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Al-Hourani, K., M. Stoddart, U. Khan, A. Riddick, and M. Kelly. "Orthoplastic reconstruction of type IIIB open tibial fractures retaining debrided devitalized cortical segments." Bone & Joint Journal 101-B, no. 8 (August 2019): 1002–8. http://dx.doi.org/10.1302/0301-620x.101b8.bjj-2018-1526.r2.
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AimsType IIIB open tibial fractures are devastating high-energy injuries. At initial debridement, the surgeon will often be faced with large bone fragments with tenuous, if any, soft-tissue attachments. Conventionally these are discarded to avoid infection. We aimed to determine if orthoplastic reconstruction using mechanically relevant devitalized bone (ORDB) was associated with an increased infection rate in type IIIB open tibial shaft fractures.Patient and MethodsThis was a consecutive cohort study of 113 patients, who had sustained type IIIB fractures of the tibia following blunt trauma, over a four-year period in a level 1 trauma centre. The median age was 44.3 years (interquartile range (IQR) 28.1 to 65.9) with a median follow-up of 1.7 years (IQR 1.2 to 2.1). There were 73 male patients and 40 female patients. The primary outcome measures were deep infection rate and number of operations. The secondary outcomes were nonunion and flap failure.ResultsIn all, 44 patients had ORDB as part of their reconstruction, with the remaining 69 not requiring it. Eight out of 113 patients (7.1%) developed a deep infection (ORDB 1/44, non-ORDB 7/69). The median number of operations was two. A total of 16/242 complication-related reoperations were undertaken (6.6%), with 2/16 (12.5%) occurring in the ORDB group.ConclusionIn the setting of an effective orthoplastic approach to type IIIB open diaphyseal tibial fractures, using mechanically relevant debrided devitalized bone fragments in the definitive reconstruction appears to be safe. Cite this article: Bone Joint J 2019;101-B:1002–1008.
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Mahmudova, U. "Systematic Structure, Biomorphology and Geographical Analysis of the Flora of Ganja City and Its Surroundings." Bulletin of Science and Practice, no. 11 (November 15, 2022): 83–91. http://dx.doi.org/10.33619/2414-2948/84/11.
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In the given article, the flora of Ganja city and its surrounding areas was studied, the plants were systematically, biomorphologically, geographically, ecologically, and endemically analyzed. The article also analyzed rare and endangered plants on scientific basis. In the researched region, 68 families, 244 genera, and 441 species of plants were identified. It is reported that the basis of the flora composition of the territories is angiosperms, the leading families of which are Poaceae with 38 genera (15.6%), 63 species (14.3%), Fabaceae 23 genera (9.4%), 48 species (10.9%); Asteraceae is represented by 15 genera (6.6%), 35 species (7.9%). It was determined that the composition of the flora of the study area is dominated by perennial grasses with 194 species (44%).
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Bouza, Carmen, and Teresa López-Cuadrado. "Epidemiology and Trends of Sepsis in Young Adults Aged 20–44 Years: A Nationwide Population-Based Study." Journal of Clinical Medicine 9, no. 1 (December 27, 2019): 77. http://dx.doi.org/10.3390/jcm9010077.
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Background: While sepsis may have especially marked impacts in young adults, there is limited population-based information on its epidemiology and trends. Methods: Population-based longitudinal study on sepsis in adults aged 20–44 years using the 2006–2015 Spanish national hospital discharge database. Cases are identified by an ICD-9-CM coding strategy. Primary endpoints are incidence and in-hospital mortality. Trends are assessed for annual percentage change (AAPC) in rates using Joinpoint regression models. Results: 28,351 cases are identified, representing 3.06‰ of all-cause hospitalisations and a crude incidence of 16.4 cases/100,000 population aged 20–44. The mean age is 36 years, 58% of cases are men, and around 60% have associated comorbidities. Seen in one third of cases, the source of infection is respiratory. Single organ dysfunction is recorded in 45% of cases. In-hospital mortality is 24% and associated with age, comorbidity and extent of organ dysfunction. Incidence rates increase over time in women (AAPC: 3.8% (95% CI: 2.1, 5.5)), whereas case-fatality decline with an overall AAPC of −5.9% (95% CI −6.6, −5.2). Our results indicate that sepsis is common in young adults and associated with high in-hospital mortality, though it shows a decreasing trend. The substantial increase in incidence rates in women needs further research.
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Zingela, Zukiswa, Louise Stroud, Johan Cronje, Max Fink, and Stephan Van Wyk. "A prospective descriptive study on prevalence of catatonia and correlates in an acute mental health unit in Nelson Mandela Bay, South Africa." PLOS ONE 17, no. 3 (March 8, 2022): e0264944. http://dx.doi.org/10.1371/journal.pone.0264944.
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Catatonia is a psychomotor abnormality caused by neurological, medical or severe psychiatric disorders and substances. Its prevalence ranges from less than 10% to just above 60%. Diagnosis may be influenced by the screening tools used. Screening of new admissions to a mental health unit for catatonia was undertaken using three instruments to determine prevalence of catatonia. Participants ranged from age 16 years and over. Recruitment took place from September 2020 to August 2021. The setting was a mental health unit within a general hospital in Nelson Mandela Metro, South Africa. Five assessors were trained by the principal investigator to apply the Bush Francis Screening Instrument (BFCSI), the Bush Francis Catatonia Rating Scale (BFCRS), and the Diagnostic and Statistical Manual 5 (DSM-5), to assess participants. Clinical and demographic data were collected using a specially designed datasheet. Data analysis was performed to identify significant associations between presence or absence of catatonia and clinical and demographic data. Up to 241 participants were screened and 44 (18.3%) had catatonia. All 44 cases were identified through the BFCSI while the DSM-5 identified only 16 (6.6%%) of the 44 cases even though the remaining 28 (63.6%) participants still required treatment for catatonic symptoms. The DSM-5 diagnostic criteria excluded staring, which was the commonest sign of catatonia identified through the BFCSI [n = 33 (75%)]. Close to half (21; 47.7%) of those with catatonia on the BFCSI had schizophrenia. The rest had bipolar disorder (12; 27.3%), substance-induced psychotic disorder (7; 15.9%) and no specified diagnosis in one (1; 2.6%). The BFCSI was very effective at identifying catatonia while the DSM-5 was inadequate, missing close to 64% (28 of 44) of cases. Predictors of catatonia in this sample were a younger age and being male. A prevalence of 18.3%, indicates that assessment for catatonia should be routinely conducted in this and similar settings.
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Fedorov, S. A., A. P. Medvedev, A. L. Maksimov, N. Yu Borovkova, M. B. Sukhanova, V. V. Pichugin, S. A. Zhurko, L. M. Tselousova, and Yu D. Brichkin. "The first experience of treatment applied to patients with pulmonary embolism that developed on the COVID-19 background." Clinical Medicine (Russian Journal) 98, no. 8 (February 7, 2021): 612–18. http://dx.doi.org/10.30629/0023-2149-2020-98-8-612-618.
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The aim of the study was to evaluate the immediate results of treatment of high-risk PE developed against the background of COVID-19, and to analyze the features of the clinical course. Material and methods. The study is based on the experience of treatment applied to three patients with pulmonary embolism (PE) that developed against the background of COVID-19. The group under consideration is represented by males. The average age was 41 ± 3.1 years old. Verification of the primary diagnosis of COVID-19 was based on positive results of polymerase chain reaction, supplemented by the results of computed tomography. The formation of high-risk PE was noted on the 5th–7th day from the moment of hospitalization. There was also a decrease in SO2 below 85%, РаО2 — below 76 mm Hg, Borg index > 8, which required non-invasive high-flow ventilation. Catheterization of the right chambers of the heart with a Swan–Ganz catheter revealed an increase in systolic pressure in the right ventricle to 57 ± 1.2 mm Hg, and diastolic pressure to 13 ± 0.34 mm Hg. Pulmonary hypertension increased up to 70 mm Hg. Changes in the biochemical analysis of blood consisted in increasing the level of troponin I to 0.65 ± 0.14 ng/ml, С reactive protein — to 5.42 ± 2.1 mg/l, and creatine phosphokinase — to 324 ± 23.1 units. An increase in the D-dimer level was observed (0.68 ± 0.11 mg/l). Systemic thrombolysis actilyse was performed in all the cases. Results. Positive clinical dynamics was observed up to 15 hours after thrombolytic therapy. The level of SO2 came back to the initial values and was in the range 93–96% and RaO2 — from 86–92 mm Hg by the end of the first day after the intervention. The average pressure gradient in the pulmonary artery was 32 ± 4.12 mm Hg at the time of discharge, and at the peak — 44 ± 5.3 mm Hg.
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Postma, Joeke, and Anita J. G. Luttikholt. "Colonization of carnation stems by a nonpathogenic isolate of Fusarium oxysporum and its effect on Fusarium oxysporum f.sp. dianthi." Canadian Journal of Botany 74, no. 11 (November 1, 1996): 1841–51. http://dx.doi.org/10.1139/b96-221.
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A nonpathogenic isolate of Fusarium oxysporum, 618-12, added to soil prior to the pathogen, suppressed fusarium wilt (F. o. f.sp. dianthi race 2) in a susceptible cultivar of carnation by 80% compared with the treatment with the pathogen only. The possibility of systemically induced resistance by the nonpathogenic isolate was assessed by inoculating antagonist and pathogen at different locations (stem versus soil, soil versus stem, and in a split-root system). No significant disease suppression was found with any of these spatially separated inoculations. However, inoculation of antagonist and pathogen at the same location within the stem (i.e., mixed stem inoculation) resulted in significant and reproducible disease reductions compared with stem inoculation with the pathogen alone. This reduction was found for different inoculum densities and different cultivars. Several other nonpathogenic Fusarium isolates could also reduce wilt symptoms in the susceptible carnation cultivar after mixed stem inoculation with the pathogen. This disease-suppressive effect after mixed stem inoculations may be caused by locally induced resistance or competition between isolates within the stem. Plants showed vascular browning around the inoculation point following inoculation with nonpathogenic isolates. Disease suppression, as well as vascular browning, were absent when dead conidia of the isolate 618-12 were used. After its addition to soil, the isolate was recovered from 44–78% of carnation stems. Spread of the nonpathogenic isolate within the stem occurred only in the first 4 days after stem inoculation, and it remained confined to limited distances from the inoculation point between 4 and 59 days after inoculation. The pathogenic isolate could be isolated at increasingly greater distances from the inoculation point during this period. These data suggest that the nonpathogenic isolate is not actively spread through the plant by growth of the fungus. Keywords: biological control, competition, induced resistance, wilt.
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Krause, Bernd J., Kim N. Chi, A. Oliver Sartor, Karim Fizazi, Michael J. Morris, Johann S. De Bono, Scott T. Tagawa, et al. "Tumor dosimetry of [177Lu]Lu-PSMA-617 for the treatment of metastatic castration-resistant prostate cancer: Results from the VISION trial sub-study." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): 5046. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.5046.
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5046 Background: In VISION, lutetium (177Lu) vipivotide tetraxetan ([177Lu]Lu-PSMA-617; 177Lu-PSMA-617) plus protocol-permitted standard of care (SoC) significantly improved overall survival and radiographic progression-free survival compared with SoC alone, in patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer. In a VISION dosimetry sub-study, 177Lu-PSMA-617 had a good safety profile with low radiotoxicity in at-risk organs. Here, we estimated the dosimetry of tumors after administration of 177Lu-PSMA-617. Methods: The VISION sub-study was performed in a separate cohort of 29 non-randomized participants at four sites in Germany. Eligible patients received 177Lu-PSMA-617 (7.4 GBq every 6 weeks, ≤ 6 cycles) plus SoC. Patients underwent single-photon emission computed tomography/computed tomography (SPECT/CT) scans at approximately 2, 24, 48 and 168 hours after the first administration of 177Lu-PSMA-617 (Cycle 1). Up to five tumors in each patient were selected according to tumor size and relative activity uptake. Tumor delineation, volume and morphology were determined using positron emission tomography (PET)/CT images. Kinetic (time-activity) data was determined using SPECT images and the application of phantom derived recovery coefficients. Tumor dosimetry was estimated using the standard Medical Internal Radiation Dose/Radiation Dose Assessment Resource (MIRD/RADAR) method for internal dosimetry. S-values were determined using CT-derived tumor volumes and tissue type as input to the Internal Dose Assessed by Computer (IDAC-Dose) 2.1 program. Tumor dosimetry estimates were reported as absorbed dose per unit activity (Gy/GBq) and cumulative estimated absorbed dose (Gy) over all 6 cycles (44.4 GBq cumulative activity). Results: In total, 104 tumors were analyzed after administration of 177Lu-PSMA-617 in Cycle 1. Tumor sites included bone (n = 84), lymphatic tissue (n = 18), lung tissue (n = 1) and soft tissue (n = 1). Mean tumor mass by site was 14.6 (standard deviation [SD], 29.8; range, 0.49–224) g for bone and 12.5 (15.9; 0.68–60.7) g for lymphatic tissue. The mean radiation-absorbed dose for all tumors was 6.5 (SD, 8.4; range, 0.13–55) Gy/GBq, and the median absorbed dose was 4.4 Gy/GBq. The mean radiation-absorbed dose by tumor site was 5.4 (SD, 6.0; range, 0.13–45) Gy/GBq for bone and 9.7 (12; 0.99–55) Gy/GBq for lymphatic tissue. The 6-cycle cumulative estimated absorbed dose for all tumors was 287 (SD, 373; range, 5.7–2432) Gy. The 6-cycle cumulative estimated absorbed dose by tumor site was 240 (SD, 268; range, 5.7–2010) Gy for bone and 429 (549; 44–2432) Gy for lymphatic tissue. Conclusions: Tumor dosimetry estimates after administration of 177Lu-PSMA-617 in the VISION sub-study patient population were consistent with previously published estimates. Clinical trial information: NCT03511664 .
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Gohar, Faekah, Janneke Anink, Halima Moncrieffe, Lisette W. A. Van Suijlekom-Smit, Femke H. M. Prince, Marion A. J. van Rossum, Koert M. Dolman, et al. "S100A12 Is Associated with Response to Therapy in Juvenile Idiopathic Arthritis." Journal of Rheumatology 45, no. 4 (January 15, 2018): 547–54. http://dx.doi.org/10.3899/jrheum.170438.
