa generation in ACE910-tenase complex in the absence of factor VIIIa was 10.1±2.2 nM. With the intact heavy chain and A2, amounts of factor Xa were increased dose-dependently, resulting in 1.3- and 1.2-fold increases, respectively. While, the light chain and A1 subunit failed to increase at all. (ii) Vmax for factor X in ACE910-tenase was 173.0±7.0 nM and Km was 31.2±3.9 nM. Vmax obtained with the heavy chain or A2 was 175.9±6.1 or 159.0±6.1 nM, whilst Km was 17.0±2.2 or 31.9±3.5 nM, respectively, indicating that the heavy chain enhanced the binding affinity for factor X in ACE910-tenase. (iii) Vmax for factor IXa in ACE910-tenase was 43.8±2.7 nM and Km was 36.9±4.8 nM. With the heavy chain or A2, Vmax was 46.8±3.0 or 45.0±3.1 nM, and Km was 36.4±3.0 or 32.1±4.9 nM, respectively, indicating that either the heavy chain or A2 did not enhance the catalytic activity and the binding affinity for factor IXa in ACE910-tenase. Conclusion: ACE910-tenase assembly seems to be close to physiological structure by the presence of intact heavy chain interacting with factor X. In addition, ACE910 may substitute the position such as the factor VIII(a) light chain associated with FIXa and FX on ACE910-tenase assembly defecting factor VIII. Disclosures Minami: Chugai Pharmaceutical Co., Ltd.: Research Funding. Nogami:Chugai Pharmaceutical Co., Ltd.: Membership on an entity's Board of Directors or advisory committees, Research Funding. Kitazawa:Chugai Pharmaceutical Co., Ltd.: Employment, Equity Ownership, Patents & Royalties. Hattori:Chugai Pharmaceutical Co., Ltd.: Employment, Equity Ownership, Patents & Royalties. Shima:Chugai Pharmaceutical Co., Ltd.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.
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Sawattep, Jeeranut, Thad A. Howard, Noppawan P. Morales, Yupin Sanvarinda, Pranee Fucharoen, Suthat Fucharoen, and Russell E. Ware. "Single Nucleotide Polymorphism (SNP) Discovery within the UGT1A Gene Complex: Allelic Frequencies and Ethnic Differences." Blood 104, no. 11 (November 16, 2004): 3780. http://dx.doi.org/10.1182/blood.v104.11.3780.3780.
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Abstract The UDP-glycosyltransferase (UGT1A) gene complex plays an important role in the hepatic metabolism of many chemicals, toxins, and drugs including bilirubin and acetaminophen. In this large gene complex that spans over 200kb, there are at least 13 different coding regions that can serve as exon 1, followed by a common sequence that contains exons 2–5. These variable exon 1 sequences confer different chemical specificities for binding compounds, while exons 2–5 provide glycosyltransferase function (glucuronidation) that enhances water solubility and excretion. Mutations and polymorphisms within the UGT1A complex may help explain the phenotypic variability that is observed in drug metabolism for patients with hematological diseases. To date, several important polymorphisms have been identified in the coding regions of the UGT1A1 and UGT1A6 exon 1 sequences, but formal single nucleotide polymorphism (SNP) discovery has not been reported. Using genomic DNA obtained from a cohort of Thai patients with beta-thalassemia/HbE (n=37) and African-American patients with sickle cell anemia (n=12), flanking and coding sequences for UGT1A1 exon 1 (1.5kb), UGT1A6 exon 1 (1.5kb), and UGT1A common exons 2–5 (2.5kb) were fully sequenced in both directions. Polymorphisms that occurred more than once were compared to wildtype sequences obtained from NCBI, Accession Number AF297093. Single Nucleotide Polymorphisms in the UGT1A gene complex SNP NCBI nucleotide Location African-American Thai * indicates a SNP previously identified in NCBI g/c 109183 5′ 1A6 Exon 1 .875/.125 .676/.324 c/g 109301 5′ 1A6 Exon 1 .833/.167 1.000/.000 g/t 109628 1A6 Exon 1 .458/.542 .662/.338 c/t 109713 1A6 Exon 1 1.000/.000 .905/.095 a/g * 109924 1A6 Exon 1 .542/.458 .689/.311 a/g * 110150 1A6 Exon 1 .708/.292 .689/.311 a/c * 110161 1A6 Exon 1 .625/.375 .662/.338 t/g 110236 1A6 Exon 1 .750/.250 .973/.027 c/t 174679 5′ 1A1 Exon 1 .500/.500 .770/.230 g/c 174979 5′ 1A1 Exon 1 1.000/.000 .946/.054 g/a * 175253 1A1 Exon 1 1.000/.000 .932/.068 a/g 182226 Intron 2 .955/.045 .689/.311 t/c 182521 Intron 2 .850/.150 .905/.095 c/t 187524 3′ Exon 5 .417/.583 .865/.135 c/g * 187652 3′ Exon 5 .625/.375 .851/.149 c/g * 187753 3′ Exon 5 .587/.417 .838/.162 In addition to the well-described UGT1A1 (TA)n promoter polymorphism, a total of 16 SNPs were identified in these regions, including 10 that have not been previously reported. Four novel promoter SNPs were identified, along with three new UGT1A6 exon 1 coding SNPs and three non-coding SNPs within the common exon 2–5 region. The alellic frequencies for these SNPs can only be estimated from this small sample size, but indicate substantial differences between Thai and African-American patients. A larger sample size will be used to determine a more accurate allelic frequency for each SNP, and to identify haplotype associations. These novel SNPs within the UGT1A gene complex may have important effects on drug metabolism and may explain some of the phenotypic variability observed in these patient populations.
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Köhler, Michael, Fabian Harders, Fabian Lohöfer, Philipp M. Paprottka, Benedikt M. Schaarschmidt, Jens Theysohn, Ken Herrmann, et al. "Prognostic Factors for Overall Survival in Advanced Intrahepatic Cholangiocarcinoma Treated with Yttrium-90 Radioembolization." Journal of Clinical Medicine 9, no. 1 (December 25, 2019): 56. http://dx.doi.org/10.3390/jcm9010056.
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Purpose: To evaluate factors associated with survival following transarterial 90Y (yttrium) radioembolization (TARE) in patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods: This retrospective multicenter study analyzed the outcome of three tertiary care cancer centers in patients with advanced ICC following resin microsphere TARE. Patients were included either after failed previous anticancer therapy, including relapse after surgical resection, or for having a minimum of 25% of total liver volume affected by ICC. Patients were stratified and response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria at 3 months. Kaplan–Meier analysis was performed to analyze survival followed by cox regression to determine independent prognostic factors for survival. Results: 46 patients were included (19 male, 27 female), median age 62.5 years (range 29–88 years). A total of 65% of patients had undergone previous therapy, while 63% had a tumor volume > 25% of the entire liver volume. Median survival was 9.5 months (95% CI: 6.1–12.9 months). Due to loss in follow-up, n = 37 patients were included in the survival analysis. Cox regression revealed the extent of liver disease to one or both liver lobes being associated with survival, irrespective of tumor volume (p = 0.041). Patients with previous surgical resection of ICC had significantly decreased survival (3.9 vs. 12.8 months, p = 0.002). No case of radiation-induced liver disease was observed. Discussion: Survival after 90Y TARE in patients with advanced ICC primarily depends on disease extent. Only limited prognostic factors are associated with a general poor overall survival.
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Malhotra, Sumit, Praveen Vashist, Mani Kalaivani, Noopur Gupta, Suraj Singh Senjam, Ramashankar Rath, and Sanjeev Kumar Gupta. "Prevalence and causes of visual impairment amongst older adults in a rural area of North India: a cross-sectional study." BMJ Open 8, no. 3 (March 2018): e018894. http://dx.doi.org/10.1136/bmjopen-2017-018894.
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ObjectivesTo determine the prevalence, causes and associated factors for visual impairment (VI) in rural population of Jhajjar district, Haryana, north India.MethodsA community-based, cross-sectional study was conducted in two blocks of Jhajjar district. A total of 34 villages were selected using probability proportionate to size sampling method. Adults aged 50 years and above were selected using compact segment cluster sampling approach. Presenting visual acuity using LogMAR E chart was measured along with collection of other demographic details as part of the house-to-house survey. Subjective refraction and torch light examination were performed at a clinic site within the village to ascertain VI and its cause. VI was considered when presenting visual acuity was less than 6/18 in the better eye. Common causes of VI viz uncorrected refractive errors, cataract, central corneal opacity and others were noted by optometrists. Descriptive analysis was undertaken. Multivariate logistic regression analysis was performed for determining associated factors with VI.ResultsOut of 2025 enumerated adults, 1690 (83.5%) were examined at the household level and 1575 (78%) completed all study procedures. The prevalence of VI was found to be 24.5% (95% CI 21.1 to 26.3) and blindness was 5% (95% CI 3.9 to 6.1). The most common causes of VI were uncorrected refractive errors (50%) and cataract (37%). The VI in study participants was found to be associated with age, gender, marital and educational status.ConclusionsVI is still a public health problem in rural population of Jhajjar district, Haryana. Provision of spectacles and cataract surgical services are simple interventions to address this issue.
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Covington, Elizabeth W., Stephen Eure, Doug Carroll, and Christen Freeman. "Impact of Procalcitonin Monitoring on Duration of Antibiotics in Patients With Sepsis and/or Pneumonia in a Community Hospital Setting." Journal of Pharmacy Technology 34, no. 3 (February 6, 2018): 109–16. http://dx.doi.org/10.1177/8755122518756333.
