Journal articles: 'Séc. 18-19'

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Kaliki, Swathi, Nandini Bothra, Kavya Madhuri Bejjanki, Arpita Nayak, George Ramappa, Ashik Mohamed, Tarjani Vivek Dave, Mohammad Javed Ali, and Milind N. Naik. "Malignant Eyelid Tumors in India: A Study of 536 Asian Indian Patients." Ocular Oncology and Pathology 5, no. 3 (September 13, 2018): 210–19. http://dx.doi.org/10.1159/000491549.

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Purpose: To study the proportion of eyelid malignant tumors in an Asian Indian population and to review their clinical features and outcomes. Methods: This is a retrospective study of 536 patients. Results: The mean age at presentation with eyelid malignancy was 58 years. Histopathology-proven diagnoses of these patients included sebaceous gland carcinoma (SGC) (n = 285, 53%), basal cell carcinoma (BCC) (n = 128, 24%), squamous cell carcinoma (SCC) (n = 99, 18%), and miscellaneous tumors (n = 24, 4%). The statistically significant differences between eyelid malignant tumors included age at presentation, tumor location, and tumor extent. The clinicopathological correlation of SGC, BCC, SCC, and miscellaneous tumors was 91, 86, 46, and 38% (p = 0.001), respectively. Comparing SGC with BCC, SCC, and miscellaneous tumors, SGC was more commonly associated with tumor recurrence (21 vs. 3, 8, and 13%; p = 0.001), systemic metastasis (13 vs. 0, 4, and 13%; p = 0.001), and death (9 vs. 0, 4, and 0%; p = 0.004). Compared to SGC, BCC, and SCC, locoregional lymph node metastasis was more common with miscellaneous tumors (26 vs. 16, < 1, and 8%; p = 0.001) over a mean follow-up period of 19 months. Conclusion: In Asian Indians, SGC is twice as common as BCC and 3 times more common than SCC. SGC is associated with poorer prognosis compared to other eyelid malignant tumors.

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Deutschbein, Timo, Nicole Unger, Jakob Hinrichs, Martin K. Walz, Klaus Mann, and Stephan Petersenn. "Late-night and low-dose dexamethasone-suppressed cortisol in saliva and serum for the diagnosis of cortisol-secreting adrenal adenomas." European Journal of Endocrinology 161, no. 5 (November 2009): 747–53. http://dx.doi.org/10.1530/eje-09-0517.

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ObjectiveIn patients with adrenal incidentalomas, hormonally active masses need to be considered, particularly cortisol-producing adenomas (CPA), aldosterone-producing adenomas, and pheochromocytomas. The screening for hypercortisolism relies on confirming excess cortisol secretion and insufficient suppression after dexamethasone. Because of its high correlation with free cortisol and its stress-free collection, salivary cortisol (SaC) may offer advantages over serum cortisol (SeC). We evaluated the value of SaC and SeC for the diagnosis of CPA.DesignComparative study between 2001 and 2006.MethodsThirty-eight patients with confirmed CPA were compared with 18 healthy subjects as well as 48 control patients suffering from aldosterone-producing adenomas (n=13), pheochromocytomas (n=16), or nonfunctioning adenomas (n=19). Sampling of saliva and serum was performed at 2300 and at 0800 h following low-dose dexamethasone suppression. Receiver operating characteristics analysis was used to calculate thresholds with at least 95% sensitivity for CPA.ResultsRegarding the cutoffs for late-night cortisol, SaC (4.8 nmol/l, sensitivity 97%, specificity 69%) was slightly more specific than SeC (115 nmol/l, sensitivity 97%, specificity 63%). In contrast, the cutoff for dexamethasone-suppressed SaC (3.7 nmol/l, sensitivity 97%, specificity 83%) was slightly less specific than SeC (94 nmol/l, sensitivity 97%, specificity 88%). However, the latter cutoffs demonstrated greater specificity when compared with the cutoffs for late-night cortisol.ConclusionThe diagnostic accuracy of SaC is as good as SeC. Owing to its higher specificity, dexamethasone-suppressed cortisol is preferable to late-night cortisol when screening for Cushing's syndrome in patients with adrenal incidentalomas.

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Cometi, L., G. Bandini, K. El Aoufy, A. Domanico, L. Tofani, C. Bruni, S. Bellando Randone, et al. "OP0176 ULTRASOUND (US) EVALUATION OF BOWEL VASCULOPATHY IN SYSTEMIC SCLEROSIS (SSC)." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 105.2–106. http://dx.doi.org/10.1136/annrheumdis-2021-eular.647.

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Background:Gastrointestinal involvement is one of the most frequent features of SSc, affecting nearly 90% of patients, with a great impact on quality of life and morbidity. One of the key pathological factors of SSc bowel involvement is vasculopathy (1), although little is known about its pathophysiology and no treatments are currently available.Objectives:to assess with abdominal US the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) vessel characteristics and blood flow in SSc, compared to healthy controls (HC).Methods:we performed fasting abdominal US in SSc patients fulfilling the ACR/EULAR 2013 classification criteria and HC. Patients with a history of peripheral /coronary arterial disease were excluded. For both SMA and IMA, caliber (mm), Peak Systolic Velocity – PSV (cm/sec), Reverse Velocity – RV (cm/sec), End-Diastolic Velocity – EDV (cm/sec), Mean Velocity – mV (cm/sec), Blood-flow (cm/sec), Resistive Index – RI and Pulsatility Index – PI were measured.Results:28 SSc patients [25 females (89.3%), mean age 48.75 ± 12.39 years; 6 (22.22%) anti-centromere and 19 (70.37%) positive for anti-topoisomerase I antibodies] and 28 HC [18 females (64.3%), mean age 36.25 ± 12.08 years] were evaluated. In SSc, the SMA caliber was significantly smaller than in HC (5.75 ± 0.62 vs. 6.45 ± 0.60 mm, p<0.0001), while IMA dimensions did not differ.The SMA study revealed SSc patients had a significant reduction of RV (7.25 ± 6.37 vs. 18.52 ± 6.16 cm/sec, p<0.0001) and PI (3.33 ± 0.75 vs. 4.53 ± 1.03, p<0.0001) when compared to HC. In addition, in SSc the mV of SMA was significantly lower than in HC (38.03 ± 13.90 vs. 28.32 ±9.25 cm/sec, p=0.0035), as well as the RI (0.88 ± 0.04 vs. 0.91 ± 0.03, p=0.0034); EDV was significantly increased (16.34 ± 7.03 vs. 12.64 ± 5.46 cm/sec, p=0.0321). Similarly to SMA, also in IMA RV and PI were significantly lower that controls (RV: 2.69 ± 6.10 vs. 17.06 ± 5.75 cm/sec, p<0.0001; PI: 3.54 ± 0.95 vs. 6.08 ± 1.53, p<0.0001). Moreover SSc patients presented a significant reduction of PSV and RI of IMA (PSV: 72.27 ± 27.23 vs. 93.81 ± 25.73 cm/sec, p=0.0084; RI: 0.88 ± 0.04 vs. 0.91 ± 0.03, p=0.0132) when compared to HC. Although the HC group was significantly younger than the SSc group (p=0.0003), all the results were confirmed after adjustment for age (Table 1).Table 1.comparison of the characteristics of SMA and IMA between SSc patients and HC.SScHCp-valueAge adjusted p-valueSMANMean ± SDNMean ± SDCaliber (mm)285.75 ± 0.62286.45 ± 0.60<0.00010.0002PSV (cm/sec)28137.50 ± 34.5028135.26 ± 33.810.80750.7297RV (cm/sec)287.25 ± 6.372818.52 ± 6.16<0.0001<0.0001EDV (cm/sec)2816.34 ± 7.032812.64 ± 5.460.03210.0650mV (cm/sec)2838.03 ± 13.902828.32 ±9.250.00350.0150Blood-flow (cm/sec)281073.1 ± 831.1628913.36 ± 272.870.34090.4781PI283.33 ± 0.75284.53 ± 1.03<0.00010.0002RI280.88 ± 0.04280.91 ± 0.030.00340.0141IMACaliber (mm)262.71 ± 0.47242.79 ± 0.370.48720.5385PSV (cm/sec)2372.27 ± 27.232393.81 ± 25.730.00840.0044RV (cm/sec)232.69 ± 6.102317.06 ± 5.75<0.0001<0.0001EDV (cm/sec)237.87 ± 2.01237.95 ± 2.100.89210.9250mV (cm/sec)2317.83 ± 5.332314.75 ± 5.080.05140.3938Blood-flow (cm/sec)23106.70 ± 47.992084.00 ± 30.130.06760.3056PI233.54 ± 0.95236.08 ± 1.53<0.0001<0.0001RI230.88 ± 0.04230.91 ± 0.030.01320.0205SMA=superior mesentheric artery, IMA=inferior mesentheric artery, PSV=Peak Systolic Velocity, RV=Reverse Velocity, EDV=End-Diastolic Velocity, mV=Mean Velocity, PI=Pulsatility Index, RI=Resistive Index.Conclusion:this preliminary study shows, for the first time, the presence of a significant reduction of RV, PI and RI in the intestinal arteries of SSc patients when compared to HC. These data show an increased stiffness of the gastrointestinal arterial wall, in agreement with the typical SSc vasculopathy. A larger cohort is needed to confirm the results and explore the possible relationship with other clinical features of the disease.References:[1]Sjogren, RW.Gastrointestinal features of scleroderma. Curr Opin Rheumatol 1996;8:569-75.Disclosure of Interests:None declared

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Graves, J. S., B. E. Dunn, and S. C. Brown. "Embryonic chick allantois: functional isolation and development of sodium transport." American Journal of Physiology-Cell Physiology 251, no. 5 (November 1, 1986): C787—C794. http://dx.doi.org/10.1152/ajpcell.1986.251.5.c787.

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By removing the shell membranes from the chorioallantoic membrane, the chorion is damaged, as visualized by electron microscopy, and rendered permeable, as evidenced by penetration of horseradish peroxidase and increased inhibition of the allantoic Na+-K+ pump by ouabain applied on the chorionic side. The short-circuit current (SCC) of this functionally isolated allantoic epithelium is augmented by nystatin, a channel-forming ionophore, when applied to the mucosal surface. Electrical parameters were determined for three age groups between 12 and 19 days of incubation. The SCC approximately doubled from the youngest (12-13 days) to the oldest (18-19 days) groups, whereas the transepithelial resistance (Re) of 700-900 omega X cm2 remained the same. Amiloride, an inhibitor of apical Na+ uptake, inhibited 98-100% of the SCC at 10(-4) M in both 15-16 and 18-19 day epithelia. In the 12- to 13-day preparation 20-25% of the SCC was insensitive to 10(-3) M amiloride. The Ki's for amiloride were similar in all preparations, at about 5 X 10(-7) M. Determination of the Hill coefficients for inhibition revealed a lower value (0.75 +/- 0.03) for the 12-13 day preparation compared with the two older preparations with coefficients not significantly different from unity. Replacing Na+ in the bathing solutions abolished the SCC of 18-19 day epithelia, whereas about 15% of the SCC remained at 12-13 days. Thus, during development, the SCC of the allantoic epithelium increases in magnitude and becomes increasingly (to 100%) amiloride-sensitive and Na+-dependent.

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Orbai, A. M., M. E. Husni, D. D. Gladman, B. Parikh, X. Meng, C. Gaillez, and P. J. Mease. "POS1050 SECUKINUMAB LEADS TO IMPROVEMENT ACROSS PSORIATIC ARTHRITIS MANIFESTATIONS OVER 2 YEARS REGARDLESS OF PREVIOUS EXPOSURE TO A TNF INHIBITOR: A POST HOC ANALYSIS OF FUTURE 5." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 802–3. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1862.