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Objective.Around one-third of patients with juvenile idiopathic arthritis (JIA) fail to respond to first-line methotrexate (MTX) or anti-tumor necrosis factor (TNF) therapy, with even fewer achieving ≥ American College of Rheumatology Pediatric 70% criteria for response (ACRpedi70), though individual responses cannot yet be accurately predicted. Because change in serum S100-protein myeloid-related protein complex 8/14 (MRP8/14) is associated with therapeutic response, we tested granulocyte-specific S100-protein S100A12 as a potential biomarker for treatment response.Methods.S100A12 serum concentration was determined by ELISA in patients treated with MTX (n = 75) and anti-TNF (n = 88) at baseline and followup. Treatment response (≥ ACRpedi50 score), achievement of inactive disease, and improvement in Juvenile Arthritis Disease Activity Score (JADAS)-10 score were recorded.Results.Baseline S100A12 concentration was measured in patients treated with anti-TNF [etanercept n = 81, adalimumab n = 7; median 200, interquartile range (IQR) 133–440 ng/ml] and MTX (median 220, IQR 100–440 ng/ml). Of the patients in the anti-TNF therapy group, 74 (84%) were also receiving MTX. Responders to MTX (n = 57/75) and anti-TNF (n = 66/88) therapy had higher baseline S100A12 concentration compared to nonresponders: median 240 (IQR 125–615) ng/ml versus 150 (IQR 87–233) ng/ml, p = 0.021 for MTX, and median 308 (IQR 150–624) ng/ml versus 151 (IQR 83–201) ng/ml, p = 0.002, for anti-TNF therapy. Followup S100A12 could be measured in 44/75 MTX-treated patients (34/44 responders) and 39/88 anti-TNF-treated patients (26/39 responders). Responders had significantly reduced S100A12 concentration (MTX: p = 0.031, anti-TNF: p < 0.001) at followup versus baseline. Baseline serum S100A12 in both univariate and multivariate regression models for anti-TNF therapy and univariate analysis alone for MTX therapy was significantly associated with change in JADAS-10.Conclusion.Responders to MTX or anti-TNF treatment can be identified by higher pretreatment S100A12 serum concentration levels.
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Hornak, Joseph Patrik, and David Reynoso. "44. Antibiotic Class-Based Distribution and Analysis of Reported Beta-Lactam Allergies amongst Hospitalized Patients." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S45. http://dx.doi.org/10.1093/ofid/ofaa439.089.
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Abstract Background Reported β-lactam allergy (BLA) is very common, yet less than 10% of these patients exhibit true hypersensitivity. When faced with reported BLAs, physicians often choose alternative antibiotics which can be associated with C. difficile infection, drug-resistance development, poorer outcomes, & increased costs. Effective identification of these patients is necessary for subsequent, appropriate BLA “de-labeling.” Here, we conducted a single-center analysis of alternative antibiotic utilization amongst patients reporting BLA and compare the frequency of drug-resistant infections and C. difficile infection in allergic & non-allergic patients. Methods This is a retrospective review of adult patients hospitalized at The University of Texas Medical Branch from 1/1/2015 to 12/31/2019. Pooled electronic medical records were filtered by antibiotic orders and reported allergies to penicillins or cephalosporins. Patients with drug-resistant and/or C. difficile infection (CDI) were identified by ICD-10 codes. Microsoft Excel & MedCalc were used for statistical calculations. Results Data were available for 118,326 patients and 9.3% (11,982) reported a BLA, with the highest rates seen in those receiving aztreonam (85.9%, 530/617) & clindamycin (33.7%, 3949/11718). Amongst patients reporting BLA, high ratios-of-consumption (relative to all patients receiving antibiotics) were seen with aztreonam (7.0), clindamycin (2.7), cephalosporin/β-lactamase inhibitors (2.4), & daptomycin (2.1). Compared to the non-BLA population, BLA patients more frequently experienced MRSA infection (3.0% vs 1.5%, OR 1.99, 95% CI 1.79–2.23, p< 0.0001), β-lactam resistance (1.2% vs 0.6%, OR 2.07, 95% CI 1.72–2.49, p< 0.0001), and CDI (1.2% vs 0.7%, OR 1.85, 95% CI 1.54–2.23, p< 0.0001). Conclusion Our measured BLA rate matches approximate expectations near 10%. Moreover, these patients experienced significantly higher frequencies of drug-resistant bacterial infections and CDI. Targeted inpatient penicillin allergy testing stands to be particularly effective in those patients receiving disproportionately utilized alternative agents (e.g. aztreonam, clindamycin, daptomycin). β-lactam allergy “de-labeling” in these patients is likely a valuable antimicrobial stewardship target. Disclosures All Authors: No reported disclosures
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Walbank, Michael B. "Notes on Attic Decrees." Annual of the British School at Athens 85 (November 1990): 435–47. http://dx.doi.org/10.1017/s0068245400015781.
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Several fragments of 4th-century BC Athenian decree-inscriptions are discussed. Joins are made betweenIGii2. 13a and 68 andHesperia, 40, no. 3;IGii2. 257 and 300; 242 and 373; 407 andSEG32. 94;IGii2. 309 and 552; 530 and 590. Attributed to the same stele, but not joining, areIGii2. 139 and 289; 277 and 428; 540a andSEG24. 117;IGii2. 540b andHesperia, 21, no. 17;IGii2. 286 and 625; 414a and 403; 398a (+ 438) and 612; 484 and 558; 489 and 532; 495 and 709; 405 andHesperia, 4, no. 32. Other decrees discussed, mainly in light of the work of A.S. Henry on the formulae of Athenian decrees, areIGii2. 44; 81; 121; 129; 147; 154; 155; 156; 285+ 414d; 321; 335; 364; 406; 416; 1001; andSEG21. 362 and 25. 85.
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Usubov, E. L., and A. F. Zaynetdinov. "Deep anterior lamellar and penetrating keratoplasty in developed and advanced stages of keratoconus." POINT OF VIEW. EAST – WEST, no. 4 (November 2, 2021): 44–47. http://dx.doi.org/10.25276/2410-1257-2021-4-44-47.
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This article presents the results of surgical treatment of 30 patients (30 eyes) with keratoconus stage 3-4, which were divided into two groups depending on the performed surgery technique. Deep anterior lamellar keratoplasty (DALK) was performed on 20 eyes using a femtosecond laser and the surgery technique including separation of the residual corneal stroma using the "big bubble" technique, and in some cases using the manual dissection technique. In 25% of cases (5 out of 20 eyes), the DALK operation was complicated by Descemet's membrane perforation and therefore, the surgical intervention was completed by switching to penetrating keratoplasty (PK). These patients were excluded from the DALK group and included in the PK group, who underwent penetrating keratoplasty (15 eyes). The maximum follow-up period was 2 years. After DALK transparent engraftment was achieved in all cases, and after PK in 93.4% of cases, in one case (6.6%) graft rejection was observed. Key words: keratoconus, surgical treatment, deep anterior lamellar keratoplasty, penetrating keratoplasty.
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Vasco, Beatriz, Joan Carles Villalba, Luciano Lopez-Jimenez, Conxita Falga, Julio Montes, Javier Trujillo-Santos, and Manuel Monreal. "Venous thromboembolism in nonagenarians." Thrombosis and Haemostasis 101, no. 06 (2009): 1112–18. http://dx.doi.org/10.1160/th08-12-0827.
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SummaryThe balance between the efficacy and safety of anticoagulant therapy in patients aged ≥90 years with venous thromboembolism (VTE) is uncertain. RIETE is an ongoing, prospective registry of consecutive patients with acute, objectively confirmed, symptomatic VTE. We evaluated the efficacy and safety of anticoagulant therapy during the first three months in all patients aged ≥90 years. In addition, we tried to identify those at a higher risk for VTE. Of 21,873 patients enrolled from March 2001 to February 2008, 610 (2.8%) were aged ≥90 years. Of these, 307 (50%) presented with pulmonary embolism (PE), 240 (39%) had immobility ≥4 days, and 271 (44%) had abnormal creatinine levels. During the first three months of therapy, 140 patients aged ≥90 years (23%) died. Of these, 45 (32%) died of PE (34 of the initial episode, 11 of recurrent PE), 18 (13%) had fatal bleeding. Recent im-mobility ≥4 days was the most common risk factor for VTE (240 of 610 patients, 39%), but only 54 of them (22%) had received thromboprophylaxis. The most frequent causes for immobility were senile dementia, acute infection, trauma or decompen-sated heart failure. The duration of immobility was <4 weeks in 126 patients (52%), and most of them were bedridden at home. In conclusion, one in every four VTE patients aged ≥90 years died during the first three months of therapy. Of these, one in every three died of PE, one in every eight had fatal bleeding. Identifying at-risk patients may help to prevent some of these deaths.
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Maddali, L. S., and S. Maddali. "Pattern of malignancies in geriatric patients." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 19650. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19650.
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19650 Background: Information regarding pattern of malignancies in geriatric patients in India is not readily available. Methods: Between 1st January 1999 and 31st December 2006 we encountered 832 geriatric patients among a total of 3748 cases. Analysis was done with respect to age, sex and disease. Results: Geriatric patients constituted 832/3748 (22.20%) of our work load. Males 432 (51.92%) Females 400 (48.08%). Hematologic malignancies 214 (25.72%) Solid tumors 618 (74.28%). male preponderance in Hematologic malignancies 141/214 (66.89%); female preponderance in solid tumors 327/618 (52.91%). Top 7 malignancies: Males (432)-NSCLC 60 (13.89%) Prostate 57 (13.19%) NHL 48 (11.11%) Myeloma 39 (9.03%) CLL 31 (7.18%) HNSCC 30 (6.94%) Colon 26 (6.02%); Females (400)- Breast 147 (36.75%) Ovary 50 (12.50%) Uterus 44 (11.00%) NHL 25 (6.25%) Colon 20 (5.00%) NSCLC 11 (2.75%) CML 10 (2.50%). Age groups: (65–70) yrs-517 (62.13%) males 254, females 263; (71–80) yrs-264 (31.73%) males 152 females 112; (81–90) yrs-48 (5.78%) males 24, females 24; >91yrs-3 (0.36%) males 2 female 1. Top 5 malignancies in each age & sex group: Males, (65–70) yrs, 254: NSCLC 39 NHL 30 Prostate 29 Myeloma 24 Colon 19; (71–80) yrs, 152: Prostate 20 NSCLC 19 NHL 17 CLL 15 HNSCC 14; (81–90) yrs, 24: Prostate 7 Myeloma 2 CLL 2 CML 2 AML 2; Females, (65–70) yrs, 263: Breast 99 Ovary 37 Uterus 30 colon 13 NHL 13; (71–80) yrs, 112: Breast 41 Ovary 12 NHL 11 Uterus 10 CLL 9; (81–90) yrs, 24: Breast 7 Uterus 4 CLL 2 Renal cell carcinoma 2 Ovary 1. Conclusions: Solid tumors are the predominant malignancies in geriatric patients 618/832 (74.28%). B Cell neoplasms constitute bulk of the hematologic neoplasms 173/214 (80.84%). Sarcomas are uncommon 20/832 (2.40%). Important solid tumors: Prostate, NSCLC, Colon and HNSCC in males; Breast, Ovary, Uterus and colon in females. Age group (65–70) yrs is the major group 517/832 (62.13%) followed by significant age group (71–80) yrs 264/832 (31.73%). It is imperative to employ curative strategies for malignancies in this ever expanding population. No significant financial relationships to disclose.
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Híjar, Martha, Ricardo Pérez-Núñez, Elisa Hidalgo-Solórzano, Bernardo Hernández Prado, Rosario Valdez-Santiago, Erin B. Hamilton, Spencer L. James, et al. "Unintentional injuries in Mexico, 1990–2017: findings from the Global Burden of Disease Study 2017." Injury Prevention 26, Supp 1 (April 1, 2020): i154—i161. http://dx.doi.org/10.1136/injuryprev-2019-043532.
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BackgroundTo date, the burden of injury in Mexico has not been comprehensively assessed using recent advances in population health research, including those in the Global Burden of Disease Study 2017 (GBD 2017).MethodsWe used GBD 2017 for burden of unintentional injury estimates, including transport injuries, for Mexico and each state in Mexico from 1990 to 2017. We examined subnational variation, age patterns, sex differences and time trends for all injury burden metrics.ResultsUnintentional injury deaths in Mexico decreased from 45 363 deaths (44 662 to 46 038) in 1990 to 42 702 (41 439 to 43 745) in 2017, while age-standardised mortality rates decreased from 65.2 (64.4 to 66.1) in 1990 to 35.1 (34.1 to 36.0) per 100 000 in 2017. In terms of non-fatal outcomes, there were 3 120 211 (2 879 993 to 3 377 945) new injury cases in 1990, which increased to 5 234 214 (4 812 615 to 5 701 669) new cases of injury in 2017. We estimated 2 761 957 (2 676 267 to 2 859 777) disability-adjusted life years (DALYs) due to injuries in Mexico in 1990 compared with 2 376 952 (2 224 588 to 2 551 004) DALYs in 2017. We found subnational variation in health loss across Mexico’s states, including concentrated burden in Tabasco, Chihuahua and Zacatecas.ConclusionsIn Mexico, from 1990 to 2017, mortality due to unintentional injuries has decreased, while non-fatal incident cases have increased. However, unintentional injuries continue to cause considerable mortality and morbidity, with patterns that vary by state, age, sex and year. Future research should focus on targeted interventions to decrease injury burden in high-risk populations.
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Brunetto, Maurizia R., Ivana Carey, Benjamin Maasoumy, Cristina Marcos‐Fosch, André Boonstra, Gian Paolo Caviglia, Alessandro Loglio, et al. "Incremental value of HBcrAg to classify 1582 HBeAg‐negative individuals in chronic infection without liver disease or hepatitis." Alimentary Pharmacology & Therapeutics 53, no. 6 (January 19, 2021): 733–44. http://dx.doi.org/10.1111/apt.16258.