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Background: Procalcitonin (PCT) is a biomarker specific for bacterial infections versus viral or noninfectious causes. Utilizing PCT as a guide for antibiotic duration could have benefit in limiting antimicrobial overuse. Objective: The objective of this study was to analyze the effect of PCT monitoring on inpatient antibiotic duration for pneumonia and sepsis at a community hospital. Methods: This study utilized a prospective cohort design with a historical control group prior to the availability of PCT testing and a prospective intervention group after the availability of PCT testing at a community hospital. Results: A total of 102 patients (51 retrospective and 51 prospective) were included in the analysis. There was no difference in mean duration of inpatient antibiotics (6.1 ± 3.9 vs 5.4 ± 2.9 days, P = .50). Additionally, there was no difference in the average time to antibiotic de-escalation, average hospital length of stay, or intensive care unit length of stay. PCT monitoring resulted in a 41% reduction in discharge antibiotics (63% vs 37%, P = .0090) and a 2.2-day reduction in duration of overall inpatient and post-discharge antibiotics (9.5 ± 4.5 vs 7.3 ± 4.1 days, P = .013). There was no difference in mortality, relapse of infection, or 30-day readmission. Conclusion: PCT monitoring in patients with suspected pneumonia and/or sepsis in the community setting failed to show a reduction in duration of inpatient antibiotics after the introduction of PCT monitoring. However, PCT resulted in significantly fewer discharge antibiotics and overall inpatient plus post-discharge antibiotic duration, with no detrimental effect on mortality or readmission.
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Lee, Ji Won, Hyoung Jin Kang, Yen Ju Yuk, Mi Kyoung Jang, Eun Jong Han, Nam Hee Kim, Hyery Kim, Kyung Duk Park, Hee Young Shin, and Hyo Seop Ahn. "Influence of Glutathione S-Transferase A1 and P1 Polymorphisms on the Outcome of Hematopoietic Stem Cell Transplantation with Busulfan Based Conditioning Regimen In Children." Blood 116, no. 21 (November 19, 2010): 3492. http://dx.doi.org/10.1182/blood.v116.21.3492.3492.
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Abstract Abstract 3492 Introduction: Busulfan has narrow therapeutic range. High exposure is associated with systemic toxicity such as veno-occlusive disease (VOD) while underexposure results in graft failure or relapse. In children, pharmacokinetic variability was found to be high even after the introduction of intravenous busulfan. Busulfan is metabolized via liver through conjugation with glutathione S-transferase (GST) family, and inter-individual variability may be explained by GST polymorphisms. Thus, we investigated the influence of GST polymorphisms on the clinical outcomes of hematopoietic stem cell transplantation (HSCT) with busulfan based conditioning regimen in children. Patients and methods: We studied patients who underwent HSCT at Seoul National University Children's Hospital from November, 2001 to November, 2008. IV busulfan (0.8 mg/kg/dose for patients≥10 kg and 1.1 mg/kg/dose for patients <10 kg, q 6hr for 4 days) was used in combination with cyclophosphamide or fludarabine as conditioning regimen. Etoposide was added for acute lymphocytic leukemia (ALL). GST polymorphisms (GSTA1 375 A > G, -52 G > A, -567 G > T, -631 G > T, -69 C > T, GSTM1 deletion, GSTT1 deletion, and GSTP1 313 A > G) were analyzed by multiplex PCR amplification and SNP genotyping. Results: A total of 70 patients (48 male, 22 female) were analyzed. The diagnoses were ALL in 32, AML in 26, and other diseases in 12 patients. Median age at HSCT was 8.8 years (range 1.0–19.0 years). Bone marrow or peripheral blood stem cell transplantations (BMT/PBSCT) were conducted in 42 patients, and cord blood transplantations (CBT) in 28 patients. Graft failure occurred in 11 (15.7%) patients (1 (2.4%) in BMT/PBSCT, 10 (35.7%) in CBT) and relapse occurred in 15 (21.4%) patients (12 (28.6%) in BMT/PBSCT, 3 (10.7%) in CBT) after HSCT. Patients having GSTA1 *A/*A and GSTP1 313 A/A genotype (N=33) showed higher incidence of graft failure than the others (N=37) (27.3% vs 5.4%, P =.01). Conversely, the incidence of hyperbilirubinemia over grade 3 was significantly lower in the patients with GSTA1 *A/*A and GSTP1 313 A/A genotype than the other patients (6.1% vs 24.3%, P =.05). Event free survival (EFS) of patients with GSTA1 *A/*A and GSTP1 313 A/A genotype was significantly lower than the EFS of the other patients in both BMT/PBSCT and CBT, and the main causes of event were graft failure in CBT and relapse in BMT/PBSCT. Conclusions: In children undergoing HSCT with busulfan based conditioning regimen, GST A1 and P1 polymorphisms seem to have influence on the graft failure, relapse and complications. To confirm our results, further studies about the influence of GST A1 and P1 polymorphisms on the pharmacokinetics of busulfan are needed. Disclosures: No relevant conflicts of interest to declare.
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Ben Ami, Y., O. Altaratz, Y. Yair, and I. Koren. "Lightning characteristics in Eastern Mediterranean thunderstorms during different synoptic systems." Natural Hazards and Earth System Sciences Discussions 3, no. 6 (June 10, 2015): 3655–85. http://dx.doi.org/10.5194/nhessd-3-3655-2015.
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Abstract. Thunderstorms activity takes place in the Eastern Mediterranean mainly along the boreal fall and winter seasons during synoptic systems of Red Sea Trough (RST), Red Sea Trough that closed a low over the sea (RST-CL), and Cyprus Low (during fall – FCL and Winter – WCL). In this work we used the Israeli Lightning Location System ground strokes dataset (between October 2004 and December 2010) for studying the lightning strokes properties and their link to the thermodynamic conditions in each synoptic system. It is shown that the lightning activity dominates over sea during WCL and FCL systems (with maximum values of 37 strokes per 25 km2 day−1 in WCL, and 54 in FCL) and have a dominant component over land during the RST and RST-CL days. The stronger instability (high CAPE values of 621 ± 466 J kg−1) during RST-CL days together with the higher altitude of the clouds' mixed-phase region (3630 ± 316 m) result in higher ground strokes density during this system (compared to all other) but lower fraction of positive ground strokes (3 ± 0.5%). In general the fraction of positive strokes was found to be positively correlated with the wind shear values in the layer between 0 and −25 °C. It increases from the 1.2 ± 1% in early fall to 17 ± 7% in late winter, (during FCL and WCL days) and can be linked to the decrease in the sea surface (and lower troposphere) temperature during those months, due to an impact on the charge centers vertical location. The diurnal cycle in the lightning activity was examined for each synoptic system. During WCL conditions no preferred times were found along the day (as it relates to the timing of frontal systems). During the fall systems (FCL and RST-CL) there is a peak in lightning activity during the morning hours, probably related to the enhanced convection driven by the convergence between the eastern land breeze and the western synoptic winds. The distributions of peak currents in FCL and WCL systems also change from fall to winter and include more strong negative and positive strokes toward the end of the winter.
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Nussberger, G., S. Schädelin, J. Mayr, D. Studer, and P. Zimmermann. "Treatment strategy and long-term functional outcome of traumatic elbow dislocation in childhood: a single centre study." Journal of Children's Orthopaedics 12, no. 2 (April 2018): 129–35. http://dx.doi.org/10.1302/1863-2548.12.170167.
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Purpose Traumatic elbow dislocation (TED) is the most common injury of large joints in children. There is an ongoing debate on the optimal treatment for TED. We aimed to assess the functional outcome after operative and nonoperative treatment of TED. Methods We analysed the medical records of patients with TED treated at the University Children’s Hospital, Basel, between March 2006 and June 2015. Functional outcome was assessed using the Mayo Elbow Performance Score (MEPS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) Sport and Music Module score. These scores were compared between nonoperatively and operatively treated patients. Results A total of 37 patients (mean age 10.2 years, 5.2 to 15.3) were included. Of these, 21 (56.8%) children had undergone nonoperative treatment, with 16 (43.2%) patients having had operative treatment. After a mean follow-up of 5.6 years (1.2 to 5.9), MEPS and QuickDASH Sport and Music Module scores in the nonoperative group and operative group were similar: MEPS: 97.1 points (SD 4.6) versus 97.2 points (SD 2.6); 95% confidence interval (CI)-2.56 to 2.03); p = 0.53; QuickDASH Sport and Music Module score: 3.9 points (SD 6.1) versus 3.1 points (SD 4.6); 95% CI 2.60 to 4.17; p = 0.94. We noted no significant differences regarding the long-term functional outcome between the subgroup of children treated operatively versus those treated nonoperatively for TED with accompanying fractures of the medial epicondyle and medial condyle. Conclusion Functional outcome after TED was excellent, independent of the treatment strategy. If clear indications for surgery are absent, a nonoperative approach for TED should be considered. Level of evidence Level III - therapeutic, retrospective, comparative study
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Ota, Shuichi, Toshihiro Matsukawa, Satoshi Yamamoto, Shinichi Ito, Motohiro Shindo, Kazuya Sato, Takeshi Kondo, et al. "Severe Adverse Events By First Line Tyrosine Kinase Inhibitors Decrease Survival Rate in Patients with Newly Diagnosed Chronic Phase Chronic Myeloid Leukemia." Blood 128, no. 22 (December 2, 2016): 1898. http://dx.doi.org/10.1182/blood.v128.22.1898.1898.
