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Williams, Courtney, Kelly Kenzik, Maria Pisu, Stacey A. Ingram, Aidan Gilbert, Rodney Paul Rocconi, and Gabrielle Betty Rocque. "Impact of travel time on hospitalizations and patient cost responsibility by phase of care for older patients with cancer." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 37. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.37.
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37 Background: Healthcare reimbursement changes are contributing to increased closures of community hospitals and oncology practices, which may lead cancer patients to travel greater distances for care. Limited data exists on the impact of travel time on hospitalization rates and patient cost responsibility by phase of care for older cancer patients. Methods: This was a secondary analysis of Medicare claims from 2012-2015 for cancer patients age ≥65 receiving care in the University of Alabama at Birmingham Cancer Community Network. Patient addresses were obtained from network data, hospitalizations from inpatient claims, and patient cost responsibility from inpatient, outpatient, skilled nursing facility, carrier, and durable medical equipment claims. Drive time was calculated from patient home to cancer care site (CCS). Phase of care-specific (initial, survivorship, end-of-life [EOL]) rates of hospitalizations overall and by CCS vs. other care site (OCS) were calculated per 100 person-years. Hierarchical linear models compared average monthly phase-specific costs by drive time to CCS. Results: Of 23,605 older cancer patients, median drive time to CCS was 32 minutes (IQR 18-59), with 24% driving ≥1 hour to CCS. Rates of hospitalizations by initial (n = 14,225), survivorship (n = 18,805), and EOL (n = 8,211) phases of care were 54, 26, and 301 per 100 person-years, respectively. Higher rates of hospitalizations at OCS vs. CCS were shown for patients traveling ≥1 hour to CCS (initial, survivorship, and EOL rate of 41 vs. 20, 21 vs. 6, and 220 vs. 95 per 100 person-years, respectively). Median monthly costs by phase were $401 (IQR $182-$814) for initial, $369 (IQR $123-$1046) for survivorship, and $2075 (IQR $1123-$3723) for EOL. Patients traveling ≥1 hour to their CCS had higher cost responsibility, with patients in initial, survivorship, and EOL phases having $303 (95% CI $130-$476), $75 (95% CI $46-$105), and $736 (95% CI $308-$1164) higher average costs per month than those traveling < 1 hour, respectively. Conclusions: Cancer patients traveling further to receive care are potentially vulnerable to higher cost responsibility and limited access to care if community hospitals close, especially at EOL.
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Pazmino, S., V. Stouten, P. Verschueren, P. Mamouris, R. Westhovens, K. De Vlam, D. Bertrand, K. Van der Elst, B. Vaes, and D. De Cock. "AB1153 ANALGESIC AND ANTI-INFLAMMATORY DRUG USE IN PATIENTS WITH RHEUMATOID ARTHRITIS, PSORIATIC ARTHRITIS AND SPONDYLOARTHRITIS VERSUS CONTROLS IN A BELGIAN GENERAL PRACTITIONER REGISTRY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1867.1–1867. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3530.
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Background:Rheumatoid arthritis (RA), psoriatic arthritis (PSA) and spondyloarthritis (SPA) are the most common inflammatory rheumatic diseases. Pain is the hallmark symptom in these conditions and pain relief is ranked first amongst preferred outcomes by patients. Level of analgesic and anti-inflammatory drug use is unknown in these populations in Belgium.Objectives:To compare analgesic and anti-inflammatory drug use in patient populations of RA, PSA and SPA versus controls in a General Practitioners (GP) setting in an era of expanding treatment possibilities in rheumatology.Methods:Data were obtained from Intego over a 13-year time interval from 1999 to 2012. Intego is a Flemish GP-based morbidity registration network hosted at the Academic Center for General Practice of the KU Leuven, covering 2% of the Flemish general population. Patients classified under the International Classification of Primary Care codes L88 (rheumatoid/seropositive arthritis) and L99 (musculoskeletal disease other) were selected for this study. Experienced rheumatologists verified if the keywords mapped to these codes corresponded to a diagnosis of RA/SPA/PSA. The date of these diagnoses in Intego was considered “baseline”. Controls were matched on age, gender, baseline date and GP practice in a 4:1 case ratio. Intego registers all electronic drug prescriptions by the GP. Anytime use of glucocorticoids, NSAIDs, opioids except tramadol, tramadol and paracetamol in the first 3 years after diagnosis is presented. Proportions of patients and controls on analgesic and anti-inflammatory drugs were compared by Chi-Square analyses.Results:Over a 13-year period, 738, 229 and 167 patients were included with a diagnosis of RA, SPA or PSA, respectively. Table 1 presents the medication use of these populations. The three conditions had statistically significantly more prescriptions for all types of analgesic and anti-inflammatory drugs compared to controls. Approximately 70% of patients with an inflammatory rheumatic condition received mild pain medication (NSAIDs, Tramadol and Paracetamol) in the first three years after diagnosis. To note is the high use of opioids, even excluding tramadol, in these populations ranging up to 15%.Table 1.3-year analgesic and anti-inflammatory drug use in RA, SPA and PSA patients versus controlsMedicationRARA ControlSPASPA ControlPSAPSA ControlNumber of patients7382952229916167668Glucocorticoids241(33%)348(12%)29(13%)70(8%)47(28%)67(10%)NSAIDs455(62%)1156(39%)161(70%)340(37%)114(68%)267(40%)Opioids109(15%)263(9%)31(14%)53(6%)24(14%)45(7%)Tramadol87(12%)150(5%)22(10%)28(3%)16(10%)26(4%)Paracetamol233(32%)598(20%)63(28%)165(18%)51(31%)141(21%)Total analgesic and anti-inflammatory drug use506(69%)1409(48%)172(75%)407(44%)121(72%)309(46%)RA= Rheumatoid arthritis, PSA= psoriatic arthritis, SPA= spondyloarthritis. Total analgesic and anti-inflammatory drug is the sum of NSAIDs, Tramadol and Paracetamol. Anytime use of drugs are presented.Conclusion:Frequent analgesic and anti-inflammatory drug use in patients with a chronic inflammatory joint condition is to be expected, and underlined by the results of our study. Remarkably is the high use of opioids, even excluding tramadol, in patients with RA, PSA and SPA in an era of effective disease modifiers, as well in the control population. Our data shows that around 9% of the Belgian population receives at least once over a 3-year period an opioid prescription. As our data only registers electronic GP prescriptions, this is likely to be an underestimation of the true prescription proportion. Detailed analyses on dose and duration of analgesic and anti-inflammatory drugs will follow.Disclosure of Interests:Sofia Pazmino: None declared, Veerle Stouten: None declared, Patrick Verschueren Grant/research support from: Pfizer unrestricted chair of early RA research, Speakers bureau: various companies, Pavlos Mamouris: None declared, Rene Westhovens Grant/research support from: Celltrion Inc, Galapagos, Gilead, Consultant of: Celltrion Inc, Galapagos, Gilead, Speakers bureau: Celltrion Inc, Galapagos, Gilead, Kurt de Vlam Grant/research support from: Celgene, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Eli Lilly, Galapagos, Johnson & Johnson, Novartis, Pfizer Inc, UCB, Delphine Bertrand: None declared, Kristien Van der Elst: None declared, Bert Vaes: None declared, Diederik De Cock: None declared
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Knechtle, Beat, Margarida Gomes, Volker Scheer, Robert Gajda, Pantelis Theodoros Nikolaidis, Lee Hill, Thomas Rosemann, and Caio Victor Sousa. "From Athens to Sparta—37 Years of Spartathlon." International Journal of Environmental Research and Public Health 18, no. 9 (May 5, 2021): 4914. http://dx.doi.org/10.3390/ijerph18094914.
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(1) Background: Recent studies analyzed the participation and performance trends of historic races such as the oldest ultra-marathon (Comrades) or the oldest 100-km ultra-marathon (Biel). One of the toughest and historic ultra-marathons in the world is the ‘Spartathlon’ (246-km ultra-marathon from Athens to Sparta). The present study aimed to analyze the trends in participation and performance of this race. (2) Methods: Different general linear models were applied as follows: the first model was a two-way ANOVA (Decade × Sex), with separate models for all participants and for only the top five finishers in each race; the second model was a two-way ANOVA (Age Group × Sex); the third model was a two-way ANOVA (Nationality × Sex). (3) Results: Between 1982 and 2019, 3504 ultra-marathoners (3097 men and 407 women) officially finished the Spartathlon at least once. Athletes from Japan were the majority with 737 participants, followed by far by runners from Germany (n = 393), Greece (n = 326), and France (n = 274). The nations with the highest numbers of athletes amongst the top five performers were Japan (n = 71), followed by Germany (n = 59), and Great Britain (n = 31). Runners from the USA were the fastest in men, and runners from Great Britain were the fastest in women. Female and male runners improved performance across the decades. The annual five fastest women and men improved their performance over time. Runners achieved their best performance earlier in life (20–29 and 30–39 years) than female runners (30–39 and 40–49 years). Runners in age group 30–39 years were the fastest for all nationalities, except for Greece. (4) Conclusions: Successful finishers in the Spartathlon improved performance in the last four decades and male runners achieved their best performance ~10 years earlier in life than female runners.
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Novikov, Dmitry, Anton Derkachev, and Anna Sukhorukova. "HYDROGEOCHEMISTRY OF THE ZAELTSOVSKY-MOCHISHCHE FIELD OF RADON WATERS." Interexpo GEO-Siberia 2, no. 1 (2019): 125–32. http://dx.doi.org/10.33764/2618-981x-2019-2-1-125-132.
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Results of the studies into the features of the geochemistry of radon waters from the Zaeltovsky-Mochishche zone of Novosibirsk city are reported. Radon waters are fracture, cold with the temperature of 6-10 оC, they occur at a depth of 50-200 m. In the hydrogeological section, neutral and weakly alkaline waters are developed, with рН from 6,9 to 7,8, mainly with the calcium hydrocarbonate and calcium-sodium hydrocarbonate composition, with total mineralization from 322 to 895 mg/dm3. The concentrations of 222Rn in water-saturated zones of granites vary from 308 to 1521 Bq/dm3, while in the wells drilled into hornstones radon content varies within the range 37-241 Bq/dm3. The concentrations of 238U and 226Ra do not exceed 0.098 mg/dm3 and 3.5∙10-7 mg/dm3, respectively.
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Atmaca, Hulusi, Fatih Tanriverdi, Cumali Gokce, Kursad Unluhizarci, and Fahrettin Kelestimur. "Posterior pituitary function in Sheehan’s syndrome." European Journal of Endocrinology 156, no. 5 (May 2007): 563–67. http://dx.doi.org/10.1530/eje-06-0727.
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Objective: We studied posterior pituitary function in 27 patients with Sheehan’s syndrome and 14 controls. Design: All patients were investigated by water deprivation test and 26 of them by 5% hypertonic saline infusion test. None of the patients had symptoms of diabetes insipidus and all patients were on adequate glucocorticoid and thyroid hormone replacement therapy before testing. Results: According to dehydration test, 8 (29.6%) patients had partial diabetes insipidus (PDI group) and 19 (70.3%) had normal response (non-DI group). During the 5% hypertonic saline infusion test, the maximal plasma osmolality was higher in PDI (305 ± 4.3) and non-DI (308 ± 1.7) groups when compared with controls (298 ± 1.7 mOsm/kg; P < 0.005), but the maximal urine osmolality was lower in PDI group (565 ± 37) than in non-DI (708 ± 45) and control (683 ± 17 mOsm/kg) groups (P < 0.05). The osmotic threshold for thirst perception was higher in PDI (296 ± 4.3) and non-DI (298 ± 1.4) groups when compared with control group (287 ± 1.5 mOsm/kg) (P < 0.005). Basal plasma osmolalities were also higher in PDI (294 ± 1.0) and non-DI (297 ± 1.1) groups than in controls (288 ± 1.2 mOsm/kg; P < 0.001). Conclusions: Our findings demonstrated that patients with Sheehan’s syndrome have an impairment of neurohypophyseal function. The thirst center may be affected by ischemic damage and the osmotic threshold for the onset of thirst in patients with Sheehan’s syndrome is increased.
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Fitria, Fitria, and Saripah Sobah. "Pengaruh Penambahan Viscosity Modifier dan Hidrogen Peroksida (H2O2) terhadap Recovery Emas dan Perak." Jurnal Pendidikan dan Teknologi Indonesia 1, no. 9 (September 26, 2021): 345–49. http://dx.doi.org/10.52436/1.jpti.70.
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Metode ekstraksi emas yang saat ini banyak digunakan untuk keperluan eksploitasi emas skala industri adalah metode sianidasi dan metode amalgamasi. Recovery logam minor seperti emas dan perak untuk skala industri pada umumnya menggunakan teknik hidrometalurgi atau leaching (pelarutan selektif). Banyak reagen atau pereaksi yang bisa digunakan untuk proses leaching guna mengekstrak logam emas dan perak dari bijihnya, diantara reagen-reagen tersebut salah satunya menggunakan reagen sianida. tujuan dari percobaan Mengetahui Pengaruh viscosity modifier terhadap perolehan rekoveri emas dan mengetahui pengaruh hidrogen peroksida (H2O2) terhadap perolehan recovery emas. Ore yang digunakan dalam penelitian berukuran 37 ?m, dimasukkan kedalam botol A, B, C, D, E dan F dan tambahkan air sebanyak 733 ml, viscosity modifier sebanyak 0, 100, 200, 300, 400 dan 500 ppm, diputar selama 5 menit kemudian ditambahkan CN 10% selanjutnya botol diputar selama 2, 4, 8, 24, 32 dan 48 jam hal yang sama dilakukan pada penambahan hidrogen peroksida. Dari hasil penelitian yang dilakukan penambahan viscosity modifier 100 hingga 300 ppm dapat menaikkan recovery Au sebanyak 1,58 % untuk Ag tidak menunjukkan pengaruh kenaikan recovery. Penambahan H2O2 tidak berpengaruh terhadap kenaikan recovery Au (emas) tetapi dapat menaikkan recovery Ag sebesar 1,21747 % untuk 400 ppm, dan 1.58937 % untuk 500 ppm.
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Shah, P., CJ Glueck, N. Goldenberg, V. Jetty, A. Kumar, M. Goldenberg, P. Wang, N. Motayar, M. Prince, and K. Lee. "ID: 19: ELIGIBILITY FOR PCSK9 TREATMENT IN 734 HYPERCHOLESTEROLEMIC PATIENTS REFERRED TO A REGIONAL CHOLESTEROL TREATMENT CENTER WITH LDL CHOLESTEROL ≥70 MG/DL DESPITE MAXIMAL TOLERATED CHOLESTEROL LOWERING THERAPY." Journal of Investigative Medicine 64, no. 4 (March 22, 2016): 931.2–932. http://dx.doi.org/10.1136/jim-2016-000120.43.