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SummaryBackgroundAn accurate, single‐point differential diagnosis between HBeAg‐negative infection (ENI) and chronic hepatitis B (CHB) is an unmet need.AimsTo assess the diagnostic value of the new hepatitis B core‐related antigen (HBcrAg) assay.MethodsA retrospective anonymised data analysis was performed in a multicentre European (nine centres and six countries) cohort of 1582 consecutive HBsAg‐positive/HBeAg‐negative subjects classified according to EASL guidelines as: 550‐CHB, 710‐ENI and 322‐GZ (grey‐zone, HBV‐DNA <20 000 IU/mL).ResultsMean age was 44 (±13.2 y), 59% were men; HBV genotypes were 15% A, 2% B, 2% C, 45% D, 9% E, 1% F and 26% unknown. Median HBV‐DNA serum levels were 2.2 (1.5‐2.7), 3.5 (3.2‐3.8) and 5.6 (4.8‐6.6) logIU/mL in ENI, GZ and CHB, P < 0.0001. HBsAg serum levels (HBsAgsl) were comparable in CHB and GZ, but lower in ENI (2.9 [2.1‐3.6] logIU/mL), P < 0.0001. HBcrAg serum levels (HBcrAgsl) were <3 logU/mL in 90.7% (644/710) ENI, 75.2% (242/322) GZ and 4.7% (26/550) CHB (P < 0.0001). Median HBcrAgsl were 4.8 (3.9‐5.7), 2.5 (2.0‐2.9) and 2.0 (2.0‐2.5) logU/mL in CHB, GZ and ENI, (P < 0.0001). ROC‐AUCs for HBcrAg and HBsAg were 0.968 (95% CI, 0.958‐0.977) and 0.732 (95% CI, 0.704‐0.760) respectively. The optimal HBcrAgsl cut‐off to distinguish CHB from ENI was 3.14 logU/mL (95% CI, 3.02‐3.25, 91% SE, 93% SP and 92.4% DA). HBcrAgsl were associated with HBV genotypes (P < 0.001, one‐way ANOVA) but using genotype‐specific cut‐offs, HBcrAg DA remained unchanged with overlapping 95% CI.ConclusionThe HBcrAg assay showed high diagnostic performance in the accurate single‐point identification of patients with HBeAg‐negative CHB, independently of HBV genotype. This should prompt future prospective studies to confirm its diagnostic role in clinical practice.
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Sato, Asako, Sayo Yada, Emiko Hosoba, Hiroko Kanno, and Hitomi Miura. "Establishment of glycated albumin unit conversion equation from the standardized value (mmol/mol) to the routinely used value (%)." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 56, no. 2 (November 17, 2018): 204–9. http://dx.doi.org/10.1177/0004563218808325.
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Background To promote glycated albumin standardization, the Committee on Diabetes Mellitus Indices, Japan Society of Clinical Chemistry published the recommended reference method and is supplying the reference standard material (JCCRM 611). In this study, we evaluated the basic performance of ‘standardized enzymatic method’ that is traceable to JCCRM 611 and established a unit conversion formula from standardized glycated albumin value (mmol/mol) to the routinely used glycated albumin value (%). Methods To evaluate the accuracy and within-run reproducibility of the ‘standardized enzymatic method’, JCCRM 611 was measured 20 times. To establish the unit conversion formula, serum specimens with known HbA1c concentrations were collected, and their glycated albumin (%) and glycated albumin (mmol/mol) were measured. Results The accuracy of glycated albumin value of the ‘standardized enzymatic method’ was 100.8–103.0%. The within-run reproducibility CV (coefficient of variation, %) of glycated albumin value was 0.6–0.9%. In total, 240 serum specimens were collected, and the distribution of their HbA1c values was HbA1c ≤ 4.9% ( n = 23), 5.0–5.9% ( n = 50), 6.0–6.9%, ( n = 44), 7.0–7.9% ( n = 40), 8.0–8.9% ( n = 37) and ≥9.0% ( n = 46). The unit conversion equation was defined as: GA (%) = 0.05652 × GA (mmol/mol)–0.4217 ( r = 0.999). Glycated albumin (%) calculated by the equation was in close agreement (96.6–104.2%) with the actual measured glycated albumin (%). Conclusions The glycated albumin unit conversion formula was established from mmol/mol to %. This formula provides an easy method to convert the unit and is expected to be useful for the standardization of glycated albumin measurement.
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Belozerov, K. E., N. M. Solomatina, N. N. Abramova, E. A. Isupova, E. V. Gaidar, M. A. Kaneva, T. L. Kornishina, et al. "MANIFESTATIONS PECULIARITIES OF JUVENILE ARTHRITIS WITH SYSTEMIC ONSET IN PATIENTS WITH THE RESPIRATORY LESIONS’ DEVELOPMENT AT THE ONSET OF THE DISEASE. RESULTS OF A SINGLE-CENTER RETROSPECTIVE COHORT STUDY AND A BIBLIOGRAPHICAL REVIEW." Pediatria. Journal named after G.N. Speransky 102, no. 5 (October 13, 2023): 44–53. http://dx.doi.org/10.24110/0031-403x-2023-102-5-44-53.
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Juvenile arthritis with systemic onset (sJIA) is one of the most difficult tasks of differential diagnosis and selection of therapy for a rheumatologic practitioner as yet. The presence of a systemic hyperinflammatory response, the development of macrophage activation syndrome (MAS) and sepsis determine the severity of sJIA. Pulmonary involvement coupled with the development of interstitial lung disease and/or pulmonary arterial hypertension is a relatively new, potentially life-threatening complication of sJIA. The purpose of this research was to characterize patients with sJIA who had respiratory lesions (RL) at the onset of the disease. Methods used: a retrospective cohort study included the data from the case histories of 85 pediatric patients with sJIA who were divided into 2 groups: G1 with RL (dyspnea, pleurisy, interstitial lung disease, acute respiratory distress syndrome); and G2 of those who’ve had no such complaints. Results: 18 (21.1%) had RL associated with female gender, heart lesions (OR=6.4 (2.1; 19.7), p=0.0006), macrophage activation syndrome (72.2%; OR=6.6 (2.1; 21.0), p=0.0006), hemorrhagic syndrome, CNS disorders (OR=6.1 (1.2; 30.3), p=0.015), decreased levels of hemoglobin, platelets, prothrombin, fibrinogen, albumin, total protein and sodium as well as the higher levels of ferritin, lactate dehydrogenase, aspartate aminotransferase, triglycerides. Patients with lung involvement had tended to have higher C-reactive protein levels and were more likely to have transient proteinuria in the active phase of the disease. Multivariate analysis identified two criteria associated with the respiratory damage: heart damage (β=0.18, p=0.039) and hypoalbuminemia <26 g/l (β=0.73, p=0.0000001). Conclusion: the presence of macrophage activation syndrome, damage to the cardiovascular system requires targeted monitoring of respiratory damage in patients with sJIA.
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Park, Ju-Hyun, Mitchell H. Gail, Mark H. Greene, and Nilanjan Chatterjee. "Potential Usefulness of Single Nucleotide Polymorphisms to Identify Persons at High Cancer Risk: An Evaluation of Seven Common Cancers." Journal of Clinical Oncology 30, no. 17 (June 10, 2012): 2157–62. http://dx.doi.org/10.1200/jco.2011.40.1943.
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Purpose To estimate the likely number and predictive strength of cancer-associated single nucleotide polymorphisms (SNPs) that are yet to be discovered for seven common cancers. Methods From the statistical power of published genome-wide association studies, we estimated the number of undetected susceptibility loci and the distribution of effect sizes for all cancers. Assuming a log-normal model for risks and multiplicative relative risks for SNPs, family history (FH), and known risk factors, we estimated the area under the receiver operating characteristic curve (AUC) and the proportion of patients with risks above risk thresholds for screening. From additional prevalence data, we estimated the positive predictive value and the ratio of non–patient cases to patient cases (false-positive ratio) for various risk thresholds. Results Age-specific discriminatory accuracy (AUC) for models including FH and foreseeable SNPs ranged from 0.575 for ovarian cancer to 0.694 for prostate cancer. The proportions of patients in the highest decile of population risk ranged from 16.2% for ovarian cancer to 29.4% for prostate cancer. The corresponding false-positive ratios were 241 for colorectal cancer, 610 for ovarian cancer, and 138 or 280 for breast cancer in women age 50 to 54 or 40 to 44 years, respectively. Conclusion Foreseeable common SNP discoveries may not permit identification of small subsets of patients that contain most cancers. Usefulness of screening could be diminished by many false positives. Additional strong risk factors are needed to improve risk discrimination.
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Shulyat’Eva, N. V., V. N. Drozdov, and E. V. Shikh. "Incidence of iron deficiency and its pathogenesis in patients with H. pylori infection." Experimental and Clinical Gastroenterology, no. 3 (May 22, 2021): 130–35. http://dx.doi.org/10.31146/1682-8658-ecg-187-3-130-135.
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606 patients (405 men and 201 women) with HP infection were examined, 121 (m 67; f 54) found clinical or clinical and laboratory signs of iron deficiency, the frequency of iron deficiency in the examined group of patients with HP was 19.9% (16.8-23.3; CI 95%). 25 (20.7%) were diagnosed with anaemia, 66 (54.5%) patients had a latent deficit of iron, 30 patients (24.8%) showed only a decrease in TS, which is typical for pre-latent iron deficiency. 38 (31.4%) patients had a «true» iron deficiency, 44 (36.4%) patients had a combined variant of iron deficiency, and 39 (32.2%) iron deficiency developed as a result of chronic inflammation. There was a significant difference in the level of hepcidin in patients with different options for iron deficiency. In patients with “isolated” iron deficiency, it was 12.4 ± 2.3 ng/ml, vs 48.2-± 20.2 ng/ml vs 189.7 ± 31.1 ng / ml in patients with a combined pathogenic variant of iron deficiency and in patients with iron deficiency of chronic inflammation, respectively.
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Ambrozkiewicz, Filip, Jakub Karczmarski, Maria Kulecka, Agnieszka Paziewska, Magdalena Cybulska, Michal Szymanski, Jakub Dobruch, Artur Antoniewicz, Michal Mikula, and Jerzy Ostrowski. "Challenges in Cancer Biomarker Discovery Exemplified by the Identification of Diagnostic MicroRNAs in Prostate Tissues." BioMed Research International 2020 (May 6, 2020): 1–4. http://dx.doi.org/10.1155/2020/9086829.
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Identification and clinical translation of routinely tested biomarkers require a complex and multistep workflow. Here, we described a confirmatory process estimating the utility of previously identified candidate tissue miRNAs for diagnosis of prostate cancer (PCa). RNA was isolated from formalin-fixed paraffin-embedded (FFPE) prostate tissue surgically resected from 44 patients with PCa and 24 patients with benign prostate hyperplasia (BPH). Of the 92 RNA samples obtained, 68 represented 42 malignant (PCa) areas and 26 represented nonmalignant (PCa 0%) areas of the prostate tissue sections. The levels of miR-32-5p, miR-183-5p, miR-141-5p, miR-187-3p, miR-375, miR-663b, miR-615-3p, miR-205-5p, miR-221-3p, and miR-222-3p were evaluated using Exiqon chemistry. Five (miR-32-5p, miR-141-5p, miR-187-3p, miR-375, and miR-615-3p), one (miR-32-5p), and two (miR-32-5p and miR-141-5p) miRNAs discriminated between BPH and areas of cancer-bearing prostate tissue harboring different numbers of cancer cells (PCa 15–70%, PCa 2–10%, and PCA 0%, respectively), with an area under the receiver operating characteristics curve (AUC-ROC) > 0.9. Only miRNA 32-5p discriminated BPH specimens from sections of cancer-bearing prostate tissue with a low percentage, a high percentage, or no dysplastic cells. miR-32-5p could be considered as potential diagnostic biomarker discriminating BPH from noncancerous areas within cancer-bearing prostate tissue. However, further clinical studies are warranted to confirm its diagnostic utility.
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Turdieva, Sh T., Sh A. Agzamova, and G. M. Khasanova. "Enteral oxygen therapy: new approaches to rehabilitation for chronic gastroduodenal pathology in children." Experimental and Clinical Gastroenterology, no. 1 (January 18, 2024): 44–52. http://dx.doi.org/10.31146/1682-8658-ecg-221-1-44-52.
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Purpose. Studying the effect of enteral oxygen therapy (EOT), in the process of rehabilitation, on the regenerative process of the mucous membrane of the gastrointestinal tract in children with chronic gastroduodenal pathology (CGDP). Methods. The clinical observation was based on a randomized study. We examined 286 children with CGDP. The research methods fibrogastroduodenoscopy (FGDS), and tests for Helicobacter pylori infection. Results. Based on the results of the FGDS, we developed a scoring scale for the regeneration process (SSRP) without morphological biopsy. According to the results of the SSRP, in patients with inflammatory processes, after a course of standard inpatient treatment, there was a 3rd degree of regeneration, with ulcerative lesions - 4th degree. After a single rehabilitation course, using EOT, a transition to 1-degree regeneration was noted (6.6±0.77 points), without the use of EOT for 2-degree (10.9±1.23 points). The data indicated a more than 63% increase in reparative-regenerative processes when using EOT. Against this background, there was up to a 2.5-fold decrease in Helicobacter pylori carriage. Conclusions. The use of EOT helps to accelerate regenerative mechanisms of the gastric mucosa by up to 63%, and the implementation of a comprehensive rehabilitation program using EOT contributes to a significant decrease in Helicobacter pylori carriage.
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Jagt-van Kampen, Charissa T., Derk A. Colenbrander, Diederik K. Bosman, Martha A. Grootenhuis, Marijke C. Kars, and Antoinette YN Schouten-van Meeteren. "Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease." American Journal of Hospice and Palliative Medicine® 35, no. 1 (February 20, 2017): 123–31. http://dx.doi.org/10.1177/1049909117695068.
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Objectives: Anticipating case management is considered crucial in pediatric palliative care. In 2012, our children’s university hospital initiated a specialized pediatric palliative care team (PPCT) to deliver inbound and outbound case management for children with life-shortening disease. The aim of this report is to gain insight in the first 9 months of this PPCT. Methods: Aspects of care during the first 9 months of the PPCT are presented, and comparison is made between patients with malignant disease (MD) and nonmalignant disease (NMD) in a retrospective study design. Insight in the aspects of care of all patients with a life-shortening disease was retrieved from web-based files and the hour registrations from the PPCT. Results: Forty-three children were supported by the PPCT during the first 9 months: 22 with MD with a median of 50 (1-267) days and 29 minutes (4-615) of case management per patient per day and 21 patients with NMD with a median of 79.5 (5-211) days and 16 minutes of case management per day (6-64). Our data show significantly more interprofessional contacts for patients with MD and more in-hospital contacts for patients with NMD. The median number of admission days per patient was 11 (0-22) for MD (44% for anticancer therapy) and 44 (0-303) for NMD (36% for infectious diseases). Significance of Results: This overview of aspects of pediatric palliative case management shows shorter but more intensive case management for MD in comparison with NMD. This insight in palliative case management guides the design of a PPCT.
