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Masarova, Lucia, Naval Daver, Naveen Pemmaraju, Prithviraj Bose, Sherry Pierce, Taghi Manshouri, Jorge E. Cortes, Hagop M. Kantarjian e Srdan Verstovsek. "Do Patients with Post-Essential Thrombocythemia and Post-Polycythemia Vera Differ from Patients with Primary Myelofibrosis?" Blood 126, n.º 23 (3 de dezembro de 2015): 4069. http://dx.doi.org/10.1182/blood.v126.23.4069.4069.
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Abstract Introduction: Clinical characteristics of post-essential thrombocythemia/polycythemia vera myelofibrosis "post ET/PV-MF" are not well defined as for primary myelofibrosis "MF". Objective: We aimed to identify morphological, clinical and prognostic characteristics of patients with post ET/PV-MF seen at our center. Methods: Retrospective chart review of 1120 patients with MF - 766 primary MF, 354 post ET/PV-MF, who were referred to our institution between years 1984-2013 was performed; 92% presented after the year of 2000. Fisher's exact and Mann-Whitney test were used for categorical and continuous variables; Cox proportional hazard model and Kaplan-Meier curves with log rank test for correlation between the variables and survival. Survival analysis were calculated after censoring patients for stem cell transplantation "SCT" (n=92). Results: Overall median follow up was 36 months (0-411), 51% (n=573) patients had died. Progression to AML after median time of 32 months was not different between groups and occurred in 9.5% (n=106) patients over observation period of 5180 persons-years. Incidence rate was 3.4 cases per 100 persons-year. Causes of death were known in 55% of patients, and included progression of MF in 38% (n=122), infection in 27% (n=86), and other reasons with less than 10% occurrence (complications post SCT; secondary malignancy; other medical conditions). Demographics and disease characteristics are depicted in a table. 92% of patients were evaluable for karyotype; abnormalities were detected in 39% (n=404), of which 53% were unfavorable with monosomal (23%), complex (43%) and trisomy 8 (18%) being the most common. Molecularly high risk mutations "MHR" in genes ASXL1, EZH2, and IDH1/2 were positive in 35% of tested patients (n=161) regardless of presence of driver mutation. IPSS and DIPSS plus scores were similar between MF and post ET/PV-MF (with IPSS low in 8.7%, intermediate 1 in 19%, intermediate 2 in 28%, and high in 44%). By multivariate analysis, higher risk categories of IPSS and DIPSSplus predicted shorter overall survival "OS" for both cohorts (by DIPSSplus - high risk: HR 2.7, 95% CI 2.1-3.5; int-2: HR 1.6; 95% CI 1.3-2.0). Median OS stratified by IPSS was 160 (HR 1.8, 95%CI 1.0-3.0), 116 (HR 1.5, 95%CI 1.0 -1.5), 78 (HR 1.4, 95%CI 1.2-1.7) and 54 months, p=0.001. Univariate analysis identified age over 65, anemia, trombocytopenia, leukopenia, increased blasts, splenomegaly, constitutional symptoms, unfavorable karyotype, JAK2 mutation and triple negativity as predictors for inferior survival. Age over 65; hemoglobin below 10, platelets below 100 and peripheral blasts ≥1% showed significance for predicting OS by multivariate analysis. When stratified according to diagnosis, higher age, anemia, thrombocytopenia, high blasts, JAK2 positivity and triple negativity retained prognostic significance for MF whereas anemia, thrombocytopenia, and JAK2 mutation for post ET/PV-MF. Median OS was 73 months (range, 0.1-210) without difference between MF and post ET/PV-MF. Conclusion: Post ET/PV-MF does not appear to have substantial different clinical characteristics than primary MF. Table. Characteristics Total, number or median (% or range) MF, number or median (% or range) PET/PV-MF, number or median (% or range) Age 65 (20-89) 64 (20-88) 64 (27-89) Age > 65 552 (49) 367 (48) 185 (53) Males 675 (60%) 494 (65) 181 (51)* WBC 9.6 (0.4-361) 17.3 (5-19) 16.7 (5-18) WBC > 24 203 (18) 133 (18) 70 (20) WBC < 4 160 (14) 130 (17) 30 (8.5)* Plt 204 (3-2690) 237 (1-1364) 354 (6-2690)* Plt < 100 276 (25) 220 (29) 56 (16)* Hgb 10.5 (5-18) 10 (5-18) 11 (5-19)* Hgb < 10 462 (42) 329 (43) 133 (38)* Transfusion dependency 265 (24) 203 (27) 62 (18)* Blasts ≥ 1% 523 (47) 371 (49) 152 (43) Splenomegaly 668 (60) 459 (63) 209 (65) Symptoms 793 (71) 537 (70) 256 (73) LDH 1246 (189-10343) 1248 (189-10353) 1261 (205-8476) LDH > 620 958 (86) 640 (85) 318 (90)* JAK2 positive 586 (57) 371 (63) 215 (37)* MPL positive 19 (1.9) 16 (84) 3 (16)* CARL positive 53 (5) 27 (51) 26 (49)* Triple negative 26 (2.5) 21 (81) 5 (19)* *statistically significant differences (p<0.05) Disclosures Pemmaraju: Stemline: Research Funding; Incyte: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Research Funding; LFB: Consultancy, Honoraria. Cortes:Novartis: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Teva: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; ARIAD Pharmaceuticals Inc.: Consultancy, Research Funding.
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Bekisheva, А., А. Makishev e А. Kukanova. "EXPERIENCE IN THE APPLICATION OF CASE-BASED LEARNING (CBL) IN THE CLASSES IN THE DISCIPLINE "ONCOLOGY"". Astana Medical Journal 2, n.º 116 (2023): 114–17. http://dx.doi.org/10.54500/2790-1203-2023-2-116-114-117.
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Currently, education in the higher medical school has changed significantly. There is a tendency to focus on student-centeredness and learning in an active format. The use of clinical cases based on specific situations that have taken place in clinical practice are called Case-based learning (CBL). The purpose of this message: Report results of application effectiveness of the use of CBL in students in the study of oncology. The innovative CBL method is used to conduct a practical lesson for students. In total, more than 50 CBL classes were conducted with more than 600 students in the discipline "Oncology". When compiling the CBL, real cases from clinical practice were selected. According to the classification, the case has the form of "small sketches" (short vignetts) on 8 pages. Classes by the case study method were carried out at practical classes on the topic "Cancer of the esophagus". Students' knowledge was assessed on a 100-point scale according to checklists that were developed in accordance with the content of the case. The average grade score of students before the introduction of CBL on the topic "Dysphagia" was 80.3 points. and after conducting classes with the use of CBL was 89.6, in the direction of improving performance in the tested groups by 9.3 points. The results of the feedback were evaluated according to three criteria: informative, visibility, accessibility for understanding, where all students participated. Informativе was rated as "excellent" - 82%, "good" - 18%.Visibility was rated as "excellent" - 85%, "good" - 15%. Accessibility for understanding was rated as "excellent" - 92%, "good" - 8%. Conclusions. CBL is an educational perspective in which students develop research potential, strategy and opportunities. Modeling professional situations through cases allows the student not only to solve the problem, but also to develop tactics of behavior in the proposed circumstances, predict the further development of the situation, determine the ability to work in a team, the ability to express their own views on the problem, conduct a discussion or debate.