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BackgroundLDL cholesterol (LDLC) lowering has been revolutionized by PCSK9 inhibitors, Alirocumab (Praluent) and Evolocumab (Repatha), which have approved indications as an adjunct to diet-maximally tolerated cholesterol lowering therapy in heterozygous (HeFH) or homozygous (HoFH) familial hypercholesterolemia, and/or clinical atherosclerotic cardiovascular disease (CVD) where LDLC lowering is insufficient despite maximal tolerated therapy.MethodsWe applied FDA approved and commercial insurance eligibility criteria for PCSK9 inhibitor use in 734 patients serially referred over 3 years who then received ≥2 months maximally tolerated LDLC lowering diet-drug therapy with follow up LDLC ≥70 mg/dl, as well as in 37 patients approved by commercial insurance for PCSK9 inhibitors. We obtained estimates of the percentage of patients with HeFH and/or CVD who meet FDA and commercial insurance eligibility for PCSK9 inhibitors using LDLC goal-based guidelines.ResultsOf the 734 patients with LDLC ≥70 mg/dl after ≥2 months maximally tolerated LDLC lowering therapy, 220 (30%) had HeFH and/or CVD events with LDLC >100 mg/dl, meeting both FDA and commercial insurance criteria for PCSK9 inhibitor therapy. Sixty-six (9%) patients were statin intolerant, without HeFH or CVD events. Of the 37 patients whose PCSK9 inhibitor therapy was approved for coverage by medical insurance carriers, 34 (92%) had LDLC>100 mg/dl after ≥2 months on maximally tolerated LDLC lowering therapy. Sixteen (43%) of these 37 patients had HeFH without CVD (LDLC on maximally tolerated conventional treatment 181±48 mg/dl), 11 (30%) had CVD without HeFH (LDLC on maximally tolerated conventional treatment 122±22 mg/dl), and 8 (22%) had both HeFH and CVD (LDLC on maximally tolerated conventional treatment 204±56 mg/dl).ConclusionOf the 734 patients referred for high LDLC treatment, with LDLC ≥70 mg/dl after ≥2 months on maximally tolerated therapy, 220 (30%) had HeFH and/or CVD with LDLC >100 mg/dl, meeting both FDA and insurance criteria for PCSK9 inhibitor therapy. If 30% of patients with high LDLC and HeFH-CVD are eligible for PCSK9 inhibitors, then specialty pharmaceutical pricing models (∼$14,300/year) will collide with an estimated 16–21 million HeFH-CVD patients. Although the costs for PCSK9 inhibitors given to an estimated 16 to 21 million patients are extraordinary ($228–300 billion), we speculate that, when weighed against direct and indirect costs of CVD, on balance, the cost to society might be either none, or that society would, in fact, save money by an anticipated 50% reduction of CVD events with PCSK9 inhibitors. Whether the health care savings arising from the anticipated reduction of CVD on the PCSK9 inhibitors justify the broad population use of these agents remains to be determined.
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K., Maheswari, and Neha Sharma. "Magnitude, risk factors and outcome of low birth weight babies admitted to neonatal intensive care unit of a tertiary care centre in Puducherry, India." International Journal of Contemporary Pediatrics 7, no. 6 (May 22, 2020): 1389. http://dx.doi.org/10.18203/2349-3291.ijcp20202153.
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Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.
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Kohno, Shigeru, Hiroshi Kida, Masashi Mizuguchi, Nobuo Hirotsu, Tadashi Ishida, Junichi Kadota, and Jingoro Shimada. "Intravenous Peramivir for Treatment of Influenza A and B Virus Infection in High-Risk Patients." Antimicrobial Agents and Chemotherapy 55, no. 6 (April 4, 2011): 2803–12. http://dx.doi.org/10.1128/aac.01718-10.
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ABSTRACTInfluenza virus infections are known to persist longer in patients with underlying diseases, including respiratory tract diseases, and tend to become complicated by secondary influenza-associated infections, such as pneumonia. To assess the efficacy and safety of the novel anti-influenza virus drug peramivir in high-risk patients, we conducted a clinical trial of patients with diabetes or chronic respiratory tract diseases and patients being treated with drugs that suppress immune function. In this multicenter, uncontrolled, randomized, double-blind study, peramivir was intravenously administered at 300 or 600 mg/day for 1 to 5 days, as needed. Efficacy was investigated in 37 patients (300 mg,n= 18 patients; 600 mg,n= 19 patients). The median durations of influenza illness were 68.6 h (90% confidence interval, 41.5 to 113.4 h) overall, 114.4 h (90% confidence interval, 40.2 to 235.3 h) in the 300-mg group, and 42.3 h (90% confidence interval, 30.0 to 82.7 h) in the 600-mg group. The hazard ratio for the 600-mg group compared to the 300-mg group was 0.497 (90% confidence interval, 0.251 to 0.984), and the duration of influenza illness was significantly shorter in the 600-mg group than in the 300-mg group. Among the 42 patients in the safety analysis set, adverse events occurred in 73.8% and adverse drug reactions in 33.3%. No adverse events were particularly problematic clinically, and all patients recovered quickly from all events. The measured blood drug concentrations showed no tendency toward accumulation. Drug accumulation with repeated doses was thus considered to be of little concern. Intravenous peramivir appears to offer a potentially useful treatment for high-risk patients in the future.
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Adashek, Jacob, Alexey Goloubev, Shumei Kato, and Razelle Kurzrock. "179 Immunotherapy trials lack a biomarker for inclusion: implications for drug development." Journal for ImmunoTherapy of Cancer 8, Suppl 3 (November 2020): A192. http://dx.doi.org/10.1136/jitc-2020-sitc2020.0179.
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BackgroundNext-generation sequencing and other biomarkers have demonstrated the capability to identify potentially pathogenic molecular aberrancies. Immune checkpoint inhibitors (ICI) have benefited patients in almost every oncologic histology. Combining these innovations has transformed how oncologists treat previously untreatable diseases.MethodsThe 413 trials from clinicaltrials.gov website were reviewed using the terms ‘nivolumab’ or ‘pembrolizumab’ between January 1, 2019 and December 31, 2019. Additionally, all 33 interventional therapeutic trials for ‘glioblastoma multiforme’ and 79 for ‘pancreatic cancer’ that were either recruiting, not yet recruiting, or active not recruiting trials between January 1, 2019 and December 31, 2019 were analyzed.ResultsIn total of 413 trials, 57,853 were planned for enrollment with 37 (8.96%) trials requiring a biomarker for entry (n = 5,602 [9.7%]). Overall, there were 41 trials with single-agent immunotherapy planned to enroll 6222 patients and of those trials 7 (17.1%) required a biomarker for enrollment (n = 285 [4.6%]). There were 193 trials with >2 immunotherapies combined planned to enroll 21,360 patients and of those trials 17 (8.8%) required a biomarker for enrollment (n = 1254 [5.9%]). There were 69 trials with immunotherapy and chemotherapy combined planned to enroll 12,354 patients and of those trials 3 (4.3%) required a biomarker for enrollment (n = 83 [0.67%]). There were 58 trials with immunotherapy and targeted therapy combined planned to enroll 11,967 patients and of those trials 6 (10.3%) required a biomarker for enrollment (n = 3244 [27.1%]). There were 52 trials with other immunotherapy combinations (e.g. vaccine) planned to enroll 5950 patients and of those trials 4 (7.7%) required a biomarker for enrollment (736 [12.4%]). Within pancreatic cancer, 31 trials were planned to use immunotherapy (monotherapy, combination, with chemotherapy, with targeted therapy) including 4493 patients total; 5 (16%) of those trials required biomarkers enrolling 309 (7%) patients. Within glioblastoma multiforme, 13 trials were planned to use immunotherapy (monotherapy, combination, with chemotherapy, with targeted therapy) including 730 patients total; 1(8%) of those trials required biomarkers enrolling 10 (1%) patients.ConclusionsFor immunotherapy-based trials in 2019, <10% of patients expected to be enrolled would be selected by a biomarker for inclusion. Precision oncology continues to struggle in the era of ICI with an all-comers approach to patient selection and trial initiation. Selecting patients for trials based on biomarkers may help better identify responders to ICI.
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García-Comas, Maya, María José López-González, Francisco González-Galindo, José Luis de la Rosa, Manuel López-Puertas, Marianna G. Shepherd, and Gordon G. Shepherd. "Mesospheric OH layer altitude at midlatitudes: variability over the Sierra Nevada Observatory in Granada, Spain (37° N, 3° W)." Annales Geophysicae 35, no. 5 (October 25, 2017): 1151–64. http://dx.doi.org/10.5194/angeo-35-1151-2017.
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Abstract. The mesospheric OH layer varies on several timescales, primarily driven by variations in atomic oxygen, temperature, density and transport (advection). Vibrationally excited OH airglow intensity, rotational temperature and altitude are closely interrelated and thus accompany each other through these changes. A correct interpretation of the OH layer variability from airglow measurements requires the study of the three variables simultaneously. Ground-based instruments measure excited OH intensities and temperatures with high temporal resolution, but they do not generally observe altitude directly. Information on the layer height is crucial in order to identify the sources of its variability and the causes of discrepancies in measurements and models. We have used SABER space-based 2002–2015 data to infer an empirical function for predicting the altitude of the layer at midlatitudes from ground-based measurements of OH intensity and rotational temperature. In the course of the analysis, we found that the SABER altitude (weighted by the OH volume emission rate) at midlatitudes decreases at a rate of 40 m decade−1, accompanying an increase of 0.7 % decade−1 in OH intensity and a decrease of 0.6 K decade−1 in OH equivalent temperature. SABER OH altitude barely changes with the solar cycle, whereas OH intensity and temperature vary by 7.8 % per 100 s.f.u. and 3.9 K per 100 s.f.u., respectively. For application of the empirical function to Sierra Nevada Observatory SATI data, we have calculated OH intensity and temperature SATI-to-SABER transfer functions, which point to relative instrumental drifts of −1.3 % yr−1 and 0.8 K yr−1, respectively, and a temperature bias of 5.6 K. The SATI predicted altitude using the empirical function shows significant short-term variability caused by overlapping waves, which often produce changes of more than 3–4 km in a few hours, going along with 100 % and 40 K changes in intensity and temperature, respectively. SATI OH layer wave effects are smallest in summer and largest around New Year's Day. Moreover, those waves vary significantly from day to day. Our estimations suggest that peak-to-peak OH nocturnal variability, mainly due to wave variability, changes within 60 days at least 0.8 km for altitude in autumn, 45 % for intensity in early winter and 6 K for temperature in midwinter. Plausible upper limit ranges of those variabilities are 0.3–0.9 km, 40–55 % and 4–7 K, with the exact values depending on the season.
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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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Goloeva, R., Z. Alekberova, T. Popkova, S. Glukhova, and D. Novikova. "POS0116 HEART RATE VARIABILITY IN PATIENTS WITH BEHCETS DISEASE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 269.2–269. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3682.
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Background:Behcet’s disease (BD) is a systemic vasculitis affecting all types and sizes of blood vessels. Heart rate variability (HRV) reflects sympathetic -parasympathetic imbalance in the autonomic NS regulation. Low HRV values are known as independent risk factor of death and non-fatal cardiovascular events in both - survivors of a myocardial infarction and in asymptomatic population.Objectives:The aim of this study is to evaluate HRV in BD pts vs healthy controls.Methods:The study group included 74 BD pts (53males/21females) with disease duration of 9,0 (5,0;15,0)/9,0 (7;20) years, and the control group - 32/15 age-matched healthy m/f. The following HRV parameters from 24h ECG ambulatory recording were assessed: MeanNN and time-domain variables, adjusted by MeanNN (SDNNn%, SDNNin%, RMSSDn%). Additionally, all traditional cardiovascular risk factors such as systolic blood pressure (SPB), smoking status, BMI values, dyslipidemia profile, ultrasonographic values of carotid intima-media thickness (IMT), and levels high sensitive CRP (hsCRP) as a marker of inflammation were evaluated.Results:In BD patients HRV values (RMSSDn%) were significantly lower compared to healthy controls (table 1).Table 1.HRV parameters in BD patients and control groupParametersMalesFemalesBD (n=53)Control (n=32)BD (n=21)Control (n=15)Age, years30 (24; 36)30 (26; 35)32 (26; 37)28 (24; 31)MeanNN, ms810 (732; 849)782 (732; 835)776 (708; 830)764 (694; 832)SDNN n (%)16,9 (13,6; 19,4)17,2 (16,3; 21,1)13,1 (11,3; 5,3)12,2 (10,7; 14,6)SDNNi n (%)6,8 (5,1; 8,1)6,8 (5,0; 8,3)7,1 (6,1; 7,7)5,2 (4,9; 5,7)RMSSD n (%)2,1 (1,5; 2,3)**4,1 (2,7; 5,2)**1,7 (1,4; 3,7)*2,8 (2,2; 3,9)*Data are presented in median values and interquartile range, *p<0,05, **p<0,005 vs controls.There was a significant negative correlation in BD patients between HRV (SDNNin%) and age (r= -0,4; p=0,00), disease duration (r= -0,3; p=0,00), BMI (r= -0,2; p<0,01), cholesterol levels (r= -0,3; p=0,00), LDLP (r= -0,3; p=0,00) and increased IMT (r= -0,2; p=0,04), and also between HRV (RMSSD%) and age (r= -0,2; p=0,04), disease duration (r= -0,2; p=0,01), cholesterol levels (r= -0,3; p=0,00), HDLP (r= -0,2; p=0,04); a positive correlation was established between HRV (SNNN%) and smoking (r= -0,2; p=0,04). The control group showed positive correlation between HRV (SNNN%) and increased IMT (r= 0,4; p=0,01).Conclusion:HRV reduction reflects impaired sympathetic -parasympathetic regulation in BD pts, associated with pts’ age, disease duration and presence of traditional cardiovascular risk factors: BMI, increased cholesterol levels, LDLP, and such asymptomatic manifestation of atherosclerosis as increased IMT.Disclosure of Interests:None declared
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Veis, J. H., B. A. Molitoris, I. Teitelbaum, J. A. Mansour, and T. Berl. "Myo-inositol uptake by rat cultured inner medullary collecting tubule cells: effect of osmolality." American Journal of Physiology-Renal Physiology 260, no. 5 (May 1, 1991): F619—F625. http://dx.doi.org/10.1152/ajprenal.1991.260.5.f619.
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Myo-inositol (MI) is involved in the adaptation to hyperosmolality. Its uptake by rat inner medullary collecting duct (RIMCD) cells has not been studied. Compared with cells grown in isotonic media, those grown in hyperosmolality display marked enhancement in [3H]MI uptake [counts/min (cpm).microgram protein-1.2 h-1] from 217 +/- 23 to 718 +/- 64, P less than 0.001. This is mimicked by the supplementation with 300 mM mannitol (638 +/- 59, P less than 0.001) but not by 300 mM urea. The increment in [3H]MI is observed at 37 degrees C but not at 4 degrees C. MI uptake is Na+ dependent in cells grown both in hyperosmolal or isotonic media. At least 12 h of hyperosmolality are needed to enhance MI uptake, and reexposure to isotonic media for at least 24 h is required for the enhancement to reverse. The effects of the microtubular inhibitor, nocodazole (10 micrograms/ml), and the protein synthesis inhibitor, cycloheximide (30 micrograms/ml), were studied. Cells grown with nocodazole show unimpaired enhancement of MI uptake. Cycloheximide exposure (16 h) does not affect MI uptake in isotonic media (182 +/- 23 vs. 191 +/- 15), but inhibited enhanced MI uptake in hyperosmolality (822 +/- 53 in the absence vs. 331 +/- 24 in the presence of cycloheximide, P less than 0.001). We conclude that hyperosmolality stimulates the synthesis of a protein, most likely an Na-MI cotransporter, that markedly enhances MI uptake. This process may be critical to the osmoregulation of RIMCD cells.