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Petersen, Kristina, Kristin Davis, David Proctor, Connie Rogers, Sheila West, and Penny Kris-Etherton. "The Effect of Meals Containing Culinary Doses of Spices on Postprandial Endothelial Function, Lipemia and Glycemia: A Randomized, Crossover, Controlled-Feeding Study." Current Developments in Nutrition 6, Supplement_1 (June 2022): 327. http://dx.doi.org/10.1093/cdn/nzac053.068.
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Abstract Objectives The objective was to examine the effect of meals containing 0.6 g (low-spice meal), 3.7 g (moderate-spice meal), and 7.4 g (high-spice meal) of herbs/spices on postprandial flow mediated dilation (FMD), triglycerides, insulin and glucose in men and post-menopausal women at-risk for cardiovascular disease. Methods A 3-period, randomized, crossover, controlled-feeding study was conducted. Participants consumed an average American diet containing 0.5 (low-spice diet), 3.3 (moderate-spice diet), and 6.6 (high-spice diet) g/d/2100 kcal of herbs and spices for 4-weeks. At baseline and the end of each diet period, participants were given a meal challenge (1192 kcal; carbohydrate 145 g; protein 62 g; fat 44 g; saturated fat 20 g). The spice dose in the test meal corresponded to the spice level of the diet consumed for the previous 4 weeks. Blood was sampled at 0, 30, 60, 120, 180, 240 minutes for analysis of triglycerides, glucose, and insulin. FMD was measured at 0,120 and 240 minutes. Results The analytic sample included 43 participants (males 65%; age 48 ± 11 years; BMI 28.9 ± 2.9 kg/m2, FMD 6.2 ± 2.3%). No between-meal differences were observed for FMD (meal P = 0.30; time P < 0.001; meal by time interaction P > 0.99). The area under the curve for triglycerides (P = 0.39), glucose (P = 0.49) and insulin (P = 0.07) was not different between the meals. Conclusions Following intake of an average American diet with three different doses of spices (0.5, 3.3 and 6.6 g/d/2100 kcal) for 4-weeks, FMD, triglyceride, glucose and insulin responses to meals containing 0.6 g, 3.7 g and 7.4 g of spices were not different. These findings suggest that following 4-weeks of exposure to spice-containing diets, spice exposure from a meal does not dose-dependently affect endothelial function, lipemia and glucose homeostasis in the 4-hours post meal. Funding Sources McCormick Science Institute; National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR002014.
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Busch, Jonah, Kalifi Ferretti-Gallon, Jens Engelmann, Max Wright, Kemen G. Austin, Fred Stolle, Svetlana Turubanova, et al. "Reductions in emissions from deforestation from Indonesia’s moratorium on new oil palm, timber, and logging concessions." Proceedings of the National Academy of Sciences 112, no. 5 (January 20, 2015): 1328–33. http://dx.doi.org/10.1073/pnas.1412514112.
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To reduce greenhouse gas emissions from deforestation, Indonesia instituted a nationwide moratorium on new license areas (“concessions”) for oil palm plantations, timber plantations, and logging activity on primary forests and peat lands after May 2011. Here we indirectly evaluate the effectiveness of this policy using annual nationwide data on deforestation, concession licenses, and potential agricultural revenue from the decade preceding the moratorium. We estimate that on average granting a concession for oil palm, timber, or logging in Indonesia increased site-level deforestation rates by 17–127%, 44–129%, or 3.1–11.1%, respectively, above what would have occurred otherwise. We further estimate that if Indonesia’s moratorium had been in place from 2000 to 2010, then nationwide emissions from deforestation over that decade would have been 241–615 MtCO2e (2.8–7.2%) lower without leakage, or 213–545 MtCO2e (2.5–6.4%) lower with leakage. As a benchmark, an equivalent reduction in emissions could have been achieved using a carbon price-based instrument at a carbon price of $3.30–7.50/tCO2e (mandatory) or $12.95–19.45/tCO2e (voluntary). For Indonesia to have achieved its target of reducing emissions by 26%, the geographic scope of the moratorium would have had to expand beyond new concessions (15.0% of emissions from deforestation and peat degradation) to also include existing concessions (21.1% of emissions) and address deforestation outside of concessions and protected areas (58.7% of emissions). Place-based policies, such as moratoria, may be best thought of as bridge strategies that can be implemented rapidly while the institutions necessary to enable carbon price-based instruments are developed.
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Doroshenko, Dmitry A., Olga A. Tseneva, Sergey V. Mikhaylusov, Viktor D. Anosov, Elena V. Moiseenkova, Mukhamad A. Khokonov, and Stanislav K. Volkov. "ANALYSIS OF THE STRUCTURE OF LOCAL COMPLICATIONS TO ACUTE NECROTIC PANCREATITIS USING RADIATION DIAGNOSTICS METHODS." Acta medica Eurasica, no. 4 (December 27, 2023): 44–54. http://dx.doi.org/10.47026/2413-4864-2023-4-44-54.
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The use of multispiral computed tomography and ultrasound examination in pancreatic necrosis makes it possible to determine the shape, volume and localization, to distinguish four types of lesions. The aim of the study was to determine the incidence rate and the structure of local aseptic and purulent complications in acute necrotic pancreatitis using radiation diagnostics methods, to assess complications impact on the course and prognosis of the disease. Materials and methods. 63 patients with pancreatic necrosis who underwent treatment were examined during 2 years. The results of these examinations were analyzed. Two groups were identified: 1st – patients with infected pancreatic necrosis 29 (46%), 2nd – patients with sterile one 34 (54%). Ultrasound examination was performed on expert-class scanners, multispiral computed tomography with bolus tracking was performed on an Aguilion Prim device manufactured by Toshiba. Statistical processing of the results was performed in the Microsoft Excel 2017 database, the calculation of average values, standard distribution errors was made, the analysis of conjugate frequencies was given – the xi-squared test (c2) was used. Study results. Four types of infiltrative-necrotic lesions were identified: 21 cases (33.3%) of model-1 (central type); 13 cases (20.7%) of model-2 (left type); 9 cases (14.3%) of model-3 (right type); 20 cases (31.7%) of model-4 (mixed type). In group 1, severe pancreatic necrosis was significantly more often identified – in 17 out of 29 (58.6%) (c2 = 5.414; p = 0.020), mixed type (model-4) – 14 of 29 (48.3%) (c2 = 5.436; p = 0,020); in the 2nd group that of moderate severity was found more often – 21 out of 34 (61.6%) (c2 = 8.511; p = 0.004), mainly the central type (model-1) – 17 of 34 (50%) (c2 = 7.675; p = 0.006). There are no differences in the structure of local complications in group 2 depending on the severity of necrosis, in group 1, widespread parapancreatitis was more common in 22 out of 29 cases (75.9%) (p < 0.001). Mortality in infected and sterile pancreatic necrosis did not significantly differ – 24.1% and 23.5%, the highest mortality was in the mixed type of lesion in both groups (model-4) was 9 out of 20 (c2 = 5.643; p = 0.018). Conclusions. Radiation examination methods give the opportunity to predict early the pancreatic necrosis course and outcome. The development of local complications and their structure depend on the volume of necrosis, the prevalence and type of localization of destructive and inflammatory changes in retroperitoneal space.
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Recio-Boiles, Alejandro, Amber N. Clements, Sachin Kumar Deshmukh, Aaron Bertolo, Ricardo J. Estrada-Mendizabal, Kathylynn Saboda, Sharon Wu, et al. "Correlation of PIM kinases with tumor immune microenvironment and clinical presentation of metastatic hormone-sensitive prostate cancer." Journal of Clinical Oncology 42, no. 4_suppl (February 1, 2024): 211. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.211.
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211 Background: The Proviral Integration site for Moloney murine leukemia virus ( PIM1, 2, and 3) kinases are frequently overexpressed in prostate cancer (PC) and associated with aggressiveness and immune evasion. PIM overexpression increases macrophage infiltration and survival in in vivo models of PC. Here, we characterized the association of PIM1/2/3 triplet-combined High versus Low with PC immune signatures on real-world patients' clinical presentation. Methods: 44 patients of treatment-naive metastatic hormone-sensitive PC (mHSPC) patients (pts) samples were analyzed by next-generation sequencing (592, NextSeq; WES, NovaSeq), (WTS; NovaSeq) (Caris Life Sciences, Phoenix, AZ). PC with PIM1/2/3-high(H) (N=28) and -low(L) (N=16) expressions were classified by top and bottom quartile, respectively. Pathway enrichment was determined by GSEA (Broad Inst). Immune cell fractions were calculated by deconvolution of WTS using Quantiseq. Statistical significance was determined by Mann-Whitney U and adjusted for multiple comparisons (p<0.05). Continuous and categorical variables were evaluated using t-tests or Kruskal-Wallis Rank sum tests and Chi-square or Fisher’s exact tests, respectively. Results: mHSPC pts median ages were 67.28 (SD 10.65), 88% White, 44% non-Hispanic, ECOG <2 95% and other demographics showed no differences between PIM-H and L. PIM-H vs L tumors presentation was 48 vs 35% Gleason >9, 82 vs 57% T>3, 76 vs 69% N1, and 92 vs 81% M1, all p>0.05. Median PSA levels at diagnosis were 66.0 [14.0-450.7] vs 24.0 [6.6-95.0] by PIM-H and L, p=0.14. PIM-H had a higher median MAPK activation score compared to PIM-L PC (0.85 vs -1.38, q<0.05). PIM-H PC exhibited higher PSA (548.2 vs 213.2) and AR (118.6 vs 50.8) expression, all q<0.05. PIM-H had enrichment of protein secretion signaling pathway (NES: 1.2; FDR <0.25). PIM-H had higher expression of immunostimulatory ( IL1β, TNF, IL-2, and TNFSF13, FC: 1.9-3.1, p<0.05) and hypoxia-related genes ( HIF1⍺, ARNT, VEGFA, PDGFB, LDHA, NDRG1, SLC2A, PGK1, and DDIT4, FC: 1.3-2.4, p<0.05). PIM-H had higher expression of MHC class I (HLA-A, -B, -C, TAP1, TAP2, B2M, FC: 1.9-2.2, all p<0.05) and MHC class II (HLA-DPA1, -DRB1, -DPB2, -DQB2, -DBP1, -DQB1 FC: 1.8-3.2, all p<0.05) genes. PIM-H had increased infiltration of B cells, M2 MØ and NK cells (all p <=0.05). PIM-H PC had a higher T cell inflamed score (70 vs -138, p<0.05). Conclusions: These data indicate a strong association of PIM expression with increased MAPK activation score, T cell inflamed score, inflammatory, PSA, AR, MHC class I and MHC class II gene expression, and differential immune cell infiltration. However, this did not significantly translate to a worse clinical presentation of mHSPC. A better understanding of these differences with additional research may provide a rationale for tailored therapeutic approaches for PIM-expressing mHSPC.
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Duarte Coêlho, Maria Rosângela Cunha, Thaísa Regina Rocha Lopes, Juliana Prado Gonçales, Luan Araujo Bezerra, Mirela Lopes Ribeiro, Georgea Gertrudes Mendes de Oliveira Cahú, and José Valter Joaquim Silva Júnior. "Retrospective observational study on the epidemiological profile of people living with HIV/AIDS in Pernambuco state, Brazil." Journal of Infection in Developing Countries 16, no. 02 (February 28, 2022): 346–51. http://dx.doi.org/10.3855/jidc.15286.
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Introduction: HIV/AIDS is a major global public health concern. In Pernambuco state, Brazil, the number of people living with HIV/AIDS (PLWHA) is among the highest in the country. Herein, a cross-sectional retrospective observational study was carried out with 811 PLWHA followed up at the Clinical Hospital, Pernambuco, Brazil, between 2013 and 2017.
Methodology: The patients’ sociodemographic and behavioral data were obtained by interview. Information about HIV load and CD4 T lymphocyte count were obtained from patients’ records. Data were analyzed for both the total number of PLWHA and gender.
Results: Recife municipality had the highest number of PLWHA. Most PLWHA were 40-44 years old, male, brown ethnicity, heterosexual, single, with elementary education, used condoms regularly, shared sharp objects, had surgery, had no non-HIV sexual infection, did not receive transfusions, did not use injectable drugs, and had no tattoo. The median of first and last CD4 T lymphocyte counts were 241 and 549.5 cells/mm³, respectively. The first HIV load had a median of 14,882 copies/mL (IQR = 613-109,750 copies/mL). Regarding the last viral load, 63.74% had an undetectable load. All patients were using antiretroviral therapy, mean time of 5.9 (± 5.5) years. This epidemiological and medical profile was maintained when PLWHA were analyzed according to gender, except for the report of another sexually transmitted infection, in which 51.4% of men (268/521) reported having/or having had it.
Conclusions: The epidemiological profile of PLWHA in Pernambuco, Brazil, was described. This regional characterization is useful for directing public health policies, contributing to population-directed decision making.
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Csapo, Robert, Helmut Pointner, Christian Hoser, Peter Gföller, Christian Raschner, and Christian Fink. "Physical Fitness after Anterior Cruciate Ligament Reconstruction: Influence of Graft, Age, and Sex." Sports 8, no. 3 (March 6, 2020): 30. http://dx.doi.org/10.3390/sports8030030.
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Functional tests are used to facilitate return-to-sports decisions after anterior cruciate ligament reconstruction (ACLR). This study presents comprehensive physical fitness test data acquired in highly active patients within the first year after ACLR, for comparison between different grafts, age groups, and sexes. The outcomes from a specific seven-item test battery and isokinetic strength test data were extracted from a patient database. Results were compared to normative data from age- and sex-matched controls and between subgroups of patients. A total of 245 patients (94 women, 23.8 ± 8.4 years, pre-injury Tegner 7.4 ± 1.6) were tested 185 ± 44 days after surgery. In 116 patients (47.3%), one or more test results were classified as “poor” or “very poor” after comparison with normative data, with failures being most frequent during single-leg squat jump and plyometric strength tests. Test failures were more prevalent in adults than in adolescents <19 years (61.4%–62.2% vs. 24.5%, p < 0.001) and in men (61.6% vs. 24.5%, p < 0.001), but no differences were found between grafts. Isokinetic knee extensor strength was lower by 24.1% on the injured side. Six months after ACLR, nearly 50% of highly active patients presented with strength and functional fitness deficits. These deficits are particularly prevalent in older patients and men.