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Murkamilov, Ilkhom T., K. A. Aitbaev e R. Kaliev. "Peculiarities of progression of chronic glomerulonephritis associated with anemia". Clinical Medicine (Russian Journal) 94, n.º 8 (3 de outubro de 2016): 620–23. http://dx.doi.org/10.18821/0023-2149-2016-94-8-620-623.
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Aim.To study the influence of renal anemia on the clinical course of chronic kidney disease in patients with chronic glomerulonephritis (CGN) at the early stage of the disease. Materials and methods. This prospective 12 month study included evaluation of clinical and laboratory characteristics of 149 patients aged 17-66 (mean 37,6±12,6) years at the pre-dialysis stage of CGN (92 men (37,04±13,4 yr) and 57 women (38,2±11,2 yr). Results. By the end ofprospective observation, patients of group 1 (CGN without anemia) showed a decrease of the hemoglobin level accompanied by the impairment of nitrogenreleasing function with the glomerular filtration rate of 70,1 (43,1-111) ml/min compared with 87 (61,3-115,3) at the onset of observations (p<0,05). In group 2 (CGN with anemia), dynamics of the nitrogen-releasing function was similar but even more pronounced with the glomerular filtration rate reduced to 47,4 (32,2-91,8) ml/mincompared with 80,7 (39,8-107,9) at the onset of observations (p<0,05) and the serum creatinine level increased to157 (92-242) mcmol/l compared with 123 (86-171) (p<0,05). Conclusion. Reduction of hemoglobin level in patients with CGN is apparent at the early stages of the disease in association with impairment of glomerular filtration. The data obtained indicate that anemia can be a laboratory predictor of deteriorated nitrogen-releasing function.
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Pereira, F. V., F. P. Lucena, R. L. Rodrigues, L. A. Barros, C. A. Pires, A. M. R. Ferreira e M. F. V. Mello. "Prevalência e distribuição espacial da ocorrência de helmintos em primatas não humanos de vida livre no estado do Rio de Janeiro, Brasil". Arquivo Brasileiro de Medicina Veterinária e Zootecnia 72, n.º 5 (setembro de 2020): 1705–12. http://dx.doi.org/10.1590/1678-4162-11868.
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RESUMO Seiscentos primatas neotropicais foram submetidos a exames post mortem para avaliação da prevalência parasitária de helmintos gastrointestinais. Foram examinados 556 calitriquídeos (Callithrix spp.), 23 bugios (Alouatta guariba), 19 macacos-pregos (Sapajus nigritus), um mico-leão-dourado (Leontopithecus rosalia) e um mico-leão-da-cara-dourada (Leontopithecus chrysomelas). Do total de 600 animais, foram encontrados espécimes parasitos pertencentes aos filos Acanthocephala, Nemathelmintes e Platyhelminthes (classes Trematoda e Cestoda) em 110 primatas. A prevalência de primatas positivos para, pelo menos, uma espécie de helminto foi de 18,3% (110/600), sendo destes 83,6% (92/110) calitriquídeos, 8,2% (9/110) bugios, 6,4% (7/110) macacos-pregos, 0,9% (1/110) mico-leão-dourado e 0,9% (1/110) mico-leão-da-cara dourada. Em 80,4% (74/92) dos calitriquídeos foram encontrados nematoides Primasubulura sp. e em 1,1% (1/92) nematoides Trypanoxyuris callithrix, em 26,1% (24/92) acantocéfalos (Pachysentis sp.) e em 5,4% (5/92) digenéticos (Platynosomum sp.); em 77,8% (7/9) dos bugios foram encontrados nematoides (Trypanoxyuris minutus), em 11,1% (1/9) acantocéfalos (Pachysentis sp.) e em 11,1% (1/9) cestoides (Bertiella sp.); em 14,3% (1/7) dos macacos-pregos foram encontrados nematoides (Physaloptera sp.), em 28,6% (2/7) acantocéfalos (Prostenorchis sp.) e em 14,3% (1/7) digenéticos (Platynosomum sp.) e no mico-leão-da-cara-dourada foram encontrados acantocéfalos (Prostenorchis sp.). Foi realizado o georreferenciamento dos pontos de encontro dos cadáveres para pontuar a distribuição dos helmintos por região.
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Shakira, Aisha, Ama Mullah, Abd Mujahid Hamdan e Syafrina Sari Lubis. "Efektivitas Metode Multi Soil Layering (MSL) dalam Penurunan Total Koliform Limbah Cair Domestik". Jurnal Dampak 20, n.º 2 (31 de julho de 2023): 83. http://dx.doi.org/10.25077/dampak.20.2.83-92.2023.