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Background:The goal of treating psoriatic arthritis (PsA) is to achieve very low disease activity or remission across disease manifestations. In the phase 3 FUTURE 5 study (NCT02404350), patients receiving secukinumab (SEC) demonstrated sustained clinical improvements across PsA manifestations through Week 104.1 However, the effect of previous tumor necrosis factor inhibitor (TNFi) exposure on achievement of remission across PsA manifestations was not explored.Objectives:To report exploratory efficacy analyses of SEC at Week 104 on stringent endpoints across PsA manifestations in patients who were TNFi naive or inadequate responders (TNF-IR).Methods:Patient data from FUTURE 5 were stratified by previous TNFi exposure and analyzed by treatment arm. At Week 104, patients received SEC 300 or 150 mg with subcutaneous loading dose (LD), SEC 150 mg without LD, or had received placebo up to Week 16 and were switched to SEC 300 or 150 mg between Weeks 16 or 24 based on tender and swollen joint count response. Patients with suboptimal clinical response to SEC 150 mg could escalate to SEC 300 mg after Week 52 per investigator judgment.2 Exploratory efficacy analyses at Week 104 included resolution of TJC/SJC (0 tender/swollen joints), resolution of enthesitis and dactylitis, 75% improvement in the modified Nail Psoriasis Severity index (mNAPSI75), 100% improvement in the Psoriasis Area and Severity Index (PASI100), very low disease activity (VLDA), and Disease Activity in Psoriatic Arthritis (DAPSA) remission. Descriptive statistics are provided for each endpoint using an observed-case approach.Results:Regardless of previous TNFi exposure, SEC-treated patients achieved several stringent endpoints across PsA domains, including TJC/SJC resolution, resolution of dactylitis/enthesitis, mNAPSI75, and PASI100 at Week 104 (Table 1). TNFi-naive patients generally experienced greater improvements than TNF-IR patients (Table 1 above). Similar trends were observed for achievement of VLDA and DAPSA remission at Week 104 (Figure 1).Conclusion:SEC treatment resulted in sustained achievement of stringent endpoints across key PsA manifestations through Week 104 in both TNFi-naive and TNF-IR patients, with generally greater clinical responses among TNFi-naive patients.References:[1]Mease P, et al. Ann Rheum Dis. 2018;77:890-897.[2]Mease P, et al. Arthritis Rheumatol. 2019;71:(suppl 10) [abstract 1554].Table 1.Achievement of Key Outcomes Across PsA Manifestations at Week 104 Among TNF-IR and TNFi-Naive Patients Treated With SECSEC 300 mgSEC 150 mgaSEC 150 mg No LoadbPBO–SEC 300 mgPBO–SEC 150 mgcOutcomes, n/M (%)TNFi-naiven=154TNF-IRn=68TNFi-naiven=153TNF-IRn=67TNFi-naiven=157TNF-IRn=65TNFi-naiven=109TNF-IRn=44TNFi-naiven=114TNF-IRn=39TJC/SJC resolution51/140 (36.4)19/51 (37.3)46/136 (33.8)11/46 (23.9)53/125 (42.4)14/43 (32.6)40/90 (44.4)11/31 (35.5)32/96 (33.3)10/28 (35.7)Resolution of dactylitis42/48 (87.5)11/16 (68.8)37/43 (86.0)16/19 (84.2)56/62 (90.3)11/13 (84.6)35/41 (85.4)5/7 (71.4)30/33 (90.9)10/12 (83.3)Resolution of enthesitis70/88 (79.5)22/30 (73.3)70/85 (82.4)24/32 (75.0)50/69 (72.5)16/26 (61.5)37/50 (74.0)12/17 (70.6)39/56 (69.6)14/20 (70.0)mNAPSI7561/73 (83.6)15/26 (57.7)66/76 (86.8)16/23 (69.6)61/80 (76.3)13/18 (72.2)42/51 (82.4)13/17 (76.5)34/64 (53.1)7/14(50.0)PASI10034/68 (50.0)14/29 (48.3)41/85 (48.2)5/19(26.3)33/73 (45.2)4/18(22.2)23/45 (51.1)9/18(50.0)19/46 (41.3)6/13(46.2)IR, inadequate responder; M, number of evaluable patients; mNAPSI, modified Nail Psoriasis Severity Index; PASI, Psoriasis Area and Severity Index; PBO, placebo; SEC, secukinumab; TJC/SJC resolution, 0 tender/swollen joints; TNFi, tumor necrosis factor inhibitor.a Includes 53 TNFi-naive and 23 TNF-IR patients with dose escalation.b Includes 58 TNFi-naive and 19 TNF-IR patients with dose escalation.c Includes 40 TNFi-naive and 12 TNF-IR patients with dose escalation.Figure 1.Acknowledgements:This study was funded by Novartis Pharma AG. The authors thank Prasanthi Mandalay, PhD, of ArticulateScience LLC, for providing medical writing support/editorial support, which was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).Disclosure of Interests:Ana-Maria Orbai Consultant of: Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Celgene, Horizon, Janssen, Eli Lilly, and Novartis, M Elaine Husni Consultant of: AbbVie, Amgen, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, Regeneron, and UCB, Grant/research support from: Pfizer, Dafna D Gladman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Galapagos, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Novartis, Pfizer, and UCB, Bhumik Parikh Employee of: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Xiangyi Meng Employee of: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Corine Gaillez Employee of: Novartis Pharma AG, Basel, Switzerland, Philip J Mease Speakers bureau: AbbVie, Amgen, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Galapagos, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB.

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Singh, P. K., Rohit K. Shrivastava, and K. G. Sinha. "Study And Evaluation of Injection Timing of CIDI Engine Injection Pump Using Alternate Fuel i.e Biodiesel Fuel." SAMRIDDHI : A Journal of Physical Sciences, Engineering and Technology 8, no. 01 (June 25, 2016): 11–19. http://dx.doi.org/10.18090/samriddhi.v8i1.11407.

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In this investigation an experimental study of the effects of FIP injection timing on Specific Fuel Consumption(SFC), Brake Thermal Efficiency(BTE), Engine Exhaust Gas Temperature(EEGT), CO, HC, NOX and Smoke of “Kirloskar- 6R1080TA, 6-CylinderInline, Direct Injection, Turbocharged Intercooled, 191 hp Diesel Engine” has been conducted. Injection Timing retardation method has been utilised to reduce SFC, EEGT, CO, HC, NOX, Smoke and increase BTE of Kirloskar-6R1080TA Diesel Engine. The Kirloskar 6R1080TA engine has been tested for six different injection timings (23°, 21°, 20°, 19°, 18° and 17° CA BTC) at same engine speeds and load conditions. The SFC,EEGT, CO, HC, NOX and Smoke of engine are approximately higher and BTE lower for injection timings at 23°, 21°, 20°, 18° and 17° CA BTC than 19° CA BTC at same speed and load. The results are showing that SFC,EEGT,CO,HC,NOX and Smoke are approximately reduces and BTE increases by reducing injection timing from 23° CA BTC to 19° CA BTC. Optimum FIP injection timing for Kirloskar 6R1080TA engine has been achieved at 19° CA BTC.

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Yamada, Milton Macoto, Fábio Gelape Faleiro, Uilson Vanderlei Lopes, Acassi Batista Flores, José Luis Pires, and Gilson Roberto Pires Melo. "Genetic divergence in cocoa progenies for backcrossing program to witches' broom disease resistance." Revista Ceres 57, no. 1 (February 2010): 73–78. http://dx.doi.org/10.1590/s0034-737x2010000100013.

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Backcrossing has been little used in cacao breeding, particularly due to the long time required to transfer genes and recover the genetic background of the recurrent parent. The objective of this study was to select individuals, resulting from the backcross CEPEC-42 x SIC-19, genetically related to the recurrent parent SIC-19 by using RAPD molecular markers, among those with resistance to witches' broom. Of the 31 plants that clustered with SIC-19, 18 from the replanted material remained free of the disease in the field, with good vegetative aspect and, therefore can be used for backcross to reach the desired objective.

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Becker-Guedes, F., Y. Sahai, P. R. Fagundes, E. S. Espinoza, V. G. Pillat, W. L. C. Lima, Su Basu, et al. "The ionospheric response in the Brazilian sector during the super geomagnetic storm on 20 November 2003." Annales Geophysicae 25, no. 4 (May 8, 2007): 863–73. http://dx.doi.org/10.5194/angeo-25-863-2007.

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Abstract. A very intense geomagnetic storm (superstorm) began with storm sudden commencement (SSC) at 08:03 UT on 20 November 2003, as a result of the coronal mass ejection (CME) by sunspot 484 hurled into space on 18 November 2003. The geomagnetic storm attained |Dst|max=472 nT at 20:00 UT (20 November). In this paper we present the simultaneous ionospheric sounding observations, using the Canadian Advanced Digital Ionosondes (CADIs), carried out from Palmas (PAL; 10.2° S, 48.2° W; dip latitude 5.5° S; a near equatorial station) and São José dos Campos (SJC; 23.2° S, 45.9° W; dip latitude 17.6° S; station located under the crest of equatorial ionospheric anomaly), Brazil. In addition, total electron content (TEC) measurements from several GPS receiving stations in the Brazilian sector during this storm are presented. The simultaneous ionospheric sounding observations carried out at SJC and PAL, and TEC observations on 3 consecutive days viz., 19 November (quiet), 20 November (disturbed) and 21 November (recovery phase) are presented. Salient features from the ionospheric observations in the Brazilian sector during the superstorm are discussed. The difference in the observed ionospheric response at the two stations (PAL and SJC) is considerable. This is not surprising given that PAL is close to the magnetic equator and SJC is near the crest of the equatorial ionospheric anomaly (EIA). It should be pointed out that soon after the SSC (about 4 h later), the F-region critical frequency (foF2), the F-region peak height (hpF2), and variations of virtual heights at different frequencies (iso-frequency plots) all show wavelike oscillations of the F-region during daytime at both the ionospheric sounding stations. Unusual rapid uplifting of F-region at PAL was observed during both the main and recovery phases of the storm.

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Raman, R. S., Vijaykumar Bhagwan Barge, Darivenula Anil Kumar, Himanshu Dandu, R. Rakesh Kartha, Varun Bafna, Vishaly T. Aravinda, and Thummala C. Raghuram. "A Phase II Safety and Efficacy Study on Prognosis of Moderate Pneumonia in Coronavirus Disease 2019 Patients With Regular Intravenous Immunoglobulin Therapy." Journal of Infectious Diseases 223, no. 9 (February 15, 2021): 1538–43. http://dx.doi.org/10.1093/infdis/jiab098.

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Abstract Background Currently, there is no specific drug for the treatment of coronavirus disease 2019 (COVID-19). Therapeutic benefits of intravenous immunoglobulin (IVIG) have been demonstrated in wide range of diseases. The present study is conducted to evaluate the safety and efficacy of IVIG in the treatment of COVID-19 patients with moderate pneumonia. Methods An open-label, multicenter, comparative, randomized study was conducted on COVID-19 patients with moderate pneumonia. One hundred eligible patients were randomized in 1:1 ratio either to receive IVIG + standard of care (SOC) or SOC. Results Duration of hospital stay was significantly shorter in the IVIG group compared with that of SOC alone (7.7 vs 17.5 days). Duration for normalization of body temperature, oxygen saturation, and mechanical ventilation were significantly shorter in IVIG compared with SOC. Percentages of patients on mechanical ventilation in 2 groups were not significantly different (24% vs 38%). Median time to reverse-transcription polymerase chain reaction negativity was significantly shorter with IVIG than SOC (7 vs 18 days). There were only mild to moderate adverse events in both groups except for 1 patient (2%), who died in SOC. Conclusions Intravenous immunoglobulin was safe and efficacious as an adjuvant with other antiviral drugs in the treatment of COVID-19.

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Anigilaje, Emmanuel Ademola, and Ishola Ibraheem. "Acute kidney injury in children with nephrotic syndrome at the University of Abuja Teaching Hospital, Abuja, Nigeria: 2016 to 2021." AIMS Medical Science 9, no. 1 (2022): 18–31. http://dx.doi.org/10.3934/medsci.2022004.

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<abstract><sec> <title>Background</title> Information regarding acute kidney injury (AKI) is scarce among Nigerian children with nephrotic syndrome (NS). This study describes the prevalence, risk factors and outcomes of AKI among children with NS at the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. </sec><sec> <title>Materials and methods</title> This is a review of children with NS, from January 2016 to October 2021 at the UATH. AKI was classified by the paediatric RIFLE criteria. </sec><sec> <title>Results</title> Of the 75 children with NS, aged 13 months to 18 years, with a mean age of 10 ± 18 years, and majorly (64, 85.3%) males. AKI occurred in 19 of 75 (25.3%) subjects comprising Failure in 15 (78.9%), Injury in 3 (15.8%) and Risk in 1 (5.3%). Regarding risk factors of AKI at hospital admission; subjects with no sepsis were at reduced odds of AKI (OR = 0.01, 95% CI = 0.02–0.06, p < 0.001); and the risk of AKI was reduced among subjects without gross haematuria (OR = 0.07, 95% CI = 0.01–0.66, p = 0.004). The likelihood of AKI increased in the presence of peritonitis (OR = 7.91, 95% CI = 2.15–29.15, p < 0.001) and urinary tract infections (UTIs) (OR = 2.55, 95% CI = 1.39–4.66, p < 0.001). Subjects with historical exposure to nephrotoxic medications (NTM) were also at risk of AKI (OR = 1.79, 95% CI = 1.13–2.84, p = 0.001). The only 2 deaths (2.6%) observed in the short term was among those with AKI (2/19, 10.5%) but full renal recovery occurred in the majority (16/19, 84.2%). </sec><sec> <title>Conclusions</title> AKI is common in our children with NS. Sepsis, gross haematuria, peritonitis, UTIs and NTM were its identified risk factors. It is prudent to have a suspicion of AKI among children with NS with these risk factors in our setting. </sec></abstract>

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Guruvaiah, Mahendraperumal, Madhuri Narra, Garima Dixit, Punit Karawadia, and Deval Shah. "Isolation, Screening and Optimization of Estuary Region (Khambhat, Gujarat) Microalgae for Lipid/Oil Production." International Journal of Applied Sciences and Biotechnology 3, no. 2 (June 25, 2015): 197–201. http://dx.doi.org/10.3126/ijasbt.v3i2.12534.

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Water and soil samples were collected from gulf of Khambhat region, Gujarat. The cations and anions like calcium, chloride, fluoride, magnesium, sulphate and total hardness as calcium carbonate were analyzed. Collected estuarine samples were cultured in three different media under standard laboratory conditions. These enrichments were then used to isolate pure unialgal culture by conventional method. Thirty four isolates belonging to twelve species of Cyanobacteria, twenty species of Chlorophyta and two taxa of Bacillariophyta were identified and are maintained at SPRERI centre. The Chlorophyta were found better accumulators of lipids than the cyanobacterial species. Five promising strains (SBC 7, SBC 9, SBC 17, SBC 18 and SBC 19) have been selected. In-house isolates SBC19 and SBC 17 showed highest acetyl CoA carboxylase (ACCase) of 55.2 (U/ml) and 51.2 (U/ml) respectively, with 0.375 g l-1 nitrogen concentration in 24 days. Biomass production was highest for 2.4 g/l, (SBC 19) and 2.7 g/l (SBC 17) with 1.5 g l-1 nitrogen concentration. The highest lipid content was 52% and 48% in SBC19 and SBC 17, respectively, with 0.375 g l-1 nitrogen concentration of solvent extraction method. Lipid accumulation was found enhanced by more than 50% on dry mass basis under nitrogen starvation.Int J Appl Sci Biotechnol, Vol 3(2): 197-201 DOI: http://dx.doi.org/10.3126/ijasbt.v3i2.12534

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Campione, Elena, Caterina Lanna, Terenzio Cosio, Luigi Rosa, Maria Pia Conte, Federico Iacovelli, Alice Romeo, et al. "Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence." International Journal of Environmental Research and Public Health 18, no. 20 (October 19, 2021): 10985. http://dx.doi.org/10.3390/ijerph182010985.

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Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients.