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Matallanas, J., and D. Lloris. "Description of Merluccius tasmanicus sp. nov. and redescription of Merluccius australis (Pisces: Merlucciidae)." Journal of the Marine Biological Association of the United Kingdom 86, no. 1 (January 12, 2006): 193–99. http://dx.doi.org/10.1017/s0025315406013038.
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A new hake species, Merluccius tasmanicus sp. nov., is described from New Zealand waters and another species, Merluccius australis is redescribed. Merluccius tasmanicus sp. nov. differs from all other congeneric species in the following combination of characters: upper profile of the head slowly concave; lateral line slowly concave in the caudal region; body depth 4.9–5.9 times in standard length (SL); orbital diameter 6.1–7.1 times in head length, 2.1–2.2 times in snout length and 1.6–1.9 times in interorbital width; second dorsal fin rays, 42–43; anal fin rays, 42–44; lateral line scales ∼164. Merluccius australis is redescribed to clarify the identity of this species. Merluccius australis differs from all other congeneric species in the following combination of characters: upper profile of the head straight; lateral line straight in the caudal region; body depth 6.6–7.1 times in SL; orbital diameter 4.5–5.4 times in head length, 1.2–1.7 times in snout length and 1.0–1.3 times in interorbital width; second dorsal fin rays, 40–43; anal fin rays, 40–43; lateral line scales, more than 155. Merluccius tasmanicus sp. nov. is found in New Zealand and Patagonian waters and occasionally in Japanese waters; Merluccius australis is reported in both New Zealand and Patagonian waters.
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Portnyagina, Nadezhda Vasilyevna, and Elmira Elizbarovna Echishvili. "Some results of the introduction study of <i>Leonurus cardiaca</i> plants in the middle taiga subzone of the Komi Republic." Samara Journal of Science 12, no. 4 (July 15, 2024): 87–92. http://dx.doi.org/10.55355/snv2023124113.
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The article summarizes the results of many years of studying Leonurus cardiaca L. under cultural conditions in the North. It was revealed that in the first year of life, with the seedling method of cultivation, motherwort plants are in the pregenerative period. The transition of individuals into the generative period is noted in the second year of life. The winter hardiness and stability of plants in agrocoenosis is quite high. Under cultural conditions, specimens of L. cardiaca plants of different geographical origins retained the rhythms of seasonal development characteristic of this species. It was revealed that plants of L. cardiaca are characterized by extended periods of flowering (38–44 days) and fruiting (35–40 days). The growing season from the beginning of regrowth to seed collection was 127–132 days. In the years studied, different samples of L. cardiaca formed mature seeds weighing 1000 pcs. seeds 0,86–1,03 g and laboratory germination of 55–91%, which meets the requirements for the quality of seed material of this type. L. cardiaca plants reached their maximum development in the third to fifth years of life, being in a middle-aged generative ontogenetic state: plant height 98–166 cm, shoot-forming capacity – 18–22 pcs. per individual, inflorescence length 26–36 cm, raw material of the main shoot 7,2–8,6 g of wet and 2,1–2,9 g of air-dried phytomass. For the first time the mass fraction of nitrogen (2,4–2,9%) and the amino acid composition of proteins were determined in the above-ground raw phytomass of L. cardiaca. 17 amino acids were quantified, including seven essential ones (39,4% of the total). The highest content in plants was observed for amino acids: glutamic (12,5%), aspartic (11,6%), leucine (9,9%), lysine (8,3%), alanine (6,6%), valine (6,6%) and arginine (5,8%).
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Grant, Clive S., James N. Ingle, Vera J. Suman, Daniel A. Dumesic, D. Lawrence Wickerham, Richard D. Gelber, Patrick J. Flynn, et al. "Menstrual Cycle and Surgical Treatment of Breast Cancer: Findings From the NCCTG N9431 Study." Journal of Clinical Oncology 27, no. 22 (August 1, 2009): 3620–26. http://dx.doi.org/10.1200/jco.2008.21.3603.
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Purpose For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi–cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28%) in luteal phase; 363 (44%) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7%, 82.1%, and 79.2% for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9%, 92.2%, and 91.8%, respectively. Conclusion When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30% of the patients did not meet criteria for either follicular- or luteal-phase categories.
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LeCroy, Madison N., Kimberly P. Truesdale, Donna M. Matheson, Sharon M. Karp, Shirley M. Moore, Thomas N. Robinson, Jerica M. Berge, Holly L. Nicastro, and Alicia J. Thomas. "Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium." Public Health Nutrition 22, no. 17 (May 21, 2019): 3189–99. http://dx.doi.org/10.1017/s1368980019000958.
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AbstractObjective:To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI.Design:Children’s weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models.Setting:Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies.Participants:Predominantly low-income, racial/ethnic minorities: NET-Works (n 534, 2–4-year-olds); GROW (n 610, 3–5-year-olds); GOALS (n 241, 7–11-year-olds); IMPACT (n 360, 10–13-year-olds).Results:Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (P for trend < 0⋅01) and snack occasion frequency and HEI-2010 score (β coefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β coefficient (95 % CI): NET-Works, −3⋅15 (−5⋅37, −0⋅92); GROW, −2⋅44 (−4⋅27, −0⋅61); GOALS, −5⋅80 (−8⋅74, −2⋅86)). Associations with BMI were almost all null.Conclusions:Meal-like and beverage patterns described most children’s snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2–5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.
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Demetrio, D., A. Magalhaes, M. Oliveira, R. Santos, and R. Chebel. "11 Invivo-derived embryo pregnancy rates at Maddox Dairy from 2008 to 2018." Reproduction, Fertility and Development 32, no. 2 (2020): 130. http://dx.doi.org/10.1071/rdv32n2ab11.
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Maddox Dairy, located in Riverdale, CA, USA, is a Holstein herd that milks 3500 cows with a 305-day mature-equivalent milk production of 12 800 kg, and they have been producing high genetic animals by embryo transfer (ET) since the early 1980s. Invivo-derived embryos from Holstein donors were transferred fresh (grade 1 or 2) or frozen (grade 1), at morula (4), early blastocyst (5), or blastocyst (6) stage, to virgin heifers (VH, natural oestrus, 13-15 months old) or lactating cows (LC, Presynch-Ovsynch, 86 days in milk, first or second lactation) 6 to 9 days after oestrus. Pregnancy diagnosis was done by transrectal ultrasonography at 32-46 days in VH and by the IDEXX PAG test at 30 days in LC. June, July, August, September, and October were called critical months (first service AI conception rate drops below 44%) and compared with the other months. The data from 32 503 ETs between January 2008 and December 2018 are summarised on Table 1. Pregnancy rates (PR) are lower for LC recipients than for VH. Embryo transfers performed 7 or 8 days after oestrus had higher PR in both types of recipients and embryos, but Day 6 and 9 oestrus are also used with fair results. The season does not seem to affect PR. There is not enough difference in the combination of stage and days from oestrus for invivo-derived embryos. These numbers do not belong to a planned experiment. Several management changes during the years were made, which make it very difficult to apply statistical methods to analyse the data correctly. They are used as a tool to make decisions in an attempt to improve future results. Table 1.Pregnancy rate (PR) of virgin heifers (top) and lactating cows (bottom)-fresh (SH) and frozen (OZ) invivo-derived embryo transfer1 Heat-months SH-ST4 SH-ST5 SH-ST6 SH-All OZ-ST4 OZ-ST5 OZ-ST6 OZ-All PR% n PR% n PR% n PR% n PR% n PR% n PR% n PR% n Heifers 6 d-CM 62 934 66 243 68 69 63 1246 56 473 58 219 62 42 57 734 6 d-OM 62 1623 67 489 69 211 64 2323 56 600 55 296 48 137 55 1033 6 d-T 62 2557 67 732 69 280 63 3569 56 1073 57 515 51 179 56 1767 7 d-CM 64 1506 68 495 67 221 65 2222 60 822 62 340 63 156 61 1318 7 d-OM 66 2723 68 1021 69 510 67 4254 57 1120 59 581 57 231 58 1932 7 d-T 66 4229 68 1516 69 731 67 6476 58 1942 60 921 60 387 59 3250 8 d-CM 65 1348 64 518 67 322 65 2188 59 595 64 258 63 108 61 961 8 d-OM 66 2166 68 886 70 510 67 3562 61 770 60 364 51 130 60 1264 8 d-T 66 3514 67 1404 69 832 66 5750 60 1365 62 622 56 238 60 2225 9 d-CM 60 109 56 43 70 20 60 172 60 5 33 6 50 4 47 15 9 d-OM 58 129 63 57 60 40 60 226 63 16 50 18 75 4 58 38 9 d-T 59 238 60 100 63 60 60 398 62 21 46 24 63 8 55 53 All-CM 64 3897 66 1299 67 632 65 5828 58 1895 61 823 63 310 60 3028 All-OM 65 6641 67 2453 69 1271 66 10 365 58 2506 58 1259 53 502 58 4267 All-T 65 10 538 67 3752 69 1903 66 16 193 58 4401 60 2082 57 812 59 7295 Lactating cows 6 d-CM 54 265 48 86 50 12 53 363 38 141 31 77 50 10 36 228 6 d-OM 49 463 52 203 45 56 50 723 46 101 48 54 59 27 48 182 6 d-T 51 728 51 289 46 68 51 1086 41 242 38 131 57 37 42 410 7 d-CM 54 755 59 274 56 103 55 1137 43 928 48 450 43 192 45 1570 7 d-OM 55 914 66 367 54 109 58 1393 46 1052 45 564 47 353 46 1969 7 d-T 55 1669 63 641 55 212 57 2530 45 1980 46 1014 46 545 45 3539 8 d-CM 63 252 68 82 76 33 65 368 48 219 56 80 42 33 50 332 8 d-OM 61 257 64 161 53 47 61 466 50 191 53 77 56 16 51 284 8 d-T 62 509 65 243 63 80 63 834 49 410 55 157 47 49 50 616 All-CM 56 1272 58 442 60 148 57 1868 44 1288 47 607 43 235 45 2130 All-OM 55 1634 62 731 51 212 56 2582 47 1344 46 695 48 396 47 2435 All-T 55 2906 60 1173 55 360 57 4450 45 2632 47 1302 46 631 46 4565 1ST=stage; CM=critical months (June, July, August, September, and October); OM=other months.
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Body, Barbara A., Melodie A. Beard, E. Susan Slechta, Kimberly E. Hanson, Adam P. Barker, N. Esther Babady, Tracy McMillen, et al. "Evaluation of the Vitek MS v3.0 Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System for Identification ofMycobacteriumandNocardiaSpecies." Journal of Clinical Microbiology 56, no. 6 (April 11, 2018): e00237-18. http://dx.doi.org/10.1128/jcm.00237-18.
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ABSTRACTThis multicenter study was designed to assess the accuracy and reproducibility of the Vitek MS v3.0 matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry system for identification ofMycobacteriumandNocardiaspecies compared to DNA sequencing. A total of 963 clinical isolates representing 51 taxa were evaluated. In all, 663 isolates were correctly identified to the species level (69%), with another 231 (24%) correctly identified to the complex or group level. Fifty-five isolates (6%) could not be identified despite repeat testing. All of the tuberculous mycobacteria (45/45; 100%) and most of the nontuberculous mycobacteria (569/606; 94%) were correctly identified at least to the group or complex level. However, not all species or subspecies within theM. tuberculosis,M. abscessus, andM. aviumcomplexes and within theM. fortuitumandM. mucogenicumgroups could be differentiated. Among the 312Nocardiaisolates tested, 236 (76%) were correctly identified to the species level, with an additional 44 (14%) correctly identified to the complex level. Species within theN. novaandN. transvalensiscomplexes could not always be differentiated. Eleven percent of the isolates (103/963) underwent repeat testing in order to get a final result. Identification of a representative set ofMycobacteriumandNocardiaspecies was highly reproducible, with 297 of 300 (99%) replicates correctly identified using multiple kit lots, instruments, analysts, and sites. These findings demonstrate that the system is robust and has utility for the routine identification of mycobacteria andNocardiain clinical practice.
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Krebs, John W., Robert C. Holman, Urhonda Hines, Tara W. Strine, Eric J. Mandel, and James E. Childs. "Rabies surveillance in the United States during 1991." Journal of the American Veterinary Medical Association 201, no. 12 (December 15, 1992): 1836–48. http://dx.doi.org/10.2460/javma.1992.201.12.1836.
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Summary In 1991, 49 states, the District of Columbia, and Puerto Rico reported 6,972 cases of rabies in nonhuman animals and 3 cases in human beings to the Centers for Disease Control. Ninety-one percent (6,354 cases) were wild animals, whereas 8.9% (618 cases) were domestic species. The total number of reported cases of rabies increased 42.9% over that of 1990 (4,881 cases), with most of the increase resulting from continued spread of the epizootic of rabies in raccoons in the mid-Atlantic and northeastern states. Large increases in cases of rabies in animals were reported from Connecticut (200 cases in 1991, compared with 3 in 1990, an increase of 6,567%), Delaware (197 cases in 1991, compared with 44 in 1990, an increase of 348%), New York (1,030 cases in 1991, compared with 242 in 1990, an increase of 326%), and New Jersey (994 cases in 1991, compared with 469 in 1990, an increase of 112%). Other noteworthy increases were reported by Wyoming (96.4%), Texas (69.7%), California (41.3%), Oklahoma (33.1%), Minnesota (31.4%), Georgia (26.7%), and Maryland (23.7%). Hawaii reported 1 imported case of rabies in a bat. Only 16 states reported decreases in rabies in animals in 1991, compared with 30 in 1990. Pennsylvania and Iowa reported decreases of 40.6% and 27.4%, respectively. Rhode Island was the only state that did not report a case of rabies in 1991.
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Lim, Sung Hee, Jaeyun Jung, Jung Young Hong, Seung Tae Kim, Se Hoon Park, Joon Oh Park, Kyoung-Mee Kim, and Jeeyun Lee. "Prevalence of RAF1 Aberrations in Metastatic Cancer Patients: Real-World Data." Biomedicines 11, no. 12 (December 9, 2023): 3264. http://dx.doi.org/10.3390/biomedicines11123264.