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This research employs Multi Soil Layering (MSL), an environmentally friendly technology, to remove coliform bacteria contaminants from wastewater using a novel alternative medium. The purpose of this study is to evaluate the efficacy of the MSL method employing bio rings in reducing pollutant parameters in domestic wastewater, particularly total coliform. This study utilized Hydraulic Loading Rate (HLR) variations of 23.80 L/m2/hour, 7.14 L/m2/hour, and 3.40 L/m2/hour, as well as Hydraulic Retention Time (HRT) variations of 4, 6, 8, 10, and 12 hours. The results of domestic wastewater treatment using the MSL method using HLR variations on total coliform from 1.89 105 MPN/100mL to 6.0 102 MPN/100mL, the total colony parameter from 5.95 106 CFU/mL to 3.6 105 CFU/mL, the chemical oxygen demand parameter value of 53 mg/L with an effectiveness of 98.6%, the total suspended solid parameter is valued at 25 mg/L with reduction effectiveness of 98.6% and the pH value changes to 7.3 at the HLR variation of 3.40 L/m2/hour. As for using the HRT variation for 12 hours the total coliform from 1.16 104 MPN/100mL to 9 102 MPN/100mL, the total colony parameter from 4.91 106 CFU/mL to 3.0 105 CFU/mL, the chemical oxygen demand parameter was 92 mg/L with its effectiveness 99%, the total suspended solid parameter is 87 mg/L with reduction effectiveness of 67% and the potential of hydrogen value changes to 7.6. Therefore, the MSL method employing bio rings can be used as a new option for domestic effluent treatment. Keywords: domestic wastewater, coliform total, Multi Soil Layering (MSL) ABSTRAK Penelitian ini menggunakan Multi Soil Layering (MSL), sebuah teknologi ramah lingkungan, untuk menghilangkan kontaminan bakteri coliform dari air limbah menggunakan media alternatif baru. Tujuan dari penelitian ini adalah untuk mengevaluasi efikasi metode MSL dengan bioring dalam menurunkan parameter polutan dalam air limbah domestik, khususnya total coliform. Penelitian ini memanfaatkan variasi Hydraulic Loading Rate (HLR) 23,80 L/m2/jam, 7,14 L/m2/jam, dan 3,40 L/m2/jam, serta variasi Hydraulic Retention Time (HRT) 4, 6, 8, 10, dan 12 jam. Hasil pengolahan air limbah domestik dengan metode MSL menggunakan variasi HLR pada total coliform dari 1,89 × 105 MPN/100mL menjadi 6,0 × 102 MPN/100 mL, parameter total koloni dari 5,95 × 106 CFU/mL menjadi 3,6 × 105 CFU/mL, nilai parameter kebutuhan oksigen kimia 53 mg/L dengan efektivitas 98,6%, parameter total padatan tersuspensi senilai 25 mg/L dengan efektivitas reduksi 98,6% dan nilai pH berubah menjadi 7,3 pada variasi HLR 3,40 L/m2/jam. Sedangkan untuk menggunakan variasi HRT selama 12 jam total coliform dari 1,16 × 104 MPN/100mL menjadi 9 × 102 MPN/100mL, parameter total koloni dari 4,91 × 106 CFU/mL menjadi 3,0 × 105 CFU/mL, kebutuhan oksigen kimia parameter 92 mg/L dengan efektivitas 99%, parameter total padatan tersuspensi 87 mg/L dengan efektivitas reduksi 67% dan nilai potensial hidrogen berubah menjadi 7,6. Oleh karena itu, metode MSL yang menggunakan bio ring dapat digunakan sebagai pilihan baru untuk pengolahan limbah rumah tangga. Kata kunci: air limbah domestik, total koliform, Multi Soil Layering (MSL)
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Krebs, John W., Jean S. Smith, Charles E. Rupprecht e James E. Childs. "Rabies surveillance in the United States during 1998". Journal of the American Veterinary Medical Association 215, n.º 12 (15 de dezembro de 1999): 1786–98. http://dx.doi.org/10.2460/javma.1999.215.12.1786.
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During 1998, 49 states, the District of Columbia, and Puerto Rico reported 7,961 cases of rabies in nonhuman animals and 1 case in a human being to the Centers for Disease Control and Prevention, a decrease of 6.5% from 8,509 cases in nonhuman animals and 4 cases in human beings reported in 1997. More than 92% (7,358 cases) were in wild animals, whereas > 7.5% (603 cases) were in domestic species (compared with 93% in wild animals and 7% in domestic species in 1997). Decreases were evident in all of the major contributing species groups, with the exception of skunks and bats. The relative contributions of the major groups to the total reported for 1998 were raccoons (44.0%; 3,502 cases), skunks (28.5%; 2,272), bats (12.5%; 992), foxes (5.5%; 435), cats (3.5%; 282), cattle (1.5%; 116), and dogs (11.5%; 113). No further discernable westward extension of the epizootic of rabies in raccoons in Ohio was reported. Twelve of the 19 states enzootic for the raccoon variant of the rabies virus and the District of Columbia reported decreased numbers of cases of rabies during 1998, compared with 13 states and the District of Columbia that reported increases during 1997. Three states, Rhode Island (143.2%), Massachusetts (77.2%), and New Hampshire (69.4%), reported increases of > 50% during 1998, compared with totals reported for 1997. In Texas, the number of cases of rabies associated with enzootic canine variants of the rabies virus remained greatly diminished; however, overall totals of reported cases of rabies increased in Texas and 12 other states where skunks are the major terrestrial reservoir of rabies. At the national level, the total of 82 reported cases of rabies among horses and mules was greater than that reported for any year since 1981 (88 cases) and represented a 74.5% increase, compared with the total for 1997. The 992 cases of rabies reported in bats during 1998 were the greatest proportionate contribution by bats since 1990. Reported cases of rabies in cats (282), dogs (113), and cattle (116) decreased 6.0%, 10.3%, and 4.9%, respectively. One indigenously acquired case of rabies reported in a human being during 1998 was the result of infection with a rabies virus variant associated with silver-haired and eastern pipistrelle bats.
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Fondevila, M., C. Castrillo, J. Gasa e J. A. Guada. "Rumen-undegradable dry matter and neutral detergent fibre as ratio indicators of digestibility in sheep given cereal straw-based diets". Journal of Agricultural Science 125, n.º 1 (agosto de 1995): 145–51. http://dx.doi.org/10.1017/s0021859600074591.
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SUMMARYStudies were conducted in 1989 at the University of Zaragoza, Spain, to determine the value of undegradable dry matter and neutral detergent fibre (uDM and uNDF) forestimating apparent dry matter digestibility (DMD), with sheep diets based on untreated or ammonia-treated barley straw (US or TS) offered alone or supplemented with 300 or 600 g/day of grass hay (H), barley (B) or sugarbeet pulp (P). Marker recovery in faeces was 107·9±1·90 and 96·4±1.43% for uDM and uNDF, respectively. Faecal uDM excretion was overestimated, especially with TS as sole feed and in B-supplemented diets (116%), whereas underestimation of uNDF excretion was observed mainly in unsupplemented US (92%), supplemented TS (92%) and in diets including H (91 %). Digestibility estimations from uDM or uNDF concentration in feeds and faeces (DuDM or DuNDF) were affected in the same way as DMD by the dietary sources of variation. Correlation coefficients between in vivo digestibility and its estimates with both internal markers were 0·80, and differences between DMD and DuDM and DuNDF were –2·5±0·14 and 2·2±0·13 percentage units, respectively. The suitability of both markers for predicting apparent digestibility, and the choice between them, would depend on diet characteristics.
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Seesaghur, Anouchka, Peter Egger, Joshua Warden, Ali Abbasi, Bethany Levick, Majid Riaz, Peter McMahon, Matthew Thompson e Sue Cheeseman. "Assessment of bone-targeting agents use in patients with bone metastasis from breast, lung or prostate cancer using structured and unstructured electronic health records from a regional UK-based hospital". BMJ Open 13, n.º 5 (maio de 2023): e069214. http://dx.doi.org/10.1136/bmjopen-2022-069214.