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Abstract Background: Chronic phase chronic myeloid leukemia (CML-CP) has become a manageable disease for most patients treated with tyrosine kinase inhibitors (TKIs). However, all TKIs have broad spectrum of toxic effects, and have to be managed by cessation, reduction and supportive care. The objective of this study is to analyze the adverse events (AEs) with different TKIs used as initial therapy for CML and their impact on outcome. Methods: We retrospectively evaluated a total of 494 patients with CML who received at least one TKI, imatinib, dasatinib, nilotinib and bosutinib in a practice setting between 2004 and 2014 at multicenter participating in the Hokkaido hematology study group. Results: Of the 494 patients (315 males and 179 females), with a median age of 59.5 years (range 2-93), imatinib, dasatinib or nilotinib were prescribed as the first line TKI in 283 (62.3%), 109 (24%) and 102 (22.5%) patients, respectively. Disease status at primary diagnosis was composed of chronic phase (450), accelerated phase (21) and blastic phase (23). With a median follow-up of 4.7 years in patients with CML-CP, the 5-year overall survival (OS), event-free survival (EFS) were 94.5% and 92.3%, respectively. The patients with complication or organ dysfunction (61/450, 13.6%) and age >60 (227/450, 50.4%) at diagnosis had significantly inferior OS (p= 0.0089 and p= 0.0012). The patients achieved higher rates of major molecular response (MMR) at 6 and 12 months after initial treatment with dasatinib, nilotinib vs imatinib (41.5%, 42.6% vs 12.5% and 54.3%, 54.5% vs 41.5%, p<.0001 and p<.0001), but final MMR rates were similar in dasatinib, nilotinib vs imatinib (70.2%, 70.3% vs 63.9%, p=0.179). Moreover, there were no significant differences in EFS and OS for specific TKIs (p= 0.345 and p= 0.458). Of the 450 patients with CML-CP, 312 treatment modifications after the first line TKI treatment were carried out: 144 (46.2%) TKI changes or definitive discontinuations, 60 (19.2%) dose reductions, 36 (11.5%) temporary discontinuations and 72 (23.3%) dose reductions after temporary discontinuation. The main reasons for the 312 treatment modifications were 254 AEs (81.4%) and 41 failure or progression (13.1%). After initial TKI treatment, 272 (60.4%), 118 (26.2%), 37 (8.2%) and 23 (5.1%) patients had no, 1, 2 and 3 TKI changes, respectively. However, the number of TKI changes was not related to OS and EFS (p= 0.574 and p= 0.267). In the first line TKI treatment, grade I-II and III-IV AEs occurred in 185 (41.1%) and 123 (27.3%) patients. AEs resulting in treatment modifications occurred in 142 (55.5%) patients for imatinib, 53 (53.5%) for nilotinib and 59 (62.1%) for dasatinib. Grade III-IV AEs in the first line TKI treatment was significantly correlated to inferior OS and EFS as compared with grade 0-II AEs (p= 0.00612 and p= 0.0014). Multivariate analyses confirmed the fact that grade III-IV AEs significantly predicted for inferior EFS and OS, HR=3.311, 95% CI 1.34-8.175 (p= 0.0094) and HR=3.096, 95% CI 1.4560-6.587 (p= 0.0033), respectively. Conclusions: Although long-term outcomes were similar in each TKI regardless of the first line TKI selection, severe AEs in the first line TKI treatment decreased survival rate of the patients with CML-CP. We need the personalized or some specialized treatment for elderly patients or patients with frailty. Early change of TKIs is recommended, when encountered with severe AEs of specific TKIs. Disclosures No relevant conflicts of interest to declare.
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Volkova, Marina Sergeevna, Pavel Viktorovich Lipilkin, Gabriella Dzhoanna Zigler, Yuliya Nikolaevna Moiseeva, Alexey Viktorovich Nedilko, Alexey Viktorovich Nedilko, and Tatyana Alexandrovna Terpitskaya. "СУЖДЕНИЕ О ПОДБОРЕ ОПТИМАЛЬНОЙ ОЦЕНКИ РИСКА ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА ДЛЯ ВРАЧА-ЛЕЧЕБНИКА." V mire nauchnykh otkrytiy 10, no. 4 (March 16, 2018): 111. http://dx.doi.org/10.12731/wsd-2018-4-111-133.
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Цель исследования: анализ и установление простой и корректной лабораторной оценки риска развития ишемической болезни сердца для врача-лечебника в лечебно-профилактических учреждениях со слабым материально-техническим оснащением.Материалы и методы: выполнен ретроспективный анализ 960 лабораторных показателей пациентов клинико-диагностической лаборатории Ростовского государственного медицинского университета по обращению за период с 2015 по 2017 годы в возрасте от 25 до 78 лет.В анализ включены показатели глюкозы, креатинина, мочевины, аспартатаминотрансферазы, аланинаминотрансфераза и липидограммы (холестерин, триацилглицериды, липопротеины высокой плотности, коэффициент атерогенности). Выборка осуществлялась на основании наличия полного соответствия показателей у каждого конкретного пациента ввиду того, что не у всех пациентов был полный спектр исследований. В итоге выборка корреляционного диапазона для: глюкозы и липидограммы составила 450 показателей, для глюкозы, аспартатаминотрансферазы, аланинаминотрансфераза, креатинина и липидограммы 309 показателей, для глюкозы, аспартатаминотрансферазы, аланинаминотрансфераза, креатинина, мочевины и липидограммы 186 показателей.Группировка показателей липидограммы проводилась в направлениях:– по признаку связанного повышенного показателя глюкозы (≥6,1), как вероятного эквивалентного маркёра ишемической болезни сердца, у группы А и нормального (<6,1) у группы Б из диапазона глюкозы и липидограммы.– по признаку связанного повышенного абсолютного показателя аспартатаминотрансферазы (≥37), как вероятного маркёра ишемической болезни сердца, у группы №1 и нормального (<37) у группы №2 из диапазона глюкозы, аспартатаминотрансферазы, аланинаминотрансфераза, креатинина и липидограммы.– по признаку связанного повышенного показателя коэффициента атерогенности (≥3) с индексом триациглицериды\глюкоза у группы 1а и низкого (<3) у группы 2б из диапазона данных глюкозы, аспартатаминотрансферазы, аланинаминотрансфераза, креатинина и липидограммы.Результаты: при сравнении двух групп показателей липидограммы по признаку связанного повышенного и нормального показателя глюкозы получили для холестерина, триацилглицеридов, липопротеинов высокой плотности t=0,3, v≈956, p=0,76; t=4,2, v≈355, p=0,00003; t=0,2, v≈8, р=0,84 соответственно. Так удаётся отвергнуть нулевую гипотезу (H0) только для показателей триацилглицеридов.При сравнении двух групп показателей липидограммы в спектре признака повышенного и нормального АСТ не удалось отвергнуть H0 для холестерина, триацилглицеридов, липопротеинов высокой плотности при t=0,73, v≈876, p=0,47; t=1,14, v≈481, p=0,25; t=0,54, v≈9, р=0,6 соответственно. Это значит, что по отношению к признаку повышенного показателя аспартатаминотрансферазы не обнаружилось статистически значимой разности связанного липидного профиля с липидным профилем нормального показателя аспартатаминотрансферазы, при изначально установленном условии, что исследуемые показатели не имели выраженной корреляционной связи между собой.При сравнении двух групп показателей индекса триациглицериды/глюкоза в спектре повышенного и сниженного коэффициента атерогенности удалось отвергнуть H0 при t=3,8, v≈192, p=0,0001. Следовательно, при установленном лабораторно риске наличия атеросклероза у исследуемой группы с повышенным коэффициентом атерогенности статистически значимо возрастает уровень показателя триациглицериды/глюкоза.Заключение: таким образом, из исследования удалось:1) установить наибольшую клиническую значимость глюкозы, коэффициента атерогенности и триацилглицеридов из всех лабораторных маркёров, которые учитывались в выборке для диагностики ишемической болезни сердца;2) подобрать оптимальный лабораторный тест, состоящий из двух анализов показателей: глюкозы и триацилглицеридов, которые соответствуют главному оценочному критерию «доступность»;3) обозначить рекомендацию электрокардиограммы и лабораторного теста на анализ глюкозы, коэффициента атерогенности и триацилглицеридов, как достаточного, чтобы верифицировать диагноз ишемической болезни сердца для врача-лечебника в лечебно-профилактических учреждениях со слабым материально-техническим оснащением.
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Hornsby, Kristofer T., Ashley R. Streig, Scott E. K. Bennett, Jefferson C. Chang, and Shannon Mahan. "Neotectonic and Paleoseismic Analysis of the Northwest Extent of Holocene Surface Deformation along the Meers Fault, Oklahoma." Bulletin of the Seismological Society of America 110, no. 1 (December 10, 2019): 49–66. http://dx.doi.org/10.1785/0120180148.