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Труханов, А. В., С. В. Труханов, В. Г. Костишин, Л. В. Панина, М. М. Салем, И. С. Казакевич, В. А. Турченко, В. В. Кочервинский, and Д. А. Кривченя. "Мультиферроидные свойства и структурные особенности Al-замещенных гексаферритов бария M-типа." Физика твердого тела 59, no. 4 (2017): 721. http://dx.doi.org/10.21883/ftt.2017.04.44274.328.
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Выполнены прецизионные исследования кристаллической и магнитной структуры замещенных гексаферритов бария M-типа BaFe12-xAlxO19 (0.1≤ x≤1.2) методом порошковой дифракции нейтронов в интервале температур 300-730 K. Исследованы электрическая поляризация и намагниченность, а также магнитоэлектрический эффект рассматриваемых составов в электрическом (до 110 kV/m) и магнитном (до 14 T) полях при комнатной температуре. Установлено сохранение коллинеарной ферримагнитной структуры с замещением. Обнаружено наличие спонтанной поляризации и сильной взаимосвязи диэлектрической и магнитной подсистем при комнатной температуре. Величина магнитоэлектрического эффекта составляет в среднем около 5%, несколько увеличиваясь с ростом концентрации катионов алюминия. Прецизионные структурные исследования позволили установить причину и механизм возникновения спонтанной поляризации в замещенных гексаферритах бария M-типа BaFe12-xAlxO19 (x≤1.2) с коллинеарной ферримагнитной структурой. Работа выполнена при софинансировании Министерства образования и науки РФ по программе повышения конкурентоспособности НИТУ "МИСиС" среди ведущих мировых научно-образовательных центров (N К4-2015-040 и К3-2016-019) и при поддержке грантов БРФФИ (N Ф15Д-003) и ОИЯИ (N 04-4-1121-2015/2017). Л.В. Панина благодарит правительство РФ за поддержку в рамках государственного заказа по организации научной работы. DOI: 10.21883/FTT.2017.04.44274.328
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Onyia, Sussan U. Arinze, Awoere T. Chinawa, Anne C. Ndu, Tochi J. Okwor, Olanike I. Agwu-Umahi, Ifeoma Obionu, Wilson C. Kassy, Emmanuel N. Aguwa, and Theodora A. Okeke. "Factors and characteristics of physical violence among healthcare workers of a tertiary hospital in Enugu, Nigeria." International Journal Of Community Medicine And Public Health 6, no. 12 (November 27, 2019): 5027. http://dx.doi.org/10.18203/2394-6040.ijcmph20195440.
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Background: Healthcare workers (HCWs) especially those involved in patients’ care are at high risk of violence. The study is aimed at determining factors and characteristics of physical violence among HCWs in a tertiary hospital in Nigeria.Methods: The descriptive cross-sectional study was carried out among 412 HCWs from March to July, 2018. Data entry and analysis were done using Epi InfoTM 3.5.4 and Chi square and Fischer’s exact test where applicable were used to ascertain factors associated with physical workplace violence.Results: Respondents included 111 (26.9%) doctors and 301 (73.1%) nurses. Prevalence of physical violence was 12.6%. Of those who experienced workplace violence, the perpetrators were mainly patients’ relatives 37 (71.2%) and patients 8 (15.4%). In majority of cases, 28 (53.8%), no action was taken against the assailant. Prevalence of physical violence was significantly higher among nurses (15.3%) than doctors (5.4%) p=0.007. It is also higher among females (14.2%) than males (7.8%), although not significantly. Furthermore, HCWs who work in newborn units were most likely to experience physical violence.Conclusions: The study revealed that physical violence is prevalent among HCWs and violence prevention programs should be instituted to address it.
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Maia, A. M. L. Rodrigues, E. Medeiros, and G. G. Henry-Silva. "Distribution and density of the bivalve Anomalocardia brasiliana in the estuarine region of Northeastern Brazil." Brazilian Journal of Biology 78, no. 1 (May 26, 2017): 32–40. http://dx.doi.org/10.1590/1519-6984.02316.
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Abstract The objective of this study was to analyze the density and distribution of the bivalve Anomalocardia brasiliana in beaches in the estuarine region of the semiarid in Rio Grande do Norte State, Barra and Pernambuquinho (04°56.978’S and 37°08.961’W and 04°56.792’S and 37°09.375’W, respectively). Samples were collected monthly during 37 months using five transects (300 m long and 400 m apart) laid perpendicularly to the beach line toward the sea. Seven collection points, 50 m apart, were set in each transect, and shellfish and sediment samples were collected. Temperature and salinity were measured in each transect. The results showed a temperature variation of average values of 3 °C; the greatest variation (33.2 °C) was observed in May of 2009. The lowest average salinity values were observed between April and June of 2009 (5, 8.7, and 7.8, respectively). This fact was due to an atypical rainfall in the region, which resulted in a large freshwater inflow into the estuary; the average salinity values were about 40 in the remaining months. The highest precipitation values were observed in April/09, April/10, and April/11; the highest precipitation occurred in April/09 (316.3 mm). The lower average densities of A. brasiliana were observed in April and May/09 when compared to the other months; the lowest value was observed in April/09 (26 ind/m2). The highest densities occurred between November/10 and July/11, with values ranging from 70 to 322 ind/m2. The highest inflow of young individuals (lengths from 2 to 5 mm) was observed between April and June of 2010 and on September/10 while the highest frequency of adults (from 20 to 25 mm) occurred between December of 2010 and April of 2011. Hence, the results of this study show that in the months with the greatest rainfall, salinity and the average density of A. brasiliana showed the lowest values.
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Tendero, Inmaculada, Mariana Correa Rossi, Mauricio Viera, José Manuel Amado, María José Tobar, Ángel Vicente, Armando Yañez, and Vicente Amigó. "Laser Surface Modification in Ti-xNb-yMo Alloys Prepared by Powder Metallurgy." Metals 11, no. 2 (February 22, 2021): 367. http://dx.doi.org/10.3390/met11020367.
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The main objective was to study the effect of surface modification by laser on Ti-Nb-Mo powder metallurgical alloys to improve their mechano-chemical behavior and their application as a biomedical implant. The used powder mixtures were produced in an inert atmosphere. Uniaxial compaction took place at 600 MPa with high-vacuum sintering at 1250 °C for 3 h. The specimens for the three-point flexure test were prepared and their mechanical properties determined. Microstructural characterization was performed by scanning electron microscopy (SEM) and X-ray diffraction (XRD) to obtain the distribution of phases, porosity, size, and shape of the grains of each alloy. Corrosion behavior was evaluated by electrochemical tests using an artificial saliva electrolyte modified from Fusayama at 37 °C. Chemical characterization was completed by analyzing the ionic release by Inductively coupled plasma atomic emission spectroscopy (ICP-EOS) after immersion for 730 h in Fusayama solution modified with NaF at 37 °C to simulate a 20-year life span based on a daily 2-min cycle of three toothbrushes. Corrosion behavior confirmed promising possibilities for the biomedicine field. The surface porosity of the samples not submitted to surface treatment deteriorated properties against corrosion and ion release. The obtained phase was β, with a low α”-martensite percentage. The maximum resistance to bending was greater after surface fusion. Plastic deformations were above 7% under some conditions. Microhardness came close to 300 HV in heat-affected zone (HAZ) and 350 HV in fusion zone (FZ) (under the determined condition. The elastic modulus lowered by around 10%. The corrosion rate was lower in Ti-27Nb-8Mo and Ti-35Nb-6Mo. Niobium release was significant, but below the physiological limit.
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Raskob, Gary E., Aaron M. Wendelboe, John Grady Heller, Kai Ding, Nimia L. Reyes, Karon Abe, Alys Adamski, Michele G. Beckman, and Lisa Carolyn Richardson. "Incidence and characteristics of cancer-associated thrombosis in a racially diverse population: A population-based study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e13088-e13088. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e13088.
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e13088 Background: Venous thromboembolism (VTE) is a common complication in cancer patients, but contemporary data on the incidence and characteristics of cancer-associated VTE in different racial populations is limited. We sought to measure the incidence rate and characteristics of cancer-associated VTE in a racially diverse population. Methods: We performed a prospective, population–based cohort study of VTE in Oklahoma County, OK during April 1, 2012–March 31, 2014. Surveillance staff regularly visited all tertiary care and relevant outpatient facilities in the county and reviewed the text from all imaging results of chest computed tomography or magnetic resonance imaging, lung perfusion scans, and ultrasound of the extremities to identify cases of VTE. Data on patient characteristics were collected from the electronic medical record. VTE was considered cancer-associated if the patient had a history of cancer other than basal or squamous cell skin cancer. Cancer was defined as “active” if metastatic or diagnosed within 6 months prior to VTE. Associations and incidence were calculated using the chi-square test and Poisson regression, respectively. Results: Of 3,255 patients with ≥1 VTE event (deep-vein thrombosis and/or pulmonary embolism), 732 (23%) had a history of cancer, of whom 309 had active cancer. The types of cancer varied widely. The age-adjusted incidence of cancer-associated VTE was 648 per 100,000 adult population (age ≥ 18). Incidence increased with each decade of age. The racial/ethnic-specific incidence rates were as follows (each per 100,000): Whites non-hispanic (607), Blacks non-Hispanic (557), Native Americans (128), Asian/Pacific Islanders (113) and Hispanics (70). Risk factors for VTE among the 732 with cancer-associated VTE included previous VTE (19%), hospitalization (37%), surgery (33%), and central venous catheter (22%). Of those with a history of cancer ≥ 6 months previously, 32% had no other identifiable VTE risk factor. Conclusions: Cancer-associated VTE comprised about 20-25% of the total population burden of VTE. The incidence varied substantially by race/ethnicity. An appreciable proportion of those with a history of cancer ≥ 6 months previously subsequently developed VTE in the absence of other risk factors.
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Puthussery, Shuby, Leah Li, Pei-Ching Tseng, Lesley Kilby, Jogesh Kapadia, Thomas Puthusserry, and Amardeep Thind. "Ethnic variations in risk of preterm birth in an ethnically dense socially disadvantaged area in the UK: a retrospective cross-sectional study." BMJ Open 9, no. 3 (March 2019): e023570. http://dx.doi.org/10.1136/bmjopen-2018-023570.
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ObjectiveTo investigate ethnic variations in risk of preterm birth (PTB), including extreme preterm birth (EPTB) and moderately preterm birth (MPTB), among mothers in an ethnically dense, socially disadvantaged area, and to examine whether any variations were dependent of area deprivation and maternal biological and behavioural factors.DesignRetrospective cross-sectional study using routinely collected data.SettingA large UK National Health Service maternity unit.Participants46 307 women who gave singleton births between April 2007 and March 2016.Outcome measuresPTB defined as <37 weeks of gestation and further classified into EPTB (<28 weeks of gestation) and MPTB (28 to <37 weeks of gestation).ResultsOverall prevalence of PTB was higher (8.3%) compared with the national average (7.8%). Black Caribbean (2.2%) and black African (2.0%) mothers had higher absolute risk of EPTB than white British mothers (1.3%), particularly black Caribbean mothers whose relative risk ratio (RRR) was nearly twice after adjustment for all covariates (RRR=1.93[1.20 to 3.10]). Excess relative risk of EPTB among black African mothers became non-significant after adjustment for prenatal behavioural factors (RRR=1.41[0.99 to 2.01]). Bangladeshi mothers had the lowest absolute risk of EPTB (0.6%), substantially lower than white British mothers (1.3%); the difference in relative risk remained significant after adjustment for area deprivation (RRR=0.59[0.36 to 0.96]), but became non-significant after adjustment for maternal biological factors. Changes were evident in the relative risk of EPTB and MPTB among some ethnic groups compared with the white British on adjustment for different covariates.ConclusionsHigher than national rates of PTB point to the need for evidence-based antenatal and neonatal care programmes to support preterm babies and their families in ethnically dense socially disadvantaged areas. Differential impact of area deprivation and the role of modifiable behavioural factors highlight the need for targeted preventive interventions for groups at risk.
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Scher, Howard I., Glenn Heller, Margaret K. Yu, Thian Kheoh, Weimin Peng, and Johann S. De Bono. "Clinical outcome of metastatic castration-resistant prostate cancer (mCRPC) patients (pts) with a post-treatment circulating tumor cell (CTC) of 0 vs CTC > 0: Post hoc analysis of COU-AA-301." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 5015. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.5015.
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5015 Background: Assessment of radiographic response by RECIST in the majority of mCRPC pts is limited by the lack of measurable disease. Changes in CTC counts (CTCs) enumerated using Veridex CellSearch from unfavorable at baseline (BL [≥ 5 cells/7.5 mL]) to favorable (≤ 4) are prognostic for survival, and the test is FDA cleared as an aid in the monitoring of metastatic PC. The CTC cutpoint of ≥ 5 excludes many pts from response assessment. Examining CTCs alone and in combination with other biomarkers as a potential surrogate for clinical benefit was a secondary objective of COU-AA-301, a phase 3 trial of abiraterone acetate + prednisone vs prednisone alone in mCRPC. Methods: Pts from both treatment (tmt) groups with BL CTC > 0 were combined to assess CTC = 0 as a response criterion. Association between CTC response, defined as BL CTC > 0 and post-BL CTC = 0, and clinical outcomes was assessed. CTCs were determined at BL and 4, 8, and 12 wks. Pts with BL CTC > 0 and missing post-tmt CTCs were considered nonresponders. Radiographic response was first assessed at Wk 12. Overall survival (OS) was estimated using the Kaplan-Meier method. Results: Among739 pts with BL CTC > 0, 141 had measurable disease. At Wk 12, 19% (141/739) of pts were CTC responders and 81% (598/739) were CTC nonresponders. Among CTC responders, 74% (104/141) had stable disease or better by RECIST; 26% (37/141) were either not evaluable or had disease progression by RECIST. Median OS was 23.8 and 10.0 mos for CTC responders (n = 141) and nonresponders (n = 598), respectively. Among pts with liver and/or lung metastases, 86% (24/28) of CTC responders at Wk 12 had stable disease or better by RECIST; 14% (4/28) had disease progression by RECIST. Median OS was 19.9 and 7.1 mos for CTC responders (n = 28) and nonresponders (n = 127), respectively. Similar results were observed in Wk 8 CTC responders. Conclusions: For mCRPC pts with BL CTC > 0, CTC response on tmt (CTC = 0) is associated with longer survival and could be considered a response criterion. Additional analysis is required to fully characterize the relationship between CTC = 0 and objective response by RECIST in pts with measurable disease. Clinical trial information: NCT00638690.