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ObjectiveTo assess use of bone-targeting agents (BTA) in patients with confirmed bone metastases (BM) from breast cancer (BC), non-small cell lung cancer (NSCLC) or prostate cancer (PC).DesignRetrospective cohort study.SettingRegional hospital-based oncology database of approximately 2 million patients in England.ParticipantsPatients aged ≥18 years with a diagnosis of BC, NSCLC or PC as well as BM between 1 January 2007 and 31 December 2018, with follow-up to 30 June 2020 or death; BM diagnosis ascertained from recorded medical codes and unstructured data using natural language processing (NLP).Main outcomes measuresInitiation or non-initiation of BTA following BM diagnosis, time from BM diagnosis to BTA initiation, time from first to last BTA, time from last BTA to death.ResultsThis study included 559 BC, 894 NSCLC and 1013 PC with BM; median age (Q1–Q3) was 65 (52–76), 69 (62–77) and 75 (62–77) years, respectively. NLP identified BM diagnosis from unstructured data for 92% patients with BC, 92% patients with NSCLC and 95% patients with PC. Among patients with BC, NSCLC and PC with BM, 47%, 87% and 88% did not receive a BTA, and 53%, 13% and 12% received at least one BTA, starting a median 65 (27–167), 60 (28–162) and 610 (295–980) days after BM, respectively. Median (Q1–Q3) duration of BTA treatment was 481 (188–816), 89 (49–195) and 115 (53–193) days for patients with BC, NSCLC and PC. For those with a death record, median time from last BTA to death was 54 (26–109) for BC, 38 (17–98) for NSCLC and 112 (44–218) days for PC.ConclusionIn this study identifying BM diagnosis from both structured and unstructured data, a high proportion of patients did not receive a BTA. Unstructured data provide new insights on the real-world use of BTA.
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Keene, David J., Joseph Alsousou, Paul Harrison, Heather M. O’Connor, Susan Wagland, Susan J. Dutton, Philippa Hulley, Sarah E. Lamb e Keith Willett. "Platelet-rich plasma injection for acute Achilles tendon rupture". Bone & Joint Journal 104-B, n.º 11 (1 de novembro de 2022): 1256–65. http://dx.doi.org/10.1302/0301-620x.104b11.bjj-2022-0653.r1.
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Aims To determine whether platelet-rich plasma (PRP) injection improves outcomes two years after acute Achilles tendon rupture. Methods A randomized multicentre two-arm parallel-group, participant- and assessor-blinded superiority trial was undertaken. Recruitment commenced on 28 July 2015 and two-year follow-up was completed in 21 October 2019. Participants were 230 adults aged 18 years and over, with acute Achilles tendon rupture managed with non-surgical treatment from 19 UK hospitals. Exclusions were insertion or musculotendinous junction injuries, major leg injury or deformity, diabetes, platelet or haematological disorder, medication with systemic corticosteroids, anticoagulation therapy treatment, and other contraindicating conditions. Participants were randomized via a central online system 1:1 to PRP or placebo injection. The main outcome measure was Achilles Tendon Rupture Score (ATRS) at two years via postal questionnaire. Other outcomes were pain, recovery goal attainment, and quality of life. Analysis was by intention-to-treat. Results A total of 230 participants were randomized, 114 to PRP and 116 to placebo. Two-year questionnaires were sent to 216 participants who completed a six-month questionnaire. Overall, 182/216 participants (84%) completed the two-year questionnaire. Participants were aged a mean of 46 years (SD 13.0) and 25% were female (57/230). The majority of participants received the allocated intervention (219/229, 96%). Mean ATRS scores at two years were 82.2 (SD 18.3) in the PRP group (n = 85) and 83.8 (SD 16.0) in the placebo group (n = 92). There was no evidence of a difference in the ATRS at two years (adjusted mean difference -0.752, 95% confidence interval -5.523 to 4.020; p = 0.757) or in other secondary outcomes, and there were no re-ruptures between 24 weeks and two years. Conclusion PRP injection did not improve patient-reported function or quality of life two years after acute Achilles tendon rupture compared with placebo. The evidence from this study indicates that PRP offers no patient benefit in the longer term for patients with acute Achilles tendon rupture. Cite this article: Bone Joint J 2022;104-B(11):1256–1265.
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VARGHESE, JOBIN, MATHEU PRESUME, KUZHICHALIL PEETHAMBHARAN SURENDRAN e MAILADIL THOMAS SEBASTIAN. "A NOVEL DIELECTRIC CERAMIC FOR MICROWAVE PASSIVE CIRCUITS". International Journal of Modern Physics: Conference Series 22 (janeiro de 2013): 153–58. http://dx.doi.org/10.1142/s2010194513010040.
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The tetragonal Ca 9 Nd 2 W 4 O 24 (CNW) ceramic was prepared by the conventional solid state ceramic route and their dielectric properties were investigated in the radio and microwave frequencies. The CNW ceramics sintered at 1450 °C for 4 h showed a densification 92 % with εr = 16 and tanδ = 0.004 at 15.1 GHz. The thermal conductivity of ceramic at room temperature was found to be 1.6 W m−1K−1 and coefficent of thermal expansion of CNW ceramics was 4.2 ppm/°C measured in the range of 25 to 600 °C. The dielectric and thermal properties of CNW ceramic are reported for the first time.
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Silva, Edna Oliveira, Anselmo José Perez, Luiz Aparecido Bortolotto, Wellington Lunz, José Geraldo Mill e Luciana Carletti. "Pressão arterial e indicadores de função vascular de corredores com diferentes níveis de desempenho no teste cardiopulmonar". Revista Brasileira de Educação Física e Esporte 31, n.º 4 (23 de dezembro de 2017): 747–58. http://dx.doi.org/10.11606/1807-5509201700040747.
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O objetivo deste estudo foi comparar os valores de pressão arterial sistólica e diastólica periférica (PASp e PADp) e central (PASc e PADc) e o índice de função vascular em corredores de rua de diferentes desempenhos. A amostra foi composta por 48 participantes, 20-40 anos, 32 corredores de rua com diferentes níveis de desempenho, e 16 indivíduos sedentários. Avaliou-se a aptidão cardiorrespiratória e a velocidade máxima de corrida, através do teste cardiopulmonar de exercício (TCPE). A pressão central e periférica foi investigada por tonometria de aplanação e a velocidade da onda de pulso (VOP) pelo equipamento Complior. O ecocardiograma foi usado para avaliar a estrutura cardíaca. ANOVA de uma via foi utilizada considerando p <0,05. A ANCOVA foi usada para ajustar fatores de confusão. Corredores com desempenho superior apresentaram menor PASp que os demais grupos (120±7 vs 127±8 vs 130 ±8 mmHg). A duração da diástole foi maior nos corredores com desempenho superior (845±92 ms) em relação aos corredores com desempenho inferior (786±174 ms e controle (641±128 ms). O índice de amplificação (AI) não foi diferente entre os grupos (109 ± 21%; 109 ± 11%; 110 ± 1%) assim como a VOP (7,1 ± 1ms. 7,6 ± 1.1ms. 8,0 ± 1,1ms). Corredores com desempenho superior apresentaram maior massa do ventrículo esquerdo (MVE g/m²) em relação aos demais (116±12 g/m² vs 100±18 g/m² vs 86±13 g/m²), e menor débito cardíaco em comparação ao grupo controle (4,8±1 l/ min. vs 6,0±1 l/min). Portanto corredores com desempenho superior apresentaram maior MVE g/m², menor débito cardíaco, menor PASc e PASp, e melhor duração da diástole que seus pares sedentários, mas não apresentam melhores indicadores de função vascular na mesma comparação.