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ABSTRACT The Meers fault (Oklahoma) is one of few seismogenic structures with evidence for Holocene surface rupture in the stable continental region of North America. The 37-kilometer-long southeast section of the full 54-kilometer-long Meers fault is interpreted to be Holocene active. The 17-kilometer-long northwest section is considered Quaternary active, but not Holocene active. We reevaluate surface expression and earthquake timing of the northwest Meers fault to improve seismic source characterization. We use airborne light detection and ranging and historical stereopaired aerial photos to evaluate the fault scarp and local fault-zone geomorphology. In the northwest, complex surface deformation includes fault splays, subtle monoclinal warping, and a minor change in fault strike. We interpret that the along-strike transition from surface faulting on the southeast Meers fault to surface folding on the northwest Meers fault occurs at the lithologic contact between Permian Post Oak conglomerate and Hennessey shale. We excavated a paleoseismic trench to evaluate the timing of surface-deforming earthquakes on the northwest section of the fault. The excavation revealed weathered Permian Hennessey shale and an ∼1–2-meter-thick veneer of Holocene alluvial deposits that were progressively deformed during two surface-folding earthquakes likely related to blind fault rupture beneath the site. Repeated onlapping to overlapping stratigraphic sequences and associated unconformities are intimately related to folding events along the monocline. OxCal paleoearthquake age modeling indicates that earthquakes occurred 4704–3109 yr B.P. and 5955–4744 yr B.P., and that part of the northwest section of the Meers fault is Holocene active. We find the Holocene-active section of the Meers fault should be lengthened 6.1 km to the northwest, to a total Holocene-active fault length of 43 km. Empirical scaling relationships between surface rupture length and magnitude reveal that the fault could generate an Mw 7.0 earthquake.
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Sossa, Claudia Patricia, and Rolando Barahona. "Comportamiento productivo de novillos pastoreando en trópico de altura con y sin suplementación energética." Revista de la Facultad de Medicina Veterinaria y de Zootecnia 62, no. 1 (February 27, 2015): 67–80. http://dx.doi.org/10.15446/rfmvz.v62n1.49386.
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En Colombia, la producción de carne bovina tradicionalmente se realiza en el trópico bajo, mientras que en el trópico de altura, los sistemas ganaderos predominantes son de lechería especializada. Las gramíneas de trópico alto son de mayor valor nutricional que las de trópico bajo, aunque pueden presentar un exceso de proteína, por lo cual una estrategia de suplementación debe basarse en la inclusión de materias primas energéticas. Al analizar la oferta de nutrientes en el pasto kikuyo (<em>Pennisetum clandestinum</em>) se observan altos contenidos de proteína (20.6%) y baja disponibilidad de energía (2.31 Mcal EM/ kg). Así, el presente estudio se realizó con el propósito de evaluar la producción de carne bovina en condiciones de trópico de altura (Santa Rosa de Osos, Antioquia). Durante 122 días se evaluó el crecimiento de 18 novillos de diversos cruces, que pastoreaban en dos grupos en praderas de kikuyo hasta alcanzar el peso de beneficio (420 kg). El primer grupo (peso inicial 316±370 kg) recibió 0.55 kg/día de un suplemento energético a base de maíz, melaza y sebo (51%, 12% y 37%, respectivamente), mientras el segundo grupo (peso inicial 322,8±27.8 kg) se encontraba sólo en pastoreo. Los animales suplementados (CS) pastoreaban en 2.5 ha y los no suplementados (SS) en 3.2 ha. Hubo una ganancia total de 78.8 y 73.3 kg de peso/novillo durante todo el período, equivalentes a ganar 646 y 601 gr/animal/día y a producir 848.5 y 617.1 kg de carne/ha/año en el sistema CS y SS, respectivamente. Cebar novillos en trópico de altura puede ser una actividad productiva exitosa, pero es necesario identificar, tanto el nivel de inclusión, como la fuente energética adecuada para mejorar la relación energía:proteína en la dieta de animales pastoreando <em>P. clandestinum</em>.
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Ogdie, Alexis, J. Lynn Palmer, Jeffrey Greenberg, Jeffrey R. Curtis, Leslie R. Harrold, Daniel H. Solomon, Arthur Kavanaugh, Joel M. Kremer, and Philip J. Mease. "Predictors of Achieving Remission among Patients with Psoriatic Arthritis Initiating a Tumor Necrosis Factor Inhibitor." Journal of Rheumatology 46, no. 5 (January 15, 2019): 475–82. http://dx.doi.org/10.3899/jrheum.171034.
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Objective.To examine predictors of remission among patients with psoriatic arthritis (PsA) initiating a tumor necrosis factor (TNF) inhibitor.Methods.Patients with PsA enrolled in the Corrona Registry between 2005 and 2013 were followed from initiation of a TNF inhibitor (TNFi; etanercept, adalimumab, infliximab, certolizumab, or golimumab) to the visit closest to 12 months. Additional inclusion criteria included 3 tender or 3 swollen joints. Outcomes of interest were Clinical Disease Activity Index (CDAI) ≤ 2.8 (remission), low disease activity (LDA; CDAI ≤ 10), change in the modified Health Assessment Questionnaire (mHAQ) ≥ 0.35 and achievement of mHAQ < 0.30. Predictors were measured on or before TNFi initiation. Covariates significant in univariable logistic regression models and ≤ 5% missing values were included in a multivariable model and removed individually until all remaining variables were significant (p < 0.05).Results.Among 1832 TNFi initiations, 774 initiations (624 patients) met inclusion criteria. Median age at initiation was 52 years [interquartile range (IQR) 44–60], 56% were female, median PsA duration was 4 years (IQR 2–11), and median CDAI at baseline was 20 (IQR 14.5–28). Remission was achieved by 14% and LDA (or remission) by 37%. Achieving remission was positively associated with college education (OR 1.88, 95% CI 1.11–3.19) but negatively associated with female sex (0.62, 95% CI 0.40–0.97), obese body mass index (0.51, 95% CI 0.32–0.81), hypertension (0.55, 95% CI 0.32–0.95), previous biologic use (0.41, 95% CI 0.26–0.65), and baseline pain (0.80 per 10 mm visual analog scale, 95% CI 0.73–0.87). Predictors for LDA, mHAQ < 0.30, and mHAQ change were similar.Conclusion.Few patients with PsA in a US-based registry achieved remission by CDAI criteria. Female sex, obesity, comorbidities, and education influence achievement of remission on a TNFi.
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Ostrom, Quinn T., Gabrielle Truitt, Haley Gittleman, Daniel J. Brat, Carol Kruchko, Reda Wilson, and Jill S. Barnholtz-Sloan. "Relative survival after diagnosis with a primary brain or other central nervous system tumor in the National Program of Cancer Registries, 2004 to 2014." Neuro-Oncology Practice 7, no. 3 (December 16, 2019): 306–12. http://dx.doi.org/10.1093/nop/npz059.
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Abstract Background The majority of reported cancer survival statistics in the United States are generated using the National Cancer Institute’s publicly available Surveillance, Epidemiology, and End Results (SEER) data, which prior to 2019 represented 28% of the US population (now 37%). In the case of rare cancers or special subpopulations, data sets based on a larger portion of the US population may contribute new insights into these low-incidence cancers. The purpose of this study is to characterize the histology-specific survival patterns for all primary malignant and nonmalignant primary brain tumors in the United States using the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR). Methods Survival data were obtained from the NPCR (includes data from 39 state cancer registries, representing 81% of the US population). Relative survival rates (RS) with 95% CI were generated using SEER*Stat 8.3.5 from 2004 to 2014 by behavior, histology, sex, race/ethnicity, and age at diagnosis. Results Overall, there were 488 314 cases from 2004 to 2014. Overall 5-year RS was 69.8% (95% CI = 69.6%-69.9%). Five-year RS was 35.9% (95% CI = 35.6%-36.1%) for malignant and 90.2% (95% CI = 90.1%-90.4%) for nonmalignant tumors. Pilocytic astrocytoma had the longest 5-year RS (94.2%, 95% CI = 93.6%-94.6%) of all glioma subtypes, whereas glioblastoma had the shortest 5-year RS (6.1%, 95% CI = 6.0%-6.3%). Nonmalignant nerve sheath tumors had the longest 5-year RS (99.3%, 95% CI = 99.1%-99.4%). Younger age and female sex were associated with increased survival for many histologies. Conclusions Survival after diagnosis with primary brain tumor varies by behavior, histology, and age. Using such a database that includes more than 80% of the US population may represent national survival patterns.
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Kapoor, Nimmi S., Lisa D. Curcio, Carlee A. Blakemore, Amy K. Bremner, Rachel E. McFarland, John G. West, and Kimberly C. Banks. "Benefits and safety of multigene panel testing in patients at risk for hereditary breast cancer." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 16. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.16.
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16 Background: Recently introduced multi-gene panel testing including BRCA1 and BRCA2 genes (BRCA1/2) for hereditary cancer risk has raised concerns with the ability to detect all deleterious BRCA1/2 mutations compared to older methods of sequentially testing BRCA1/2 separately. The purpose of this study is to evaluate rates of pathogenic BRCA1/2mutations and variants of uncertain significance (VUS) between previous restricted algorithms of genetic testing and newer approaches of multi-gene testing. Methods: Data was collected retrospectively from 966 patients who underwent genetic testing at one of three sites from a single institution. Test results were compared between patients who underwent BRCA1/2testing only (limited group, n = 629) to those who underwent multi-gene testing with 5-43 cancer-related genes (panel group, n = 337). Results: Deleterious BRCA1/2 mutations were identified in 37 patients, with equivalent rates between limited and panel groups (4.0% vs 3.6%, respectively, p = 0.86). Thirty-nine patients had a BRCA1/2 VUS, with similar rates between limited and panel groups (4.5% vs 3.3%, respectively, p = 0.49). On multivariate analysis, there was no difference in detection of either BRCA1/2 mutations or VUS between both groups. Of patients undergoing panel testing, an additional 3.9% (n = 13) had non-BRCA pathogenic mutations and 13.4% (n = 45) had non-BRCA VUSs. Mutations in PALB2, CHEK2, and ATM were the most common non-BRCA mutations identified. Conclusions: Multi-gene panel testing detects pathogenic BRCA1/2 mutations at equivalent rates as limited testing and increases the diagnostic yield. Panel testing increases the VUS rate, mainly due to non-BRCA genes. Patients at risk for hereditary breast cancer can safely benefit from upfront, more efficient, multi-gene panel testing.