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Jover, B., M. Dupont, G. Geelen, W. Wahba, A. Mimran, and B. Corman. "Renal and systemic adaptation to sodium restriction in aging rats." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 264, no. 5 (May 1, 1993): R833—R838. http://dx.doi.org/10.1152/ajpregu.1993.264.5.r833.
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The influence of age on the systemic and renal adaptation to dietary sodium restriction was assessed in 10-, 20-, and 30-mo-old female WAG/Rij rats. In control conditions, mean arterial pressure (MAP) was similar in all rats and plasma renin activity (PRA) was lower in 30- than in 10- and 20-mo-old rats (2.5 +/- 0.6, 5.1 +/- 0.4, and 3.9 +/- 1.0 ng ANG I.ml-1.h-1, respectively). Dietary sodium restriction was associated with a reduction in MAP in 30-mo-old rats, whereas no change occurred in 10- and 20-mo-old rats. Impairment in the early (days 1-6) renal adaptation to salt restriction was observed in 30- compared with 10- and 20-mo-old rats (6-day cumulative sodium excretion of 728 +/- 139, 437 +/- 53, and 478 +/- 37 mumol, respectively). During the 7- to 12-day period, MAP stabilized in the oldest rats and cumulative sodium excretion became similar to that of other age groups. The early increase in PRA and urinary aldosterone excretion observed in 10- and 20-mo-old rats was consistently blunted in 30-mo-old rats. These findings suggest that the delayed response of the renin-angiotensin-aldosterone system has a major role in the impaired renal and systemic adaptation to dietary sodium removal in senescent rats.
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Demetrio, D., A. Magalhaes, M. Oliveira, R. Santos, and R. Chebel. "11 Invivo-derived embryo pregnancy rates at Maddox Dairy from 2008 to 2018." Reproduction, Fertility and Development 32, no. 2 (2020): 130. http://dx.doi.org/10.1071/rdv32n2ab11.
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Maddox Dairy, located in Riverdale, CA, USA, is a Holstein herd that milks 3500 cows with a 305-day mature-equivalent milk production of 12 800 kg, and they have been producing high genetic animals by embryo transfer (ET) since the early 1980s. Invivo-derived embryos from Holstein donors were transferred fresh (grade 1 or 2) or frozen (grade 1), at morula (4), early blastocyst (5), or blastocyst (6) stage, to virgin heifers (VH, natural oestrus, 13-15 months old) or lactating cows (LC, Presynch-Ovsynch, 86 days in milk, first or second lactation) 6 to 9 days after oestrus. Pregnancy diagnosis was done by transrectal ultrasonography at 32-46 days in VH and by the IDEXX PAG test at 30 days in LC. June, July, August, September, and October were called critical months (first service AI conception rate drops below 44%) and compared with the other months. The data from 32 503 ETs between January 2008 and December 2018 are summarised on Table 1. Pregnancy rates (PR) are lower for LC recipients than for VH. Embryo transfers performed 7 or 8 days after oestrus had higher PR in both types of recipients and embryos, but Day 6 and 9 oestrus are also used with fair results. The season does not seem to affect PR. There is not enough difference in the combination of stage and days from oestrus for invivo-derived embryos. These numbers do not belong to a planned experiment. Several management changes during the years were made, which make it very difficult to apply statistical methods to analyse the data correctly. They are used as a tool to make decisions in an attempt to improve future results. Table 1.Pregnancy rate (PR) of virgin heifers (top) and lactating cows (bottom)-fresh (SH) and frozen (OZ) invivo-derived embryo transfer1 Heat-months SH-ST4 SH-ST5 SH-ST6 SH-All OZ-ST4 OZ-ST5 OZ-ST6 OZ-All PR% n PR% n PR% n PR% n PR% n PR% n PR% n PR% n Heifers 6 d-CM 62 934 66 243 68 69 63 1246 56 473 58 219 62 42 57 734 6 d-OM 62 1623 67 489 69 211 64 2323 56 600 55 296 48 137 55 1033 6 d-T 62 2557 67 732 69 280 63 3569 56 1073 57 515 51 179 56 1767 7 d-CM 64 1506 68 495 67 221 65 2222 60 822 62 340 63 156 61 1318 7 d-OM 66 2723 68 1021 69 510 67 4254 57 1120 59 581 57 231 58 1932 7 d-T 66 4229 68 1516 69 731 67 6476 58 1942 60 921 60 387 59 3250 8 d-CM 65 1348 64 518 67 322 65 2188 59 595 64 258 63 108 61 961 8 d-OM 66 2166 68 886 70 510 67 3562 61 770 60 364 51 130 60 1264 8 d-T 66 3514 67 1404 69 832 66 5750 60 1365 62 622 56 238 60 2225 9 d-CM 60 109 56 43 70 20 60 172 60 5 33 6 50 4 47 15 9 d-OM 58 129 63 57 60 40 60 226 63 16 50 18 75 4 58 38 9 d-T 59 238 60 100 63 60 60 398 62 21 46 24 63 8 55 53 All-CM 64 3897 66 1299 67 632 65 5828 58 1895 61 823 63 310 60 3028 All-OM 65 6641 67 2453 69 1271 66 10 365 58 2506 58 1259 53 502 58 4267 All-T 65 10 538 67 3752 69 1903 66 16 193 58 4401 60 2082 57 812 59 7295 Lactating cows 6 d-CM 54 265 48 86 50 12 53 363 38 141 31 77 50 10 36 228 6 d-OM 49 463 52 203 45 56 50 723 46 101 48 54 59 27 48 182 6 d-T 51 728 51 289 46 68 51 1086 41 242 38 131 57 37 42 410 7 d-CM 54 755 59 274 56 103 55 1137 43 928 48 450 43 192 45 1570 7 d-OM 55 914 66 367 54 109 58 1393 46 1052 45 564 47 353 46 1969 7 d-T 55 1669 63 641 55 212 57 2530 45 1980 46 1014 46 545 45 3539 8 d-CM 63 252 68 82 76 33 65 368 48 219 56 80 42 33 50 332 8 d-OM 61 257 64 161 53 47 61 466 50 191 53 77 56 16 51 284 8 d-T 62 509 65 243 63 80 63 834 49 410 55 157 47 49 50 616 All-CM 56 1272 58 442 60 148 57 1868 44 1288 47 607 43 235 45 2130 All-OM 55 1634 62 731 51 212 56 2582 47 1344 46 695 48 396 47 2435 All-T 55 2906 60 1173 55 360 57 4450 45 2632 47 1302 46 631 46 4565 1ST=stage; CM=critical months (June, July, August, September, and October); OM=other months.
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Pungolino, Ester, Giuseppe Rossi, Maria Angela Mura, Alessandra Perego, Ester Maria Orlandi, Mauro Turrini, Lorenza Borin, et al. "REL-Protocol PhilosoPhi34: An Open Label, Single Arm, Phase II Study of Nilotinib 300 Mg BID in Newly Diagnosed Chronic Phase Chronic Myeloid Leukaemia Patients, to Study the Disappearance of CD34+/Lin-Ph+ Cells from Bone Marrow during Treatment. Preliminary Data." Blood 126, no. 23 (December 3, 2015): 1597. http://dx.doi.org/10.1182/blood.v126.23.1597.1597.
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Abstract Background. Chronic Myeloid Leukaemia (CML) can be effectively treated with the first generation Tyrosine Kinase Inhibitor (TKI) Imatinib, and more effectively with the second generation TKI, like Nilotinib. However, despite the deeper and faster responses induced by nilotinib in a large proportion of patients, the possible eradication of the pathological stem cells is not yet clearly elucidated. In fact, in vitro data suggest that quiescent stem cells are not sensitive to Bcr/Abl inhibition (Corbin AS, et al 2011; Hamilton A, et al 2012). A preliminary in-vivo study (Defina M, et al 2012) shows that in patients in CCyR even after short-term of nilotinib therapy, residual leukemic progenitors are rarely detected. Methods. On behalf of Rete Ematologica Lombarda (REL), Italy, we designed a single arm prospectic study, PhilosoPhi34 (EudraCT: 2012-005062-34), with the aim to investigate the efficacy of nilotinib 300 mg BID in obtaining the disappearance of Bone Marrow (BM) leukemic stem cells (CD34+/lin-Ph+) in newly diagnosed CP-CML. Primary objective of the study: to enumerate the BM CD34+/lin-Ph+ cells at the end of 6 months of treatment. Secondary objectives: to enumerate the BM CD34+/lin-Ph+ cells at 3 and 12 months; to assess the percentage of patients showing MR ≤10% IS at 3 months and MR ≤1% IS at 6 months and the MMR IS and MR4.5 IS by 3, 6 and 12 months of treatment. BM blood samples (range of 5-20 ml) were collected at diagnosis and after 3, 6 and 12 months of nilotinib treatment. BM mononuclear cells were purified by density gradient centrifugation and then CD34+/lin- cells were isolated using Diamond CD34 Isolation Kit (Miltenyi Biotec). The purity of CD34+/lin- cells was about 97% as determined by flow cytometry. BM CD34+/lin- cells were counted and a range of 100,000-800,000 has been noted at diagnosis. After the treatment we observed that the number of CD34+/lin- cells dramatically decreased after 3 (1,000-600,000), 6 (1,000-260,000) and 12 months (100-130,000). In particular, CD34+/lin- cells were even less than 1000 at 12 month of treatment. In order to verify the disappearance of leukemic stem cells, isolated CD34+/lin- cells were tested by standard FISH (i.e. to categorize a sample as negative at least 200 nucleus were examined). From April 2013 and June 2015 we enrolled 87 pts, as for protocol. We report here the preliminary results. Results. Of 56 patients in CCyR after 6 months of treatment, FISH performed on BM CD34+/lin- cells nuclei was evaluable in 51 cases (5 negative cases were excluded because of less than 200 nucleus were analysed). In 4 out of 51 patients (7.8%), Ph+ nuclei were detected. The Sokal score of these 4 patients was 1 low, 2 intermediate and 1 high risk with a ratio (positive nuclei/total nuclei) of 295/300, 1/200, 2/92, 3/300, respectively. Among 58 patients tested at 3 months and 44 tested at 12 months of treatment, the number of evaluable patients was 48 and 37, respectively; 8/48 (16.6%) and 0/37 (0%) patients showed Ph+ nuclei. Only 2 out of 8 positive patients had a high Sokal score. Regarding efficacy of treatment, Table 1 summarizes the MRs IS observed after 3, 6 and 12 months of treatment in 71, 57 and 41 patients, respectively. Conclusion. Data of this prospective study confirms that nilotinib 300 mg BID, rapidly and progressively induces the clearance of BM CD34+/lin-Ph+ cells in CP-CML patients. In particular, on CD34+/lin- cells, after 6 months of treatment, only 7.8% of patients showed positive nuclei. On 37 patients after 12 months of treatment, no positive nuclei were detected. So far, the kinetic of reduction of such cells seems not influenced by Sokal score. According to international studies, PhilosoPhi34 shows a very high efficacy of Nilotinib to induce MRs in CP-CML patients, at the standard time points. Table 1. Molecular Response (MR) in CP-CML patients treated with Nilotinib 300mg BID from diagnosis. MR IS 3 months 6 months 12 months ≤10% 67/71 94% 57/57 100% 40/41 97.50% ≤1% 57/71 80% 55/57 96.50% 40/41 97.50% ≤0.1% 17/71 24% 41/57 72% 35/41 85% ≤0.01% 3/71 4% 19/57 33% 20/41 48.70% MR4.5(UD) 2/71 2.80% 10 (6)/57 17.5% (10.5%) 15 (9)/41 36.5% (22%) UD: undetectable We acknowledge all REL Colleagues for their collaboration and Novartis SpA for the partial financial support to the study. Disclosures No relevant conflicts of interest to declare.
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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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Park, Se Yoon, Hyo-Ju Son, Seungjae Lee, Eunjung Lee, and Tae Hyong Kim. "867. The Scope of a Weekly Infection Control Team Rounding in an Acute-care Teaching Hospital." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S472. http://dx.doi.org/10.1093/ofid/ofaa439.1056.
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Abstract Background Activities of infection control and prevention are diverse and complicated. Regular and well-organized inspection of infection control is essential element of infection control program. The aim of study was to identify strong points and limitations of weekly infection control rounding (ICTR) in an acute care hospital. Methods We conducted weekly ICTR to improve the compliance of infection control in the real field at a 734-bed academic hospital in Republic of Korea. The monitoring team consists of five infection prevention practitioners and four infectious diseases physicians. Total 85 practices of infection control and prevention belonging to the respective category among 9 categories were observed. The result of the rounding are categorized well maintained, improvement is needed, long-term support such as space or manpower is needed, not applicable and could not observed. We investigated retrospectively the functional coverage of a weekly ICTR from January to December 2018. Results During the study period, weekly ICTR were performed total 47 times in 37 departments. ICTR visited median 7 times [interquartile range (IQR) 6-7 times] per department. When visiting a department, ICTR observed median 16 practices (IQR 12-22). During the monitoring period, we could observe 7511 practices in total. Of those results, Most of the practices (74.8%) were able to be monitored properly by ICTR, while some of the practices were not applicable (21.3%) or difficult to observe through ICTR (3.9%)(Table 1). The most common practices among the difficult-to-observe group belong to strategies to prevent catheter-related or surgical site infection and pneumonia (13%, 68/538), safety injection practices (8%, 65/758), linen and laundry management (7%, 33/496), followed by strategies to prevent occupationally-acquired infection (6%, 37/578). Table 1. Conclusion ICTR has strength in regular visits to each department. However, additional observation is necessary, especially for prevention of cathether-related infection and surgical site infection. Disclosures All Authors: No reported disclosures
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Nguyen, B. X., T. Nagai, K. Kukuchi, N. T. Uoc, M. Ozawa, N. V. Linh, N. H. Duc, D. N. Q. Thanh, N. V. Hanh, and Q. X. Huu. "308 EFFECT OF GONADOTROPIN TREATMENT ON OOCYTE COLLECTION AND IN VITRO FERTILIZATION IN THE BAN MINIPIG." Reproduction, Fertility and Development 19, no. 1 (2007): 269. http://dx.doi.org/10.1071/rdv19n1ab308.