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Xie, Zhen Kun, e Zhen Xing Yue. "Large Remanent Polarization and Low Leakage Current in High-Tc 0.2Bi (Ni1/2Ti1/2)O3-0.8PbTiO3 Ferroelectric Thin Films". Key Engineering Materials 602-603 (março de 2014): 804–7. http://dx.doi.org/10.4028/www.scientific.net/kem.602-603.804.
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High Curie-temperature (Tc) polycrystalline 0.2Bi (Ni1/2Ti1/2)O3-0.8PbTiO3 (0.2BNT-0.8PT) thin films were fabricated on Pt (111)/Ti/SiO2/Si substrates via an aqueous chemical solution deposition (CSD) technique. The thin films exhibited good crystalline quality and dense, uniform microstructures with an average grain size of 55 nm. The dielectric, piezoelectric and ferroelectric properties of the films was investigated. The permittivity peak appeared at 485 °C, which was 100 °C higher than that of Pb (Zr,Ti)O3 thin films. The local effective piezoelectric coefficient d33 was 45 pm/V at 3V. Moreover, a large remnant polarization with 2Pr up to 92 uC/cm2 and a small leakage current of 2.2×10-5 A/cm2 under an electric field of 400 kV/cm were obtained. The magnitude of the measured polarization and the high Curie temperature make the 0.2BNT-0.8PT films promising candidates for application in high-temperature ferroelectric and piezoelectric devices.
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Matalon, Kimberlee Michals, Phyllis B. Acosta e Colleen Azen. "Role of Nutrition in Pregnancy With Phenylketonuria and Birth Defects". Pediatrics 112, Supplement_4 (1 de dezembro de 2003): 1534–36. http://dx.doi.org/10.1542/peds.112.s4.1534.
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Objective. The maternal phenylketonuria (PKU) syndrome is caused by high blood phenylalanine (Phe) levels during pregnancy, leading to a host of birth defects, especially microcephaly and congenital heart disease (CHD). For finding whether the maternal PKU syndrome could be prevented, an international collaborative study was organized to evaluate treatment with a Phe-restricted diet. Blood Phe levels, maternal weight gain, and nutrient intakes during pregnancy were evaluated as to their effect on the rate of microcephaly and CHD in the offspring. Methods. The study was a prospective, longitudinal effort aimed at lowering blood Phe during pregnancy. Women were enrolled at time of referral for pregnancy. Nutrient intake analysis, which serves as the basis for this report, was available from 251 pregnancies. Subjects were stratified by blood Phe control of ≤600 μmol/L by 8 weeks gestation or >600 μmol/L by 8 weeks gestation. Outcome of these pregnancies was correlated to blood Phe levels, weight gain, and nutrient intake. Results. The study goal was to attain blood Phe levels of 120 to 360 μmol/L 3 months preconception; however, this goal was achieved by only a limited number of patients. Therefore, the data presented were based on blood Phe control ≤600 μmol/L or >600 μmol/L by 8 weeks of gestation. Blood Phe control of ≤600 μmol/L by 8 weeks of gestation was attained by 86 (34.3%) of the 251 women in this study, whereas the other 165 women had blood Phe control >600 μmol/L by 8 weeks of gestation. Of the 251 offspring, 166 were born with normal head circumference and 85 were born with microcephaly (<2 standard deviations below normal). Women with blood Phe >600 μmol/L at 8 weeks of gestation included 78 (92%) of the 85 infants with microcephaly compared with 8% in the group of women who had blood Phe levels ≤600 μmol/L. Weight gain during pregnancy was related to the rate of microcephaly. The highest occurrence of microcephaly (58%) was found in the pregnant women who gained <70% of recommended weight gain. Stepwise logistic regression analysis was used to determine factors associated with microcephaly. Significant factors included higher blood Phe levels when off diet, higher average Phe exposure during the pregnancy, low prepregnancy weight, poor weight gain during the pregnancy, and lower intake of protein and higher iron intake during the pregnancy. Infants with CHD were found only in the group of women who had blood Phe levels >600 μmol/L by 8 weeks of gestation. There was a higher rate of CHD in the offspring who were born to women who consumed <50% of the recommended intake of protein in the first trimester. The main source of protein for women with PKU is the medical food; therefore, when protein intake was low, vitamin and mineral intakes were also inadequate. Conclusions. The data indicate that blood Phe control and how soon it is attained during pregnancy with PKU is important. Normal pregnancy weight gain should be encouraged to reduce microcephaly. Adequate protein and vitamin intakes early in pregnancy may have a protective effect for the prevention of CHD, even if blood Phe is elevated. The rate of microcephaly and CHD may be reduced if nutrient intake is optimal while attempting to control blood Phe levels.
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Turab qızı Hüseynova, Aytac. "Read More About The Modernization of the oil refinery of Heydar Aliyev". SCIENTIFIC WORK 66, n.º 05 (20 de maio de 2021): 106–8. http://dx.doi.org/10.36719/2663-4619/66/106-108.
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The Oil Refinery of Heydar Aliyev was created in July 1953 as a new oil refining plant Baki. The combined atmospheric vacuum plant is the main plant at the oil refining factory and its starting capacity produces 6 million tons of crude oil. In 2010, 43,000 tons A-98, 1.18 tons of A-92 and 19,700 tons of gasoline A-80. At the same time, 600 400t kerosene, 214,000 diesel fuels, 214,000 tons. Liquid gas, 267 500t coke and 220 600t. With this investigation, the history of the oil refinery and the details of modernization were considered. 21 out of 24 types of Azerbaijani oil are processed at the Baku Oil Refinery named after Heydar Aliyev, of which 15 types of oil products, including gasoline, aviation kerosene, diesel fuel, fuel oil, petroleum coke, etc. are produced. The plant fully meets the needs of the republic in oil products. In addition, 45% of oil products are exported to foreign countries. Key words: Azerbaijani, oil, recycling, factory, modernization
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Snoeck, P. P. N., M. C. Silva, L. C. O. Moura, M. M. Neves e M. Henry. "92 EFFECT OF LOW-DENSITY LIPOPROTEIN ON THE QUALITY OF CRYOPRESERVED RAM SEMEN". Reproduction, Fertility and Development 23, n.º 1 (2011): 151. http://dx.doi.org/10.1071/rdv23n1ab92.