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Fernandes, Ricardo, Sasha Mazzarello, Carol Stober, Mohamed F. K. Ibrahim, Shaan Dudani, Kirstin Perdrizet, Habeeb Majeed, et al. "Primary Febrile Neutropenia Prophylaxis for Patients Who Receive FEC-D Chemotherapy for Breast Cancer: A Systematic Review." Journal of Global Oncology, no. 4 (December 2018): 1–8. http://dx.doi.org/10.1200/jgo.2016.008540.
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Purpose Despite widespread use of fluorouracil, epirubicin, cyclophosphamide, docetaxel (FEC-D) chemotherapy in breast cancer, the optimal strategy for primary febrile neutropenia (FN) prophylaxis remains unknown. A systematic review was therefore performed. Methods Embase, Ovid MEDLINE, PubMed, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, and conference proceedings were searched from 1946 to April 2016 for trials that reported the effectiveness of primary FN prophylaxis with FEC-D chemotherapy. Outcome measures were incidence of FN; treatment-related hospitalizations; chemotherapy dose delays, reductions, and discontinuations; and adverse events from prophylaxis. Results Of 2,205 identified citations, eight studies (n = 1,250) met our eligibility criteria. Three additional studies (n = 293) were identified from a prior systematic review. Three randomized controlled trials (n = 576), one phase IV single-arm trial (n = 69), one prospective observational study (n = 37), and six retrospective studies (n = 861) were identified. Agents investigated were pegfilgrastim (n = 108), filgrastim (n = 1,119), and ciprofloxacin (n = 89). The heterogeneity of studies meant that a narrative synthesis of results was performed. Median FN rates for patients who received FEC-D with and without primary prophylaxis were 10.1% (interquartile range [IQR], 3.9% to 22.6%) and 23.9% (IQR, 9.2% to 27.3%), respectively. In the absence of primary prophylaxis, FN was more common during docetaxel than during FEC. Data from six studies showed a median rate of dose reductions and delays of 6.1% (IQR, 3.1% to 14.3%) and 19.3% (IQR, 10.5% to 32.8%), respectively, that occurred as a consequence of FN. Toxicity from prophylaxis itself was rarely reported. Conclusion Primary FN prophylaxis is effective in patients who receive FEC-D chemotherapy. The paucity of prospective data makes optimal recommendations about the choice and timing of prophylaxis challenging.
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Larabi, Islam Amine, Marie Martin, Nicolas Fabresse, Isabelle Etting, Yve Edel, Gregory Pfau, and Jean Claude Alvarez. "Hair testing for 3-fluorofentanyl, furanylfentanyl, methoxyacetylfentanyl, carfentanil, acetylfentanyl and fentanyl by LC–MS/MS after unintentional overdose." Forensic Toxicology 38, no. 1 (November 7, 2019): 277–86. http://dx.doi.org/10.1007/s11419-019-00502-0.
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Abstract Purpose To demonstrate the usefulness of hair testing to determine exposure pattern to fentanyls. Methods A 43-year-old male was found unconscious with respiratory depression 15 min after snorting 3 mg of a powder labeled as butyrylfentanyl. He was discharged from hospital within 2 days without blood or urine testing. Two locks of hair were sampled 1 month (M1 A: 0–2 cm (overdose time frame); B: 2–4 cm; C: 4–6 cm) and 1 year (Y1: A: 0–2 cm; B: 2–4 cm) later to monitor his exposure to drugs of abuse by liquid chromatography–tandem mass spectrometry after liquid-liquid extraction. Results Hair analysis at M1 showed a repetitive exposure to 3-fluorofentanyl (A/B/C: 150/80/60 pg/mg) with higher concentration in segment A reflecting the overdose period. The non-detection of butyrylfentanyl was consistent with the analysis of the recovered powder identified as 3-fluorofentanyl. Furanylfentanyl (40/20/15 pg/mg) and fentanyl (37/25/3 pg/mg) were also detected in hair. The second hair analysis at Y1 showed the use of three new fentanyls, with probably repetitive exposures to methoxyacetylfentanyl (A/B: 500/600 pg/mg), and single or few exposures to carfentanil (2.5/3 pg/mg) and acetyl fentanyl (1/1 pg/mg). A decreasing exposure to 3-fluorofentanyl (25/80 pg/mg), and increasing consumption of furanylfentanyl (310/500 pg/mg) and fentanyl (620/760 pg/mg) were also observed despite methadone treatment initiation. The patient claimed not consuming three out of the six detected fentanyls. Conclusions We report single or repetitive exposure to several fentanyls using hair testing. To our knowledge, this is the first demonstration of 3-fluorofentanyl and methoxyacetylfentanyl in hair samples collected from an authentic abuser.
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Kordowitzki, P., S. Klein, K. G. Hadeler, P. Aldag, M. Nowak-Imialek, A. Lucas-Hahn, and H. Niemann. "3 SIRT1—A POSSIBLE MARKER FOR REPRODUCTIVE AGING OF IN VIVO-DERIVED BOVINE OOCYTES?" Reproduction, Fertility and Development 29, no. 1 (2017): 109. http://dx.doi.org/10.1071/rdv29n1ab3.
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Maternal aging-associated reduction of oocyte viability is a common feature in mammals. Effective measures to counteract this process have not yet been developed. Cows are commonly used as a model of early human development, including maternal aging, because both species share a very high degree of similarity, including follicle selection, cleavage and blastocyst formation and a long reproductive lifespan. SIRT1, a member of the Sirtuin family, deacetylates transcriptional regulators localised in the nucleus and cytoplasm by a NAD+-dependent mechanism. Resveratrol (3,4′,5-trihydroxystilbene) is an antioxidant identified in various plant species and red wine which enhances SIRT1 activity. Based on these observations, the goal of the present study was to examine, if SIRT1 gene and protein expression is either affected by maternal age and/or can be modulated by resveratrol. Cumulus-oocyte-complexes of prepubertal (5–6 months old) and adult/aged (2 to 8 lactation) cows were collected by ovum pick-up twice a week. Medium for in vitro maturation (TCM 199) and in vitro fertilization (FertTalp) was supplemented with 20 µL of Resveratrol® (Sigma-Aldrich, Buchs, Switzerland) to get a final concentration of 2 µM Resveratrol respectively. Standard (TCM 199 and FertTalp) media without Resveratol were used as control. Cleavage rates and blastocyst formation were evaluated. Comprehensive gene expression assays of germinal vesicle and metaphase II (MII)-stage oocytes and blastocyst were conducted using next-generation sequencing technology. Finally, SIRT1 protein expression in oocytes and blastocysts were analysed by fluorescence immunostaining under a confocal microscope (LSM510, Zeiss, Germany) and relative fluorescent intensity was calculated. The cleavage rates of adult and prepubertal donors did not differ significantly among the treatments (standard protocol: 56.5 ± 5.4% for adult and 53.0 ± 4.7% for prepubertal donors, Resveratrol supplemented protocol: 62.1 ± 4.3% for cows and 63.6 ± 3.9% for calves). The blastocyst rates were slightly enhanced in the Resveratrol supplemented groups (cows: 34.2 ± 3.8% and calves: 33.1 ± 4.2%) compared to those of standard protocol (cows: 27.5 ± 4.8% and calves: 26.4 ± 3.3%). Relative mRNA abundance levels of SIRT1 were lower in oocytes and blastocysts derived from cows than in those derived from their younger counterparts (2.8-fold change; P = 0.05), but did not differ significantly among treatment groups. Protein expression profiles revealed that bovine SIRT1 was localised in the nucleus. The relative fluorescence levels of SIRT1 were significantly lower (221 ± 34 FIU) in control groups compared to the resveratrol treated groups (865 ± 45 FIU, respectively; P = 0.05). Additionally, SIRT1 protein levels were significantly higher in MII-oocytes (1255 ± 56 FIU) and blastocysts (984 ± 26 FIU) derived from calves compared with their older counterparts (442 ± 37 FIU and 310 ± 23 FIU, respectively, P = 0.05). In conclusion, these results indicate that resveratrol affects SIRT1 protein expression in oocytes and blastocysts of donors in different age. Thus, we hypothesise that SIRT1 is a reliable marker for reproductive aging, which could also be useful for better understanding of human infertility caused by aging.
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Murray, Neil, Sally Ballard, Angela Casbard, Mike Murphy, Irene Roberts, and Simon Stanworth. "A Multi-Centre Prospective Observational Study of Platelet Transfusion Practice in Neonates with Severe Thrombocytopenia." Blood 108, no. 11 (November 16, 2006): 961. http://dx.doi.org/10.1182/blood.v108.11.961.961.