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Starovoytova, M., O. Desinova, L. P. Ananyeva, O. Koneva, L. Garzanova, O. Ovsyannikova, R. Shayakhmetova, V. Babak, and T. Beketova. "POS1232 COVID-19 IN PATIENTS WITH SYSTEMIC SCLEROSIS: ONE RHEUMATOLOGY CENTER EXPERIENCE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 899.2–899. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3086.

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Background:Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) virus infection or COVID-19 is a serious problem for patients with systemic autoimmune diseases Given the serious complications, including acute lung injury, patients with systemic sclerosis (SSc), especially SSs associated with interstitial lung disease (ILD), may represent a high risk group for infection and the development of severe COVID-19.Objectives:We present an analysis of the COVID-19 course and outcomes in 110 SSc pts.Methods:The study included 147 patients with SSc. The information was clarified by means of telephone survey after 10 months of the pandemic (December 2020). Covid-19 was diagnosed when confirmed by positive oral /nasopharyngeal swab, in the presence of positive antibodies and/or characteristic symptoms, and data from chest computed tomography (CT). 110 pts (77%) out of 147 patients in the SSc registry, gave the necessary information. COVID-19 was diagnosed in 59 pts (53 %). 42 pts (71%) had SSc-ILD. Pts mean age was 54.96 (s.d.11, min 31, max 79), 83% women (49 women and 10 men). 38 pts (65%) had a limited form of SSc, 15 (26%) pts had diffuse form SSc, 6% had overlap (SSc-polymyositis (PM) and SSc had rheumatoid arthritis (RA) and 3% had visceral form of SSc). All patients received low-dose prednisone, and more than half of the pts received immunosuppressive therapy. Rituximab therapy was performed in 24 pts (41%).Results:Almost all patients had positive swab from the oral cavity/nasopharynx. And only in 4 (7%) pts nasopharyngeal swabs were negative, in these patients specific antibodies and characteristic CT changes were detected. Chest CT was performed in 51 (86%) pts. Novel coronavirus pneumonia developed in the vast majority of pts - in 46 (78 %) pts. CT1 (up to 25% of lung lesions) had 10 (17%) pts, CT2 (25-50%) – 21(36%) pts, CT 3 (50-75%) – 15(25%) pts. In 5 (8.5%) pts no changes were detected on CT. The course of COVID-19 was mild and moderate (20 (34%) pts and 18 (31%) pts respectively), severe course was observed in 21 (35%) pts, including fatal in 12 (20%) pts. Among the deceased pts, only 1 patient with SSc-PM had not had ILD, but 7 patients had been treated with rituximab.Conclusion:SSc SARS-CoV-2-infected patients may be at risk of severe disease and mortality due to the frequent presence of ILD and the frequent use of immunosuppressive, including biological, therapy.Disclosure of Interests:None declared

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Gogna, Mónica, and Georgina Binstock. "Anticoncepción y maternidad: Hallazgos de un estudio cuanti-cualitativo con adolescentes de 18 y 19 años de cuatro provincias argentinas." Salud Colectiva 13, no. 1 (April 11, 2017): 63. http://dx.doi.org/10.18294/sc.2017.990.

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El artículo analiza los factores que favorecen o dificultan el acceso a los métodos de anticoncepción y a su uso efectivo por parte de adolescentes residentes en las ciudades de Resistencia (Chaco), Posadas (Misiones) y Santiago del Estero (Santiago del Estero) y en las regiones sanitarias V y VII (Buenos Aires). Los datos provienen de una encuesta aplicada a una muestra intencional de 480 adolescentes de 18 y 19 años (sin hijos, con un hijo y con más de un hijo), y de 21 entrevistas semiestructuradas con población de similares características. El 74,2% de las encuestadas reportó usar un método anticonceptivo “siempre” y un 12,2% “la mayoría de las veces”. Los métodos más utilizados fueron la píldora (40,7%) y el preservativo (37,0%). Solo el 13,2% utilizaba un método de mediana o larga duración (inyectable o dispositivo intrauterino). Los principales motivos reportados por quienes “nunca” usaban métodos (13,6%) fueron estar buscando un embarazo (27,6%) y la oposición de la pareja (27,6%). Las entrevistas revelaron dificultades con el uso de los métodos y déficits en la consejería anticonceptiva.

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SC, Bunt, Presley C, Tarkenton T, Wilmoth K, Didehbani N, Stokes M, Miller SM, Bell K, Batjer H, and Cullum CM. "A - 03 Concussion Symptom Reporting in Sport-Related Concussions During The COVID-19 Pandemic." Archives of Clinical Neuropsychology 36, no. 4 (May 21, 2021): 643. http://dx.doi.org/10.1093/arclin/acab035.03.

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Abstract Objective Evaluation of concussion symptoms is a key element in management of sport-related concussions (SRC). The COVID-19 pandemic has been linked to increased reports of anxiety and depression in the general population, though it is unknown if this increase has also affected reporting of concussion symptoms. The purpose of this study was to determine whether there were differences in reporting of concussion symptoms in adolescents who sustained an SRC before versus during the COVID-19 pandemic. Methods Subjects (n = 707) aged 12–18 with SRC were evaluated within 14 days of injury (M = 5.64 days, SD = 3.68) at a North Texas Concussion Registry (ConTex) clinic and completed the Sport Concussion Assessment Tool-5 (SCAT-5) Symptom Evaluation. Subjects were grouped by those evaluated before (n = 625) or after (n = 82) March 23, 2020 and were similar in age, sex, and history of treatment for anxiety or depression. T-tests were used to compare the number of endorsed concussion symptoms and symptom severity between groups. Results There was no significant difference in number of concussion symptoms endorsed (M = 10.81, SD = 6.53 vs M = 11.35, SD = 6.25, p = 0.463) or symptom severity (M = 28.33, SD = 24.14, M = 26.79, SD = 20.91, p = 0.540) between before vs during COVID-19 SRC groups. Conclusions In this cohort of young athletes, results suggest that despite effects of the COVID-19 epidemic on community mental health, we did not see evidence of a systematic influence on SRC symptom reporting during the pandemic.

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Pinto, André De Araújo, Gaia Salvador Claumann, Rita Maria Dos Santos Puga Barbosa, Markus Vinicius Nahas, and Andreia Pelegrini. "Estágios de mudança de comportamento para a atividade física em adolescentes da Região Amazônica." Brazilian Journal of Kinanthropometry and Human Performance 19, no. 4 (November 7, 2017): 493. http://dx.doi.org/10.5007/1980-0037.2017v19n4p493.

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DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p493 The aim of this study was to estimate the prevalence of stages of behavior change (SBC) for physical activity and to verify the associated demographic and economic factors, in adolescents from the Amazon. A total of 2,517 adolescents (aged 14-19 years) from public high schools participated of the study. SBC for physical activity, demographic (sex, age, school year, school shift and residence area) and economic factors (occupational status, family income and maternal schooling) were investigated. The associations between SBC and independent variables were tested by multinomial logistic regression. Most adolescents were in the maintenance stage (40.8%) and the minority was in pre-contemplation stage (9.0%). Female adolescents were more likely of being in the action (OR=1.44; CI95%=1.14-1.81), preparation (OR=2.71; CI95%=2.14-3.44), contemplation (OR=2.89; CI95%=2.25-3.69) and pre-contemplation (OR=2.91;CI 95%=2.16-4.00) stages compared to male adolescents. Adolescents aged 16-17 years were less likely of being in the action stage (OR=0.71; CI95%=0.53-0.94) and those aged 18-19 years were more likely of being in the preparation stage (OR=1.50; CI95%=1.04-2.16) compared to those aged 14-15 years. Family income of six minimum wages or more was associated to higher chances of being in the action (OR=2.09; CI95%=1.38-3.17), preparation (OR=2.02; CI95%=1.31- 3.12) and contemplation (OR=1.87; IC95%=1.18-2.95) stages. Adolescents who worked were less likely of being in the pre-contemplation stage (OR=0.45; CI95%=0.27-0.74), compared to those who do not work. Most of adolescents were in the maintenance stage for physical activity. The factors associated to SBC were female sex, age groups of 16-17 years and 18-19 years, income of six minimum wages or more and work.

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Desinova, O., M. Starovoytova, and L. P. Ananyeva. "AB0569 SPECIFIC FEATURES OF VASCULAR DISORDERS IN SYSTEMIC SCLEROSIS-OVERLAP SYNDROMES." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1581. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4401.

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Background:The Systemic Sclerosis-overlap syndromes are a typical representative of the well-known group of overlap syndromes in rheumatology, causing great difficulties in diagnostic and therapeutic aspects.Objectives:To identify specific features of vascular disorders in patients with Systemic Sclerosis-overlap syndromes.Methods:100 patients (pts) were followed, including 68 pts with Systemic Sclerosis-polymyositis/dermatomyositis (SSc-PM/DM) (f:m 52: 16), aged 17 to 74 years (mean 43±13.9) and mean disease duration 5 [2-7] years, and 32 pts with Systemic sclerosis-Rheumatoid arthritis (SSc-RA) (f:m 31:1), aged 17 to 74 years (mean age 48±14.8) and average disease duration 11.5 [5-18,5] years. The comparison group consisted of 100 pts with Systemic sclerosis (SSc) (f:m 90:10), aged 51 to 75 years (mean 51±12.9) and mean disease duration 10.6 [5-13,5] years.Results:In 1/3 of pts with SSc-PM/DM, the Raynaud’s phenomenon (RP) preceded the emergence of skin lesions and was the first symptom of the disease (33%), developing in the first year in the majority (68%) of cases, being a unique sign of the disease in only 6 (9 %) pts, while in all other cases it was associated with articular involvement, skin lesions and muscle disease. In the first year of the disease 7 pts (10%) already had signs of digital ischemia (scars, ulcers), and by the end of 3 years such signs were present in 1/3 of SSc-PM/DM pts (32%). 29 pts (43%) developed recurrent digital trophic disorders, such as digital scars in 12 (18%), digital ulcers in 16 (23.5%) and digital necrosis of the distal phalanx in 1 pts (1.5%).In 25 (78%) SSc-RA pts there was a gradual, monosymptomatic – with isolated RP - onset of the disease, similar to chronic cutaneous cSSc. In 29 SSc-RA (91%) pts, RP developed in the first year, and in 23 (72%) it was the first sign of the disease, and in 12 (37.5%) it preceded the development of skin and joint symptoms. Vascular disorders progressed with increasing duration and activity of the process. 7 patients (22%) developed recurrent digital trophic disorders - predominantly finger scars, while 3 (9%) pts had digital ulcers, developing in 11.66±7.62 years on average from the onset of the disease. Correlation analysis revealed a link between patients’ age of and presence of telangiectasias (p<0.02). Digital trophic disorders were significantly more frequent in patients with longer disease duration (p<0.05).Comparing of SSc-overlap syndromes and SSc pts showed, that although RP was present in all of them, nevertheless digital vascular-trophic disorders such as scars, ulcers (p<0.02) and necrosis (p<0.001) were less likely to develop in pts with SSc-overlap syndromes, similarly, telangiectasia and osteolysis were also significantly less frequent (p=0.04) distinguishing SSc-overlap syndromes from limited SSc (Table). Although, SSc-overlap syndromes pts had more severely affected muscles and joints as compared to SSc.Table 1.Comparative characteristics of vascular disorders in SSc and SSc patientsAnalyzed featuresSScn=100 (%)SSc- overlap syndromesn=100 (%)SSc-PM/DMn= 68 (%)SSc-RAn=32 (%)Raynaud phenomenon100 (100)100 (100)68 (100)32 (100)Digital trophic disorders: scars19 (19)19 (19)12 (18)7 (22) ulcers34 (34)**19 (19)**16 (23,5)3 (9)* necrosis16 (16)***1 (1)***1 (1,5)***0 (0)***Telangiectasia60 (60)*46 (46)*34 (50)12 (37,5)*Osteolysis37 (37)*24 (24)*16 (23,5)8 (25)* р<0,05, ** р<0,03, *** р<0,001Conclusion:Digital trophic disorders (ulcers, necrosis), as well as telangiectasia and osteolysis are significantly less likely to develop in SSc-overlap syndromes than in SSc, which should be taken into account when panning therapeutic strategies in this category of patients.Disclosure of Interests:None declared

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Kalinkin, D. E., A. B. Karpov, D. E. Maksimov, E. N. Kiriakidi, and R. M. Takhauov. "ASSESSMENT OF LYMPHOID NEOPLASM RISK FACTORS IN PEOPLE OCCUPATIONALLY EXPOSED TO PROLONGED IONIZING RADIATION." Siberian journal of oncology 19, no. 6 (December 31, 2020): 7–18. http://dx.doi.org/10.21294/1814-4861-2020-19-6-7-18.

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Objective: To estimate the incidence of malignant neoplasms of lymphoid tissue (MNLT) among employees of the siberian chemical combine (SCC) occupationally exposed to prolonged ionizing radiation.Material and methods. The study included 44,041 employees of the SCC, of whom 16,938 were occupationally exposed to prolonged low-intensity ionizing radiation (IR). Of 295 cases with hemoblastoses, there were 89 with occupational exposure to IR. The structure and incidence of hemoblastoses (based on the number of person-years of observation, (PYO), as well as the standardized relative risk (SRR) of their development and excess relative risk (err) per unit dose of radiation (GR) were evaluated. Calculation of SRR was carried out for the following intervals of the total dose of external exposure: 0; >0–0.05; >0.05–0.10; >0.10-0.15; >0.15–0.20; >0.20-0.30; >0.30-0.50; >0.5–1.0; ≥ 1.0 Gy. The control group consisted of occupationally non-exposed employees of the SCC. The calculation of SRR and err was performed using the poisson regression using the amfit module of the EPICURE package.Results. The incidence of MNLT among males of SCC was 17.1 per 100,000 PYO, with the highest incidence rates for Non-Hodgkin’s lymphoma (NHL), chronic lymphocytic leukemia (CLL) and chronic leukemia (CL) excluding CLL. Among females of the SCC, the incidence of MNLT was 21.3 per 100,000 PYO. It was found that in none of the intervals of the external exposure there was no statistically significant excess of the SRR compared with the control group. The results of ERR/GY calculation also did not demonstrate the increased risk of hemoblastosis among people occupationally exposed to IR.Conclusion. Occupational exposure in the studied dose range does not increase the risk of developing MNLT.