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Egg yolk is the most widely used cryoprotectant in the composition of extenders for cryopreservation of mammalian spermatozoa; yet, efforts have been made to find ways to substitute it due to the possibility of transporting pathogenic microorganisms, the lack of standardization, and the presence of substances that inhibit metabolic exchanges or decrease the motility of sperm. The protective effect of egg yolk was attributed to the presence of low density lipoproteins (LDL) that prevent cholesterol efflux by increasing membrane stability and resistance to low temperatures. (Moussa et al. 2002 Theriogenology 57, 1695–1706) demonstrated that the purification of LDL is possible, thereby allowing its use as a replacement for integral egg yolk in extender. Then, this study aimed to evaluate the effect of substitution of egg yolk by different LDL concentrations during cryopreservation of ram semen. A total of 6 sheep, 3 ejaculates per animal, were collected. After collection, the ejaculates were evaluated and diluted in different extenders: E1) Tris, glucose, 15% egg yolk, and 5% glycerol; E2) Tris, glucose, 5% LDL (Moussa et al. 2002 Theriogenology 57, 1695–1706), and 5% glycerol; E3) Tris, glucose, 10% LDL, and 5% glycerol; and E4) Tris, glucose, 20% LDL, and 5% glycerol. The samples were adjusted to a final concentration of 600 × 106 sptz mL–1 and filled into 0.25-mL straws and frozen in a TK 4000® machine. After thawing, sperm motility and spermatic vigor were evaluated, and the test of thermo-resistance (TTR) was conducted. Functional and structural integrity of the spermatic membrane were evaluated through the hypoosmotic test and the use of fluorescent dyes. The kinetic parameters of sperm were assessed by the computerized system (CASA). The statistical analysis was performed using the statistical program SAS (Statistical Analysis System), and the averages were compared using the Duncan multiple test. No difference (P > 0.05) was found between extenders for progressive motility after thawing. After 3 h of TTR, E1 showed higher values (P < 0.05) than E2, not differing from E4. The percentage of cells reactive to the hypoosmotic test was lower with the use of E2 (P < 0.05) than with other groups. Regarding the fluorescence technique, the average percentage of cells with intact membrane after thawing was higher in samples preserved in the extenders E1, E3, and E4 (P < 0.05) than in E2. Velocity average pathway (VAP), velocity straight line (VSL), and linearity of cryopreserved ram semen were (P < 0.05) significantly higher in E1 than in E2 and E3. The other kinetic parameters were similar in all groups tested. The results indicate that the extenders containing 10 and 20% of LDL are capable of protecting the spermatic cells during cryopreservation. Research supported by the FAPESB.
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Calder, Peter R., Joseph E. McKay, Anna J. Timms, Tracy Roskrow, Sharon Fugazzotto, Penina Edel e W. D. Goodier. "Femoral lengthening using the Precice intramedullary limb-lengthening system". Bone & Joint Journal 101-B, n.º 9 (setembro de 2019): 1168–76. http://dx.doi.org/10.1302/0301-620x.101b9.bjj-2018-1271.r1.
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Aims The Precice intramedullary limb-lengthening system has demonstrated significant benefits over external fixation lengthening methods, leading to a paradigm shift in limb lengthening. This study compares outcomes following antegrade and retrograde femoral lengthening in both adolescent and adult patients. Patients and Methods A retrospective review of prospectively collected data was undertaken of a consecutive series of 107 femoral lengthening operations in 92 patients. In total, 73 antegrade nails and 34 retrograde nails were inserted. Outcome was assessed by the regenerate healing index (HI), hip and knee range of movement (ROM), and the presence of any complications. Results The mean lengthening was 4.65 cm (1.5 to 8) in the antegrade group and 4.64 cm (1.6 to 8) in the retrograde group. Of the 107 lengthenings, 100 had sufficient datapoints to calculate the mean HI. This was 31.6 days/cm (15 to 108). There was a trend toward a lower (better) HI with an antegrade nail and better outcomes in adolescent patients, but these were not statistically significant. Hip and knee ROM was maintained and/or improved following commencement of femoral lengthening in 44 patients (60%) of antegrade nails and 13 patients (38%) of retrograde nails. In female patients, loss of movement occurred both earlier and following less total length achieved. Minor implant complications included locking bolt migration and in one patient deformity of the nail, but no implant failed to lengthen and there were no deep infections. Three patients had delayed union, five patients required surgical intervention for joint contracture. Conclusion This study confirms excellent results in femoral lengthening with antegrade and retrograde Precice nails. There is a trend for better healing and less restriction in hip and knee movement following antegrade nails. There are clinical scenarios, that mandate the use of a retrograde nail. However, when these are not present, we recommend the use of antegrade nailing. Cite this article: Bone Joint J 2019;101-B:1168–1176
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LeBel, Denis, e Marlyne Beattie. "Identification of the catalytic subunit of the ATP diphosphohydrolase by photoaffinity labeling of high-affinity ATP-binding sites of pancreatic zymogen granule membranes with 8-azido-[α-32P]ATP". Biochemistry and Cell Biology 64, n.º 1 (1 de janeiro de 1986): 13–20. http://dx.doi.org/10.1139/o86-003.
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Photoaffinity labeling has been performed on pancreatic zymogen granule membranes using 8-azido-[α-32P]ATP (8-N3-ATP). Proteins of 92, 67, 53, and 35 kdaltons (kDa) were specifically labeled. ATP (100 μM) inhibited very strongly the labeling with 8-N3-ATP, while ADP was much less potent, AMP and cAMP being inefficient. The apparent constants for 8-N3-ATP binding were in the micromolar concentration range for the four labeled proteins. Without irradiation, 8-N3-ATP was a competitive inhibitor (Ki = 2.66 μM) for the hydrolysis of ATP by the ATP diphosphohydrolase. The optimal conditions for the photolabeling of the 92- and 53-kDa proteins were pH 6.0 in presence of divalent cations. On the other hand the 67- and 35-kDa proteins required an alkaline pH and the addition of EDTA in the photolabeling medium. No proteins could be labeled on intact zymogen granules, showing that all the high-affinity ATP-binding sites of the membrane were located at the interior of the granule. Both the 92- and 53-kDa glycoproteins could bind to concanavalin A–Sepharose and be extracted in the detergent phase in the Triton X-114 phase separation system. These latter properties are typical of integral membrane proteins. In addition, the 53-kDa labeled protein was sensitive to endo-β-N-acetylglucosaminidase digestion. Photolabeling with 8-N3-ATP of two different preparations of purified ATP diphosphohydrolase also led to the labeling of a 53-kDa protein. Thus among the four proteins labeled with 8-N3-ATP on the pancreatic zymogen granule membrane, the 53-kDa integral membrane glycoprotein was shown to bear the catalytic site of the ATP diphosphohydrolase.
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Smith, Denis, Magali Rouyer, Emmanuel Mitry, Alain Monnereau, Antonio Sa Cunha, Emmanuelle Bignon, Alise Le Monies et al. "Cetuximab in first-line treatment of metastatic colorectal cancer in a real-life setting: Preliminary results of the EREBUS cohort." Journal of Clinical Oncology 30, n.º 4_suppl (1 de fevereiro de 2012): 621. http://dx.doi.org/10.1200/jco.2012.30.4_suppl.621.