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Purpose: Therapeutic targeting of RAF1 is a promising cancer treatment, but the relationship between clinical features and RAF1 aberrations in terms of the MAPK signaling pathway is poorly understood in various solid tumors. Methods: Between October 2019 and June 2023 at Samsung Medical Center, 3895 patients with metastatic solid cancers underwent next-generation sequencing (NGS) using TruSight Oncology 500 (TSO500) assays as routine clinical practice. We surveyed the incidence of RAF1 aberrations including mutations (single-nucleotide variants [SNVs]), amplifications (copy number variation), and fusions. Results: Among the 3895 metastatic cancer patients, 77 (2.0%) exhibited RAF1 aberrations. Of these 77 patients, 44 (1.1%) had RAF1 mutations (SNV), 25 (0.6%) had RAF1 amplifications, and 10 (0.3%) had RAF1 fusions. Among the 10 patients with RAF1 fusions, concurrent RAF1 amplifications and RAF1 mutations were detected in one patient each. The most common tumor types were bladder cancer (11.5%), followed by ampulla of Vater (AoV) cancer (5.3%), melanoma (3.0%), gallbladder (GB) cancer (2.6%), and gastric (2.3%) cancer. Microsatellite instability high (MSI-H) tumors were observed in five of 76 patients (6.6%) with RAF1 aberrations, while MSI-H tumors were found in only 2.1% of patients with wild-type RAF1 cancers (p < 0.0001). Conclusion: We demonstrated that approximately 2.0% of patients with metastatic solid cancers have RAF1 aberrations according to NGS of tumor specimens.
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Tillett, W., V. Navarro-Compán, N. Booth, T. Holzkaemper, J. Hill, E. Lubrano, and T. Truer. "AB0548 EFFECTIVENESS OF IXEKIZUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM A REAL-WORLD EUROPEAN SURVEY." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1307–8. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2001.
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Background:Limited real world (RW) data are available for IL-17A blocker ixekizumab (Ixe), approved for psoriatic arthritis (PsA) in EU Feb 2018.Objectives:Describe RW outcomes for PsA patients (pts) receiving Ixe.Methods:Cross-sectional, observational study of PsA pts treated with Ixe in the 2020 Adelphi PsA Plus Program (FR, DE, ES & UK). Rheumatologists recruited the first 6 consecutive consulting Ixe pts and provided demographics, PsA manifestations, clinical measures (66 swollen joint count (SJC), 68 tender joint count (TJC), psoriasis area and severity index [PASI], body surface area [BSA] affected by psoriasis [PsO]), rheumatologist-recorded pt measures (skin/joint pain & fatigue [0-10 numeric rating scales (NRS)], health assessment questionnaire [HAQ-DI]) & prescribed dose. All outcomes recorded for pts with scores available at Ixe initiation (II) & at last assessment (LA).Results:124 rheumatologists provided data for 698 Ixe pts, mean age 49 years (19-79), 48% female, mean BMI 27 (18-44), 56% dermatologist co-managed and mean time diagnosed 6 years (0-35). At Ixe initiation, 78% of pts with known BSA had concomitant mod-sev-PsO defined as BSA≥10% (mean 19.8, n=428) and mean PASI 26.3 (n=164). The predominant PsA phenotype was polyarthritic in 49% (n=345), mono/oligoarthritic in 30% (n=208), axial in 12% (n=81) and enthesitic in 8% (n=55). Previous treatment before Ixe included ≥1 conventional synthetic DMARD (csDMARD) for 71% of pts. Of bio-experienced pts (57%), 40% had received ≥2 biologics. Mean Ixe treatment duration (n=698) 39.4 weeks (wks, 0-170), of which 575 (82%) had received >12 wks of Ixe. 71% of pts received label recommended dose (80mg every 4wks). 52% pts received csDMARD in combination with Ixe. In the RW, Ixe improved TJC, SJC, joint pain, BSA, fatigue and HAQ-DI, Table 1.Table 1.Outcomes for pts receiving Ixe >12weeks (n=575)OverallBSA ≥10% at Ixe initiationMod-sev-PsO physician judgementPredominant mono/oligo arthritisPredominant polyarthritisWith csDMARDWithout csDMARDBSA, n35627025498184188168mean [SD]Ixe initiation (II)19.8 [14.8]24.7 [13.5]23.1 [13.6]17.4 [15.0]20.9 [15.0]21.8 [15.0]17.4 [14.2]Last Assessment (LA)6.6 [7.5]9.3 [8.7]7.9 [7.9]5.0 [6.0]7.6 [8.4]7.3 [7.9]5.9 [7.1]Mean weeks on Ixe43414150414146TJC*, n125728639725669mean [SD, %<5]II12.2 [10.6, 29]14.4 [11.3, 18]12.9 [11.1, 21]6.4 [8.2, 59]15.4 [10.8, 12]13.0 [9.9, 25]11.5 [11.1, 32]LA4.1 [6.4, 77]5.2 [7.7, 71]3.6 [6.3, 80]1.1 [1.4, 97]6.2 [7.7, 64]3.4 [3.9, 73]4.6 [7.8, 80]SJC*, n1458210244846085mean [SD, %<5]II14.8 [13.5, 33]18.8 [14.4, 22]16.3 [13.8, 26]7.2 [8.5, 68]18.2 [13.6, 12]14.5 [12.0, 37]15.1 [14.8, 31]LA4.8 [8.7, 79]7.0 [10.7, 66]5.1 [9.3, 75]0.9 [1.9, 95]6.6 [9.0, 68]3.1 [7.8, 90]5.9 [9.1, 71]Joint pain (NRS 0-10), n575270349166291294281mean [SD]II6.6 [1.7]6.7 [1.7]6.7 [1.7]6.2 [1.8]7.0 [1.5]6.6 [1.7]6.6 [1.6]LA2.7 [1.9]3.0 [2.1]2.8 [2.0]2.1 [1.6]3.0 [2.1]2.8 [1.9]2.5 [1.9]Fatigue (NRS 0-10), n575270349166291294281mean [SD]II5.4 [2.5]5.8 [2.4]5.7 [2.5]4.7 [2.5]5.7 [2.4]5.7 [2.4]5.1 [2.5]LA2.6 [2.1]2.7 [2.1]2.7 [2.2]2.0 [1.9]2.9 [2.2]2.7 [2.1]2.6 [2.1]HAQ DI, n59414210283128mean [SD, %<0.5]II1.8 [0.7, 5]1.9 [0.6, 0]1.8 [0.7, 2]1.9 [0.7, 10]1.8 [0.8, 7]1.9 [0.6, 3]1.7 [0.8, 7]LA0.8 [0.6, 41]0.8 [0.6, 32]0.8 [0.7, 45]0.7 [0.7, 60]0.7 [0.6, 36]0.7 [0.5, 32]0.7 [0.8, 50]*Additional analysis for pts whose fatigue/joint pain rating improved (from ≥4 at Ixe initiation to ≤3 at LA), their mean TJC was 2.7 & SJC 4.3 at LA for fatigue, TJC 1.7 & SJC 2.7 at LA for joint pain.When BSA was not recorded, physician judgement of PsO severity was used. No imputation of missing data.Conclusion:We report RW outcome data amongst pts treated with Ixe including mono/oligo arthritis and a limited sample of enthesitis and dactylitis pts. Our results are consistent with clinical trial populations across disease domains, including an improvement in joint pain.Disclosure of Interests:William Tillett Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc. and UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc. and UCB, Grant/research support from: AbbVie, Celgene, Eli Lilly & company, Janssen and UCB, Victoria Navarro-Compán Speakers bureau: AbbVie, BMS, Janssen, Eli Lilly & Co, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: AbbVie, BMS, Janssen, Eli Lilly & Co, MSD, Novartis, Pfizer, Roche and UCB, Grant/research support from: AbbVie, BMS, Janssen, Eli Lilly & Co, MSD, Novartis, Pfizer, Roche and UCB, Nicola Booth: None declared., Thorsten Holzkaemper Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company, Julie Hill Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company, Ennio Lubrano Speakers bureau: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Consultant of: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Tamas Truer Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company.
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Mattison, Claire P., Holly Groom, Judy Donald, S. Bianca Salas, Zachary Marsh, Rachel M. Burke, Mark A. Schmidt, Aron J. Hall, and Allison L. Naleway. "1107. The MAAGE Study: Health Care Utilization for the Treatment of Medically Attended Acute Gastroenteritis." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S331—S332. http://dx.doi.org/10.1093/ofid/ofy210.941.
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Abstract Background Acute gastroenteritis (AGE) exacts a substantial disease burden across the age spectrum, although healthcare utilization for AGE is not well characterized. Through active surveillance of medically attended acute gastroenteritis (MAAGE) encounters within a large, integrated healthcare delivery system, we analyzed demographic patterns of healthcare utilization among AGE patients. Methods From April 1, 2014 to September 30, 2016, we collected information on all MAAGE encounters in Kaiser Permanente Northwest (KPNW) patients through daily abstraction from electronic health records using ICD-9/-10 codes. For each patient, a MAAGE episode was defined as all MAAGE encounters <30 days apart. Results There were 109,493 MAAGE encounters among 39,451 patients. Patients were 60.4% female and 39.6% male; 10.3% were <5 years old, 9.7% were 5–17, 31.1% were 18–44, 25.4% were 45–64, and 23.5% were ≥65. Among those with known race, 87.2% were white; 4.1% were Asian, 3.6% were black, and 5.1% were other or multiple races. Prevalence of any chronic comorbid condition was 52.9%. Of 52,107 MAAGE episodes, 81.0% first presented as outpatients; this was most common in those aged <5 (92.1%) and decreased with age to 75.0% in those ≥65. First presenting remotely (email or telephone) ranged from 4.0% in those aged <5 to 19.3% in those ≥65; 52.7% of episodes first presenting remotely had no subsequent visits. Few episodes first presented to an emergency department (3.8% in <5 year olds to 6.6% in 18–44 year olds) or inpatient setting (0.1% in <5 year olds to 1.7% in ≥65 year olds). Most MAAGE episodes comprised of one encounter (median: 1.0, mean: 2.1). The number of encounters per episode was lowest in those <5 years old (median: 1.0, mean: 1.5) and highest in those ≥65 (median: 2.0, mean: 2.5). Most deaths within 30 days from the start of an episode (131/161) were in those ≥65; there were none in those <5, 1 in those 5–17, 5 in those 18–44, and 24 in those 45–64. Conclusion We found that the number of encounters per MAAGE episode increased with age and that outpatient and remote encounters are important settings for the initial clinical management of MAAGE in all ages. These data can help to better quantify the economic burden of AGE and guide appropriate delivery of healthcare services. Disclosures All authors: No reported disclosures.
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Chino, Fumiko, Sam Meske, Muath Giaddui, Donna-Marie Manasseh, Bridgette Thom, and Marisa Weiss. "Abstract PS04-09: Patient-Reported Benefit of Resources Designed to Assist with the Financial Toxicity of Breast Cancer." Cancer Research 84, no. 9_Supplement (May 2, 2024): PS04–09—PS04–09. http://dx.doi.org/10.1158/1538-7445.sabcs23-ps04-09.
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Abstract Background: A breast cancer (BC) diagnosis can cause financial stress, which may worsen disease outcomes and create financial instability. Tailored interventions are urgently needed, but the patient perspective on the utility of financial resource options is limited. Methods: From 6-7/2022, Breastcancer.org community members consented to an online survey in English or Spanish. Eligibility included:US resident, age ³ 18, and BC diagnosis within 10 years. Survey assessed burden of out-of-pocket expenses and perceived benefit of available (1 “Not at all” to 5 “Very much”) and potential (ranked choice) resources. Results: 1,437 participated. Mean age and time since diagnosis was 46 and 2 years, respectively; 75% were in active treatment for non-metastatic (89%) or metastatic (11%) disease. Patients were 60% White, 27% Hispanic, 8% Black, and 4% other race; 94% were women. 47% had either “significant” or “catastrophic” financial burden due to BC, with higher burdens in those with metastatic disease (61% vs 45%, p< 0.001). Direct assistance programs (e.g., reduced cost medications, grants, transportation) were rated the most helpful to respondents (Table). A grant list, a provider question checklist, and access to professional advice were most often ranked as 1st choice for potential resources. There were significant differences by race/ethnicity and disease status. Conclusions: Almost one-half of surveyed patients had significant financial burden due to BC. Patient-centered solutions to lessen financial burdens and optimize patient outcomes should consider direct assistance and patient education to improve knowledge, communication, and self-advocacy. How helpful were/are each of these resources in helping you cope with the financial burdens of BC? Overall Mean Disease Status Race/Ethnicity Non-metastatic Metastatic White Black Hispanic Other Patient assistance programs offered by pharma or medical test companies 2.9 2.9 3.1* 2.9* 2.6 3.1* 2.6 (n=1,107) (n=975) (n=132) (n=618) (n=94) (n=357) (n=38) Nonprofits that provide grants to help cover expenses of people with cancer 2.8 2.8 2.7 2.8 2.6 3.1* 2.4 (n=1,113) (n=991) (n=122) (n=611) (n=100) (n=358) (n=44) Financial assistance department at the cancer center or hospital 2.8 2.8 2.7 2.7* 2.7 3.1* 2.2 (n=1,176) (n=1,046) (n=130) (n=669) (n=103) (n=362) (n=42) Coupons and savings cards to reduce the cost of prescription drugs 2.8 2.8 2.7 2.7 2.5 3.0* 2.5 (n=1,140) (n=1,008) (n=132) (n=648) (n=92) (n=358) (n=42) Programs that provide free or low-cost transportation to medical appointments 2.7 2.8* 2.4 2.6 2.5 3.0* 2.3 (n=1,042) (n=934) (n=108) (n=556) (n=93) (n=356) (n=37) Clinical trials 2.7 2.7* 2.5 2.6* 2.3 3.0* 2.1 (n=1,032) (n=928) (n=104) (n=557) (n=84) (n=357) (n=34) Professional medical billing advocates 2.7 2.7* 2.3 2.5* 2.4 3.0* 2.1 (n=1,105) (n=994) (n=111) (n=612) (n=94) (n=358) (n=41) Social worker or case manager 2.7 2.7 2.6 2.6* 2.3 2.9* 2.4 (n=1,146) (n=1,027) (n=119) (n=644) (n=99) (n=360) (n=43) Nonprofits that provide advice and education about financial issues 2.7 2.7 2.5 2.6* 2.3 3.0* 2.0 (n=1,100) (n=983) (n=117) (n=607) (n=96) (n=359) (n=38) Financial navigator 2.6 2.6 2.5 2.5 2.5 2.9* 2.1 (n=1,087) (n=976) (n=111) (n=598) (n=94) (n=356) (n=39) Which of the following programs and resources would have been (or would be) most useful to you in navigating the financial burdens of BC? Total Non-metastatic Metastatic White Black Hispanic Other (n=1,282) (n=155) (n=686) (n=121) (n=384) (n=64) A list of financial grants people diagnosed with BC can apply for 18% 18% 19% 19%* 24%* 14% 25%* A checklist of questions to ask your healthcare team to help you minimize the financial burdens of BC 15% 16% 12% 16% 17% 15% 9% Access to free or reduced-price professionals to help with medical billing, financial, benefits, and/or legal issues 13% 13% 8% 11% 8% 15%* 20%* * p< 0.001 Citation Format: Fumiko Chino, Sam Meske, Muath Giaddui, Donna-Marie Manasseh, Bridgette Thom, Marisa Weiss. Patient-Reported Benefit of Resources Designed to Assist with the Financial Toxicity of Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS04-09.