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The Ban minipig is a local breed characterized by small ovaries with a scant number of follicles available for in vitro maturation (IVM). The combination of eCG and hCG has been used successfully to control estrus in pig breeding programs. In this paper we present the first results of IVF in this breed in comparison with 2 types of oocyte preparation: (1) from animals not receiving gonatotropin treatment (group 1, n = 9); and (2) from animals receiving an injection of mixed pregnant mare serum gonadotropin and hCG, 300 IU/animal, for 3 days before oocyte collection (group 2, n = 4). All animals were 1 to 3 years old and with body weights that varied from 8 to 12 kg. At the time of collection, the ovaries were observed for follicle development; the cumulus–oocyte complexes (COCs) were aspirated using a 18-gauge needle. COCs of categories A (with more than 4 layers of cumulus cells) and B (with 2 to 4 layers of cumulus cells) were collected and matured in vitro as described previously (Kikuchi et al. 2002 Biol. Reprod. 66, 1033–1041) at 39�C under 5% CO2 in air. Matured oocytes with expanding cumulus cells were inseminated using male Ban minipig epididymal semen frozen by the methods reported by Kikuchi et al. (1998 Theriogenology 50, 615–623). The frozen–thawed spermatozoa were pre-incubated for 1 h in modified medium-199 adjusted to pH 7.8 in the incubator at 37�C. The capacitated spermatozoa were diluted and added to drops of fertilization medium (Fig-FM; Suzuki et al. 2002 Int. J. Androl. 123, 135–142) containing oocytes; the final concentration of sperm was 106/mL. After 3 h of co-incubation, attached spermatozoa and cumulus cells were removed from oocytes and the oocytes were the cultured in vitro as described previously (Kikuchi et al. 2002). The results obtained from 4 replicates showed that the number of follicles with a diameter larger than 2 mm and the rates of oocytes categorized as A and B were significantly lower (P < 0.05; ANOVA test) in the nontreated animals (0.0 and 67.5%, respectively) than in the treated group (25.5 and 87.1%, respectively). The rates of oocytes with a clearly expanding cumulus obtained after IVM were 78.6 (n = 136) and 88.1% (n = 101) for groups 1 and 2, respectively. The rates of cleaved embryos and embryos developed to the compact morula stage were 47.2 and 9.1% (n = 39), respectively, for group 1; and 89.1 and 18.8% (n = 101), respectively, for group 2. In conclusion, gonadotropin treatment before the collection of oocytes is recommended for application of IVM–IVF to local Ban minipigs. This work was supported by a grant from the VAST-Japan Society for the Promotion of Science Project.
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Kregel, K. C., J. M. Overton, D. G. Johnson, C. M. Tipton, and D. R. Seals. "Mechanism for pressor response to nonexertional heating in the conscious rat." Journal of Applied Physiology 71, no. 1 (July 1, 1991): 192–96. http://dx.doi.org/10.1152/jappl.1991.71.1.192.
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The purpose of this study was to determine the systemic hemodynamic mechanism(s) underlying the pressor response to nonexertional heat stress in the unrestrained conscious rat. After a 60-min control period [ambient temperature (Ta) 24 degrees C], male Sprague-Dawley rats (260–340 g) were exposed to a Ta of 42 degrees C until a colonic temperature (Tc) of 41 degrees C was attained. As Tc rose from control levels (38.1 +/- 0.1 degrees C) to 41 degrees C, mean arterial blood pressure (carotid artery catheter, n = 33) increased from 124 +/- 2 to 151 +/- 2 mmHg (P less than 0.05). During this period, heart rate increased (395 +/- 5 to 430 +/- 6 beats/min, P less than 0.05) and stroke volume remained unchanged. As a result, ascending aorta blood flow velocity (Doppler flow probe, n = 8), used as an index of cardiac output, did not change from control levels during heating, but there was a progressive Tc-dependent increase in systemic vascular resistance (+30% at end heating, P less than 0.05). This systemic vasoconstrictor response was associated with decreases in blood flow (-31 +/- 9 and -21 +/- 5%) and increases in vascular resistance (94 +/- 16 and 53 +/- 8%; all P less than 0.05) in the superior mesenteric and renal arteries (n = 8 each) and increases in plasma norepinephrine (303 +/- 37 to 1,237 +/- 262 pg/ml) and epinephrine (148 +/- 28 to 708 +/- 145 pg/ml) concentrations (n = 12, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Jiang, Qian, Zheng-Chen Liu, Song-Xin Zhang, Jing Li, and Robert Peter Gale. "Age and Cost Are Associated with Patient Preference for Stopping Tyrosine Kinase Inhibitor Therapy in Chronic Myeloid Leukemia." Blood 126, no. 23 (December 3, 2015): 1585. http://dx.doi.org/10.1182/blood.v126.23.1585.1585.
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Abstract Background Tyrosine kinase inhibitors (TKIs) have improved quality of life (QoL) and survival of persons with chronic myeloid leukaemia (CML). However, therapy is associated with adverse effects and substantial costs, especially in developing countries like China where the local medical insurance partially reimburse TKI therapy. Consequently, the goal of many persons with CML is achieving treatment-free remission (TFR). There are few data regarding patient preference for TFR in developing countries. Aim Explore therapy goals and patient expectations regarding discontinuing TKI therapy in Chinese with CML and identify variables associated with these preferences. Methods Data were collected from May to October, 2014 in an open-label, non-interventional, cross-sectional study using anonymous questionnaires distributed to persons with CML electronically and in print copy. Questionnaire focused on demographics, CML-related variables before beginning TKI therapy, TKI therapy, response, adverse effects and costs. Data were also collected on patient treatment goals and willingness to stop TKI. Before completing the questionnaire patients received general information about CML and CML therapy and were informed about 40% of persons achieving a complete molecular response (CMR) for ≥2 years and stopping TKI therapy remain leukaemia-free for several years and that most of the 60% relapsing after stopping TKI therapy responded to restarting TKI therapy. Results 1038 questionnaires were collected, 949 of which were evaluable. 888 respondents in chronic phase are included in this analysis. 513 respondents (58%) were male. Median age was 41 years (range, 18-88 years). 663 (75%) respondents were ≤1 year from diagnosis. 750 (84.5%) respondents were on imatinib. 718 (81%) respondents were on branded drugs (non-generic TKIs). Median TKI treatment duration was 3 years (range, <1-13 years). 666 (75%) and 369 (42%) of respondents reported achieving a complete cytogenetic response (CCyR) and complete molecular response (CMR), respectively. Most respondents had few adverse effects from TKI therapy. 153 respondents (17%) received TKIs at no cost whilst on clinical trials or through patient assistance programmes (PAPs). 735 respondents (83%) paid part or all of the cost of TKI therapy. Median annual out-of pocket expense was $11,600 (range, $240-$59,600 USD). 430 of 888 respondents (48%) reported TFR, and 401 (45%) reported a normal life span as their treatment goal. Very few respondents identified preventing disease progression, achieving a CCyR or achieving a CMR as a therapy goal. 734 respondents (83%) expected to discontinue TKI in the future including the 430 respondents who reported TFR as their therapy goal. The dominant reason for wanting to stop TKI therapy was cost (N=549; 75%) followed by poor QoL from adverse effects of TKI therapy (N=304; 41%), concern regarding long-term adverse effects (N=297; 41%), planned pregnancy (N=103; 14%), disruption in daily life (N=57; 8%) and other reasons (N=37; 5%). 154 respondents (17%) were reluctant or unwilling to stop TKI therapy in the future because they feared disease relapse and/or resistance to TKI therapy (140; 91%). Multivariate analyses confirmed younger age (HR=0.8; 95% CI, 0.7-0.9; P<0.001; and HR=0.7; 95% CI, 0.6-0.8; P<0.001) and out-of-pocket expense (HR=1.2; 95% CI, 1.1-1.4; P<0.001; and HR=1.5; 95% CI, 1.3-1.8; P<0.001) were associated with TFR as a therapy goal and expectation. Achieving a CMR (HR=2.0; 95% CI, 1.3-3.3; P=0.003) and decreased QoL from adverse effects (HR=1.2; 95% CI, 1.0-1.5; P=0.029) were independent factors associated with the expectation of discontinuing TKI therapy. Conclusions Age and out-of-pocket cost are associated with CML patients' preference for stopping TKI therapy in China. This is substantially different from patient attitudes in developed countries. Expansion of national health insurance coverage and development of generic TKIs are likely to affect this preference. Our data are important in planning clinical trials of TKI discontinuation in persons with CML. Disclosures No relevant conflicts of interest to declare.
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Bichuette, Maria Elina, and Eleonora Trajano. "Ituglanis mambai, a new subterranean catfish from a karst area of Central Brazil, rio Tocantins basin (Siluriformes: Trichomycteridae)." Neotropical Ichthyology 6, no. 1 (March 2008): 9–15. http://dx.doi.org/10.1590/s1679-62252008000100002.
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Ituglanis mambai, new species, is described from a cave in the Mambaí karst area, State of Goiás, Central Brazil. The new species distinguishes from epigean and cave congeners by the combination of the following characteristics: posterior supraoccipital fontanel absent; pectoral-fin rays usually i,7; six pleural ribs; total vertebrae 37-38 behind Weberian apparatus; shorter predorsal length (65.1-70.8% SL); shorter caudal peduncle length (8.4-11.9% SL); shorter dorsal-fin base length (7.7-11.3% SL); wider interobital width (29.2-36.5% HL); larger mouth width (43.4-64.0% HL); intermediate between epigean and other cave Ituglanis species as regards to both eyes (diameter varying from 0.5 to1.0 mm in adults, 7.8-10.1 % HL) and pigmentation, composed by irregular light brown spots along the body. The latter indicate the troglobitic status for I. mambai. In addition, this species has the maxillae with a discrete medial-posterior projection; fronto-lacrimal one half-length of the maxillae and pointed backwards; posterior process of palatine half its length, with a tenuous medial concavity; 14 dorsal and 12 ventral procurrent rays. In the natural habitat, I. mambai displayed cryptobiotic habits, trying to hide in the graveled bottom or under boulders when disturbed, apparently showing a negative response to light. It was observed a preference to slow-moving waters. Recent flood marks were observed in the stream conduit in March/April 2007 (end of the rainy season) when less individuals were observed on 300 m of the subterranean stream compared to September 2004 (end of the dry season).
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Park, Jae Young, Jong Hyuk Ahn, Yong Sun Jeon, Soon Gu Cho, Jang Yong Kim, and Kee Chun Hong. "Iliac vein stenting as a durable option for residual stenosis after catheter-directed thrombolysis and angioplasty of iliofemoral deep vein thrombosis secondary to May–Thurner syndrome." Phlebology: The Journal of Venous Disease 29, no. 7 (May 28, 2013): 461–70. http://dx.doi.org/10.1177/0268355513491724.
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Introduction This study aims to evaluate the primary patency and clinical outcomes after stenting for residual iliac venous stenosis during catheter-directed thrombolysis treatment of acute iliofemoral deep vein thrombosis arising from May–Thurner syndome. Methods A retrospective study was done for the all patients who underwent iliac vein stenting after catheter-directed thrombolysis treatment of acute iliofemoral deep vein thrombosis due to May–Thurner syndrome from January 2005 to April 2011 in Inha University Hospital. Patient information was assembled from the electronic medical records, imaging and interview. The patency of iliac vein stent was evaluated with serial computed tomography. Results Fifty-one patients were enrolled. The median age was 70 years (range 44–86). There were 37 females (72.5%). The duration of symptoms of acute deep vein thrombosis before catheter-directed thrombolysis treatment was 6 days (median, range 1–33). Self-expanding stent was used for iliac vein stenting. Initial technical success rate was 94.1%. There were two complications (3.9%): an arteriovenous fistula formation in left popliteal area and a right inguinal hematoma. Mean follow-up was 15.6 months (range 6 days–80.8 months). Primary patency rate after iliac vein stenting was 95.8% at 6 months, 87.5% at 12 months and 84.3% at 24 months. Four patients had recurrent thrombotic occlusion (7.8%) during the follow-up. Conclusion Iliac vein stenting showed good primary patency rate with few complications. Iliac vein stenting is a durable option for residual stenosis after catheter-directed thrombolysis treatment of acute deep vein thrombosis in May–Thurner syndrome.
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Dorji, Thinley, Pema Lhamo, Tshering Tshering, Lungten Zangmo, Kencho Choden, Deki Choden, and Sang Namgyal. "Barriers to self-injection of insulin among patients attending the diabetes clinics at the three referral hospitals in Bhutan: a cross-sectional study." Bhutan Health Journal 4, no. 2 (November 15, 2018): 1–5. http://dx.doi.org/10.47811/bhj.61.
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Introduction: Insulin, despite its increasing cost, is prescribed to selected cases of diabetes patients with an aim to achieve good glycaemic control. However, many on insulin do not achieve glycaemic control. We, therefore, studied the possible factors that may act as barriers to effective self-injection of insulin among diabetes patients at the three referral hospitals in Bhutan. Methods: This was a cross-sectional study, conducted from January-June 2017, involving all patients on insulin therapy for more than three months duration. Convenience sampling was used. Respondents’ basic details and self-reported barriers to insulin therapy under various domains were collected using an interviewer-administered questionnaire. Ethics approval was granted by the Research Ethics Board of Health, Bhutan. Results: There were 207 respondents on insulin therapy. The mean age of the sample was 55 years (±13.8 years) and the mean duration of diabetes was 10.6 years (± 7.8 years). Injection dexterity was an issue in 77 respondents (37.2%) while 37 respondents (17.8%) reported that they would miss their insulin shots if their caregiver were unavailable. Insulin regimens were burdensome and interfered with their daily activities (80; 38.7%) and meal timings (64; 30.9%). Although the majority (179; 86.4%) knew why insulin was indicated for them, 149 (72.0%) found that the healthcare personnel’s demonstration on the use of insulin was inadequate and 50 respondents (24.2%) felt that they did not receive enough information on how to inject insulin. Conclusions: Barriers to self-injection are common among insulin users and coordinated efforts are needed to overcome them.
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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]
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Šumilo, Dana, Linda Nichols, Ronan Ryan, and Tom Marshall. "Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records." British Journal of General Practice 69, no. 678 (November 5, 2018): e33-e41. http://dx.doi.org/10.3399/bjgp18x699833.
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BackgroundNeither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.AimTo determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.Design and settingA retrospective cohort study of electronic medical records of children aged 0–15 years registered with 739 UK general practices contributing to a research database.MethodChildren with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.ResultsThe authors included 1 630 807 children followed up for 7 200 159 person–years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4%) in 1 year, two to four sore throats (44.6%) in 1 year, sleep disordered breathing (12.3%), or obstructive sleep apnoea (3.9%).ConclusionIn the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.
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Althagafi, Alwalaa, Chris Ekong, Brian W. Wheelock, Richard Moulton, Peter Gorman, Kesh Reddy, Sean Christie, Ian Fleetwood, and Sean Barry. "Canadian neurosurgeons’ views on medical assistance in dying (MAID): a cross-sectional survey of Canadian Neurosurgical Society (CNSS) members." Journal of Medical Ethics 45, no. 5 (March 12, 2019): 309–13. http://dx.doi.org/10.1136/medethics-2018-105160.