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621 Background: Cetuximab (CTX) has demonstrated to improve survival outcomes in metastatic colorectal cancer (mCRC), but little data for real-life use is available. Methods: EREBUS is a French multicentre (n=92) hospital-based cohort. Patients initiating CTX in 2009 and 2010 were identified retrospectively from registries of nominative drug dispensations. Those with wild-type KRAS gene receiving 1st-line treatment for mCRC were followed-up for 12 months. Data were collected from patient medical records and response based on physician assessments (CT-Scan). Presented here are preliminary results of the EREBUS cohort about administration regimen and according response rates for patients included in 2009. Results: Of the 190 patients included in the cohort, data has been collected for 160 (84.2%): median age at baseline 65.5 years, 70.6% male. Regarding cancer characteristics, 79.4% of patients had a colon cancer and 53.8% a primary tumor resection. Metastatic sites were liver in 73.1% of patients, peritoneum in 29.4%, lymph nodes in 26.3%, and lung in 25.6%. For patients for which the ECOG status was available (54.4%): 79.3% have an ECOG score between 0 and 1, 20.7% ≥2. Half the patients (48.8%) had only one metastatic site. CTX was given every three weeks to 2 patients (1.3%), every two weeks to 113 of patients (70.6%), and weekly to 45 (28.1%). For those receiving CTX every two weeks: 64.9% had irinotecan-based regimens (vs. 45.5% of those receiving CTX weekly, p=0.03), 31.5% had oxaliplatin-based regimens (vs. 47.7%, p=0.06), median duration of CTX use was 3.8 months (vs. 5.3 months, p=0.69) and that of 1st-line therapy 6.3 months (vs. 7.5 months, p=0.97), 69.0% discontinued 1st-line treatment (vs. 82.2%, p=0.09) – mainly for progression (71.8 vs. 75.7%, p=0.66) or toxicity (20.5 vs. 10.8%, p=0.20). Overall response evaluated for 100 patients receiving CTX every two weeks out of 113 was 46.0% (vs. 52.6%, p=0.49, evaluated for 38 receiving CTX weekly). Conclusions: CTX administration every two weeks was the most frequent regimen. In this preliminary analysis, patients receiving weekly or every two weeks regimens had similar duration of treatment and response rate.
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Mailankody, Sham, Andrzej J. Jakubowiak, Myo Htut, Luciano J. Costa, Kelvin Lee, Siddhartha Ganguly, Jonathan L. Kaufman et al. "Orvacabtagene autoleucel (orva-cel), a B-cell maturation antigen (BCMA)-directed CAR T cell therapy for patients (pts) with relapsed/refractory multiple myeloma (RRMM): update of the phase 1/2 EVOLVE study (NCT03430011)." Journal of Clinical Oncology 38, n.º 15_suppl (20 de maio de 2020): 8504. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.8504.
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8504 Background: Orva-cel is an investigational, BCMA-directed CAR T cell product with a fully human binder. Over 100 pts have been treated in the EVOLVE phase 1 study. Pts treated at 50 and 150 × 106 CAR+ T cells were previously reported (Mailankody ASH 2018 #957). We now report results of the higher dose levels (DLs) in 51 pts who received orva-cel manufactured using the process intended to support commercial use. Methods: Pts with RRMM who had ≥3 prior regimens, a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 monoclonal antibody (mAb), received orva-cel at 300, 450, and 600 × 106 CAR+ T cells after lymphodepletion with fludarabine/cyclophosphamide. Results: Median pt age was 61 (range, 33–77) y; median time from diagnosis was 7.0 (range, 1.7–23.6) y, with a median of 6 (range, 3–18) prior regimens. Overall, 92% of pts were penta-exposed (2 IMiDs, 2 PIs, and an mAb); 61% of pts received bridging therapy (77% were refractory to bridging therapy). Two pts had dose-limiting toxicities: grade 3 neurological event (NE) for >7 d at 300 × 106 CAR+ T cells and grade 4 neutropenia for >28 d at 450 × 106 CAR+ T cells. Key efficacy and safety outcomes are shown in the Table. Cytokine release syndrome (CRS)/NEs were managed with tocilizumab and/or steroids (78%), anakinra (14%), and/or vasopressors (6%). Grade ≥3 anemia, neutropenia, and thrombocytopenia at 29 d occurred in 21%, 55%, and 44% of pts (median time to resolution to grade ≤2 of any cytopenia, ≤2.1 mo). Grade ≥3 infections occurred in 14%. After a median follow-up (F/U) of 5.9 mo, median progression-free survival was not reached. Conclusions: Orva-cel at 300, 450, and 600 × 106 CAR+ T cells demonstrated manageable safety (CRS grade ≥3: 2%; NE grade ≥3: 4%) and compelling efficacy in heavily pretreated pts with RRMM, with a 91% objective response rate (ORR) and 39% complete response (CR)/stringent CR (sCR) rate. Updated results will be presented, including minimal residual disease, durability of response, and recommended phase 2 dose. Clinical trial information: NCT03430011 . [Table: see text]
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Salimy, Djati Hoesen, e Siti Alimah. "HTGR KOGENERASI PRODUKSI HIDROGEN UNTUK KONVERSI CO2 MENJADI METANOL". Jurnal Pengembangan Energi Nuklir 17, n.º 2 (15 de março de 2016): 109. http://dx.doi.org/10.17146/jpen.2015.17.2.2556.