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Abstract Background: Platelet transfusion practice in neonates is not evidence-based and there is a lack of data relating transfusion to clinical outcome. To inform the design of clinical trials, we conducted a prospective multicentre observational study of platelet transfusion in thombocytopenic neonates to describe: transfusion practice, including reason for transfusion; clinically-related outcomes, including minor and major bleeding and mortality. Methods: Neonates with platelets <60x109/l were studied at 7 UK neonatal intensive care units Mar 05-Jun 06. With parental consent, daily data were collected on minor bleeding (blood staining of oral/nasogastric/endotracheal secretions and stool; microscopic haematuria; petechial rash; oozing from puncture sites - scored 0–7), and major bleeding (intraventricular (IVH), intra-abdominal, pulmonary or renal). Surviving neonates were studied for 7 days or until platelets were ≥60x109/l. Blood counts and all transfusions were directed by the attending neonatologist, with reason for transfusion and its effect on bleeding prospectively documented. Results: 145 of 167 (87%) eligible neonates were enrolled; 123 (85%) were < 37 weeks gestational age (GA), 89 (61%) were male. The study documented 186 episodes of thrombocytopenia (1606 study days) and 309 platelet transfusions given to 91 (63%) neonates. GA, birth weight and age at thrombocytopenic episode were: 27 (24–32) weeks; 825 (675–1370) grams; 5 (2–16) days, respectively [all data median (IQR)]. 21/145 babies (14%) had major IVH (Grade 3/4) at study entry. Platelets (x 109/l) at study entry, and at platelet nadir, and duration of count <60x109/l were: 44 (33–54); 31 (19–42); 2 (1–5) days respectively. In transfused neonates, platelets (x109/l) pre- and post-transfusion, and number of transfusions were: 27 (19–36); 84 (46–138); 2 (1–4) respectively. The principal indications for transfusion were:- platelet count below threshold of unit guideline: 265/309 (86%); deteriorating clinical condition: 17/309 (6%); and significant bleeding: 7/309 (2%). At least 1 episode of minor bleeding was recorded on 622/1606 (39%) of study days. Minor bleeding scores recorded for 12 hours pre- and post each transfusion were [median (IQR)]: 1 (0–2) and 0 (0–1) respectively. New or extension of IVH bleeding to Grade 3/4 occurred in 7 neonates and other major haemorrhage in 9 neonates (4 pulmonary, 3 GI). A total of 20/145 (14%) neonates died, 13 with major IVH bleeding (of which 10 had Grade 3/4 IVH at study entry); all received platelet transfusions [total 87; median 3 (2 to 7). Conclusion: This study confirms that most neonates with severe thrombocytopenia are preterm, most episodes develop after 72 hours of life (median 5 days) and are of short duration (median 2 days). Minor haemorrhage is common and may be reduced by platelet transfusion. Major haemorrhage is uncommon (11%), is associated with mortality (82%) and affected patients receive a large number of platelet transfusions. There is a clear distinction between the majority of thrombocytopenic neonates who receive one or two transfusions as prophylaxis with a good outcome, and the minority who suffer adverse outcomes despite transfusion. Many neonates are transfused with platelets at thresholds below those suggested in guidelines without apparent clinical detriment. These data will be invaluable for planning the randomised trials necessary for rationalising platelet transfusion in these vulnerable patients.
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Blaes, Anne Hudson, Kevin Scott Baker, Brad Benson, Robin L. Bliss, Jill Lunsford Lee, Joseph Philip Neglia, and Daniel A. Mulrooney. "Quality of life in cancer survivors compared with the general population." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16502-e16502. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16502.
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e16502 Background: Assessments of quality of life (QOL) among cancer survivors have had mixed results. Literature suggests that those treated with cranial irradiation (CNS) or stem cell transplantation (SCT) have a poorer quality of life. Methods: 309 cancer survivors (37 adult and 241 childhood malignancies, 31 SCT survivors) completed the Medical Outcomes Study 36-Item Short Form Healthy Survey (MOS SF-36). Demographic, disease and treatment characteristics were assessed and inter-group heterogeneity tested across three survivor groups (F-test for age; chi-square for disease and treatment characteristics). Aggregate data analysis for SF-36 composite and norm-based scoring measures was undertaken by using the mixed effect model with unequal random effect variances across studies. Treatment characteristics included age at diagnosis, current age, site of disease [cranial (y/n)], chemotherapy (y/n), radiation therapy (y/n), SCT with/without total body irradiation (TBI). All statistical tests were two-sided, P-values < 0.05 considered statistically significant. Results: The mean age at assessment was 33.4 years. 255 (83.9%) received chemotherapy, 187 (60.7%) radiation, 49 (15.9%) underwent SCT. Among those irradiated, 28 (9.1%) had TBI and 62 (20.1%) had CNS irradiation. The MOS SF-36 physical composite score was 50.5 (9.5-73.3) and mental health composite score was 50.2 (9.2-55.9). Pooled results for the MOS SF-36 included: bodily pain 51.9 (19.9-62.1), general health perceptions 46.7 18.6-63.9), mental health 50.6 (16.2-64.1, physical functioning 51.0 (14.9-57.0), role emotion 50.2 (9.2-55.9), role physical 50.2 (17.7-56.9), social functioning 49.5 (13.2-56.9) and vitality 51.9 (20.9-70.8). No significant variation from the general population median normative values (50.0) was identified, including those treated with CNS and SCT. There was no difference in QOL amongst those treated as children, young adults (ages 15-30 years) or adults. Role physical declined significantly with advancing age (p=0.02). Conclusions: In spite of the chronic conditions prevalent among cancer survivors, the overall QOL of most cancer survivors, including those who have received CNS or SCT, is comparable to that of the general population.
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De Swart, Louise, Chloé Reiniers, Tim Bagguley, Corine van Marrewijk, David Bowen, Jaroslav Cermak, Eva Hellström-Lindberg, et al. "Hepcidin and GDF15 Levels during the First 2 Years Follow-up in Patients with Low and Int-1 Risk Myelodysplastic Syndromes (MDS) from the European Leukemianet MDS Registry." Blood 124, no. 21 (December 6, 2014): 3267. http://dx.doi.org/10.1182/blood.v124.21.3267.3267.
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Abstract Background: The EUMDS registry is a prospective observational registry to collect data on lower risk MDS. 17 Countries and 133 centers are participating. We analyzed serum from 101 patients for ferritin, hepcidin, growth differentiation factor 15 (GDF15) and C-reactive protein (CRP) at six-month intervals in order to evaluate temporal changes in iron metabolism. Objective: To explore hepcidin and GDF15 levels over time in lower risk MDS patients and their relation with WHO2001 subtype, transfusion history and conventional iron parameters. Results: The median age of the study population was 73 years (range 44-95 years). The majority was male: 64%. Distribution according to WHO2001 MDS subtype was RCMD (41%), RARS (25%), RA (14%), RAEB (11%), 5q-syndrome (6%) and RCMD-RS (3%). Table 1 shows iron parameters at registration, 1 year and 2 years follow-up both in transfusion-dependent (TD) and transfusion-independent (TI) patients and stratified according to MDS subtypes: RS (RARS/RCMD-RS) or MDS Other (RA/RCMD/RAEB/5q-syndrome). Serum ferritin was increased in TD patients with a median concentration at registration of 550µg/L and at 2 years 818µg/L, compared to TI patients (median <250µg/L, all time points). During follow-up ferritin was most elevated in patients who received >10 red blood cell (RBC) units: median at registration 1482µg/L - 2 years 1970µg/L. Ferritin correlated significantly with hepcidin (r=0.57; p<0.001) as well as CRP: r=0.27, p<0.001. Median CRP was within reference range (<10mg/L) for both TD and TI patients at registration and during follow-up, but mainly TD patients had elevated CRP levels >50mg/L. Median serum hepcidin levels were elevated in TD patients at registration and remained elevated during follow-up, especially in patients with >10 RBC units transfused (median 27.4nmol/l at registration, 12.8nmol/l at 2 years). Remarkable fluctuation in hepcidin levels occurred in patients with elevated hepcidin during follow-up. Even in the longitudinal cohorts hepcidin fluctuated considerably, maybe due to the interval between the previous transfusion and the measurement of hepcidin or due to diurnal fluctuation. Hepcidin was lowest in MDS RS TI patients and showed a tendency to decrease over time from a median level of 4.4nmol/l at registration to 2.4nmol/l after 2 years, associated with ineffective erythropoiesis. This is supported by the high median GDF15 in these patients. Lowest GDF15 was found in TD patients with ‘MDS Other’ associated with transfusional load. The number of transfused RBC units did not affect the median GDF15 levels. Conclusions: Hepcidin levels were influenced by RBC transfusion history, but hepcidin levels appear to decrease over time in the RS subtype only. Interestingly, increase in hepcidin after transfusions was already visible early in follow-up, depending on the transfusional load and erythropoietic activity of the bone marrow. GDF15 concentration appeared to be most related to MDS subtype, functioning as a marker of ineffective erythropoiesis. Table1: ferritin, hepcidin and GDF15 during-follow-up Registration 1 yr follow-up 2 yrs follow-up N Median (p25-p75) N Median (p25-p75) N Median (p25-p75) Ferritin (µg/L) 101 286 (138 - 558) 83 287 (149 - 845) 66 347 (191 - 818) MDS Other: TI 53 205 (87 - 389) 31 148 (78 - 288) 25 202 (71 - 319) MDS Other: TD 20 479 (279 - 877) 29 845 (481 - 1538) 22 841 (323 - 2387) RARS/RCMD-RS: TI 25 268 (195 - 558) 19 233 (170 - 323) 10 319 (222 - 379) RARS/RCMD-RS: TD 3 610 (108 - 1382) 4 1909 (1206 - 2935) 9 712 (590 - 1222) Hepcidin (nmol/L) 100 5.2 (3.0 - 9.9) 83 5.8 (2.7 - 14.0) 66 5.2 (2.5 - 9.9) MDS Other: TI 53 4.6 (2.8 - 8.4) 31 4.4 (2.3 - 8.1) 25 4.2 (2.5 - 6.8) MDS Other: TD 20 11.1 (4.9 - 21.0) 29 17.2 (9.2 - 22.3) 22 9.6 (4.5 - 17.1) RARS/RCMD-RS: TI 24 4.2 (2.1 - 6.1) 19 3.5 (1.6 - 5.1) 10 2.4 (1.6 - 3.9) RARS/RCMD-RS: TD 3 9.8 (6.0 - 11.1) 4 9.3 (7.3 - 12.1) 9 5.2 (2.9 - 9.3) TI: 0 RBC units 81 4.5 (2.8 - 8.4) 51 4.0 (2.0 - 7.5) 37 3.1 (2.1 - 6.7) TD: ≤10 RBC units 17 10.6 (4.7 - 14.9) 14 9.2 (5.3 - 17.2) 14 4.3 (2.4 - 8.7) TD: >10 RBC units 2 27.4 (15.7 - 39.1) 18 18.1 (12.7 - 24.5) 15 12.8 (9.3 - 21.3) GDF15 (ng/L) 101 1945 (1207 - 3611) 82 2467 (1659 - 4318) 66 2582 (1519- 5332) MDS Other: TI 53 1831 (1100 - 3176) 31 1902 (1076 - 2698) 25 1702 (1136 - 3564) MDS Other: TD 20 1452 (1169 - 2789) 28 2583 (1937 - 4493) 22 2556 (1661 - 4050) RARS/RCMD-RS: TI 25 3532 (2124 - 4211) 19 3148 (2195 - 4560) 10 3661 (1986 - 5524) RARS/RCMD-RS: TD 3 2196 (1869 - 2893) 4 2996 (1806 - 5141) 9 5555 (3204 - 7488) Disclosures Hellström-Lindberg: Celgene: Research Funding. Symeonidis:Celgene: Research Funding; Novartis Oncology: Research Funding; Amgen: Research Funding; Novartis Oncology: Consultancy; Amgen: Consultancy. de Witte:Novartis: Research Funding; Novartis: Honoraria; Celgene: Consultancy; Novartis: Consultancy.