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BackgroundThe Supreme Court of Canada removed the prohibition on physicians assisting in patients dying on 6 February 2015. Bill C-14, legalising medical assistance in dying (MAID) in Canada, was subsequently passed by the House of Commons and the Senate on 17 June 2016. As this remains a divisive issue for physicians, the Canadian Neurosurgical Society (CNSS) has recently published a position statement on MAID.MethodsWe conducted a cross-sectional survey to understand the views and perceptions among CNSS members regarding MAID to inform its position statement on the issue. Data was collected from May to June 2016.ResultsOf the 300 active membes of the CNSS who recevied the survey, 89 respondents completed the survey, 71% of whom were attending neurosurgeons and 29% were neurosurgery residents. Most respondents,74.2%, supported the right of physicians to participate in MAID with 7.8% opposing. 37% had current patients in their practice fitting the criteria for MAID. 23.6% had been asked by patients to assist with MAID, but only 11% would consider personally providing it. 84% of neurosurgeons surveyed supported the physicians’ right to conscientious objection to MAID while 21% thought attending surgeons should be removed from the inquiry and decision-making process. 43.8% agreed that the requirment to refer a patient to a MAID service should be mandatory. Glioblastoma multiforme (65%), quadriplegia/quadriparesis secondary to spinal tumour/trauma (54%) and Parkinson’s disease (24%) were the most common suggested potential indications for MAID among the neurosurgical population.ConclusionsOur results demonstrate that most neurosurgeons in Canada are generally supportive of MAID in select patients. However, they also strongly support the physicians’ right to conscientious objection.
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FERRERO, Miguel A., Angel REGLERO, Manuel FERNANDEZ-LOPEZ, Roberto ORDAS, and Leandro B. RODRIGUEZ-APARICIO. "N-acetyl-d-neuraminic acid lyase generates the sialic acid for colominic acid biosynthesis in Escherichia coli K1." Biochemical Journal 317, no. 1 (July 1, 1996): 157–65. http://dx.doi.org/10.1042/bj3170157.
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Colominic acid is a capsular homopolymer from Escherichia coli K1 composed of α(2-8)-linked N-acetyl-d-neuraminic acid (NeuAc) residues. Recently, we have described that NeuAc synthesis in this bacterium occurs through the action of NeuAc lyase (EC 4.1.3.3) [Rodríguez-Aparicio, Ferrero and Reglero (1995) Biochem. J. 308, 501–505]. In the present work we analysed and characterized this enzyme. E. coli K1 NeuAc lyase is detected from the early logarithmic phase of growth, is induced by NeuAc and is not repressed by glucose. The enzyme was purified to apparent homogeneity (312-fold) using two types of hydrophobic chromatographies (butyl-agarose and phenyl-Sepharose CL-4B), gel filtration on Sephacryl S-200, and anion-exchange chromatography on DEAE-FPLC. The pure enzyme, whose amino acid composition and N-terminal amino acid sequence are also established, has a native molecular mass, estimated by gel filtration, of 135±3 kDa, whereas its molecular mass in SDS/PAGE was 33±1 kDa. The enzyme was able to synthesize and cleave NeuAc in a reversible reaction. The maximal rate of catalysis was achieved in 125 mM Tris/HCl buffer, pH 7.8, at 37 °C. Under these conditions, the Km values calculated for N-acetyl-d-mannosamine and pyruvate (condensation direction), and NeuAc (hydrolysis direction) were 7.7, 8.3 and 4.8 mM respectively. NeuAc synthesis by the pure enzyme was activated by Ca2+ and inhibited by Mn2+ and NeuAc, whereas the enzyme cleavage direction was inhibited by Ca2+, Mn2+ and pyruvate. The reaction products, NeuAc and pyruvate, and Ca2+ are able to regulate the direction of this enzyme (synthesis or cleavage of sialic acid) and, accordingly, to modulate colominic acid biosynthesis.
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Jha, Akhilesh Kumar, Bikranta Rimal, and Tarannum Khatun. "Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks." Med Phoenix 2, no. 1 (October 13, 2017): 34–37. http://dx.doi.org/10.3126/medphoenix.v2i1.18383.
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Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37
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Telyshev, K., L. Alekseeva, A. Lila, A. Baranov, and E. Trofimov. "AB0885 EFFECTIVENESS AND SAFETY OF GLUCOSAMINE AND CHONDROITIN COMBINATION IN PATIENTS WITH KNEE AND HIP OSTEOARTHRITIS: INTERIM ANALYSIS RESULTS OF AN OBSERVATIONAL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1747.1–1747. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3079.
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Background:Combined treatment with oral glucosamine hydrochloride (GH) and chondroitin sulfate (CS) was shown to be efficient for pain relief and function improvement in osteoarthritis patients with moderate to severe knee pain [1,2].Objectives:To investigate demographic and clinical characteristics, changes in pain, functions of daily living, quality of life and treatment satisfaction of patients with knee osteoarthritis (KOA) or hip osteoarthritis (HOA) receiving long-term treatment with oral GH and CS combination in routine clinical practice.Methods:An open-label, multicenter, observational prospective study is being conducted in the Russian Federation. Patients of both sexes with KOA or HOA (Kellgren and Lawrence grades I-III) who receive GH 500 mg+CS 400 mg capsules three times a day for the first 3 weeks of treatment, then twice daily, are included in the study. The interim analysis has been conducted after the first 550 enrolled patients (50% of the total sample size) had completed the first follow-up visit (Week 16-24 after the start of treatment).Results:The study group included 406 (73.8%) patients with KOA and 144 (26.2%) patients with HOA enrolled in 43 centers in Russia. The mean age of the patients was 61.1 years; most patients were women (88.7%). The predominant risk factors for OA were non-genetic causes (excess weight, hormonal disorders, malformations of bones and joints, joint operations) (52.8% of patients), exogenous risk factors (professional activity, trauma, sports) and hereditary diseases of bones and joints were reported in 15.5% and 4.1% of patients, respectively.Interim analysis showed clinically significant improvement in each of the KOOS and HOOS subscales at 4-6 months after the start of treatment. In patients with KOA, the mean score increase was 15.7 for the Pain subscale, 14.6 for the Quality of Life subscale, 13.8 for the Physical function (KOOS-PS), and 11.7 for the Symptoms subscale. The percentage of patients who rated the pain frequency as ‘always’ or ‘daily’ decreased from 60% to 25%.In patients with HOA, the mean score increase was 16.0 for the Pain subscale, 14.3 for the Quality of Life subscale, 16.1 for the Physical function (HOOS-PS), and 10.3 for the Symptoms subscale. The percentage of patients who rated the pain frequency as ‘never’ or ‘monthly’ increased from 34% to 60%.Most patients (89.1%) were receiving the medicinal product for ≥3 months. Treatment-related AEs were reported in 16 (3.0%) patients and mainly included gastrointestinal tract disorders (in 12 (2.2%) patients).Conclusion:The results obtained at 4-6 months after the start of treatment demonstrate clinically significant reduction of frequency and intensity of pain and other OA symptoms, as well as improvement of functions in daily living and quality of life in patients with KOA or HOA after the first course of treatment with GH + CS capsules. The majority of patients (72.5%) were satisfied with the treatment. The incidence of drug-related AEs was low, and the nature of AEs was consistent with known safety profile of GH and CS combination.References:[1]Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808.[2]Hochberg MC, Martel-Pelletier J, Monfort J, et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 2016 Jan;75(1):37-44.Disclosure of Interests:Kirill Telyshev: None declared, Ludmila Alekseeva Grant/research support from: Bayer, Alexander Lila: None declared, Andrey Baranov Grant/research support from: Bayer, Evgeny Trofimov Grant/research support from: Bayer
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Gangi, Alexandra, James Mirocha, Trista Leong, and Armando E. Giuliano. "Triple-negative breast cancer and likelihood of nodal metastates." Journal of Clinical Oncology 31, no. 26_suppl (September 10, 2013): 50. http://dx.doi.org/10.1200/jco.2013.31.26_suppl.50.
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50 Background: Axillary lymph node metastases are a prognostic indicator for breast cancer. Studies suggest that breast cancer subtypes are associated with the presence of lymph node (LN) metastases. The purpose of this study was to determine if patients with triple negative breast cancer (TNBC) have a higher risk of LN metastases than those with non-TNBC. Methods: Prospective database review identified 2,967 female patients with invasive breast cancer treated with mastectomy or breast conserving surgery (BCS) between January 2000 and May 2012. Only patients who underwent sentinel node biopsy (SNB) and/or axillary lymph node dissection (ALND) were included. Those receiving neoadjuvant therapy were excluded. Patient and tumor characteristics evaluated included age, race, tumor size, grade, stage, histologic subtype, presence of lymphovascular invasion (LVI), estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2) status. Results: BCS was performed in 1,889 and mastectomy in 1,078 patients. Breakdown by subtype included 2,201 (74%) patients with Luminal A, 344 (12%) with Luminal B, 144 (5%) with HER2, and 278 (9%) with TNBC. SNB was performed in 1,094 (37%), ALND in 756 (25%), and 1,117 (38%) patients had both. LN metastases were detected in 1050 (35%) patients. The LN positivity rate varied across subtypes with 734/2,201 (33%) in Luminal A, 143/344 (42%) in Luminal B, 108/278 (39%) in TNBC, and 65/144 (45%) in HER-2 (p = 0.0007). However, on multivariable analysis, there was no difference in LN positivity among subtypes (p=0.24). Only age < 50 (HR 1.5, CI 1.3 to 1.8), grade 2 or 3 tumors (HR 1.8, CI 1.4 to 2.5), size greater than 2cm (HR 3.2, CI 2.7 to 3.9), and presence of LVI (HR 3.9, CI 2.4 to 6.3) were significant predictors of LN positivity. Four or more involved nodes were seen most commonly in the HER2 (28/144; 19%) and Luminal B (47/344; 14%) subtypes, but not TNBC (26/278; 9%) or Luminal A (199/2201; 9%) (p < 0.0001). Conclusions: Predictors of LN metastases include younger age, higher grade, larger tumor size, and presence of LVI. Patients with TNBC are not more likely to have involved nodes than those with non-TNBC.
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Saraf, Santosh L., Robert Molokie, Johara Hassan, Michel Gowhari, James Lash, and Victor R. Gordeuk. "Clinical and Laboratory Predictors for Renal Damage in Sickle Cell Disease." Blood 120, no. 21 (November 16, 2012): 3252. http://dx.doi.org/10.1182/blood.v120.21.3252.3252.
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Abstract Abstract 3252 Renal failure is an independent marker for developing other forms of chronic organ damage and for early mortality in sickle cell disease (SCD). We conducted a retrospective, cross-sectional chart review of 292 adults with SCD (type SS or S-beta thal) treated at the University of Illinois Medical Center to assess the prevalence and factors related to kidney damage. Data was recorded from a clinic visit at least four weeks from a vaso-occlusive pain episode or red blood cell transfusion. The glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease formula. Hemoglobinuria was defined by dipstick urinalysis showing trace, small, or moderate blood and <2 RBC/high power field. Urine albumin to creatinine ratios of 30 to 300 mg/g and >300 mg/g were categorized as microalbuminuria and macroalbuminuria, respectively. The median age was 33 years and 46% of patients were on hydroxyurea. We observed microalbuminuria in 41%, macroalbuminuria in 20%, hemoglobinuria in 41% and GFR <90 mL/min in 20% of adults with SCD. Univariate associations with GFR <90 mL/min are summarized in Table 1. By logistic regression, macroalbuminuria (OR 7.5, 95% CI: 2.5–22.2; p<0.0001) and age (OR 1.11, 95% CI: 1.06–1.16; p <0.0001) were independent predictors of GFR <90 mL/min (r2 = 0.23). Given the strong correlation of macroalbuminuria with GFR <90 mL/min, we explored factors related to degree of albuminuria. Univariate associations with degree of albuminuria are shown in Table 2. Logistic regression showed that independent predictors for macroalbuminuria were the presence of hemoglobinuria (OR 93.7, 95% CI: 15.2–576.5; p<0.0001) and age (OR 1.07, 95% CI: 1.01–1.14; p=0.03) (r2=0.28, p<0.0001). We further explored predictors of hemoglobinuria given its independent association with macroalbuminuria. By logistic regression, the strongest predictor of hemoglobinuria was the natural log LDH (OR 32.4; 95% CI: 8.4–124.9; p<0.0001) (r2=0.22), but other markers of hemolysis including higher absolute reticulocyte count, greater indirect bilirubin concentration and lower hemoglobin concentration were also associated with hemoglobinuria in univariate analyses. In summary, increasing age and macroalbuminuria were independent factors associated with GFR < 90mL/min in this cohort of adults with SCD, and intravascular hemolysis as reflected in hemoglobin-positive urine dipstick with negative microscopy was associated with macroalbuminuria. Further research is needed to determine if measures to decrease intravascular hemolysis and to prevent the development of macroalbuminuria can preserve renal function in patients with SCD. Investigation is also needed to identify genomic and genetic markers that put patients at risk for kidney disease and might serve as targets for preventive and therapeutic interventions. Table 1: Correlation of GFR to clinical and laboratory variables. Variable N >90 N <90 p-value Age (years) 234 30 (25–39) 58 45 (37–54) <0.0001 Female gender 234 141 (60%) 58 38 (65%) 0.63 MAP 231 86 (90–93) 58 91 (86–98) <0.0001 HU therapy 110 48 (44%) 30 16 (53%) 0.35 Hemoglobin (g/dL) 234 8.9 (7.9–10) 58 8.1 (7.4–8.9) <0.0001 LDH (u/L) 146 309 (235–425) 41 375 (251–481) 0.11 Absolute Reticulocyte Count (×103/μL) 111 332 (234–444) 29 302 (197–368) 0.001 Hgb F (%) 218 5.5 (2.9–9.8) 52 5.5 (2.5–9.8) 0.98 Albuminuria: Microalbuminuria Macroalbuminuria 112 46 (41%) 30 11 (36.7%) 0.001 15 (13%) 13 (43.4%) Table 2: Correlation of Albuminuria to clinical and laboratory variables. Variable N Normal N Micro-albuminuria N Macro-albuminuria p-value Age (years) 57 32 (26–42) 58 38 (28–48) 28 35 (27–45) 0.20 Female gender 57 43 (75%) 58 34 (59%) 28 18 (64%) 0.16 MAP (mmHg) 56 86 (80–97) 58 88 (84–92) 28 91 (84–98) 0.24 HU therapy 56 24 (42.9%) 57 24 (42.1%) 28 17 (60.7%) 0.22 Hemoglobin (g/dL) 57 8.9 (8.1–10.3) 58 8.1 (7.5–9.4) 28 8.5 (6.9–9.4) 0.008 LDH (u/L) 54 270 (212–358) 49 363 (251–434) 27 377 (355–488) <0.0001 Indirect bilirubin (mg/dL) 56 1.7 (1.2–2.5) 57 2.4 (1.4–3.3) 28 2.0 (1.3–4.3) 0.03 Absolute reticulocyte count (×103/μL) 57 256 (213–399) 56 332 (243–448) 28 369 (276–466) 0.06 Hgb F (%) 52 6.6 (2.7–9.7) 56 5.1 (2.8–11.7) 26 7.8 (3.7–13) 0.54 Hemoglobinuria 53 3 (5.7%) 54 29 (53.7%) 26 22 (84.6%) <0.0001 Disclosures: No relevant conflicts of interest to declare.