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Singh, Sukhbir, Manjunath B. Govindagoudar, Dhruva Chaudhry, Pawan Kumar Singh, and Madan Gopal Vashist. "Assessment of knowledge of COVID-19 among health care workers-a questionnaire-based cross-sectional study in a tertiary care hospital of India." AIMS Public Health 8, no. 4 (2021): 614–23. http://dx.doi.org/10.3934/publichealth.2021049.

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<abstract><sec> <title>Background</title> Health Care Workers (HCW) are among the primary stakeholders and front liners in the fight against COVID-19. They are in direct contact with the patients as primary caregivers and, therefore, are at a higher risk of infection. This Pandemic offers a unique opportunity to explore the level of knowledge among ground-level HCWs during this global health crisis. </sec><sec> <title>Objective</title> We conducted this study to assess the knowledge and awareness among HCW regarding the COVID-19 Pandemic in a tertiary care hospital. </sec><sec> <title>Methods</title> It was a cross-sectional study done on HCW comprising faculty, senior residents, junior residents, demonstrators, and nursing staff of various specialties directly involved in the care of suspected/confirmed COVID-19 patients. A pretested questionnaire consisting of 20 questions was used as a study tool and was circulated through the digital platform. </sec><sec> <title>Results</title> There were a total of 437 respondents. In the subgroup analysis, the respondents in the age group of 55–64 years had a higher mean knowledge score, followed by the respondents in the age group of 18–24 years. For years of experience, the mean knowledge score varied from 13.89 (10–20 years of experience) to 13.83 (5–10 years of experience). The mean knowledge score was the highest for consultants (14.10), followed by Resident Doctors (13.96). </sec><sec> <title>Conclusions</title> This study has shed some critical clues for further research and interventions. Firstly, as health care workers are probably learning about COVID-19 from their practical exposure rather than formal teaching, it is pertinent to address this issue through well-planned formal sessions of training workshops and lectures. </sec></abstract>

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Secord, Angeles Alvarez, Deanna Teoh, Jingquan Jia, Andrew B. Nixon, Lisa Grace, David J. Adams, and Susan K. Murphy. "Dasatinib (BMS-35482) Interacts Synergistically With Docetaxel, Gemcitabine, Topotecan, and Doxorubicin in Ovarian Cancer Cells With High SRC Pathway Activation and Protein Expression." International Journal of Gynecologic Cancer 24, no. 2 (February 2014): 218–25. http://dx.doi.org/10.1097/igc.0000000000000056.

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PurposeThis study aimed to explore the activity of dasatinib in combination with docetaxel, gemcitabine, topotecan, and doxorubicin in ovarian cancer cells.MethodsCells with previously determined SRC pathway and protein expression (SRC pathway/SRC protein IGROV1, both high; SKOV3, both low) were treated with dasatinib in combination with the cytotoxic agents. SRC and paxillin protein expression were determined pretreatment and posttreatment. Dose-response curves were constructed, and the combination index (CI) for drug interaction was calculated.ResultsIn the IGROV1 cells, dasatinib alone reduced phospho-SRC/total SRC 71% and p-paxillin/t-paxillin ratios 77%. Phospho-SRC (3%–33%; P = 0.002 to 0.04) and p-paxicillin (6%–19%; P = 0.01 to 0.05) levels were significantly reduced with dasatinib in combination with each cytotoxic agent. The combination of dasatinib and docetaxel, gemcitabine, or topotecan had a synergistic antiproliferative effect (CI, 0.49–0.68), whereas dasatinib combined with doxorubicin had an additive effect (CI, 1.08).In SKOV3 cells, dasatinib resulted in less pronounced reductions of phospho-SRC/total SRC (49%) and p-paxillin/t-paxillin (62%). Phospho-SRC (18%; P < 0.001) and p-paxillin levels (18%; P = 0.001; 9%; P = 0.007) were significantly decreased when dasatinib was combined with docetaxel and topotecan (p-paxillin only). Furthermore, dasatinib combined with the cytotoxics in the SKOV3 cells produced an antagonistic interaction on the proliferation of these cells (CI, 1.49–2.27).ConclusionsDasatinib in combination with relapse chemotherapeutic agents seems to interact in a synergistic or additive manner in cells with high SRC pathway activation and protein expression. Further evaluation of dasatinib in combination with chemotherapy in ovarian cancer animal models and exploration of the use of biomarkers to direct therapy are warranted.

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Falavigna, Asdrubal, Orlando Righesso, Alisson Roberto Teles, and Pedro Guarise da Silva. "Management of wound infection after lumbar arthrodesis maintaining the instrumentation." Coluna/Columna 14, no. 2 (June 2015): 117–20. http://dx.doi.org/10.1590/s1808-1851201514020r129.

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<sec><title>OBJECTIVE:</title> To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.</sec><sec><title>METHODS:</title> Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.</sec><sec><title>RESULTS:</title> Mean age was 59.31 (±13.17) years old and most patients were female (94.7%; 18/19). The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.</sec><sec><title>CONCLUSION:</title> Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.</sec>

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Kaye, Avi Gurion, and Robert Siegel. "The efficacy of IL-6 inhibitor Tocilizumab in reducing severe COVID-19 mortality: a systematic review." PeerJ 8 (November 2, 2020): e10322. http://dx.doi.org/10.7717/peerj.10322.

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Background In the absence of highly effective antiviral therapies against SARS-CoV-2, it is crucial to counter the known pathophysiological causes of severe COVID-19. Evaluating the efficacy existing drugs may expedite the development of such therapeutics. Severe COVID-19 is largely the result of a dysregulated immune response characterized by lymphocytopenia, neutrophilia and critical hypercytokinemia, or “cytokine storm,” which is largely mediated by the cytokine interleukin-6 (IL-6). The IL-6 inhibitor tocilizumab (TCZ) could potentially suppress the effects of the pro-inflammatory cytokine and thereby lower mortality from the disease. This systematic analysis aimed to investigate and synthesize existing evidence for the efficacy of TCZ in reducing COVID-19 mortality. Methodology PubMed and SearchWorks searches were performed to locate clinical studies with primary data on TCZ treatment for severe COVID-19. Sixteen case-control studies comparing mortality between TCZ and standard of care (SOC) were identified for quantitative synthesis. The systematic analysis was pre-approved through PROSPERO (CRD42020193479). Results Combined mortality for the TCZ-treated and SOC groups were 26.0% and 43.4% respectively. In all but one of the studies, the odds ratio of mortality from COVID-19 pointed towards lower fatality with TCZ vs the SOC. A combined random effects odds ratio calculation yielded an odds ratio of 0.453 (95% CI [0.376–0.547], p < 0.001). Additionally, 18 uncontrolled trials were identified for qualitative analysis producing a raw combined mortality rate of 16.0%. Conclusions Important caveats to this research include the lack of prospective randomized control trials and the absence of data from the large COVATA study from the published literature. However, results from this systematic analysis of published research provide positive evidence for the potential efficacy of TCZ to treat severe COVID-19, validating the ethical basis and merit of ongoing randomized controlled clinical trials.

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Ridray, S., D. Heudes, O. Michel, L. Penicaud, and A. Ktorza. "Increased SMC proliferation after endothelial injury in hyperinsulinemic obese Zucker rats." American Journal of Physiology-Heart and Circulatory Physiology 267, no. 5 (November 1, 1994): H1976—H1983. http://dx.doi.org/10.1152/ajpheart.1994.267.5.h1976.

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The long-term effect of long-lasting hyperinsulinemia on aortic smooth muscle cell (SMC) proliferation after endothelial injury was investigated using the obese Zucker rat model, which is characterized especially by early spontaneous development of hyperinsulinemia and insulin resistance. SMC proliferation was provoked by the passage of an embolectomy catheter with a tightly inflated balloon and was assessed by measuring the incorporation of [3H]thymidine in the DNA of intima-media layers. Compared with controls, the SMC mitotic activity was not significantly increased from day 2 to day 7 after injury, but from day 14 to day 30 after endothelial denudation, SMC proliferation was significantly less decreased in obese than in lean rats [on day 14, DNA synthesis = 107 +/- 18 counts.min-1.micrograms DNA-1 in lean and 345 +/- 44 counts.min-1.micrograms DNA-1 in obese rats (P = 0.003); and on day 30, DNA synthesis = 74 +/- 18 counts.min-1.micrograms DNA-1 in lean and 133 +/- 19 counts.min-1.micrograms DNA-1 in obese rats (P = 0.0055)]. As a result, the intima-media DNA content was higher in obese than in lean rats on day 14 and even more so on day 30, suggesting a higher amount of SMCs in the intima-media. Moreover, on day 30, the aortic thickening, as measured by a histomorphometric technique, was much higher in obese than in lean rats. This difference was entirely due to an increase in SMC content of the intima, mainly resulting from a dramatic increment in the number of nuclei and nuclear number density.(ABSTRACT TRUNCATED AT 250 WORDS)

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Hoffmann-Vold, A. M., C. Brunborg, F. Tirelli, P. Carreira, N. Del Papa, A. Mekinian, M. Vonk, et al. "POS0054 THE IMPACT AND OUTCOME OF COVID-19 ON SYSTEMIC SCLEROSIS PATIENTS FROM THE EUROPEAN SCLERODERMA TRIAL AND RESEARCH GROUP (EUSTAR)." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 232.2–233. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3267.

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Background:Coronavirus disease-19 (COVID-19) has been a major clinical challenge worldwide. Sex, age and comorbidities have been associated with worse outcome in the general population. Systemic sclerosis (SSc) is a severe, autoimmune disease with frequent multi-organ involvement.Objectives:To assess the impact of COVID-19 and to determine factors associated with worse outcome in SSc patients from the European Scleroderma Trial and Research (EUSTAR) database.Methods:SSc patients from the EUSTAR database with COVID-19 were prospectively collected between 15.03.-31.12.2020. Two outcomes were chosen: (1) hospitalization; and (2) severe outcome defined as either non-invasive ventilation, mechanical ventilation/extracorporeal membrane oxygenation (ECMO) or death. General risk factors assessed were sex, age and number of comorbidities. SSc related risk factors were SSc subtype, autoantibodies, disease duration, SSc associated organ manifestations including interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), cardiac, gastrointestinal (GI), and musculoskeletal involvement; digital ulcers (DU), CRP at last visit, renal disease (scleroderma renal crisis and SSc associated renal insufficiency), modified Rodnan skin score (mRSS) and immunosuppressive treatment. Descriptive statistics and logistic regression models were applied.Results:In total, 178 European SSc patients with COVID-19 were registered with a median observation time of 5.5 weeks (Table 1). 95 patients (53%) could recall SAR-Cov-2 contact, while 47 (26%) had no contact. 156 (88%) were symptomatic at COVID-19 onset with fever, cough, malaise and dyspnea being most prevalent. Over the disease course, 63 (36%) developed pneumonia. In total, 67/176 (38%) were hospitalized which were in 84% due to COVID-19. 41/170 (24%) had a severe outcome including 21 (12%) deaths. 128 (72%) recovered completely, while 14 (8%) complained of sequela, with 7 (50%) stating respiratory complications. Age, non-SSc comorbidities, presence of ILD, PAH and SSc associated renal or cardiac disease were numerically associated with hospitalization and severe outcome (Table 1). Univariable logistic analyses for hospitalization and severe outcome are shown in Figure 1. In multivariable logistic regression, age (OR 1.03, 95%CI 1.01-1.07, p=0.019), presence of non-SSc comorbidities (OR 2.52, 95%CI 1.16-5.47, p=0.019) and SSc-related renal disease (predicting success perfectly) were associated with hospitalization and for severe outcome age (OR 1.05, 95%CI 1.01-1.08).Conclusion:SSc patients at older age, with non-SSc comorbidities, SSc related renal disease or ILD are at risk of a more severe outcome and should follow precautions to avoid COVID-19 infections and need careful monitoring in case of COVID-19.Table 1.SSc disease characteristics of COVID-19 patientsAll(n=172)Hospitalized(n=67)Severe outcome(n=41)Age at COVID-19, yrs (SD)57 (14.0)63 (13.8)65 (12.2)Male sex, n (%)38 (21)18 (27)12 (29)≥1 comorbidity, n (%)63/176 (36)37 (55)30 (58)SSc disease duration at COVID, yrs (SD)11.5 (8.8)13.3 (9.7)12.7 (10.2)Diffuse cutaneous SSc, n (%)74 (42)29 (43)19 (46)mRSS, median (IQR)5 (8)5 (9)5 (7)ILD, n (%)90/175 (51)36/65 (55)26/40 (65)PAH, n (%)21/175 (12)11/65 (17)8/40 (20)GI disease, n (%)112/176 (64)45 (67)30 (73)Cardiac disease, n (%)37/166 (22)19/59 (32)16/36 (44)Musculoskeletal disease, n (%)40/175 (23)15/65 (23)6/40 (15)Renal disease, n (%)8/175 (5)7/65 (11)5/40 (13)Ever DU, n (%)69/175 (39)27/65 (42)14/40 (35)CRP, ng/ml (SD)35/177 (20)14 (21)9 (22)Immunosuppressive treatment, n (%)104/177 (59)41/66 (62)26 (63)Figure 1.Univariable logistic analyses for hospitalization and severe outcomeDisclosure of Interests:Anna-Maria Hoffmann-Vold Speakers bureau: Actelion, Boehringer Ingelheim, Roche, Merck Sharp & Dohme, ARXX, Lilly and Medscape, Consultant of: Actelion, Boehringer Ingelheim, Bayer, ARXX, and Medscape, Grant/research support from: Boehringer Ingelheim, Cathrine Brunborg: None declared, Francesca Tirelli: None declared, Patricia Carreira: None declared, Nicoletta Del Papa: None declared, Arsene Mekinian: None declared, Madelon Vonk: None declared, Alessandro Giollo: None declared, Giacomo De Luca: None declared, Maria De Santis: None declared, Corrado Campochiaro: None declared, Carina Mihai: None declared, Paolo Airò Speakers bureau: Bristol Myers Squibb, Bohringer Ingelheim, Consultant of: Bristol Myers Squibb, Bohringer Ingelheim, non-financial support from CSL Behring, SOBI, Janssen, Roche, Sanofi, Pfizer, Maria Grazia Lazzaroni: None declared, Elisabetta Zanatta: None declared, Rosario Foti: None declared, Yannick Allanore: None declared, Daniel Furst: None declared, Marco Matucci-Cerinic: None declared, Armando Gabrielli: None declared, Oliver Distler Speakers bureau: Actelion, Kymera Therapeutics, Mitsubishi Tanabe Pharma, Abbvie, Acceleron, Alexion, Amgen, AnaMar, Arxx Therapeutics, Baecon, Discovery, Blade Therapeutics, Corbus Pharmaceuticals, Drug Development International, Ltd, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Kymera Therapeutics, Lilly, Novartis, Pfizer, Topadur and UCB, Consultant of: Actelion, Kymera Therapeutics, Mitsubishi Tanabe Pharma, Abbvie, Acceleron, Alexion, Amgen, AnaMar, Arxx Therapeutics, Baecon, Discovery, Blade Therapeutics, Corbus Pharmaceuticals, Drug Development International, Ltd, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Kymera Therapeutics, Lilly, Novartis, Pfizer, Topadur and UCB, Grant/research support from: Boehringer Ingelheim.