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Juvela, Seppo. "Growth and rupture of unruptured intracranial aneurysms." Journal of Neurosurgery 131, no. 3 (September 2019): 843–51. http://dx.doi.org/10.3171/2018.4.jns18687.
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OBJECTIVERisk factors for growth of unruptured intracranial aneurysms (UIAs) during a lifelong follow-up in relation to subsequent rupture are unknown. The author’s aim in this study was to investigate whether risk factors for UIA growth are different for those that lead to rupture than for those that do not.METHODSThe series consists of 87 patients with 111 UIAs diagnosed before 1979, when UIAs were not treated. A total follow-up time of the patients was 2648 person-years for all-cause death and 2182 years when patients were monitored until the first rupture, death due to unrelated causes, or the last contact (annual incidence of aneurysm rupture, 1.2%). The follow-up time between aneurysm measurements was 1669 person-years. Risk factors for UIA growth were analyzed in relation to subsequent rupture.RESULTSThe median follow-up time between aneurysm measurements was 21.7 years (range 1.2–51.0 years). In 40 of the 87 patients (46%), the UIAs increased in size ≥ 1 mm, and in 31 patients (36%) ≥ 3 mm. All ruptured aneurysms in 27 patients grew during the follow-up of 324 person-years (mean growth rates 6.1 mm, 0.92 mm/year, and 37%/year), while growth without rupture occurred in 13 patients during 302 follow-up years (3.9 mm, 0.18 mm/year, and 4%/year) and no growth occurred in 47 patients during 1043 follow-up years. None of the 60 patients without aneurysm rupture experienced one during the subsequent 639 follow-up years after the last aneurysm measurement. Independent risk factors for UIA growth (≥ 1 mm) in all patients were female sex (adjusted OR 3.08, 95% CI 1.04–9.13) and smoking throughout the follow-up time (adjusted OR 3.16, 95% CI 1.10–9.10), while only smoking (adjusted OR 4.36, 95% CI 1.27–14.99) was associated with growth resulting in aneurysm rupture. Smoking was the only independent risk factor for UIA growth ≥ 3 mm resulting in aneurysm rupture (adjusted OR 4.03, 95% CI 1.08–15.07). Cigarette smoking at baseline predicted subsequent UIA growth, while smoking at the end of the follow-up was associated with growth resulting in aneurysm rupture.CONCLUSIONSCigarette smoking is an important risk factor for UIA growth, particularly for growth resulting in rupture. Cessation of smoking may reduce the risk of devastating aneurysm growth.
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CORPUZ-RAROS, LEONILA, and SERGEY G. ERMILOV. "Catalogue of oribatid mites (Acari: Oribatida) from Continental Southeast Asia." Zootaxa 4893, no. 1 (December 7, 2020): 1–216. http://dx.doi.org/10.11646/zootaxa.4893.1.1.
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This paper presents a catalogue of oribatid mites (Acari, Oribatida) recorded from Continental Southeast Asia (CSEA) covering a period of 55 years from 1965 to the first half of 2020. This subregion comprises countries that are located on the southeastern coast of the Asian continent, namely, Myanmar, Thailand, Laos, Cambodia and Vietnam. For each species, information is compiled on references to the original description, subsequent re-combinations of specific name with other genera, and junior synonyms used in CSEA literature, if any, as well as type habitat, habitats recorded later, and distribution within outside CSEA. A historical review of explorations and taxonomic studies in the various countries is also provided. A total of 820 valid species including subspecies and seven doubtful species are known so far from CSEA. The valid species belong to 313 genera and subgenera, 94 families and 36 superfamilies in all of the five infraorders and two hyporders of the Suborder Oribatida. The Hyporder Brachypylina is most diverse with 620 species, followed by Mixonomata (88), Enarthronota (65), Nothrina (41), Palaeosomata (5) and Parhyposomata (1). Vietnam whose fauna has been best explored tops the records with 730 species, followed by a low second by Thailand (137), then Cambodia (37) and Myanmar (11) while the oribatid fauna of Laos is still entirely unknown. Altogether, the oribatid fauna of Southeast Asia (SEA), including its two subregions, now totals 1601 species belonging to 477 genera, 109 families and 40 superfamilies. Species that are known so far only from CSEA countries and thus probably endemic is highest at 36.4% for Myanmar, 32,1% for Thailand, 23.7% for Vietnam, 0 for Cambodia, 27.2% for CSEA, 59.0% for the Malay Archipelago, and 48.7% for SEA as a whole. About 7% of the recorded species of Thailand and Vietnam are cosmopolitan or semicosmopolitan in distribution, but their faunal elements are decidedly Oriental, with about half (43–54%) occurring also in other Oriental countries. The same countries also share in common many species with other zoogeographic regions, viz. 12–14% Palaearctic, 8–16% Australian, 8–11% Neotropical, 3–11% Ethiopian, and 1–3% Nearctic.
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Stephenson, RGA, and AR Bird. "Responses to protein plus energy supplements of pregnant ewes eating mature grass diets." Australian Journal of Experimental Agriculture 32, no. 2 (1992): 157. http://dx.doi.org/10.1071/ea9920157.
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Three experiments were conducted with ewes during late gestation (last 4 weeks) to examine metabolic and lamb birth weight responses to supplements. In a metabolism experiment, 18 ewes were divided into 2 groups and offered 800 g chopped Rhodes grass (Chloris gayanu, 1.1% N) with or without a supplement of 150 g cottonseed meal + 50 g molasses, daily until parturition. Supplementation was associated with significant increases in intake of digestible dry matter (37%) and crude protein (121%). Supplemented ewes had significantly greater liveweight gain (173 v. 39 g/day), plasma glucose (2.9 v. 2.5 mmol/L), glucose entry rate (20.6 v. 12.3 mmol/h), udder measurements (e.g. circumference, 548 v. 443 mm), and milk yields (measured at day 2 post-partum, 1748 v. 627 mL/day), and had heavier lambs at birth (3.9 v. 2.9 kg). In a second experiment, 10 ewes were pen-fed chopped Rhodes grass ad libitum, and 5 received individually 150 g cottonseed meal + 100 g molasses administered daily. Supplemented ewes were significantly heavier (47.8 v. 45.0 kg) in the last week before parturition. Supplementation was associated with improved ewe liveweight change (48 v. -33 g/day) and lamb birth weight (3.4 v. 2.4 kg). In a third experiment, 42 ewes grazed a 80-ha paddock during a dry season and received daily 1 of 3 individually administered treatments: control (20 mL water drench); 7 g urea + 4 g sulfate of ammonia in a 20 mL drench; 100 g meat and bone meal + 100 g molasses + 3 g urea administered as a slurry in a single drench. Performance and metabolic parameters for the 3 groups were ewe liveweight gain (38, 80, 131 g/day), rumen ammonia concentration (7.1, 10.0, 8.6 mmol/L), plasma glucose (2.6, 2.6, 2.1 mmol/L), plasma hydroxybutyrate (0.6, 0.5, 0.4 mmol/L), and lamb birth weight (3.5, 3.7, 4.0 kg). Differences were significant between the protein-supplemented and control groups for all parameters except rumen ammonia concentration. The data support the conclusion that protein supplements provide a production response in pregnant ewes that is sufficient to improve lamb survival rates when the nutrition from grass diets is inadequate.
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Rubio, I., A. Martínez-Bueno, G. López-Vivanco, N. Fuente, R. Barceló, A. Gil-Negrete, S. Carrera, G. López-Argumedo, R. Fernández, and A. Muñoz. "Elderly patients with advanced non-small cell lung cancer (nsclc). Results of chemotherapy and comparison with younger patients." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 18505. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.18505.