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Gavrilina, Olga A., Kristina A. Zakurdaeva, Anastasia N. Vasileva, Sergei Dubov, Vitaly S. Dubov, Vladimir I. Vorobyev, Lev S. Butaev, et al. "Final Results of CHRONOS19 Observational Study in Patients with Hematologic Disease and COVID-19 in Russia." Blood 138, Supplement 1 (November 5, 2021): 4994. http://dx.doi.org/10.1182/blood-2021-152735.
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Abstract Background: Research on the impact of COVID-19 on different patient populations has been of great value for the optimization of patient care since the start of the SARS-CoV-2 pandemic. Earlier, we reported the interim analysis of the immediate outcomes in patients (pts) with hematologic (hem) disease and COVID-19. Long-term results of the CHRONOS19 registry are now available. Methods: CHRONOS19 is an observational prospective cohort study among adult pts ((≥18 years) with hem diseases (malignant or non-malignant) and laboratory-confirmed or suspected (based on clinical symptoms and/or CT) COVID-19 in Russia. Data from 15 centers all over the country were collected on a web-based platform in a de-identified manner at 30, 90, and 180 days after COVID-19 was diagnosed. The primary endpoint was 30-day all-cause mortality. Secondary outcomes included COVID-19 complications, rate of ICU admission and mechanical ventilation, outcomes of hem disease in SARS-CoV-2 infected pts, overall survival, and risk factors for disease severity and mortality. Results: As of July 30, 2021, 666 pts were enrolled (females / males [n (%)]: 317 (48%) / 349 (52%); median [range] age: 56 [18-90] years. Disease types (malignant/non-malignant [n (%)]): 618 (93%) / 48 (7%), including AML 115 (17%), MM 113 (17%), NHL 106 (16%), CML / CMPD 92 (14%), ALL 52 (8%), CLL 50 (8%), MDS 25 (4%), HCL 23 (3%), HL 21 (3%), AA 16 (2%), APL 11 (2%), others 42 (6%); among them induction phase / remission / relapse or refractory / NA in 237 (35%) / 231 (35%) / 152 (23%) / 46 (7%) pts. Concomitant conditions were reported in 385 (58%) pts: cardiovascular 254 (66%), diabetes 76 (20%), obesity 57 (15%), pulmonary 41 (11%), chronic renal 44 (11%) or hepatic 33 (9%) disease, other 90 (23%). At a median follow-up of 7,5(1-19) months, 618 pts were evaluable for the primary outcome. Thirty-day all-cause mortality was 16% (100 pts died). Death due to COVID-19 complications occurred in 82 pts, 14 pts died due to progression of hem disease. Overall, 217 (33%) pts had severe disease, COVID-19 complications were detected in 458 (70%) pts, the most common were pneumonia in 425 (93%) pts, respiratory failure in 252 (55%) pts, multiple organ failure in 56 (12%) pts, cytokine storm in 52 (11%) pts, ARDS in 47 (10%) pts, and sepsis in 44 (10%) pts. The rate of ICU admission was 23% (145 pts) with high mortality in this group of pts (77%), 111 (17%) pts required mechanical ventilation, among them only 5 (4.5%) pts survived. Treatment of hem disease was changed, interrupted, or discontinued in 395 (60%) pts with a median delay of 4 weeks. At 30 days, the rate of relapse / progression of hem disease was 5% / 8% (24 / 40 of 517 evaluable pts). At the longer follow-up (90 and 180 days), relapse / progression occurred in another 9 / 23 pts. At the data cutoff, the median overall survival was not reached. Antibody detection was performed in 253 pts: 211 (84%) pts had IgG to SARS-CoV-2. In a univariate analysis, older age (> 60 years), myelotoxic agranulocytosis, transfusion dependence, diabetes among comorbidities, ARDS and other complications, except CRS, ICU and mechanical ventilation (Fig. 1) were associated with higher risks of mortality (p<0.05). The final results of the CHRONOS19 study will be presented. Conclusions: Patients with hem disease and COVID-19 have higher mortality than a general population with SARS-CoV-2 infection, predominantly due to COVID-19 complications. The longer-term follow-up did not reveal any concerns in terms of hem disease outcomes. Figure 1 Figure 1. Disclosures Vorobyev: Janssen, Roche, Sanofi, Takeda, Biocad, Abbvie: Other: Advisory Boards, Speakers Bureau; Astellas, Novartis, AstraZeneca: Speakers Bureau. Chelysheva: Pharmstandart: Speakers Bureau; Pfizer: Speakers Bureau; Bristol Myers Squibb: Speakers Bureau; Novartis Pharma: Speakers Bureau.
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Bezerra, Danielle V. F., José W. Queiroz, Victor A. V. Câmara, Bruna L. L. Maciel, Eliana L. T. Nascimento, and Selma M. B. Jerônimo. "Factors Associated with Schistosoma mansoni Infestation in Northeast Brazil: A Need to Revisit Individual and Community Risk Factors." American Journal of Tropical Medicine and Hygiene 104, no. 4 (April 7, 2021): 1404–11. http://dx.doi.org/10.4269/ajtmh.19-0513.
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ABSTRACTIn Brazil, schistosomiasis continues to be an important health issue. The aim of this study was to identify factors associated with Schistosoma mansoni infestation. A cross-sectional study was performed to assess factors associated with S. mansoni endemicity in a municipality in Northeast Brazil with a history of reporting schistosomiasis. Participants were divided into four groups: 1) new S. mansoni cases (n = 44), 2) past history of S. mansoni treatment (n = 78), 3) immediate neighbors (n = 158), and 4) nearby controls (n = 35). Multiple comparisons analysis was performed. Subjects had a mean of 6.6 ± 3.9 years of education, and no difference was observed regarding family income (one-way analysis of variance, P = 0.215). A total of 95.9% of the individuals had rudimentary cesspit as sanitary wastewater. The mean body mass index was 28.3 ± 5.1, with 41.0% and 24.1% overweight and obesity, respectively. Of note, 28.9% of adults had hypertension. Hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin were higher in the recent S. mansoni treated group (Wilks’ lambda, P < 0.001). Male gender was more prevalent in new S. mansoni cases (likelihood ratio, P < 0.001), close proximity to water collections was a risk for S. mansoni infestation (likelihood ratio, P < 0.001), and a better hematological status was observed in individuals recently treated with praziquantel. This study indicates the need to maintain surveillance for S. mansoni in low-transmission areas and the need to establish community-based interventions to control transmission.
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Lillo-Bevia, José R., and Jesús G. Pallarés. "Validity and Reliability of the Cycleops Hammer Cycle Ergometer." International Journal of Sports Physiology and Performance 13, no. 7 (August 1, 2018): 853–59. http://dx.doi.org/10.1123/ijspp.2017-0403.
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Purpose: To validate the new drive indoor trainer Hammer designed by Cycleops®. Methods: A total of 11 cyclists performed 44 randomized and counterbalanced graded exercise tests (100–500 W) at 70-, 85-, and 100-rpm cadences in seated and standing positions on 3 different Hammer units, while a scientific SRM system continuously recorded cadence and power output data. Results: No significant differences were detected between the 3 Hammer devices and the SRM for any workload, cadence, or pedaling condition (P value between 1.00 and .350), except for some minor differences (P = .03 and .04) found in the Hammer 1 at low workloads and for Hammer 2 and 3 at high workloads, all in seated position. Strong intraclass correlation coefficients were found between the power output values recorded by the Hammers and the SRM (≥.996; P = .001), independently from the cadence condition and seated position. Bland–Altman analysis revealed low bias (−5.5 to 3.8) and low SD of bias (2.5–5.3) for all testing conditions, except marginal values found for the Hammer 1 at high cadences and seated position (9.6 [6.6]). High absolute reliability values were detected for the 3 Hammers (150–500 W; coefficient of variation <1.2%; SEM <2.1). Conclusions: This new Cycleops trainer is a valid and reliable device to drive and measure power output in cyclists, providing an alternative to larger and more expensive laboratory ergometers and allowing cyclists to use their own bicycles.
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Pun, Khagi Maya, Priscilla Samson, and Rekha Timalsina. "Stress, stress responses and coping strategies among bachelor nursing students." Journal of Patan Academy of Health Sciences 5, no. 2 (December 30, 2018): 74–80. http://dx.doi.org/10.3126/jpahs.v5i2.24016.
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Introductions: Inability to use effective coping strategies to minimize stress due to high academic and clinical expectations may affect nursing students’ health, academic and clinical performance. The aim of this study was to assess the level of stress, stress responses and use of coping strategies among bachelor nursing students.
Methods: This-cross-sectional study included bachelor nursing program students selected by stratified random sampling technique from four nursing colleges affiliated to Tribhuvan University in Kathmandu Valley, Nepal, during August 18th to September 15th 2017. Data were collected using structured self-administered questionnaire. Perceived stress scale, physio-psycho-social responses scale and coping check lists were used to assess stress, stress responses and coping strategies of bachelor nursing students.
Results: There were total 284 participating nursing students, 240 (84.5%) had moderate level of stress and 20 (7%) high level of stress. The common source of stress were assignments and workload (2.37±0.63), and clinical environment (2.16±0.74). Students’ physio-psycho-social responses during stress, 109 (38.4%) reported best emotional health, 125 (44%) best social behavioral and 189 (66.7%) best physical health. Coping strategies were, problem focused 175 (61.6%), social support coping 173 (60.9%), and avoidance coping 165 (58.1%). There was a positive correlation between stress and coping (r=0.138).
Conclusions: More than 3/4th of bachelor nursing studentsreported moderate level of stress, problem focused coping strategies was commonly used and half of the students maintained good level of physio-psychosocial health during stress.
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Plotkin, Scott R., Jennifer Da, Danielle Silverman, Vanessa Merker, Ina Ly, Alona Muzikansky, Michael Parsons, et al. "CTNI-79. PHASE 2 RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF THE ANTI-NERVE GROWTH FACTOR (NGF) ANTIBODY TANEZUMAB IN SUBJECTS WITH MODERATE TO SEVERE PAIN DUE TO SCHWANNOMATOSIS." Neuro-Oncology 25, Supplement_5 (November 1, 2023): v96. http://dx.doi.org/10.1093/neuonc/noad179.0361.
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Abstract INTRODUCTION Schwannomatosis (SWN) is a rare neurogenetic condition (prevalence 1:125,000) characterized by multiple schwannomas and severe chronic pain. Increased expression of nerve growth factor (NGF) has been identified in painful schwannomas. METHODS We conducted a single-institution, phase 2, randomized, double-blind, placebo-controlled trial of tanezumab, an anti-NGF antibody. Eligibility criteria included age ≥ 18; moderate-to-severe SWN-related pain; ability to discontinue NSAIDs; and absence of osteoarthritis. Participants were treated with tanezumab 10 mg SQ or placebo (double-blind treatment) followed by tanezumab 10 mg SQ (single-arm treatment). The primary endpoint was change in NRS-11 scores between days 1 and 57 (double-blind). Secondary endpoints included change in PROMIS-Pain Interference (PI) T-scores. RESULTS Nine subjects were enrolled (median age 44 years, 7 females). At baseline, mean NRS-11 score was 7.6 (SD 2.1) and mean PROMIS-PI T-score was 63.2 (SD 6.6). During double-blind treatment, four participants were randomized to receive tanezumab (early group) and five were randomized to placebo (delayed group). For the early group, the mean change in NRS-11 score was -2.5 (SD 4.5) after initial tanezumab and 0 (SD 0) with continued treatment. For the delayed group, the mean change in NRS-11 score was -0.4 (SD 2.1) with placebo and -1.4 (SD 1.9) after tanezumab. For the early group, the mean change in PROMIS-PI T-score was -6.2 (SD 10.9) after initial tanezumab and -0.4 (SD 2.0) with continued treatment. For the delayed group, the mean change in PROMIS-PI T-score was 1.1 (SD 2.9) after placebo and -3.3 (SD 4.1) after tanezumab. Discussion: For SWN patients with moderate-to-severe pain, addition of tanezumab was associated with decreases in pain intensity and pain interference. Although these changes reflect clinically meaningful differences per published literature, they were not statistically significant. This study was underpowered due to poor accrual and a larger study in this patient population is warranted.
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Barron, Michelle A., Neil Fishman, G. Mark Baillie, and Helga Brake. "Multicenter Evaluation of Fungal Prophylaxis in Hematopoietic Stem Cell Transplantation." Blood 108, no. 11 (November 16, 2006): 5293. http://dx.doi.org/10.1182/blood.v108.11.5293.5293.