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Parinova, Elena V., Aleksander K. Fedotov, Dmitry А. Koyuda, Julia А. Fedotova, Eugene А. Streltsov, Nikolai V. Malashchenok, Ruslan Ovsyannikov, and Sergey Yu Turishchev. "Изучение особенностей формирования композитных структур на основе столбиков никеля в матрице диоксида кремния с помощью синхротронных XANES исследований в режиме регистрации выхода электронов или фотонов." Kondensirovannye sredy i mezhfaznye granitsy = Condensed Matter and Interphases 21, no. 1 (March 7, 2019): 116–25. http://dx.doi.org/10.17308/kcmf.2019.21/726.
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Методом синхротронной спектроскопии ближней тонкой структуры края рентгеновского поглощения (X-ray Absorption Near Edge Structure – XANES) проведена диагностика массивов столбиков никеля, случайным образом распределенных в слое SiO2 на подложке кремния. Столбики никеля были получены методом электрохимического осаждения металла в поры матрицы диоксида кремния, сформированные трековым методом. Латентные треки формировались путем облучения слоя SiO2 тяжелыми ионами золота на ускорителе института Хан-Майтнер (Берлин, Германия). Методом растровой электронной микроскопии установлены особенности заполнения пор металлом, показана специфика образования столбиков Ni, их морфология (поверхность и сколы). Для исследований электронно-энергетического строения массивов Ni столбиков методом XANES использовалось высокоинтенсивное синхротронное излучение ультрамягкого рентгеновского диапазона накопительного кольца BESSY II Гельмгольц Центра Берлин. Путем анализа локального окружения атомов никеля и кислорода по данным синхротронного метода XANES изучена специфика фазового состава поверхностных слоев, включая интерфейс столбик-матрица. Возможное образование фазы силицида никеля показано лишь при определенных режимах формирования массивов столбиков, в случае частичного разрушения матрицы диоксида кремния и при контакте металла с подложкой Si. Изучена специфика естественного окисления поверхности гетероструктуры столбик никеля - диоксид кремния.
ИСТОЧНИК ФИНАНСИРОВАНИЯ
Исследование выполнено при поддержке гранта РФФИ (проект №18-32-01046 мол_а) и при частичной поддержке Миниcтеpcтва обpазования и науки Pоccийcкой Федеpации в pамкаx гоcудаpcтвенного задания ВУЗам в cфеpе научной деятельности на 2017–2020 гг. – пpоект № 16.8158.2017/8.9.
БЛАГОДАРНОСТИ
Авторы работы выражают благодарность Директору и администрации Гельмгольц Центра Берлин, а также Координаторам Российско-Германской лаборатории и каналов синхротрона BESSY II Гельмгольц Центра Берлин.
ЛИТЕРАТУРА
Herino R. Sci. Eng. B, 2000, vol. 69-70, pp. 70-76. https://doi.org/10.1016/S0921-5107(99)00269-X
Sasano J., Murota R., Yamauchi Y., Sakka T., Ogata Y. H. Electroanal. Chem., 2003, vol. 559, pp. 125-130. https://doi.org/10.1016/S0022-0728(03)00383-8
Rumpf K., Granitzer P., Pölt P., Reichmann A., Krenn H. Thin Solid Films, 2006, vol. 515, pp. 716-720. https://doi.org/1016/S0022-0728(03)00383-810.1016/j.tsf.2005.12.182
Granitzer P., Rumpf K., Krenn H. Thin Solid Films, 2006, vol. 515, pp. 735-738. https://doi.org/10.1016/j.tsf.2005.12.259
Fink D., Alegaonkar P. S., Petrov A. V., Wilhelm M., Szimkowiak P., Behar M., Sinha D., Fahrner W. R., Hoppe K., Chadderton L. T. Instr. Meth B, 2005, vol. 236, pp. 11-20. https://doi.org/10.1016/j.nimb.2005.03.243
Ivanou D. K., Streltsov Е. A., Fedotov A. K., Mazanik A. V., Fink D., Petrov A. Thin Solid Films, 2005, vol. 490, pp. 154-160. https://doi.org/1016/j.tsf.2005.04.046
Ivanova Yu. A., Ivanou D. K., Fedotov A. K., Streltsov Е. A., Demyanov S. E., Petrov A. V., Kaniukov E. Yu., Fink D. Materials Science, 2007, vol. 42, pp. 9163–9169. https://doi.org/10.1007/s10853-007-1926-x
Ragoisha G. A., Bondarenko A. S., Osipovich N. P., Rabchynski S. M., Streltsov E. A. Electrochimica Acta., 2008, vol. 53, pp. 3879-3888. https://doi.org/10.1016/j.electacta.2007.09.017
Turishchev S. Yu., Parinova E. V., Fedotova J. A., Mazanik A. V., Fedotov A. K., Apel P. Yu. Condensed Matter and Interfaces, 2013, vol. 15, no. 1, pp. 54-58. URL: http://www.kcmf.vsu.ru/resources/t_15_1_2013_010.pdf (in Russ.)
Erbil A., Cargill III G. S., Frahm R., Boehme R. F. Rev. B, 1988, vol. 37, pp. 2450-2465. https://doi.org/10.1103/PhysRevB.37.2450
Turishchev S. Yu., Terekhov V. A., Nesterov D. N., Koltygina K. G., Parinova E. V., Koyuda D. A., Schleusener A., Sivakov V., Domashevskaya E. P. Condensed Matter and Interfaces, 2016, V. 18, no. 1, pp. 130-141. URL: http://www.kcmf.vsu.ru/resources/t_18_1_2016_014.pdf (in Russ.)
Chuvenkova O. A., Domashevskaya E. P., Ryabtsev S. V., Yurakov Yu. A., Popov A. E., Koyuda D. A., Nesterov D. N., Spirin D. E., Ovsyannikov R. Yu., Turishchev S. Yu. Physics of the Solid State, 2015, vol. 57, no. 1, pp. 153-161. https://doi.org/10.1134/S1063783415010072
Turishchev S. Yu., Terekhov V. A., Koyuda D. A., Ershov A. V., Mashin A. I., Parinova E. V., Nesterov D. N., Grachev D. A., Karabanova I. A., Domashevskaya E. P. Semiconductors, 2017, vol. 51, no. 3 pp. 349-352. https://doi.org/10.1134/S1063782617030241
Kasrai M., Lennard W. N., Brunner R. W., Bancroft G. M., Bardwell J. A., Tan K. H. Surf. Sci., 1996, vol. 99, pp. 303-312. https://doi.org/10.1016/0169-4332(96)00454-0
Fedotova J., Saad A., Ivanou D., Ivanova Yu., Fedotov A., Mazanik A., Svito I., Streltsov E., Tyutyunnikov S., Koltunowicz T. N. Electrical Review, 2012, vol. 88, pp. 305-308.
Zimkina T. M., Fomichev V. A. Ultrasoft X-ray spectroscopy. Leningrad, LGU Publ., 1971, 132 p.
Stohr J. NEXAFS Spectroscopy. Springer, Berlin, 1996, 403 p.
Regan T. J., Ohldag H., Stamm C., et al. Rev. B, 2001, vol. 64, p. 214422. https://doi.org/10.1103/PhysRevB.64.214422
Barranco A., Yubero F., Espinós J. P., Groening P., González-Elipe A. R. Appl. Phys., 2005, vol. 97, p. 113714. https://doi.org/10.1063/1.1927278
Domashevskaya E. P., Storozhilov S. A., Turishchev S. Yu., Kashkarov V. M., Terekhov V. A., Stognei O. V., Kalinin Yu. E., Sitnikov A. V., Molodtsov S. L. Physics of the Solid State, 2008, vol. 50, no. 1, pp. 139-145. https://doi.org/10.1134/S1063783408010253
Terekhov V. A., Turishchev S. Y., and Domashevskaya E. P. / Ed. Sattler Klaus D. Systems of Silicon Nanocrystals and their Peculiarities (Chapter 5). Silicon Nanomaterials Sourcebook. Volume Two. Hybrid Materials, Arrays, Networks, and Devices. CRC Press, Taylor and Francis Group, 2017, 45 p.
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UESUGI, AARON R., and LINDA J. HARRIS. "Growth of Salmonella Enteritidis Phage Type 30 in Almond Hull and Shell Slurries and Survival in Drying Almond Hulls." Journal of Food Protection 69, no. 4 (April 1, 2006): 712–18. http://dx.doi.org/10.4315/0362-028x-69.4.712.
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Traceback investigation of a 2000 to 2001 outbreak of salmonellosis associated with consumption of raw almonds led to isolation of the outbreak strain Salmonella enterica serovar Enteritidis phage type (PT) 30 on three geographically linked almond farms. Interviews with these growers revealed that significant rain fell during the 2000 harvest when many almonds were drying on the ground. The objectives of this study were to document weather conditions during the 2000 harvest, determine the potential for growth of Salmonella Enteritidis PT 30 in hull or shell slurries, and evaluate survival of Salmonella Enteritidis PT 30 on wet almond hulls during drying. Dry almond hulls and in-shell kernels wetted for 24 h increased in weight by 250 to 300% and 100%, respectively. Both hull and shell slurries supported rapid growth of Salmonella Enteritidis PT 30 at 24°C; slurries containing hulls also supported growth at 15°C. Maximum Salmonella Enteritidis PT 30 concentrations of 6.2 and 7.8 log CFU/ml were observed at 15 and 24°C, respectively. Salmonella Enteritidis PT 30 grown in wet hulls that were incubated at 24°C survived drying at either 15 or 37°C. Reductions of 1 to 3 log CFU/g of dry hull were observed during drying; reductions generally declined as incubation time increased from 2 to 7 days. Evaluation of shipping records revealed that approximately 60% of outbreak-associated almonds had not been exposed to rain, eliminating this factor as the sole cause of the outbreak. However, the data provide evidence that wet almonds may be a greater risk for high concentrations of Salmonella, and specific guidelines should be established for harvesting and processing almonds that have been exposed to rain or other water sources.
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Soe, A. K., S. N. Avdeev, G. S. Nuralieva, V. V. Gaynitdinova, and A. G. Chuchalin. "Predictors of poor outcomes in acute exacerbations of chronic obstructive pulmonary disease." Russian Pulmonology 28, no. 4 (October 18, 2018): 446–52. http://dx.doi.org/10.18093/0869-0189-2018-28-4-446-452.
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The aimof this study was to identify predictors of poor outcomes in patients hospitalized for severe acute exacerbation of COPD (AECOPD).Methods. This retrospective, observational cohort study was conducted in Pulmonology Department of a city hospital in 2015 – 2016 and involved patients hospitalized for severe AECOPD. Patients were divided according to outcomes. Poor outcomes included at least one of the followings: the need in invasive (IMV) or non-invasive (NIV) ventilation, admission to ICU, in-hospital death and COPD- related readmission during 2 months. Demographic, clinical, laboratory parameters, pulmonary function tests and blood gas analysis were analyzed; different multidimensional prognostic scores were also evaluated and compared.Results. Of 121 patients included, a poor outcome had occurred in 45 patients (37%). Among them, NIV was required in 21 (17%), IMV in 8 (6%), and admission to ICU in 16 patients (13%); death was registered in 6 patients (5%) and readmission in 27 (22%) of the patients. Patients with poor outcomes were admitted more frequently by ambulance (62% vs 40%; p = 0.003), more often were admitted to a hospital for AECOPD in the previous year (69% vs 45%; p = 0.0006), and had lower pH (p = 0.001), lower PaO2 (p = 0.001), higher PaCO2 (p = 0.001), and a worse score on several prognostic scales such as APACHE II (13.9 ± 5.4 vs 7.8 ± 3.6; p = 0.001), DECAF (2.4 ± 0.6 vs 1.5 ± 0.6; p = 0.001), BODEx (5.6 ± 1.8 vs 3.9 ± 1.1; p = 0.001), DOSE (2.9 ± 1.5 vs 2.2 ± 1.2; p = 0.029), and ADO (4.9 ± 1.5 vs 4.3 ± 1.3; p = 0.015) at admission. They more frequently received O2 therapy (87% vs 46%; p = 0.001) and had longer hospital stay (19.2 ± 6.2 days vs 12.5 ± 1.8 days; p = 0.001). Conclusions. Hypercapnia, hypoxemia and worse prognostic scores on admission predicted poor outcome in patients hospitalized for AECOPD during the previous year.
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Brooten, Dorothy, JoAnne M. Youngblut, Carmen Caicedo, Teresa del Moral, G. Patricia Cantwell, and Balagangadhar Totapally. "Parents’ Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death." American Journal of Hospice and Palliative Medicine® 35, no. 1 (November 15, 2016): 75–82. http://dx.doi.org/10.1177/1049909116678597.
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Background and Objectives: Infant/child death is described as a most stressful life event; however, there are few reports of effects on parent physical health during the first year after the death. The study’s purpose is to examine the patterns of parent acute illnesses, hospitalizations, and medication changes over 1 to 13 months after neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) infant/child death in 3 racial/ethnic groups. Methods: Secondary analyses were conducted with longitudinal data on parent health and functioning 1 to 13 months after infant/child NICU/PICU death. Parents (176 mothers, 73 fathers; 44% Hispanic, 35% black non-Hispanic, and 21% white non-Hispanic) of deceased infants/children were recruited from 4 children’s hospitals and state death records. Inclusion criteria—parents understood English or Spanish and had a deceased neonate/child ≤ 18. Exclusion criteria —deceased newborn from multiple gestation pregnancy, child in foster care, child’s injury due to suspected abuse, or parent death in illness/injury event. Parents reported numbers and types of acute illnesses, hospitalizations, and medication changes 1 to 13 months postdeath. Results: Parents’ acute illnesses, hospitalizations, and medication changes were greatest between months 1 and 6, with relative quiescence in months 7 to 10, and an increase in months 11 to 13. Mothers (aged 32 ± 7.8 years) reported 300 acute illnesses (primarily colds/flu, headaches, anxiety/depression, and infections) and 89 hospitalizations (primarily infections, chest pain, and gastrointestinal problems). Fathers (aged 37 ± 8.8 years) reported 104 acute illnesses (colds/flu and headaches) and 9 hospitalizations. Conclusion: After infant/child NICU/PICU death, mothers had greater morbidity than fathers, with no significant differences by race/ethnicity. Parents’ health needs to be monitored in months 1 to 6 and months 11 to 13, and interventions targeted to parents in these months.
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Puduvalli, Vinay K., Jing Wu, Ying Yuan, Terri S. Armstrong, Elizabeth Vera, Jimin Wu, Jihong Xu, et al. "A Bayesian adaptive randomized phase II multicenter trial of bevacizumab with or without vorinostat in adults with recurrent glioblastoma." Neuro-Oncology 22, no. 10 (March 13, 2020): 1505–15. http://dx.doi.org/10.1093/neuonc/noaa062.