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18505 Background: Lung cancer is increasingly diagnosed in elderly patients and is the first cause of cancer death. Treatment of this subset represents a challenge to medical oncologists. Methods: We retrospectively reviewed clinical characteristics, co-morbidity (Charlson Index), toxicity and results of all patients ≥ 65 years (y) old, diagnosed of advanced NSCLC. We compared these results with younger patients’. Results: From January-95 to June-02, we treated 477 patients (pt), 176 ≥ 65 years, 301 < 65 y. Treatment: 177 pt, MIC (mitomycine + ifosfamide + cisplatin), 60 ≥ 65 y and 117 < 65 y; 156, CG (Cisplatin + Gemcitabine), 52 > 65 y and 104 < 65 y; 144, CP (Cisplatin + Paclitaxel), 64 ≥ 65 y and 120 < 65 y. Characteristics: median age 60 (31–78); 428 male, 49 female; ECOG 0/1/2/3: 83/312/71/5, Stage IIIA, IIIB and IV: 72/199/206, Histology: squamous carcinoma 215, adenocarcinoma 190, large cell 19, bronchioloalveolar 7, undifferentiated 45 pt. No significant differences between the two groups. Overall response rate: 39% (CR, 32.9%, PR, 6.1%), Stable disease 26.4% and Progressive disease, 26.4%. Patients ≥ 65 y: CR 5.7%, PR 45.5%, SD 23.3% and PD 18.2%. Patients < 65 y: CR 6.3% PR 25.6%, SD 28.2% and PD 31.2%. Predictive factors for response: ECOG and stage. Response rate was superior in patients ≥ 65 y and in patients ≥ 70 y. Overall survival: 38.29 weeks (w): < 65 y, 38.57 w; 65–70 y, 37.71 w and ≥ 70 y, 37 w. Multivariate analysis: ECOG, stage and sex were prognostic factors; age, histology, Charlson index and schedule treatment were not significant. Grade 3/4 episodes of toxicity: ≥ 65 y, 184/17, and < 65 y, 232/8. Treatment delays: ≥ 65 y, 115 and < 65 y, 100. Hospitalization due to toxicity: >≥ 65 y, 34 and < 65 y, 23. Treatment was stopped in 13 pt >≥ 65 y and in 7 pt < 65 y. Conclusions: Age is not a predictive factor for response to chemotherapy, neither a prognostic factor for survival. Charlson index does not seem to be useful for these patients. Although toxicity is superior, cisplatin-based schedules are safe and active. No significant financial relationships to disclose.
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Toishibekov, M. M., M. T. Jazkbayev, and B. B. Molzhigitov. "55 EFFECT OF TREHALOSE FOR FROZEN–THAWED RAM SPERM MOTILITY PARAMETERS." Reproduction, Fertility and Development 27, no. 1 (2015): 120. http://dx.doi.org/10.1071/rdv27n1ab55.
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Computer-assisted sperm analysers have become the standard tool for evaluating sperm motility because they provide objective results for thousands of mammalian spermatozoa. Ram semen was collected using electro-ejaculation from 10 adult rams of Chingizskaya indigenous sheep breed. Motility was determined using computer-automated semen analysis (Hamilton Thorne Motility Analyzer, Beverly, MA, USA). Trehalose solution (0.375 M) was added to Tris-buffered saline solution to give the following trehalose extenders: 25, 50, 75, and 100% (vol:vol), and analysed for motility using computer-automated semen analysis. The sperm pellets were resuspended at 24°C in cooling extender – trehalose extenders of each concentration containing 5% egg yolk. The diluted semen was cooled to 5°C within 2 h. The semen was then further diluted 1 : 1 with freezing extender – each trehalose extender containing 1.5% glycerol to obtain a sperm concentration of 2.0 × 108 cells mL–1 – and then loaded into 0.5-mL straws. Straws were frozen using a programmable freezer with a freezing curve of 5°C to –5°C at 4°C per min, –5°C to –110°C at 25°C per min, and –110°C to –140°C at 35°C per min, and then the straws were plunged into liquid nitrogen for storage. Frozen samples were thawed in a 37°C water bath for 30 s and analysed for motility using computer-automated semen analysis. Statistical analyses were performed with a Student's test. The fresh semen samples showed the next results: motility 88.3 ± 2.4%, progressive motility 26.8 ± 6.9%, and progressive velocity 61.9 ± 4.2 μm s–1. Motility of the frozen-thawed spermatozoa was 63.6 ± 2.9% (25% trehalose), 55.6 ± 5.2% (50%), 32.4 ± 4.7% (75%), and 23.6 ± 3.2 (100%). Progressive motility was 15.6 ± 3.9% (25%), 13.7 ± 3.7% (50%), 4.5 ± 1.3% (75%), and 5.2 ± 1.3% (100%). Progressive velocity was 93.5 ± 8.3 μm s–1 (25%), 85.4 ± 8.1 μm s–1 (50%), 65.7 ± 6.1 μm s–1 (75%), 35.2 ± 3.3 μm s–1 (100%). Motility of the frozen-thawed spermatozoa significantly decreased with increasing concentrations of trehalose in the extender (P < 0.05). These preliminary studies showed that further research is needed of use trehalose for ram spermatozoa cryoconservation.
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Ferré, Fabrice, Nicolas Boeschlin, Bruno Bastiani, Adeline Castel, Anne Ferrier, Laetitia Bosch, Fabrice Muscari, et al. "Improving Provision of Preanesthetic Information Through Use of the Digital Conversational Agent “MyAnesth”: Prospective Observational Trial." Journal of Medical Internet Research 22, no. 12 (December 4, 2020): e20455. http://dx.doi.org/10.2196/20455.
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Background Due to time limitations, the preanesthetic consultation (PAC) is not the best time for patients to integrate information specific to their perioperative care pathway. Objective The main objectives of this study were to evaluate the effectiveness of a digital companion on patients' knowledge of anesthesia and their satisfaction after real-life implementation. Methods We conducted a prospective, monocentric, comparative study using a before-and-after design. In phase 1, a 9-item self-reported anesthesia knowledge test (Delphi method) was administered to patients before and after their PAC (control group: PAC group). In phase 2, the study was repeated immediately after the implementation of a digital conversational agent, MyAnesth (@+PAC group). Patients’ satisfaction and their representations for anesthesia were also assessed using a Likert scale and the Abric method of hierarchized evocation. Results A total of 600 tests were distributed; 205 patients and 98 patients were included in the PAC group and @+PAC group, respectively. Demographic characteristics and mean scores on the 9-point preinformation test (PAC group: 4.2 points, 95% CI 3.9-4.4; @+PAC: 4.3 points, 95% CI 4-4.7; P=.37) were similar in the two groups. The mean score after receiving information was better in the @+PAC group than in the PAC group (6.1 points, 95% CI 5.8-6.4 points versus 5.2 points, 95% CI 5.0-5.4 points, respectively; P<.001), with an added value of 0.7 points (95% CI 0.3-1.1; P<.001). Among the respondents in the @+PAC group, 82% found the information to be clear and appropriate, and 74% found it easily accessible. Before receiving information, the central core of patients’ representations for anesthesia was focused on the fear of being put to sleep and thereafter on caregiver skills and comfort. Conclusions The implementation of our digital conversational agent in addition to the PAC improved patients' knowledge about their perioperative care pathway. This innovative audiovisual support seemed clear, adapted, easily accessible, and reassuring. Future studies should focus on adapting both the content and delivery of a digital conversational agent for the PAC in order to maximize its benefit to patients.
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Sidana, Surbhi, Nidhi Tandon, Angela Dispenzieri, Morie A. Gertz, Francis Buadi, Martha Lacy, David Dingli, et al. "Factors predicting organ response in light chain amyloidosis (AL)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 8048. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.8048.
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8048 Background: Organ response (OR) in AL is often delayed and difficult to predict early. Methods: We retrospectively analyzed 1308 patients (pts) with newly diagnosed AL from 2006 – 2015 to determine factors which could predict for OR. Results: Median age was 64 years (yr) and Mayo Stage was: 1 (22%); 2 (23%); 3 (25%); 4 (31%). Organ involvement was: cardiac (74%, n=932); renal (59%, n=738), liver (16%, n=205); gut (24%, n=310) and autonomic (12%, n=152). 59% (n=765) had > 1 organ involved, including 43% (n=567) with > 1 critical organ (heart, kidney, liver) involved. Treatment was: ASCT based (28%, n=330, N=1186), bortezomib based (24%, n=281), alkylator based (33%, n=392), others (5%, n=54) and none (10%). In evaluable pts, VGPR or better rates were: 53% at 6 months (m) (N=625), 72% at 12 m (N=465) and 57% overall (N=688). Table 1 lists OR at various time points. Complete OR in all involved critical organs was seen in: 51% (n=308, N=600), partial response (at least 1 OR when >1 organ involved) in 12% (n=73) and none in 37% (n=219). Complete OR was associated with better overall survival (OS) than partial or no OR (median OS: not reached vs 42 m vs 29 m; P <0.0001). In multivariate model the following variables at baseline or 1 yr mark were predictive of complete OR: lower Mayo Stage (p=0.01), fewer critical organs involved (p=0.007), higher baseline GFR (p=0.03), female sex (Complete OR 60% vs 47%; p=0.04) and VGPR at 1 yr (Complete OR 70% vs. 36%; p <0.0001). Other factors included in the model were age (p=0.9), bilirubin (p=0.1) and transplant (p=0.2). All aforementioned factors were significant in univariate analysis. Conclusions: Achievement of response in all involved critical organs is associated with better survival in AL pts than partial or no OR. Various baseline factors and VGPR at 1 yr can predict for achieving complete OR, with 70% pts who achieve VGPR at 1 yr having a complete OR. [Table: see text]