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ZHANG, MIN, SUMAYA AHAD, M. BANIYAMUDDIN, WENJU LIANG, and WASIM AHMAD. "A new and three known species of the genus Tylencholaimellus Cobb in M.V. Cobb, 1915 (Nematoda: Dorylaimida) from Changbai Mountain, China." Zootaxa 3499, no. 1 (September 27, 2012): 46. http://dx.doi.org/10.11646/zootaxa.3499.1.3.

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A new and three known species of the genus Tylencholaimellus Cobb in M.V. Cobb, 1915 are described from ChangbaiMountain, Northeast China. Tylencholaimellus sinensis n. sp. species is characterized by having a medium sized body (L=1.1–1.3 mm); outer cuticle with fine transverse striations; inner layer distinctly striated; radial refractive elementsabundant; labial disc absent; lip region offset by constriction; lips rounded and amalgamated; odontostyle 18–19 µm,odontophore 7–8 µm, combined length 25–27μm; anterior uterine sac 0.8–1.6 mid body diameters long; mono-opisthodelphic female genital system with small anterior uterine sac; transverse vulva and short conoid tail.Tylencholaimellus striatus Thorne, 1939, T. montanus Thorne, 1939 and T. cinctus Orr & Dickerson, 1965 are described for the first time from this region of the world.

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Panda, Nikhil, James C. Etheridge, Takshveer Singh, Yves Sonnay, George Molina, Barbara K. Burian, Nina Capo-Chichi, et al. "We Asked the Experts: The WHO Surgical Safety Checklist and the COVID-19 Pandemic: Recommendations for Content and Implementation Adaptations." World Journal of Surgery 45, no. 5 (February 26, 2021): 1293–96. http://dx.doi.org/10.1007/s00268-021-06000-y.

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Abstract Background As surgical systems are forced to adapt and respond to new challenges, so should the patient safety tools within those systems. We sought to determine how the WHO SSC might best be adapted during the COVID-19 pandemic. Methods 18 Panelists from five continents and multiple clinical specialties participated in a three-round modified Delphi technique to identify potential recommendations, assess agreement with proposed recommendations and address items not meeting consensus. Results From an initial 29 recommendations identified in the first round, 12 were identified for inclusion in the second round. After discussion of recommendations without consensus for inclusion or exclusion, four additional recommendations were added for an eventual 16 recommendations. Nine of these recommendations were related to checklist content, while seven recommendations were related to implementation. Conclusions This multinational panel has identified 16 recommendations for sites looking to use the surgical safety checklist during the COVID-19 pandemic. These recommendations provide an example of how the SSC can adapt to meet urgent and emerging needs of surgical systems by targeting important processes and encouraging critical discussions.

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ADESIYUN, ABIODUN A., IFEDAPO RAJI, and VIVIAN YOBE. "Enterotoxigenicity of Staphylococcus aureus from Anterior Nares of Dining Hall Workers." Journal of Food Protection 49, no. 12 (December 1, 1986): 955–57. http://dx.doi.org/10.4315/0362-028x-49.12.955.

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The frequency of isolation of enterotoxigenic Staphylococcus aureus in dining hall workers of a Nigerian University was determined. Of a total of 186 workers sampled, 47 (25.3%) were carriers of enterotoxigenic S. aureus in their anterior nares, including 19 (22.4%) of 85 cooks and 11 (23.9%) of 46 stewards. Fifty-five (26.6%) of 207 strains of S. aureus tested produced staphylococcal enterotoxins A (SEA), B (SEB), C (SEC), D (SED) or E (SEE). SEA predominated, with 18 (8.7%) strains elaborating it and representing 32.7% of all enterotoxigenic strains. SEC and SED were produced by 14 (6.8%) and 13 (6.3%) strains, respectively, and 9 (4.3%) strains produced SEB and SEE. It appears that SEA poses the greatest risk to students consuming foods contaminated by S. aureus of nasal origin from these workers.

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Kazelian, Lucía R., Gerardo Zapata, Stella Maris Pereiro González, Mariano Maydana, Adrian Lescano, Alberto Lorenzatti, and José L. Navarro Estrada. "RACCOVID-19: primer Registro Argentino de Complicaciones Cardiovasculares en pacientes con COVID-19." Revista Argentina de Cardiologia 89, no. 4 (October 17, 2021): 285–92. http://dx.doi.org/10.7775/rac.es.v89.i4.20408.

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Introducción: La enfermedad por coronavirus (COVID-19) ha causado una de las mayores pandemias conocidas al día de la fecha. La Sociedad Argentina de Cardiología (SAC) y la Federación Argentina de Cardiología (FAC) elaboraron el primer Registro Argentino de Complicaciones Cardiovasculares en pacientes con COVID-19 (RACCOVID-19), con el propósito de relevar, a nivel nacional, su impacto en la evolución hospitalaria de estos pacientes. Objetivos: Documentar la aparición de complicaciones cardiovasculares en pacientes internados por COVID-19 y evaluar predictores de riesgo de dichas complicaciones y su impacto pronóstico. Material y Métodos: Se incluyen datos de 2750 pacientes en 50 centros de 11 provincias del país, desde el 18 de mayo hasta el 31 de octubre de 2020. Resultados: La edad promedio fue de 57±18 años y hubo predominio de sexo masculino (60,2%). La tasa de complicaciones cardiovasculares fue del 15,3%. La insuficiencia cardíaca (43,5%), las arritmias (33,5%) y el daño miocárdico (31,1%) fueron las complicaciones más frecuentes. La mortalidad fue del 19,3%. Un modelo de predicción de sobrevida en la etapa hospitalaria incluyó las siguientes variables: edad, sexo masculino, valores de hematocrito y creatinina al ingreso, existencia de antecedentes patológicos, formas de presentación de COVID-19 graves y presencia de complicaciones cardiovasculares. Conclusiones: El registro RACCOVID-19 mostró una tasa de complicaciones cardiovasculares del 15,3%. La mortalidad total del registro fue del 19,3% y las complicaciones cardiovasculares junto con otras variables de presentación, así como la gravedad del cuadro clínico de COVID-19, forman parte de un perfil de riesgo clínico asociado a mayor mortalidad.

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Ohba, Shota, Masashi Shimohira, Takuya Hashizume, Masahiro Muto, Kengo Ohta, Yusuke Sawada, Akihiro Mizuno, Yosuke Nakai, Hisao Suda, and Yuta Shibamoto. "Feasibility and Safety of Sac Embolization Using N-Butyl Cyanoacrylate in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms or Isolated Iliac Artery Aneurysms." Journal of Endovascular Therapy 27, no. 5 (May 21, 2020): 828–35. http://dx.doi.org/10.1177/1526602820923954.

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Purpose: To evaluate the feasibility and safety of sac embolization with N-butyl cyanoacrylate (NBCA) in emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) in comparison to EVAR without sac embolization. Materials and Methods: Between February 2012 and December 2019, among 44 consecutive patients with ruptured AAA or IAA, 29 underwent EVAR. Of these, 22 patients (median age 77.5 years; 18 men) had concomitant sac embolization using NBCA; the remaining 7 patients (median age 88 years; 6 men) underwent EVAR without sac embolization and form the control group. The technical success, clinical success (hemodynamic stabilization), procedure-related complications, and mortality were compared between the groups. Results: All EVAR procedures and embolizations were successful. The clinical success rates in the NBCA and control groups were 95% (21/22) and 71% (5/7), respectively (p=0.14). There was no complication related to the procedure. Type II endoleak occurred in 4 of 21 patients (19%) in the NBCA group vs none of the control patients. One patient (5%) died in the NBCA group vs 3 (43%) in the controls (p=0.034). Conclusion: Sac embolization using NBCA in emergency EVAR appears to be feasible and safe for ruptured AAA and IAA.

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Sutiyono, S., D. Samsudewa, and A. Suryawijaya. "Estrus and pregnancy rate of Simmental-Ongole Crossbred and Ongole Grade heifer after being synchronized and inseminated." Journal of the Indonesian Tropical Animal Agriculture 43, no. 4 (December 11, 2018): 438. http://dx.doi.org/10.14710/jitaa.43.4.438-444.

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The aim of the study was to examine the synchronization of estrus and artificial insemination in heifers of Ongole grade and Simental-Ongole grade. The research used 19 Ongole Grade (OG) and 18 Simental-Ongole Crossbred (SOC) heifers. This research applied purposive sampling to determine the research population. The criteria to select the population were heifers which have in mature body. The normality of heifer’s reproductive organs were identified by performing rectal palpation, then 50 mg of medroxy progesterone acetate on vaginal sponge was used to synchronized estrus. The estrus heifer was inseminated using frozen semen. The observed parameters were the number of heifers with normal and abnormal reproductive organs, estrus sign and pregnancy. Data were analyzed descriptively. This study showed that OG and SOC with abnormal reproductive organs was 1 heifer (5.56%) and 7 heifers (36.84%), respectively. The responses of estrus synchronization in heifers with normal and abnormal reproductive organs were 94.17% and 100% in OG, and 100% and 42.86% in SOC. Meanwhile, the pregnancy rate was 70.59 and 0% in OG, and 50.00 and 0% in SOC. In conclusion, the number of SOC heifers with abnormal reproductive organs is higher than OG. Estrus synchronization using 50 mg medroxy progesterone acetate increase the amount of estrus and pregnancy in heifers with normal reproductive organs.

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Zwimpfer, Thomas J., and Mark Bernstein. "Spinal cord concussion." Journal of Neurosurgery 72, no. 6 (June 1990): 894–900. http://dx.doi.org/10.3171/jns.1990.72.6.0894.

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✓ The hallmark of concussion injuries of the nervous system is the rapid and complete resolution of neurological deficits. Cerebral concussion has been well studied, both clinically and experimentally. In comparison, spinal cord concussion (SCC) is poorly understood. The clinical and radiological features of 19 SCC injuries in the general population are presented. Spinal cord injuries were classified as concussions if they met three criteria: 1) spinal trauma immediately preceded the onset of neurological deficits; 2) neurological deficits were consistent with spinal cord involvement at the level of injury; and 3) complete neurological recovery occurred within 72 hours after injury. Most cases involved young males, injured during athletics or due to falls. Concussion occurred at the two most unstable spinal regions, 16 involving the cervical spinal and three the thoracolumbar junction. Fifteen cases presented with combined sensorimotor deficits, while four exhibited only sensory disturbances. Many patients showed signs of recovery with the first few hours after injury and most had completely recovered within 24 hours. Only one case involved an unstable spinal injury. There was no evidence of ligamentous instability, spinal stenosis, or canal encroachment in the remaining 18 cases. Two patients, both children, suffered recurrent SCC injuries. No delayed deterioration or permanent cord injuries occurred. Spinal abnormalities that would predispose the spinal cord to a compressive injury were present in only one of the 19 cases. This suggests that, as opposed to direct cord compression, SCC may be the result of an indirect cord injury. Possible mechanisms are discussed.

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Tompkins, William P., Christine Agnes Ciunci, Suzanne Walker, Kelly Patton, Amy Schwartz, and Christopher Davella. "Serious illness conversation and end of life care utilization at an academic medical center." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 29. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.29.

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29 Background: Hospice has been associated with improved quality of life for patients, cost savings, and reduction in caregiver-grief-related depression. While cancer patients make up a plurality of hospice utilizers nationally, many patients are only on hospice for a limited period (in Medicare patients, a median of 18 days). Studies suggest engaging cancer patients to discuss goals and priorities using the Serious Illness Conversation (SIC) Guide has a positive impact on prognostic understanding and end-of-life planning. More frequent utilization of SICs may prompt earlier enrollment of oncology patients in hospice when appropriate. Methods: We identified cancer patients enrolled in hospice at the Abramson Cancer Center at Penn Presbyterian Medical Center from 2019-2020 after all providers received SIC training. Patient demographics, cancer diagnosis, type of hospice (home versus inpatient), SIC usage, palliative care referral patterns and time on hospice were abstracted. Results: 104 patients were enrolled in hospice during the study period. The majority of patients were female (51%). 45% were Caucasian, and 31% were African American. The most common cancer diagnoses were thoracic (52%) and gastrointestinal (32%) malignancies. 85 patients (82%) were enrolled on home hospice and 19 patients (18%) inpatient hospice. Palliative care usage included 50 inpatient and 24 outpatient consultations; 30 patients (29%) in the cohort never utilized palliative care. 52 (50%) of patients did not have a SIC. 47% (40 patients) enrolled in home hospice had an SIC while 63% (12 patients) on inpatient hospice had an SIC. The median time interval between a patient’s SIC conversation and hospice enrollment was longer in home hospice patients (74 days) compared to inpatient hospice (33 days). Patients on home hospice spent an average of 44 days on hospice versus 2 days in the inpatient setting. Conclusions: Half of the patients at Penn Presbyterian Medical Center enrolled in hospice during the study period did not have an SIC, and 29% did not see palliative care prior to starting hospice. The median time from SIC initiation to hospice enrollment was significantly longer for patients on home hospice compared to inpatient hospice suggesting a need for earlier SIC interventions. Patients enrolled in inpatient hospice spent a considerably shorter period of time on hospice also underscoring the importance of earlier end of life planning. Our findings indicate a need for additional interventions to facilitate earlier SIC conversations in the outpatient setting and a demand for increased palliative care access.