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Abstract Background Bevacizumab has promising activity against recurrent glioblastoma (GBM). However, acquired resistance to this agent results in tumor recurrence. We hypothesized that vorinostat, a histone deacetylase (HDAC) inhibitor with anti-angiogenic effects, would prevent acquired resistance to bevacizumab. Methods This multicenter phase II trial used a Bayesian adaptive design to randomize patients with recurrent GBM to bevacizumab alone or bevacizumab plus vorinostat with the primary endpoint of progression-free survival (PFS) and secondary endpoints of overall survival (OS) and clinical outcomes assessment (MD Anderson Symptom Inventory Brain Tumor module [MDASI-BT]). Eligible patients were adults (≥18 y) with histologically confirmed GBM recurrent after prior radiation therapy, with adequate organ function, KPS ≥60, and no prior bevacizumab or HDAC inhibitors. Results Ninety patients (bevacizumab + vorinostat: 49, bevacizumab: 41) were enrolled, of whom 74 were evaluable for PFS (bevacizumab + vorinostat: 44, bevacizumab: 30). Median PFS (3.7 vs 3.9 mo, P = 0.94, hazard ratio [HR] 0.63 [95% CI: 0.38, 1.06, P = 0.08]), median OS (7.8 vs 9.3 mo, P = 0.64, HR 0.93 [95% CI: 0.5, 1.6, P = 0.79]) and clinical benefit were similar between the 2 arms. Toxicity (grade ≥3) in 85 evaluable patients included hypertension (n = 37), neurological changes (n = 2), anorexia (n = 2), infections (n = 9), wound dehiscence (n = 2), deep vein thrombosis/pulmonary embolism (n = 2), and colonic perforation (n = 1). Conclusions Bevacizumab combined with vorinostat did not yield improvement in PFS or OS or clinical benefit compared with bevacizumab alone or a clinical benefit in adults with recurrent GBM. This trial is the first to test a Bayesian adaptive design with adaptive randomization and Bayesian continuous monitoring in patients with primary brain tumor and demonstrates the feasibility of using complex Bayesian adaptive design in a multicenter setting.
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Suffoletto, Brian, and Aaron Landau. "Nudging Emergency Care Providers to Reduce Opioid Prescribing Using Peer Norm Comparison Feedback: A Pilot Randomized Trial." Pain Medicine 21, no. 7 (December 17, 2019): 1393–99. http://dx.doi.org/10.1093/pm/pnz314.
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Abstract Objective To determine the feasibility, acceptability, and potential impact of using audit and feedback (A&F) with or without peer norm comparison on opioid prescribing by emergency medicine providers. Methods A convenience sample of 37 emergency medicine providers were recruited from 16 emergency departments in Western Pennsylvania for a pilot randomized controlled trial. Participants completed a baseline survey, were randomly allocated to A&F (N = 17) or A&F with peer norm comparison (N = 20), and were asked to complete a postintervention survey. We matched each participant 1:1 to a control who was not exposed to either intervention. Results At baseline, 57% of participants perceived that they prescribed opioids at the same frequency as their peers, whereas 32% perceived prescribing less than and 11% perceived prescribing more than their peers. Most participants rated the interventions as helpful, with no differences between conditions. For the A&F with peer norm comparison condition, from pre- to postintervention, there was a relative increase of 20% in the percentage of participants who perceived that they prescribed more opioids than their peers but no change in the A&F condition (P = 0.02). 56.8% of controls, 52.9% of A&F participants, and 75.5% of A&F with peer norm comparison participants reduced their opioid prescribing (P = 0.33). The mean reduction in opioid prescriptions (SD) was 3.3. (9.6) for controls, 3.9 (10.5) for A&F, and 7.3 (7.8) for A&F with peer norm comparison (P = 0.31). Conclusions Audit and feedback interventions with peer norm comparisons are helpful to providers, can alter perceptions about prescribing norms, and are a potentially effective way to alter ED providers’ opioid prescribing behavior.
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Li, Xiao Ying, George Boon-Bee Goh, Hang Hock Shim, Stephanie Man Chung Fook-Chong, Yet Hua Loh, and Wan Cheng Chow. "Fructose intake in patients with non-alcoholic fatty liver disease." Proceedings of Singapore Healthcare 28, no. 4 (April 4, 2019): 218–23. http://dx.doi.org/10.1177/2010105819840370.
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Background: Although growing evidence suggests that fructose intake contributes to the development of non-alcoholic fatty liver disease (NAFLD), fructose intake in NAFLD patients has not been documented locally. Objectives: The objectives of this study were to compare fructose intake between NAFLD patients and controls with chronic hepatitis B, and to ascertain whether fructose intake was associated with the presence of NAFLD. Methods: This was a cross-sectional, case–control study. Thirty-four patients diagnosed with NAFLD and 34 controls with chronic hepatitis B participated in this study between 2012 and 2014 in the Singapore General Hospital outpatient setting. Fructose, energy and nutrient intake were assessed by using food frequency questionnaires. Results: NAFLD patients had higher body mass index (28.6±4.0 vs. 22.5±3.9 kg/m2, p<0.001) and waist circumference (100.0±7.9 vs. 80.2±11.7 cm, p<0.001) than controls. Cases reported higher intakes of energy (2378±708 vs. 1796±398 kcal, p<0.001), protein (109±37 vs. 84±25 g, p<0.01), fat (87±33 vs. 62±19 g, p<0.001), total carbohydrate (294±83 vs. 232±63 g, p<0.001) and fructose (42±17 vs. 31±15 g, p<0.05). Logistic regression analysis showed waist circumference (odds ratio: 1.25; 95% confidence interval: 1.11–1.41; p<0.001) and energy intake (odds ratio: 1.002; 95% confidence interval: 1.001–1.004; p<0.05) were significant risk factors for NAFLD. Conclusions: Total calorie, macronutrient and fructose intake in NAFLD patients were significantly higher than in controls. Waist circumference and energy intake were significantly associated with NAFLD. Reducing total calorie intake and adopting healthy eating habits should be emphasized to NAFLD patients to manage their clinical conditions.
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Weber, Jeffrey S., James M. G. Larkin, Dirk Schadendorf, Jedd D. Wolchok, John Wagstaff, Reinhard Dummer, David Hogg, et al. "Management of gastrointestinal (GI) toxicity associated with nivolumab (NIVO) plus ipilimumab (IPI) or IPI alone in phase II and III trials in advanced melanoma (MEL)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 9523. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.9523.
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9523 Background: NIVO and IPI are approved as monotherapy and in combination for treatment of MEL. These treatments are associated with select (potentially immune-related) adverse events (AEs) of the GI tract, most commonly diarrhea and colitis. We describe the management of GI toxicity in patients (pts) treated with NIVO+IPI or IPI from phase II (CheckMate 069) and III (CheckMate 067) trials. Methods: Pts received NIVO 1 mg/kg + IPI 3 mg/kg Q3W x 4, followed by NIVO 3 mg/kg Q2W until progression or unacceptable toxicity, or IPI 3 mg/kg Q3W x 4, followed by placebo. Minimum follow-up was 2 yrs for CheckMate 069 and 18 months for CheckMate 067. Results: Of 407 pts treated with NIVO+IPI, 195 (48%) experienced any grade select GI AEs, and of 357 pts treated with IPI, 132 (37%) experienced any grade select GI AEs. Grade 3/4 select GI AEs were reported in 67 (16%) pts treated with NIVO+IPI and in 41 (11%) pts treated with IPI; median time to onset was 7.1 weeks (range 0.9-48.9) with NIVO+IPI and 7.3 weeks (range 0.6-14.9) with IPI. To manage these AEs, immune-modulating medications (IMM) were used in 61/67 (91%) pts in the NIVO+IPI group and in 41/41 (100%) in the IPI group. Corticosteroids (CS) were used in 61/67 (91%) and 41/41 (100%) pts, and infliximab (IFX) was used in 21/67 (31%) and 14/41 (34%) pts in the NIVO+IPI and IPI groups, respectively. In the NIVO+IPI group, the resolution rate of grade 3/4 select GI AEs was 96%, 97%, and 95% with a median time to resolution of 3.3, 3.0, and 3.9 weeks in all treated pts, CS, and CS+IFX managed pts, respectively; 88%, 92%, and 79% resolved with a median time to resolution of 3.9, 2.4, and 7.8 weeks in the IPI group, respectively. Objective response rates (ORR) were unchanged in the presence of any grade select GI AEs, or by using CS or CS+IFX (Table). Conclusions: NIVO+IPI or IPI alone is associated with a high incidence of GI select AEs, but most are effectively managed by IMMs, which do not appear to inhibit tumor response. Clinical trial information: NCT01844505; NCT01927419. [Table: see text]
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Michallet, Mauricette, Quoc-Hung Le, Thomas Prebet, Mohamad Mohty, Jean Michel Boiron, Hélène Esperou, Noel Milpied, Nathalie Dhédin, and Didier Blaise. "Updated Analysis of Hematopoietic Stem Cell Transplantations after Reduced Intensity Conditioning Regimen (RIC HSCT) for Hematological Malignancies from the Société Française de Greffe de Moelle Osseuse et de Thérapie Cellulaire (SFGM-TC) Registry." Blood 106, no. 11 (November 16, 2005): 45. http://dx.doi.org/10.1182/blood.v106.11.45.45.
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Abstract This report updates a retrospective study from SFGM-TC registry concerning 738 patients who underwent RIC HSCT for hematological malignancies [280 F, 458 M, median age: 51 years (1–72)] between 1997 and 2004. The diagnosis were 173 AML, 40 ALL, 68 MDS, 152 NHL, 36 HD, 45 CLL, 70 CML, 154 MM; 332 patients have been previously transplanted. At time of conditioning, 261 patients were in CR, 224 in PR and 253 in progressive disease (PD). Peripheral blood stem cells (PBSC) were used in 574 patients and bone marrow in 164 patients from 655 HLA related donors and 83 unrelated donors. As conditioning, 152 patients received fludarabine and TBI (2 grays), 300 patients fludarabine, busulfan and anti-thymocyte globulins (FBS) (ATG 1d: 57, 2 d: 84, 3 d: 58, 4 d: 18, 5 d: 83) and 286 patients an other regimen. As GVHD prophylaxis, 722 patients received a cyclosporine A (CsA) based regimen. After transplant, 252 patients (35%) in the global population developed an acute GVHD ≥ grade II (grades III and IV: 116) and 208 patients (37%) in the PBSCT population (grades III and IV: 100). A chronic GVHD was present in 258 patients (38%) in the global population (115 limited and 143 extensive) and 221 patients (42%) in the PBSCT population (95 limited and 126 extensive). With a median follow-up of 27 months, the 3-year probability of overall survival (OS) and event-free survival (EFS) for the global population was 38% (33–44) and 28%(24–34) and for PBSC SCT patients 39%(33–46) and 32%(27–39) respectively. The 3-year probability of OS varied according to diagnosis (CLL: 62%, NHL:50%, CML:44%, MM:41%, MDS:37%, AML:26%, ALL:20%) and cGVHD (no:28%, yes:61%). The cumulative TRM incidence was 12% at 1 year and 13% at 3 years. A multivariate analysis was performed studying pre and post transplant factors for OS, EFS and GVHD:. Table 1 summarizes all variables showing a significant impact on OS and EFS. Furthermore, analyses showed the impact of one variable on AGVHD and cGVHD for PBSCT population: FBS with ATG 1day vs 2 days [HR:1.56(1.19–2.04) p=0.001, HR:1.50(1.14–1.97) p=0.003]. In conclusion, besides the influence of known factors on OS and EFS after RIC HSCT, this study pointed out, on a large series with a long-term follow-up, the major impact of disease status, acute and chronic GVHD and demonstrated the important role of ATG duration on GVHD incidence. Table 1: Multivariate analyses OS/EFS Variables OS (HR) p EFS (HR) p Conditionning :FBS ATG 1d vs 2 d Global 1.47 (1–2.2) 0,05 NS PBSC 1.6 (1.03–2.49) 0,04 NS FBS ATG 5d vs 2 d PBSC NS 1.13(1.04–1,24) < 0.01 PD vs CR Global 1.22 (1.1–1.32) < 0.01 1.15 (1.07–1.25) < 0.01 PBSC 1.2 (1.1–1,3) < 0.01 1.14 (1.05–1.24) < 0.01 Previous HSCT: yes vs no Global 1.27 (1.02–1,59) 0,04 1.25 (1.01–1.55) 0.04 AGVHD : Grade II vs 0-I PBSC 1.21 (1–1.47) 0,05 NS AGVHD : Grade III-IV vs 0-I Global 1,28 (1,14–1,43) < 0.01 1.12 (1–1.25) 0.04 PBSC 1.3 (1.14–1.47) < 0.01 1.13 (1–1.28) 0.05 cGVHD : yes vs no Global 0.2 (0.14–0.28) < 0.01 0.25 (0.19–0.35) < 0.01 PBSC 0.19 (0.13–0.28) < 0.01 0.25 (0.18–0.34) < 0.01
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Augusto, João B., Katia Menacho, Mervyn Andiapen, Ruth Bowles, Maudrian Burton, Sophie Welch, Anish N. Bhuva, et al. "Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19." Wellcome Open Research 5 (July 28, 2020): 179. http://dx.doi.org/10.12688/wellcomeopenres.16051.1.
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Background: Most biomedical research has focused on sampling COVID-19 patients presenting to hospital with advanced disease, with less focus on the asymptomatic or paucisymptomatic. We established a bioresource with serial sampling of health care workers (HCWs) designed to obtain samples before and during mainly mild disease, with follow-up sampling to evaluate the quality and duration of immune memory. Methods: We conducted a prospective observational study on HCWs from three hospital sites in London, initially at a single centre (recruited just prior to first peak community transmission in London), but then extended to multiple sites 3 weeks later (recruitment still ongoing, target n=1,000). Asymptomatic participants attending work complete a health questionnaire, and provide a nasal swab (for SARS-CoV-2 RNA by RT-PCR tests) and blood samples (mononuclear cells, serum, plasma, RNA and DNA are biobanked) at 16 weekly study visits, and at 6 and 12 months. Results: Preliminary baseline results for the first 731 HCWs (400 single-centre, 331 multicentre extension) are presented. Mean age was 38±11 years; 67% are female, 31% nurses, 20% doctors, and 19% work in intensive care units. COVID-19-associated risk factors were: 37% black, Asian or minority ethnicities; 18% smokers; 13% obesity; 11% asthma; 7% hypertension and 2% diabetes mellitus. At baseline, 41% reported symptoms in the preceding 2 weeks. Preliminary test results from the initial cohort (n=400) are available: PCR at baseline for SARS-CoV-2 was positive in 28 of 396 (7.1%, 95% CI 4.9-10.0%) and 15 of 385 (3.9%, 2.4-6.3%) had circulating IgG antibodies. Conclusions: This COVID-19 bioresource established just before the peak of infections in the UK will provide longitudinal assessments of incident infection and immune responses in HCWs through the natural time course of disease and convalescence. The samples and data from this bioresource are available to academic collaborators by application https://covid-consortium.com/application-for-samples/.