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Abstract BACKGROUND: The University HealthSystem Consortium (UHC) conducted a benchmarking study to assess members’ compliance with published guidelines for prevention of fungal infections in hematopoietic stem cell transplant (HSCT) recipients. METHODS: Adult HSCT patients were evaluated by retrospective chart review of cases discharged between 01/01/04 and 06/30/05. Data collected included demographics, use of prophylaxis (px), and outcomes. Patients were classified as high or low risk for fungal infection according to NCCN and CDC guidelines. RESULTS: Thirteen UHC member hospitals submitted a total of 242 HSCT cases. Patient characteristics and administration of antifungal therapy are shown in Table 1. 57% (137/242) of patients were classified as high risk for fungal infection. Overall, 85% (205/242) of patients received antifungal px. Compliance with national guideline directed antifungal px was 54%. Of patients who did not receive px, 59% (22/37) were high-risk. 32% (7/22) of these patients required empiric antifungal therapy, 29% (2/7) had a confirmed fungal infection and 1 of these patients died. Of patients who received antifungal px, 44% (90/205) were classified as low risk. 6.7% (6/90) went on to require empiric therapy and 2 died. 84.4% of patients had fluconazole as at least one of their prophylactic agents, and 34% of patients received prophylactic antifungals that provided coverage for both Aspergillus and Candida species. 5.4% (13/242) of HSCT recipients died during the target hospitalization. 76.9% (10/13) of these patients were high risk. 61.5% (8/13) had signs/symptoms of a suspected or definitive fungal infection at the time of death (6 were high risk). CONCLUSION: Most HSCT patients did not receive appropriate fungal px based on current guidelines. Failure represented both under and over utilization of px. Further study is required to explain poor adherence to current guidelines. Table 1: Patient Characteristics by Degree of Risk High Risk (n=137) Low Risk (n=105) % (n) % (n) *ABX = broad spectrum antibiotics Chemotherapy prior to admission 53.3% (73) 61.9% (65) Radiation prior to admission 23.4% (32) 17.1% (18) Allogeneic Transplant 75.9% (104) 17.1% (18) Cytomegalovirus disease 11.7% (16) 6.7% (7) GVHD 15.3% (21) 1.0% (1) Mucositis 55.5% (76) 7.6% (8) Systemic corticosteroids 63.5% (87) 44.8% (47) Fever unresponsive to >4 days of ABX 19.0% (26) 12.4% (13) Neutropenia during antifungal therapy 39.4% (54) 27.6% (29) History of Aspergillus infection 3.6% (5) 0.0% (0) Antifungal therapy: Prophylaxis 83.9% (115) 85.7% (90) Failed prophylaxis 21.2% (29) 5.7% (6) Empiric therapy 25.4% (32) 10.5% (11) Definite treatment 6.6% (8) 0.0% (0)
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Reis, Rachelle Simões, José F. C. Henriques, Guilherme Janson, Karina Maria Salvatore Freitas, and Wilana Moura. "Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study." Dental Press Journal of Orthodontics 24, no. 6 (December 2019): 56–64. http://dx.doi.org/10.1590/2177-6709.24.6.056-064.oar.
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ABSTRACT Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.
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Modi, Sagar, Manjari Tripathi, Soma Saha, and Ravinder Goswami. "Seizures in patients with idiopathic hypoparathyroidism: effect of antiepileptic drug withdrawal on recurrence of seizures and serum calcium control." European Journal of Endocrinology 170, no. 5 (May 2014): 777–83. http://dx.doi.org/10.1530/eje-14-0075.
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ObjectiveThere is limited information on seizures in patients with idiopathic hypoparathyroidism (IH). We assessed seizure characteristics at presentation, subclinical seizures during follow-up, and the effect of antiepileptic drug (AED) withdrawal in IH patients.Designs and methodsSeizure characteristics were assessed in 70 patients with IH attending endocrine clinic. Provoked electroencephalography (EEG) was performed for subclinical seizures in 44 of them. AEDs were withdrawn using strict criteria, i.e. i) no seizure during past 2 years, ii) normal EEG, iii) serum total calcium ≥1.8 mmol/l, and iv) feasibility to follow-up regularly after AED withdrawal for at least 9 months (n=14). The effects of AED withdrawal on seizures and serum total calcium were assessed.ResultsSeizures were present in 64.3% of patients, generalized tonic–clonic in 86.7%, and treated with phenytoin (46.7%), valproate (40%), and carbamazepine (26.7%). Most (69/70) patients were seizure-free during the follow-up of 6.6±4.5 years. Ten of 14 (71.4%) patients were successfully withdrawn from AED and remained seizure free during the follow-up period of 13.5±2.4 months (range 9–18). AEDs were restarted because of the recurrence of seizures (n=3) and poor compliance with calcium/vitamin D (n=1). The mean serum total calcium increased from 1.9±0.19 to 2.1±0.14 mmol/l after AED withdrawal (P=0.004).ConclusionSeizures were present in 64.3% of patients with IH and they responded to AED and calcium/1-α-(OH)D during the follow-up. With strict eligibility criteria, it was possible to withdraw AED in 71% of patients with IH. Serum total calcium improved significantly after AED withdrawal.
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Coutzac, Clélia, Isabelle Trouilloud, Pascal Artru, Julie Henriques, Thérese Masson, Christelle De La Fouchardiere, Solene Doat, et al. "Trifluridine/tipiracil or regorafenib in refractory metastatic colorectal cancer patients: An AGEO prospective “real life” study." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 4036. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.4036.
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4036 Background: Regorafenib (R) and trifluridine/tipiracil (T) have proved their efficacy in patients (pts) with metastatic colorectal cancer (mCRC) refractory to standard chemotherapy and targeted therapies. However, it remains unclear which drug should be administered first. Methods: This observational study was prospectively conducted in 13 centers between 6/2017 and 9/2019 in France. All consecutive pts with chemoresistant mCRC and receiving T and/or R were eligible. The aim of this study was to describe efficacy and tolerability of T and/or R. Overall survival (OS) and progression-free survival (PFS) of pts receiving T then R (T/R) and the opposite sequence (R/T) were also assessed. Results: A total of 237 pts (25% R and 75% T) were enrolled (109 male, median age: 67 years (32-91), mean previous lines of treatment: 2.5 (1-7)). Baseline ECOG PS was 0-1 in 77% of pts. As compared to R pts, T pts were significantly older (68 years vs 63; p = 0.033) and with > 3 metastatic sites (44% vs 30%, p = 0.018). Median OS were 6.6 and 6.2. months in the T and R group, respectively (NS). Median PFS were 2.4 and 2.1 months in the T and R group, respectively (NS). After matching 46 paired pts according to primary tumor resection, age and number of metastatic sites, a trend to a longer OS (9.5 vs 6.8 months; p = 0.17) and a significantly longer PFS (2.8 vs 2 months; p = 0.048) were observed in the T group. Among the overall population, 24% of pts received R/T or T/R sequence. Median OS from first treatment were 10.7 months in the R/T group and 9.8 months in the T/R (NS). Treatment sequence was not an independent prognostic factor for OS or PFS in multivariable analysis. Tolerability profiles were similar to previously published data, but dose reductions were more frequent in the R group (44 vs 27%, p = 0.008). Conclusions: Efficacy and safety results in this real life prospective study are in line with those published phase III trials. Both treatments seem similar in term of efficacy favoring T for clinical use as shown by the higher number of patients receiving this drug.
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Kucukardali, Yasar, Arzu Yalcin, Murat Hakan Terekeci, Mehmet Akif Ozturk, Betul Kucukardali, and Elif Cigdem Altunok. "Risk Factors for Mortality in Elderly Patients who Live in Nursing Homes: 8-year Follow-up Period." Asian Journal of Medical Sciences 10, no. 6 (October 30, 2019): 1–10. http://dx.doi.org/10.3126/ajms.v10i6.25702.
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Background: In developed countries and our country, the ratio of the elderly to the total population is increasing due to the rise in worldwide medical care spendings and the medical workforce allocated for the treatment of the acute and chronic problems of the elderly.
Aims and Objectives: The number of studies based on long-term observations of the risk factors that affect the survival and mortality rates of the elderly in nursing homes is quite rare. Currently, there are no studies concerning this issue in the country. The authors carried out an eight years prospective study to determine the risk factors for mortality in a private nursing home with a capacity of 150 beds located in Istanbul.
Materials and Methods: From January 2007 to March 2015, we scanned the number of medications, comorbidities, nutritional status, age, mental score, number of falls and fractures, levels of hemoglobin, albumin, creatinine, and glucose parameters related with mortality in 612 patients admitted to the nursing home.
Results: The median overall survival time was 34 months. A total of 240 (39%) residents died within eight years, 44% within two years and 55% within three years. The evaluation results shothat 360 (51%) of the 612 residents, were females and the mean age was 76.49 (± 11.36) years. Hazard ratios of the related parameters that related to mortality were respectively 1,3 for age, 1,5 for BMI less than 20kg/m2, 4,2 for more than six comorbidities, 7,01 for six to nine number of medications, 5 for dependency, 0,7 for one to three episodes of infection, 0,5for falls, 1,3 for fracture, 3,1 for mental score of less than 18, 1,9 for hemoglobin less than 12gr/dl, 4,03 for creatinine higher than 1.5 mg/dl, 2,43 for glucose greater than 126 mg/dl, 4,8 for albumin less than 3 g/dl (95% CI).
Conclusion: The risk factors causing mortality are; old age, BMI less than 20, more than six comorbidities, more than six medications, dependency, one to three episodes of infection, impaired mental score less than 18, anemia, hyperglycemia, kidney failure, hypoalbuminemia at the patients who admitted to nursing homes. Early optimal monitoring of these parameters can provide a positive contribution to the survival of elderlyresidents in nursing homes.
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Gonçalves, Mayara Rodrigues, Eduarda Ramos Carlesse, Mário Augusto Muggiati, Francisco Diego Negrão Lopes Neto, Graciele De Matia, and Rosires Pereira de Andrade. "Estudo comparativo entre dispositivos intrauterinos inseridos em mulheres no puerpério sob diferentes técnicas e períodos / Comparative study between intrauterine devices inserted in women in the puerperium under different techniques and periods." Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo 64, no. 3 (December 18, 2019): 213. http://dx.doi.org/10.26432/1809-3019.2019.64.3.213.
Full textAbstract:
Introdução: Os períodos gestacional e puerperal são ideais para o aconselhamento do planejamento familiar. A Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO) aconselha o uso dos dispositivos intrauterinos no puerpério, após o parto transpélvico ou cesárea. A inserção após o parto se divide em imediata (até 10 minutos após a dequitação placentária), precoce (entre 10 minutos e 48 horas de pós-parto) ou tardia (após 4 semanas de pós-parto). Sua principal complicação é a expulsão, e está relacionada ao momento da inserção. Objetivo: Analisar o perfil epidemiológico das participantes e comparar as taxas de expulsão entre dois dispositivos intrauterinos, o DIU-TCu380A e o Sistema Intrauterino Liberador de Levonorgestrel (SIU-LNG), inseridos durante o pós-parto e transcesárea, sob diferentes técnicas e períodos. Métodos: Os dispositivos foram oferecidos a 206 puérperas da Maternidade Victor Ferreira do Amaral de Curitiba - PR, 117 optaram pelo SIU-LNG e 89 pelo DIU-TCu308A. Foram incluídas 155 participantes, 15 (9,67%) inserções ocorreram durante a cesárea e 140 (90,32%) após o parto transpélvico. Após 45 dias da inserção, foi realizada uma avaliação ginecológica e ultrassonográfica do dispositivo. Em relação à inserção após o parto transpélvico, o estudo foi dividido em 4 fases de acordo com a técnica de inserção utilizada. A primeira fase (n: 34; 21,93%) utilizou o aplicador do produto. A segunda (n: 12; 7,74%), utilizou o aplicador com o pinçamento do colo uterino. A terceira (n: 14; 9,03%) utilizou a Pinça Cheron 25cm. E a quarta fase (n: 80; 51,61%), a Pinça Collin Coração Curva 24cm. Resultados: A idade média das participantes foi de 27,1 anos (±5,9) e a paridade 2,1 filhos (±1,1). As taxas de expulsão foram de 44% (n: 15), 42% (n: 5) e 36% (n: 5) nas três primeiras fases, e 13,75% (n: 11) na última fase (p=0,00028). O SIU-LNG apresentou 14,6% de expulsões (n: 7) e o DIU-TCu380A 12,5% (n: 5)(p=0,7751). No pós-parto, a taxa de insucesso de ambos os dispositivos foi de 13,8% (n: 11) e na cesárea de 6,6% (n: 1)(p=0,403). Conclusão: A população estudada apresentou faixa etária entre 21 e 30 anos e possuía até 2 filhos. A maioria (56,2%) estava em união estável e 92% declarou-se satisfeita ou muito satisfeita com o uso do DIU. A técnica de inserção utilizada na fase 4 obteve melhores resultados. As variáveis relacionadas ao tipo de inserção, o tempo de inserção e o dispositivo usado não interferiram na taxa de expulsão. Descritores: Medidas em epidemiologia, Anticoncepção, Período pós-parto, Dispositivos intrauterinos, Expulsão de dispositivo intrauterinoABSTRACTIntroduction: The gestational and puerperal period are ideal for family planning. The Brazilian Federation of Gynecology and Obstetrics Associations advises the intrauterine devices in puerperium after transpelvic delivery or during cesarean. Postpartum insertion is divided into immediate (up to 10 minutes after placental clearance), early (between 10 minutes and 48 hours postpartum) or late (after 4 weeks postpartum). Expulsion is the main complication, and is related to the time of insertion. Objective: Analyze the epidemiological profile and compare the expulsion rates between two intrauterine devices, the IUD-TCu380A and the Levonorgestrel Releasing Intrauterine System (SIU-LNG), inserted during postpartum and transceiver, under different techniques and periods. Methods: The devices were offered to 206 postpartum women of Victor Ferreira do Amaral Maternity of Curitiba - PR, 117 opted for SIU-LNG and 89 for IUD-TCu308A. Were included 155, 15 (9.67%) insertions occurred in cesarean and 140 (90.32%) after transpelvic delivery. After 45 days insertion, was performed a gynecological and ultrasonographic evaluation. The insertion after transpelvic delivery was divided into 4 phases according to the insertion technique. The first phase (n: 34; 21.93%) used the product applicator. The second (n: 12; 7.74%) used the applicator with cervical clamping. The third (n: 14; 9.03%) used Cheron Tweezers 25cm. And the fourth phase (n: 80; 51.61%), Collin Heart Curved Tweezers 24cm. Results: The participants' mean age was 27.1 (±5.9) and parity 2.1 (±1.1). The expulsion rates were 44% (n: 15), 42% (n: 5) and 36% (n: 5) in the first three phases, and 13.75% (n: 11) in the last phase (p=0.00028). SIU-LNG presented 14.6% of expulsions (n: 7) and IUD-TCu380A 12.5% (n: 5) (p=0.7751). Postpartum failure rate was 13.8% (n: 11) and cesarean 6.6% (n: 1) (p=0.403). Conclusion: Approximately 2/3 of women were up to 30 years old and up to 2 children. The insertion technique used in phase 4 obtained better results. Variables related to insertion type, insertion time and the device used did not affect the expulsion rate.Keywords: Epidemiologic studies, Contraception, Postpartum period, Intrauterine devices. Intrauterine device expulsion