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Zhu, Honglin, Chengsong Zhu, Wentao Mi, Tao Chen, Hongjun Zhao, Xiaoxia Zuo, Hui Luo, and Quan-Zhen Li. "Integration of Genome-Wide DNA Methylation and Transcription Uncovered Aberrant Methylation-Regulated Genes and Pathways in the Peripheral Blood Mononuclear Cells of Systemic Sclerosis." International Journal of Rheumatology 2018 (September 2, 2018): 1–19. http://dx.doi.org/10.1155/2018/7342472.

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Objective. Systemic sclerosis (SSc) is a systemic connective tissue disease of unknown etiology. Aberrant gene expression and epigenetic modifications in circulating immune cells have been implicated in the pathogenesis of SSc. This study is to delineate the interaction network between gene transcription and DNA methylation in PBMC of SSc patients and to identify methylation-regulated genes which are involved in the pathogenesis of SSc. Methods. Genome-wide mRNA transcription and global DNA methylation analysis were performed on PBMC from 18 SSc patients and 19 matched normal controls (NC) using Illumina BeadChips. Differentially expressed genes (DEGs) and differentially methylated positions (DMPs) were integrative analyzed to identify methylation-regulated genes and associated molecular pathways. Results. Transcriptome analysis distinguished 453 DEGs (269 up- and 184 downregulated) in SSc from NC. Global DNA methylation analysis identified 925 DMPs located on 618 genes. Integration of the two lists revealed only 20 DEGs which harbor inversely correlated DMPs, including 12 upregulated (ELANE, CTSG, LTBR, C3AR1, CSTA, SPI1, ODF3B, SAMD4A, PLAUR, NFE2, ZYX, and CTSZ) and eight downregulated genes (RUNX3, PRF1, PRKCH, PAG1, RASSF5, FYN, CXCR6, and F2R). These potential methylation-regulated DEGs (MeDEGs) are enriched in the pathways related to immune cell migration, proliferation, activation, and inflammation activities. Using a machine learning algorism, we identified six out of the 20 MeDEGs, including F2R, CXCR6, FYN, LTBR, CTSG, and ELANE, which distinguished SSc from NC with 100% accuracy. Four genes (F2R, FYN, PAG1, and PRKCH) differentially expressed in SSc with interstitial lung disease (ILD) compared to SSc without ILD. Conclusion. The identified MeDEGs may represent novel candidate factors which lead to the abnormal activation of immune regulatory pathways in the pathogenesis of SSc. They may also be used as diagnostic biomarkers for SSc and clinical complications.

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Zhao, Na, Xiao Fan Zeng, Sheng Bi, Yue Zhao, and Jian Zhong Zhou. "The Effect of Water Network Connection Project on Water Quality in Lakes Based on Remote Sensing." Applied Mechanics and Materials 409-410 (September 2013): 242–45. http://dx.doi.org/10.4028/www.scientific.net/amm.409-410.242.

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Spatial distributions of chlorophyll-a (Chl-a), secchi disc transparency (SD), and total nitrogen (TN) were estimated using Landset7 ETM+ SLC-OFF data before and after the connection project of Donghu Lake and Shahu Lake in Wuhan, China. Results show that water quality in the two lakes is improved in most area, especially in the joint connection. There are 23%, 19%, 18% in average improvement for Chl-a, SD, and TN respectively. This study suggests that besides controlling of point and non-point sources pollution, water network connection project is effective on water quality in lakes.

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Chen, Zhaohui, Lixin Wu, Bo Qiu, Shantong Sun, and Fan Jia. "Seasonal Variation of the South Equatorial Current Bifurcation off Madagascar." Journal of Physical Oceanography 44, no. 2 (February 1, 2014): 618–31. http://dx.doi.org/10.1175/jpo-d-13-0147.1.

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Abstract In this paper, seasonal variation of the South Equatorial Current (SEC) bifurcation off the Madagascar coast in the upper south Indian Ocean (SIO) is investigated based on a new climatology derived from the World Ocean Database and 19-year satellite altimeter observations. The mean bifurcation integrated over the upper thermocline is around 18°S and reaches the southernmost position in June/July and the northernmost position in November/December, with a north–south amplitude of about 1°. It is demonstrated that the linear, reduced gravity, long Rossby model, which works well for the North Equatorial Current (NEC) bifurcation in the North Pacific, is insufficient to reproduce the seasonal cycle and the mean position of the SEC bifurcation off the Madagascar coast. This suggests the importance of Madagascar in regulating the SEC bifurcation. Application of Godfrey’s island rule reveals that compared to the zero Sverdrup transport latitude, the mean SEC bifurcation is shifted poleward by over 0.8° because of the meridional transport of about 5 Sverdrups (Sv; 1 Sv ≡ 106 m3 s−1) between Madagascar and Australia. A time-dependent linear model that extends the Godfrey’s island rule is adopted to examine the seasonal variation of the SEC bifurcation. This time-dependent island rule model simulates the seasonal SEC bifurcation well both in terms of its mean position and peak seasons. It provides a dynamic framework to clarify the baroclinic adjustment processes involved in the presence of an island.

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Wang, George, and Richard Macaulay. "PP142 Health Technology Assessment – A Major Bottleneck In Patient Access?" International Journal of Technology Assessment in Health Care 35, S1 (2019): 65. http://dx.doi.org/10.1017/s0266462319002563.

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IntroductionConditional marketing authorization (CMA) and accelerated assessment (AA) have been introduced to expedite the development of and access to therapies in Europe. However, to reach patients medicines must also be publicly reimbursed. This research evaluated the reimbursement of therapies which have received European CMA or underwent AA.MethodsMedicines that received CMA or underwent AA between January 2012 and December 2017 were identified. Appraisals of these medicines conducted by major European payer bodies were obtained from relevant websites and key data were extracted.ResultsOut of the 38 medicines that received a CMA, 83 percent (19/23) were assessed by the National Institute for Health and Care Excellence (NICE) and received positive decisions, compared with 57 percent (16/26) by the Scottish Medicines Consortium (SMC) (defined as recommended/restricted), 74 percent (14/19) by Gemeinsamer Bundesausschuss (G-BA) (defined as any level of additional benefit), and 29 percent by Haute Autorité de Santé (HAS) (amélioration du service médical rendu I-III). The median delay between CMA approval and positive health technology assessment (HTA) outcome was 13 months for NICE, 11 months for SMC, 7 months for G-BA, and 5 months for HAS. Thirty-two medicines underwent AA. Of these, 68 percent (17/25) were appraised by G-BA and received positive outcomes, compared with 29 percent (7/24) by HAS, 90 percent (19/21) by SMC, and 86 percent (18/21) by NICE. The median delay between AA approval and positive HTA outcome was 7.4 months for G-BA, 7.9 months for HAS, 11.7 months for SMC, and 11.8 months for NICE.ConclusionsCMA has expedited regulatory approval for products that address severe unmet needs. However, many of these products fail to gain public reimbursement, and even when they do there is a significant delay. AA provides market authorizations two months earlier than standard centralized assessment. Although high rates of positive payer outcomes have been achieved, the products typically experience substantial additional delays in securing public reimbursement. A parallel, cooperative approach among regulatory and HTA bodies across Europe is required to truly expedite patient access.

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Eren, Tülay, Gökşen İmamoğlu, Fatih Yildiz, Süheyla Arslan, Sultan Kocacan, Salih Çakar, Ozan Yazici, Doğan Yazılıtaş, Nuriye Özdemir, and Berna Öksüzoğlu. "Local treatment options for management of loco-regional esophageal squamous cell carcinoma." Romanian Journal of Military Medicine 122, no. 2 (August 1, 2019): 36–42. http://dx.doi.org/10.55453/rjmm.2019.122.2.7.

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Aim: Surgical treatment is the main treatment method for esophageal cancer. The prognosis is poor due to high local recurrence and distant metastasis rates. Study aims to evaluate the most effective local treatment modality esophageal squamous cell carcinoma (SCC) according to real life data. Method: 136 patients were studied retrospectively. All patients were middle or lower esophageal cancer and had the SCC histology. Patients were divided into the surgical resection, definitive CRT (dCRT), and multimodal treatment groups according to curative local treatment they received. Result: 32.4% were in the surgical, 36% were in the dCRT, and 31.6% were in the multimodal group. Median disease-free survival was 21 months (95% CI 14-27) in the surgical group, 8 months (95% CI 4-11) in the dCRT group, and 18 months (95% CI 0-39) in the multimodal group (p=0.059). The median overall survival was found to be 40 months (95% CI 0-92) in the surgical group, 19 months (95% CI 15-22) in the dCRT group, and 54 months (95% CI 11-96) in the multimodal group (p=0.012). In multimodal group, the number of patients receiving preoperative CRT was 25, and postoperative CRT was 18. Median OS was 47 months (95% CI 0-99) in the preoperative CRT group, and 64 months (NA) in the postoperative CRT group (p=0.302). Conclusion: DFS and OS contributions of multimodal treatment in esophageal SCC have been shown in the present study. The addition of CRT to surgery in the preoperative or postoperative period has a contribution independently of the treatment sequence.

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Reckamp, Karen L., Mary Weber Redman, Konstantin H. Dragnev, Liza C. Villaruz, Bryan A. Faller, Tareq Al Baghdadi, Susan Hines, et al. "Phase II randomized study of ramucirumab plus pembrolizumab versus standard of care for advanced non-small cell lung cancer previously treated with a checkpoint inhibitor: Toxicity update (Lung-MAP non-matched sub-study S1800A)." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 9075. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.9075.

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9075 Background: The therapeutic landscape in metastatic NSCLC has dramatically changed with approvals of immunotherapy agents in both treatment-naïve and previously treated cancer patients (pts) and irrespective of histology. Pts with tumors that develop resistance is a significant area of unmet need. Vascular endothelial growth factor (VEGF) has been shown to modulate the tumor immune microenvironment and combination immune checkpoint and VEGF/VEGF receptor inhibition have shown benefit in multiple tumor types. Lung-MAP is a master protocol for pts with stage IV, previously treated NSCLC. Pts who were not eligible for a biomarker-matched substudy enrolled in S1800A. The adverse event profile will be presented. Methods: S1800A is a phase II randomized trial for pts who previously received PD-1 or PD-L1 inhibitor therapy for at least 84 days and platinum-based doublet therapy with ECOG 0-1 stratified by PD-L1 expression, histology and intent to receive ramucirumab in the standard of care (SOC) arm. Pts were randomized 1:1 to pembrolizumab and ramucirumab P+R or SOC (docetaxel +R [SOC w R]; docetaxel, pemetrexed or gemcitabine [SOC wo R]). The primary endpoint was overall survival. Secondary endpoints included response, duration of response, investigator assessed-progression free survival and evaluation of toxicity. Results: From May 17, 2019 to November 16, 2020, 166 pts enrolled and 140 determined eligible [69 (49%) P+R; 46 (33%) SOC w R; 25 (18%) SOC wo R]. Treatments for those who received SOC wo R included 3 on docetaxel (19%); 12 on gemcitabine (75%); and on 1 on pemetrexed (6%). 131 were eligible for adverse event (AE) assessment. The most common AE were fatigue (38%), proteinuria (28%), hypertension (23%), diarrhea (22%) and hypothyroidism (22%) on P+R; fatigue (61%), anemia (48%), diarrhea (41%) and neutropenia (39%) on SOC w R and anemia (56%), leukopenia (56%), fatigue (44%) and neutropenia (44%) on SOC wo R. Grade ≥ 3 treatment-related AEs occurred in 32% of pts on P+R, 54% of pts on SOC w R and 56% of pts on SOC wo R. Cardiac and thromboembolic events occurred in 12% of pts on P+R, 11% of pts on SOC w R and 0% of pts on SOC wo R. Grade 5 AE occurred in 2 pts on P+R (respiratory failure and cardiac arrest), 3 pts on SOC w R (2 respiratory failure and sepsis) and 1 pt on SOC wo R (sepsis). Four patients were diagnosed with COVID-19 (1 on P+R and 3 on SOC) and 3 died (1 on P+R and 2 on SOC). Conclusions: Grade 3 toxicities were lower in P+R compared to SOC arms with or without R. Cardiac and thromboembolic events were similar in arms that included R. P+R was generally well-tolerated. Efficacy outcomes will be presented when data matures. Clinical trial information: NCT03971474.

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Martínez-López, D., D. Prieto-Peña, L. Sanchez-Bilbao, A. Herrero-Morant, C. Álvarez-Reguera, M. Trigueros-Vazquez, M. A. González-Gay, and R. Blanco. "POS1231 COVID-19 INFECTION IN RHEUMATIC IMMUNE-MEDIATED INFLAMMATORY DISEASES. EPIDEMIOLOGICAL STUDY IN A SINGLE UNIVERSITY HOSPITAL." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 899.1–899. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3039.

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Background:Immune-mediated inflammatory diseases (IMID) have an increased risk of infections due to the disease itself, and/or immunosuppressive therapy. Risk of COVID-19 infection in the different rheumatic IMID (R-IMID) remains controversial.Objectives:To assess the epidemiology and comorbidities of COVID-19 in R-IMID from a Single-University hospital.Methods:Cross-sectional study in a Single-University hospital. We included all consecutive patients with a diagnosis of a R-IMID and a positive test for COVID-19 up to November 6th, 2020. Medical records of 11,199 patients that suffered COVID-19 in our region, and 6891 with R-IMID from our hospital were reviewed. Incidence data in the different underlying R-IMID were calculated for patients with follow-up in our hospital. Confirmed infection was defined if the patient had a positive nasopharyngeal swab for SARS-CoV-2.Results:We included 147 patients from our region (96 women/51 men), mean age 60±18 years. Underlying R-IMID were: Rheumatoid arthritis (RA) (n=36, 24.5%), Axial spondyloarthritis/Psoriatic arthritis (SpA/PsA) (n=54, 36.7%), Polymyalgia Rheumatica (PMR) (n=16, 10.9%), systemic lupus erythematosus (SLE) (n=10, 6.8%), sarcoidosis (n=5, 3.4%), Sjögren’s syndrome (SS) (n=4, 2.7%), giant cell arteritis (GCA) (n=3, 2%), Behçet’s disease (n=3. 2%), ANCA-vasculitis (n=2, 1.4%) and systemic sclerosis (SSc) (n=1, 0.7%).Main comorbidities were hypertension (n=65, 44.2%), dyslipidemia (n=64, 43.5%), age higher than 65 years old (n=55, 37.4%), obesity (n=35, 23.8%), coronary vascular disease (n=27, 18.4%), diabetes mellitus (n=22, 15%), chronic obstructive pulmonary disease (n=15, 10.2%) and chronic kidney disease (n=15, 10.2%).Total cumulative COVID-19 incidence in all patients from our region was 1.9% (11,199 /582,905). From 147 patients with COVID-19 from our region, 115 (76 women/39 men; mean age, 59±18 years) were followed in our hospital. In the latter, the global cumulative incidence in R-IMID was 1.7% (115/6891), ranging from 1.3% in Systemic Scleroderma (SSc) and Giant Cell Arteritis (GCA) up to 5.3% in Behcet’s disease (Table 1 and Figure 1).Table 1.Incidence and relative risk of COVID-19 in patients with different R-IMID in a Single-University hospitalR-IMIDTotal cumulative incidence in our hospital(%)Relative risk (95% confidence interval)Global population582,905 inhabitants1.9-Global R-IMID6,891 patients1.70.9 (0.7-1)Behçet’s disease5.32.7 (0.9-8.2)ANCA-vasculitis3.51.8 (0.4-7.1)PMR2.81.4 (0.8-2.6)SS2.61.4 (0.5-3.6)SLE2.31.2 (0.6-2.3)Sarcoidosis2.31.2 (0.3-4.7)SpA/PsA2.21.1 (0.8-1.5)RA1.60.8 (0.6-1.2)GCA1.30.7 (0.2-2.8)SSc1.30.7 (0.1-4.6)GCA: Giant cell arteritis, PsA: Psoriatic arthritis, RA: Rheumatoid arthritis, SLE: Systemic lupus erythematosus, SpA: Axial spondyloarthritis, SSc: Systemic scleroderma.Figure 1.Number of patients with COVID-19 in different R-IMID in a Single-University hospital. Data are presented on a logarithmic scale.In addition, Relative Risk (RR) in different R-IMID compared to the general population was calculated (Table 1). Although RR did not reach statistical significance in any R-IMID, most R-IMID showed a tendency to a higher risk, with the exception of RA, GCA and SSc.Conclusion:In our series, the total cumulative incidence of COVID-19 in R-IMID was similar to the general population. Higher RR, without statistical significance, was observed in Behçet’s disease, ANCA-vasculitis and Polymyalgia Rheumatica.GCA: Giant cell arteritis, PsA: Psoriatic arthritis, RA: Rheumatoid arthritis, SLE: Systemic lupus erythematosus, SpA: Axial spondyloarthritis, SSc: Systemic scleroderma.Disclosure of Interests:David Martínez-López: None declared, Diana Prieto-Peña Grant/research support from: UCB Pharma, Roche, Sanofi, Pfizer, Abbvie, Lilly, Lara Sanchez-Bilbao: None declared, Alba Herrero-Morant: None declared, Carmen Álvarez-Reguera: None declared, Martin Trigueros-Vazquez: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi and MSD., Consultant of: Abbvie, Pfizer, Roche, Sanofi and MSD., Grant/research support from: Abbvie, MSD, Jansen, Roche, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Grant/research support from: Abbvie, MSD and Roche

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Kim, Bum Joon, and Jung Sik Kim. "Dual MOSFET Hydrogen Sensors with Thermal Island Structure." Key Engineering Materials 543 (March 2013): 93–96. http://dx.doi.org/10.4028/www.scientific.net/kem.543.93.

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A low powered hydrogen gas sensor of the FET (field-effect transistor) structure was designed, fabricated and characterized for self-compensation to outer environments. The dual-gate FET hydrogen sensor was integrated with a micro-heater and two Pt-gate FETs; a sensing device for hydrogen detection, and a reference device as an electrical compensator. The identical output between the sensitive-FET and reference-FET was stable at temperatures ranging from room temperature to 250°C due to the same temperature dependence of the currentvoltage (IV) characteristics. The Pt-FET sensor showed stable responses to hydrogen at a range of operation temperatures. The optimal point in the micro-heater operation for 5,000 ppm H2 gas injection was approximately 150°C. The highest sensitivity was 0.112 mA, and the response and recovery times were 18 sec and 19 sec, respectively. The low-power MOSFET gas sensor was found to be suitable for applications in portable gas monitoring units and automobiles.

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Afsah, Elsayed M., Metwally Hammouda, Mona M. Khalifa, and Essam H. Al-shahaby. "Mannich Bases as Synthetic Intermediates: Alkylation of Amines and Diamines with Bis-ketonic Mannich Bases." Zeitschrift für Naturforschung B 63, no. 5 (May 1, 2008): 577–84. http://dx.doi.org/10.1515/znb-2008-0516.

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The bis-ketonic Mannich base, N,N-bis(β -benzoylethyl)methylamine hydrochloride (1) reacts with primary arylamines and diamines to give ketonic sec-arylamines 3a - e and 4. The piperidines 7a - c were obtained from 1 and primary alkylamines, whereas the 1,4-diazepine derivative 10 was obtained from 1 and ethylenediamine. Treatment of the bis-base 1,4-di[β -(N-morpholino)propionyl]benzene bis(hydrochloride) (11) with primary arylamines gave the corresponding bis-(sec-arylamines) 12a - b, whereas its reaction with ophenylenediamine afforded the bis[1,5-benzodiazepine] ring system 14. The synthesis of the diazacyclophane ring system 15 has been achieved by treating 11 with piperazine. Attempted synthesis of 4- aza-[7]-paracyclophane (16) from 11 and benzylamine led to 17. The reaction of 1 or 11 with phenylhydrazine gave the 2-pyrazolines 18 and 19. Treatment of 3 or 4 with phenylhydrazine and formaldehyde afforded the 2H-1,2,4-triazepines 20a - c and the bis[2H-1,2,4-triazepine] ring system 21.

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Cox, Justine, Nguyen V. Hue, Amjad Ahmad, and Kent D. Kobayashi. "Surface-applied or incorporated biochar and compost combination improves soil fertility, Chinese cabbage and papaya biomass." Biochar 3, no. 2 (January 29, 2021): 213–27. http://dx.doi.org/10.1007/s42773-020-00081-z.

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AbstractMany Hawaiian agricultural soils are acidic with low-nutrient retention; therefore, organic soil amendments are often used to improve soil properties and increase yields. Amendments can be incorporated for annual crops, but perennial orchards need surface application to avoid damaging surface roots. Pot trials compared responses to incorporated (IBC) or surface-applied (SBC) combination of hardwood biochar and chicken manure compost (4% v/v of each amendment) added to an Andisol and Oxisol. Soil pH was increased by 0.4–1.1 units in IBC and by 0.2–0.5 for SBC in the 0–10 cm soil layer. Both SBC and IBC increased soil total N, extractable P, Ca and Mg in the 0–10 cm soil layer. Soil pH, total C and extractable Ca were also higher in the 10–20 cm soil layer for IBC soil, indicating movement and/or leaching of amendments. Chinese cabbage biomass was 18–70% higher in the IBC and 14–47% higher in the SBC than that in the unamended soil, while papaya biomass was 23% and 19% higher in SBC and IBC, respectively. There was a greater response in the more acidic Andisol soil, with larger improvements in soil pH, plant nutrient uptake and root biomass than the Oxisol. Surface application was as effective in increasing plant growth as the incorporated amendment, providing evidence for farm scale assessment. Biochar and compost are recommended for use in tropical soils, and surface application may be beneficial to annual and perennial crops.

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Park, Chan Hong, and Sang Ho Lee. "Effect of lumbar epidural steroid injection on neuropathic pain: a prospective observational study." AIMS Neuroscience 9, no. 1 (2022): 24–30. http://dx.doi.org/10.3934/neuroscience.2022003.

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<abstract><sec> <title>Background</title> Low back pain (LBP) is caused by disc herniation, spinal stenosis, facet syndrome or etc. This LBP could be either nociceptive or neuropathic pain (NP). In addition, these neuropathic pain is a major contributor to chronic low back pain. It is already known that lumbar epidural steroid injection (ESI) is effective for low back pain, but no study has assessed both nociceptive and neuropathic pain separately. This study investigated whether neuropathic or nociceptive pain was better improved after an epidural steroid injection. </sec><sec> <title>Methods</title> This was a prospective study. Patients were classified according to the pre-procedure painDETECT questionnaire (PD-Q) score. If the PD-Q score was ≤12, it was considered as nociceptive pain, and it the PD-Q was ≥19, it was considered NP. The patients were given a transforaminal (TF) or interlaminar (IL) epidural steroid injection (ESI). The PD-Q was filled out by each patient prior to the ESI (baseline), and again at 4 weeks after the ESI. Outcomes was assessed using a numerical rating scale (NRS) score, short form McGill Pain Questionnaire (MPQ), and revised Oswestry Back Disability Index (ODI) at 1 month later. </sec><sec> <title>Results</title> A total of 114 patients were enrolled and of these, 54 patients with a PD-Q score of ≤12 were classified into the nociceptive pain, and 60 patients with a PD-Q score ≥19 were classified into the neuropathic pain group. At 1 month after treatment, both groups had significantly lower than improved their mean NRS score. Not withstanding these improvements and difference between NRS, the differences in MPQ and ODI after treatment between the groups (nociceptive vs. neuropathic) not significant. After the procedure (TF-ESI or IL-ESI), the patients in group 1 (PD-Q score ≤12, n = 54) had no change in their PD-Q score. Among the patients in group 2 (pre-treatment PD-Q score ≥19, n = 41), 13 patients moved to a PD-Q score <12 and 15 patients had a PD-Q score of 13–18. </sec><sec> <title>Conclusion</title> For the short-term relief of neuropathic pain, ESI was effective for both nociceptive and neuropathic pain, therefore ESI could be treat the try neuropathic pain component in patients with low back pain. </sec></abstract>

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Begum, Fatima, Chaudhury Meshkat Ahmed, Enamul Kabir, Nurun Nahar, Sadia Sultana, Sajal Banerjee, Shahana Afroz, and Nazma Zaman. "Early Cardiac Changes in Radioiodine Treated Young Athyrotic Patients Receiving Thyroid Stimulating Hormone (TSH) Suppressive Levothyroxine (LT4) Replacement." Bangladesh Journal of Nuclear Medicine 18, no. 1 (December 24, 2017): 9–15. http://dx.doi.org/10.3329/bjnm.v18i1.34925.

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Objective: The objective of this study was to evaluate early changes of heart due to thyroid stimulating hormone (TSH) suppressive levothyroxine (LT4) replacement in young athyrotic patients with differentiated thyroid carcinoma (DTC). Materials andMethods: Thirty young athyrotic patients with DTC, age ranged 20-39 years after radioactive iodine ablation therapy (RAIT), were selected prospectively. These patients had been receiving 200µg/day LT4 replacement therapy starting from the third day of RAIT. Age, sex, body mass index (BMI), body surface area (BSA) and life style matched 23 healthy volunteers were recruited in the study. Clinical, thyroid hormones levels and Doppler Echocardiographic and Tissue Doppler Imaging (TDI) data were taken at baseline at two months of initiation of LT4 replacement in patients with DTC and in healthy volunteers. Echocardiographic data of patients with DTC were repeated at second visit after 6-12 months of RAIT and both data compared with control.Results: Diastolic parameters evaluated by Doppler Echocardiography and TDI were significantly different in patients with DTC compared to control. Early diastolic tissue velocity (Em) in patients with DTC showed higher value at second visit compared to control (Em, control subjects, 19±6 cm /sec, patients at second visit, 23 ± 4 cm /sec, p<0.03). Late diastolic flow (Am) of patients was higher at two visits (Am, at first visit, 15±5 cm/sec; at second visit, 19 ± 6 cm/sec) (p<0.004) compared to control (Am, 9 ± 1.6 cm/sec). Modified Tei index was significantly increased (mean 0.48 ± 0.06) in second visit in patients with DTC compared to control (mean 0.33 ± 0.04) and at first visit (mean 0.31 ± 0.05, p<0.001) respectively.Conclusion: It is concluded that supraphysiologic dose of LT4 has side effects on heart even within short period of replacement. TDI is an important tool to evaluate the early changes in myocardium.Bangladesh J. Nuclear Med. 18(1): 9-15, January 2015

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Sampimon, Otlis, Bart HP van den Borne, Inge Santman-Berends, Herman W. Barkema, and Theo Lam. "Effect of coagulase-negative staphylococci on somatic cell count in Dutch dairy herds." Journal of Dairy Research 77, no. 3 (May 10, 2010): 318–24. http://dx.doi.org/10.1017/s0022029910000191.

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The effect was quantified of coagulase-negative staphylococci (CNS) intramammary infections on quarter- and cow-level somatic cell count (SCC) and on bulk milk somatic cell count (BMSCC) in different BMSCC cohorts in Dutch dairy herds. Two datasets were used for this purpose. In the first dataset, on 49 randomly selected dairy farms a total of 4220 quarter milk samples of 1072 cows were collected of all cows and heifers with a test-day SCC ⩾250 000 and ⩾150 000 cells/ml, respectively, and of 25% of cows and heifers below these thresholds. In the second dataset, on 39 selected dairy farms a total of 8329 quarter milk samples of 2115 cows were collected of all cows with a test-day SCC ⩾250 000 cells/ml following two consecutive SCC <250 000 cells/ml, and of heifers using the same SCC criteria but with a threshold of 150 000 cells/ml. These cows and heifers were defined as new high SCC. In both datasets, CNS was the most frequently isolated pathogen, 11% in the first dataset and 12% in the second dataset. In both datasets, quarters with CNS IMI had a lower SCC than quarters infected with major pathogens, and a higher SCC than culture-negative quarters. The same was found for SCC at cow level. Coagulase-negative staphylococci were more often found in quarters with SCC ⩾200 000 cells/ml in dairy farms with a BMSCC <150 000 cells/ml compared with dairy farms with a higher BMSCC. Prevalence of CNS in cows and heifers with a high SCC was higher in dairy farms with a BMSCC <150 000 cells/ml compared with dairy farms with a medium or high BMSCC: 30, 19 and 18%, respectively. This indicates that CNS IMI as a cause of subclinical mastitis is relatively more important in dairy farms with a low BMSCC and may become a point of attention in udder health management on that type of farm.

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Beets, Michael W., Robert G. Weaver, Aaron Beighle, Collin Webster, and Russell R. Pate. "How Physically Active Are Children Attending Summer Day Camps?" Journal of Physical Activity and Health 10, no. 6 (August 2013): 850–55. http://dx.doi.org/10.1123/jpah.10.6.850.

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Background:Summer day camps (SDC) represent one of the largest settings, outside the academic school year, where children can engage in safe, enjoyable physical activity (PA). Yet, little is known about this setting and how active children are while attending.Methods:System for Observing Play and Leisure Activity in Youth was used to categorize PA of boys/girls as Sedentary/Walking/Vigorous across multiple days (8 AM to 6 PM) in 4 large-scale community-based SDCs. Contextual characteristics of type of activity, activity management, equipment, and in/outdoors were collected simultaneously. Mixed-model regression analyses examined associations between PA categories and contextual characteristics.Results:A total of 4649 scans of 2462 children were made across 27 days in the SDCs. Physical activity opportunities represented 38% of the daily schedule. Overall, 74%–79%, 13%–16%, and 7%–9% of children were observed Sedentary, Walking, or Vigorous during the SDC, and this changed to 62%–67%, 18%–19%, and 15%–18% observed Sedentary, Walking, or Vigorous during PA opportunities. Water-based PA, equipment, and free-play were related to increased PA. Children waiting-in-line for turns, staff instructing, and organized PA were related to increased sedentary.Conclusions:These findings provide evidence of modifiable characteristics of SDCs associated with PA. Improving staff skills related to facilitating active environments is a viable avenue to increase PA accumulated within SDCs.

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Ramzy, J. A., R. Rengan, M. Mandal, S. Rani, M. E. Vega Sanchez, F. Jaffe, G. D’Alonzo, et al. "0567 Hypoxic Burden and Apnea-Hypopnea Duration in Patients with Positional Obstructive Sleep Apnea." Sleep 43, Supplement_1 (April 2020): A217—A218. http://dx.doi.org/10.1093/sleep/zsaa056.564.

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Abstract Introduction Recently, the measurement of the hypoxic burden and apnea-hypopnea duration has been shown to correlate with mortality in patients with obstructive sleep apnea (OSA). We hypothesized that in patients with mild positional OSA (apnea-hypopnea index [AHI] < 5 events/hr in the non-supine position) the hypoxic burden would be increased and apnea-hypopnea duration shortened and similar to patients with non-positional OSA. Methods Fourteen patients with positional OSA and 24 patients non-positional OSA with similar severity of OSA based on the respiratory event index (REI) were included. All patients had a home sleep apnea test for suspected OSA. The hypoxic burden was calculated by the multiplication of REI and the mean area under the desaturation curves. Results Thirty-eight patients [12 (35%) males, 50±12 yrs, BMI 35±7 kg/m2, Epworth Sleepiness Scale (ESS) 11±8, REI 10±3 events/hr, apnea-hypopnea duration 19±4 sec, mean SaO2 94±2%, lowest SaO2 79±8%, % total sleep time (TST) SaO2 < 90% 11±16%, hypoxic burden 30±17 %min/hr] completed the study. Fourteen patients [9 (64%) males, 46±14 yrs, BMI 31±6 kg/m2, ESS 7±5, REI 9±3 events/hr, mean SaO2 94±2%, lowest SaO2 81±6%, %TST SaO2 < 90% 4±6%] had positional OSA (supine REI 16±7 events/hr, non-supine REI 3±1 events/hr) and 24 patients had non-positional OSA [3 (13%) males, 52±10 yrs, BMI 38±7 kg/m2, ESS 12±9, REI 10±3 events/hr, mean SaO2 94±2%, lowest SaO2 77±9%, %TST SaO2 < 90% 14±19%]. The hypoxic burden was elevated in both the positional and non-positional OSA patients with no difference between the groups (26±19 %min/hr and 32±15 %min/hr, respectively, p=0.13). The apnea-hypopnea duration was similar in positional and non-positional OSA patients (20±3 sec and 18±4 sec, respectively, p=0.08 sec). Conclusion In patients with mild positional OSA the hypoxic burden, which has been associated with cardiovascular mortality, is elevated and similar to patients with non-positional OSA. Support None

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Balasingh, C., Alias Abuhasan, and P. K. Predecki. "Diffraction Peak Broadening Studies in Al2O3 (Whisker) Composites." Powder Diffraction 6, no. 1 (March 1991): 16–19. http://dx.doi.org/10.1017/s0885715600016791.

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AbstractDiffraction peak broadening analyses were carried out on diffraction profiles of several reflections from hot-pressed α-Al2O3 containing 29, 18 and 10 volume % β-SiC whiskers. The data were analyzed and compared using four different integral breadth methods for microstrain and crystalline size. All four methods gave comparable results, within an order of magnitude, for the microstrains in each phase: (2-15 × 10−4 for the matrix and (6-19 × 10−4 for the whiskers). Microstrains in both matrix and whiskers decreased with decreasing volume % of whiskers for all four methods. Trends in the crystallite size were less consistent but for the matgrix, an incrfease from ∼665 to 1565Å was found with decreasing whisker content using DeKeijser's method.

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Salgado, Doris Martha, Martha Rocío Vega, Cesar Alberto Panqueba, Carlos Fernando Narváez, and Jairo Antonio Rodríguez. "Análisis descriptivo del compromiso de órganos en niños con dengue grave en Neiva, Colombia." Revista de la Facultad de Medicina 65, no. 4 (October 1, 2017): 565–70. http://dx.doi.org/10.15446/revfacmed.v65n4.59835.

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Introducción. La infección por dengue puede comprometer órganos como el miocardio y el hígado. Tal hecho puede agravar la evolución clínica, por ello estos órganos han sido considerados en la clasificación revisada de la Organización Mundial de la Salud (OMS) para esta enfermedad.Objetivo. Describir la presencia de afectación por dengue en órganos como miocardio, hígado y sistema nervioso central (SNC) en niños de Neiva, ColombiaMateriales y métodos. Este estudio analizó 930 niños con diagnóstico de dengue confirmado que ingresaron al Hospital Universitario Hernando Moncaleano Perdomo de Neiva entre enero de 2009 y diciembre de 2010. Para el diagnóstico y estratificación clínica se usó la clasificación revisada de la OMS. La infección por dengue se confirmó por detección plasmática de NS1 o IgM específica. Se realizó seguimiento clínico y paraclínico diario durante toda la hospitalización.Resultados. De los 930 niños, 105 fueron clasificados como dengue grave (DG) y, de estos, 19 presentaron órganos afectados. El miocardio fue el más comprometido (14 casos), seguido por el hígado (4 casos) y el SNC (1 caso).Conclusión. El compromiso clínico del miocardio, el hígado o el SNC se observó en el 18% de los casos de niños con DG. Es necesario un diagnóstico y tratamiento oportuno de esta patología en niños.

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Maziarz, Richard T., Mrinal M. Patnaik, Bart L. Scott, Sanjay R. Mohan, Abhinav Deol, Scott D. Rowley, Dennis Dong Hwan Kim, et al. "Radius: A Phase 2, Randomized Trial of Standard of Care (SOC) with or without Midostaurin to Prevent Relapse Following Allogeneic Hematopoietic Stem Cell Transplant (alloHSCT) in Patients (pts) with FLT3-Itd-Mutated Acute Myeloid Leukemia (AML)." Blood 128, no. 22 (December 2, 2016): 2248. http://dx.doi.org/10.1182/blood.v128.22.2248.2248.

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Abstract Introduction Midostaurin is an orally available multikinase inhibitor that blocks FLT3 kinase activity. FLT3 mutations are associated with more frequent and earlier relapses and worse survival. The phase 3 RATIFY trial showed that midostaurin compared with placebo improved overall and event-free survival in newly diagnosed pts with FLT3-mutated AML when administered in combination with standard chemotherapy and as single-agent maintenance (Stone et al, ASH 2015). The ongoing RADIUS trial (NCT01883362) is investigating whether adding midostaurin to SOC after alloHSCT reduces the risk of relapse in pts with FLT3-ITD-mutated AML. Here we report safety data from the first 56 enrolled pts. Methods RADIUS is a randomized, open-label, phase 2 study comparing SOC vs midostaurin + SOC after alloHSCT in adult pts with AML with FLT3-ITD mutations (planned enrollment, N = 60). Study treatment started 28-60 days after alloHSCT. SOC was dictated by the treating physician. Pts were randomized to either SOC or midostaurin 50 mg twice daily + SOC (hereafter called the midostaurin arm) continuously for ≤ 12 months and will be followed up for ≥ 24 months. The study was designed to look for any safety or efficacy signals and not powered to find differences between study treatments. The primary endpoint is relapse-free survival at 18 months after alloHSCT. Adverse events (AEs) were followed up for 30 days after treatment. Key inclusion criteria are documented FLT3-ITD mutation, age 18-70 years, and first complete remission status. Pts could enroll after the date of engraftment and hematologic recovery to an absolute neutrophil count > 1000/μL and platelet count ≥ 20,000/μL without requiring transfusion. Results Pts were randomized from Feb 5, 2014, to Jun 13, 2016. The 2 arms (n = 28 each) were balanced regarding age, sex, and race. Most pts (93%) had de novo AML. At data cutoff (Jun 3, 2016), data were not mature enough to evaluate efficacy. Median (range) follow-up in the SOC and midostaurin arms was 240 (3-786) and 234 (3-656) days, respectively. Overall, 18 pts (64%) in the SOC arm and 19 pts (68%) in the midostaurin arm stopped treatment. Of these, 10 (36%) and 8 (29%) in the SOC and midostaurin arms, respectively, completed 12 months of treatment. Other reasons for stopping treatment were relapse (2 [7%] and 2 [7%]), death (2 [7%] and 0 [0%]), administrative problems (2 [7%] and 1 [4%]), withdrawn consent (1 [4%] and 3 [11%]), abnormal test results (1 [4%] and 0 [0%]), and AEs (0 [0%] and 4 [14%]). In the 24 pts who received ≥ 1 dose in the midostaurin arm, the median midostaurin dose was 76.2 (range, 25-100) mg daily. In the 15 pts (54%) who required a dose change, the reasons for dose changes were AEs (13 [46%]), dosing error (3 [11%]), re-escalation (3 [11%]), abnormal test results (2 [7%]), per protocol (2 [7%]), use of concomitant strong CYP3A4 inhibitors (1 [4%]), and other reasons (4 [14%]). The most common any-grade (Gr) AEs were fatigue (29%) and AST, headache, nausea and vomiting (all 25%) in the SOC arm and nausea and vomiting (both 64%) and diarrhea (43%) in the midostaurin arm (Figure 1). The most common Gr 3/4 AEs were nausea and hypertension in the SOC arm (all 3 [11%] each) and diarrhea, increased ALT, neutrophil count decreased (all 3 [11%] each) and platelet count decreased (5 [18%]) in the midostaurin arm. No on-treatment deaths occurred in the midostaurin arm. AEs led to discontinuation of midostaurin in 4 pts and included Gr 1 nausea, Gr 2 nausea and vomiting, Gr 3 lung infection, and Gr 2 elevated liver enzymes (n = 1 each). All of these except the lung infection were considered related to midostaurin. Graft-vs-host disease (GVHD) occurred in 16 pts (57%) in the SOC arm and 18 pts (64%) in the midostaurin arm (Figure 2). No stage ≥ 3 organ involvement occurred. Most cases of GVHD (11 [39%] in the SOC arm and 17 [61%] in the midostaurin arm) were acute. The most commonly affected organ was the skin (11 [39%] and 13 [46%], respectively, of which 5 [18%] and 4 [14%], respectively, were stage 2). Conclusions The preliminary safety data in the post-alloHSCT setting was consistent with data from other studies. Rates of Gr 1/2 nausea, vomiting, and diarrhea were higher in the midostaurin arm. Midostaurin did not change rates of GVHD. Because of the limited duration of follow-up, effects on chronic GVHD are unknown. Follow-up is ongoing, with efficacy data anticipated in 2017. Disclosures Maziarz: Athersys: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Membership on an entity's Board of Directors or advisory committees; Novartis Pharmaceuticals Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Scott:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Research Funding, Speakers Bureau; Alexion: Speakers Bureau; Agios: Membership on an entity's Board of Directors or advisory committees. Deol:Jazz Pharmaceuticals: Consultancy. Haines:Novartis: Employment. Bonifacio:Novartis: Employment. Rine:Novartis: Employment. Fernandez:Fate Pharmaceuticals: Honoraria; Chimerix: Honoraria; Sanofi: Speakers Bureau.

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