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ABSTRAK HTGR KOGENERASI PRODUKSI HIDROGEN UNTUK KONVERSI CO2 MENJADI METANOL. Telah dilakukan studi HTGR (High Temperature Gas-cooled Reactor) kogenerasi produksi hidrogen untuk konversi CO2 menjadi metanol. Metode yang digunakan adalah studi pustaka. Tujuan studi adalah menganalisis HTGR yang dikogenerasi dengan proses produksi hidrogen untuk konversi CO2 menjadi metanol sebagai skema teknologi alternatif produksi metanol dengan proses hidrogenasi CO2. Dalam studi disimulasikan bahan baku CO2 diperoleh dengan memanfaatkan emisi CO2 dari PLTU batubara. Dengan skema ini gas alam sebagai bahan baku digantikan dengan air dan CO2, sementara kebutuhan energi panas, kukus dan listrik dipasok dari reaktor HTGR. Hasil studi menunjukkan bahwa HTGR yang dikogenerasi dengan produksi hidrogen proses termokimia siklus iodine-sulfur, dimungkinkan untuk diaplikasikan guna mengkonversi CO2 menjadi metanol. Produksi metanol dengan kapasitas sebesar 14667,7 ton/hari, mampu menghemat gas alam sebesar 15,106 juta MMBTU/tahun yang setara dengan pengurangan laju emisi CO2 sebesar 0,9 juta ton/tahun. Jika ditambah serapan emisi CO2 dari PLTU sebagai bahan baku sebesar 691428,6 ton per tahun, potensi penghematan laju emisi CO2 sebesar 1,6 juta ton/tahun. Pasokan energi panas, kukus dan listrik dari reaktor HTGR dengan daya 2×600 MWt dapat memenuhi kebutuhan proses produksi, dengan kelebihan listrik sebesar 92 MWe. Total kelebihan listrik yang dapat disambungkan ke jaringan sebesar 196 MWe, yang berasal dari PLTU batubara (104 MWe) dan reaktor HTGR (92 MWe). Kata kunci: HTGR kogenerasi, dekomposisi air, hidrogenasi CO2, metanol, emisi CO2 ABSTRACTHTGR COGENERATION TO HYDROGEN PRODUCTION FOR CO2 CONVERSION TO BE METHANOL. Study have been conducted on the application of HTGR cogeneration to hydrogen production for conversion of CO2 into methanol. The method used is literature studies. The purpose of the study is to analyze the HTGR (High Temperature Gas-cooled Reactor) cogeneration to hydrogen production for CO2 conversion to be methanol as an alternative scheme of methanol production by process of CO2 hydrogenation. This study also simulated that CO2 raw material is coming coal power plant. With the scheme, the raw material of natural gas is replaced with water and CO2 , while the need energy of heat, steam and electricity supplied from HTGR reactor. With this scheme, the use of natural gas as a raw material, energy source of heat, steam and electricity are not needed anymore. The study shows that the process of nuclear water splitting of iodine-sulfur cycle is possible to convert CO2 into methanol. Production with a capacity of 14667,7 ton/day of methanol, will save natural gas of about to 15,106 million MMBTU yearly which is equivalent to a reduction CO2 emissions by 0.9 million ton/year. In addition with CO2 emission from coal power plant that used as raw material amount 691428,6 ton/year, potential of total CO2 reduction is about 1,6 million ton/year. Supply of thermal energy, steam and electricity that comes from HTGR reactor with capacity of 2×600 MWt can meet the needs of the production process, with the excess electricity of 92 MWe. Total electricity that can be connected to the grid is about 196 MWe, 104 MWe from coal power plant, and 92 MWe from HTGR.Keywords: HTGR cogeneration, water splitting, CO2 hydrogenation, methanol, CO2 emission
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Al-Jawda, J. M., A. N. Balasem, K. R. Asmar e A. S. K. Ali. "PRELIMINARY STUDY ON AQUACULLURE OF CTENOPHARYNGODON IDELLA VAL." Iraqi Journal of Veterinary Medicine 26, n.º 1 (1 de novembro de 2021): 143–48. http://dx.doi.org/10.30539/ijvm.v26i1.1132.
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The classical method of aquaculture in Iraq employed Cyprinus carpio L. (Common carp) as monoculture or as predominat species togather with grass carp and silver carp. In the present study monoculture of grass carp was performed. Three - hundreds fingerlings of grass carp of 1.5 g weight were cultured in about 600 m2 eartheen pond from 20th of June till 9th of November, 1997. For the first two months of the experiment, no additional feed was added to what had been available in the pond. For the rest of the culture period, 1773 kg of five species of plants were utilized. They were included 91 kg of Phargmites australis, 972 kg of Paspalim sp., 423 kg of Medicago sativa, 171 kg of Ceratophyllum demersum and 116 kg of Paspalum Paspaloides. In addition to that a total of 150 kg of manure was used as a fertilizer in three occasions. At the end of the experiment the average weight of the fishes was 498 gm ranged from 370 gm to 980 gm. Further study was commence where 300 fingerlings of grass carp weighting 34 gm as an average were cultured together with 50 fingerlings of silver carp (average weight 92 gm). The experiment January 1998. For the first two months of experiment the fishes didn't consume began in additional food probably due to the low temperature of water during this period.
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Hight, Susan C. "Determination of Lead and Cadmium in Ceramicware Leach Solutions by Graphite Furnace Atomic Absorption Spectroscopy: Method Development and Interlaboratory Trial". Journal of AOAC INTERNATIONAL 84, n.º 3 (1 de maio de 2001): 861–72. http://dx.doi.org/10.1093/jaoac/84.3.861.
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Abstract This method was developed to improve sensitivity and eliminate time consuming, evaporative pre-concentration in AOAC Method 973.82 and American Society for Testing and Materials method C738 for testing foodware. The method was developed using leach solutions obtained by leaching 9 differently decorated ceramic vessels with 4% acetic acid for 24 h at room temperature. Lead and cadmium concentrations in leach solutions were 0.005–17 600 and 0.0004–0.500 μg/mL, respectively. Concentrations were determined using peak area, phosphate chemical modifier (8.3 μg PO4−3), and a standard curve for quantitation. Optimized pre-atomization and atomization temperatures were 1300 and 1800°C, respectively, for Pb and 1100 and 1700°C, respectively, for Cd. Characteristic masses (mo) were 10 and 0.4 pg for Pb and Cd, respectively. Precision of repeated analyses of calibration solutions was ≤3% relative standard deviation. Precision of duplicate leach solution analyses on different days was 0–9% relative difference. Recovery from fortified leach solutions was 96–106%. Results obtained by this method agreed 92–110% with those of confirmatory analyses. Results of certified reference material solutions agreed 94–100% with certificate values. Pb and Cd limits of quantitation (LOQ) were 0.005 and 0.0005 μg/mL, respectively. Results from 3 trial laboratories for 4 leach solutions containing Pb and Cd concentrations of 0.017–1.47 and <0.0005–0.0864 μg/mL, respectively, agreed 89–102% with results of the author. Two attributes of this method were noteworthy: (1) Background absorbance due to organic matter was entirely absent from atomization profiles, making the use of short pre-atomization hold times (2 s) possible. (2) Instrument precision was excellent and only one determination per solution was needed. Acceptance criteria for quality control measurements and a practical procedure for estimating the method LOQ during routine regulatory analyses are described.
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Войтов, Віктор Анатолійович, Катерина Андріївна Фененко e АндрійГригорович Кравцов. "ЕКСПЕРИМЕНТАЛЬНІ ДОСЛІДЖЕННЯ ІНФОРМАТИВНИХ ЧАСТОТ АКУСТИЧНОЇ ЕМІСІЇ ТРИБОСИСТЕМ ПРИ ЗМІНІ КОНСТРУКТИВНИХ, ТЕХНОЛОГІЧНИХ ТА ЕКСПЛУАТАЦІЙНИХ ФАКТОРІВ". Problems of Friction and Wear, n.º 3(92) (27 de setembro de 2021): 4–16. http://dx.doi.org/10.18372/0370-2197.3(92).15927.
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У представленій роботі отримано експериментальні залежності, які підтвердили адекватність розроблених математичних моделей формування акустичного випромінювання (АЕ) із зони тертя трибосистем з урахуванням конструктивних, технологічних та експлуатаційних факторів. За результатами досліджень розроблено рейтинг факторів, які впливають на формування величин інформативних частот АЕ та межі діапазону їх випромінювання. На першому місці, по ступеню впливу, знаходяться експлуатаційні фактори – швидкість ковзання та навантаження. Інформативні частоти знаходяться в смузі 110-600 кГц. На другому місці конструктивний фактор – величина площі тертя. Інформативні частоти знаходяться в смузі 120-580 кГц. На третьому місці технологічні фактори – шорсткість поверхонь тертя, Ra та Sm. Інформативні частоти знаходяться в смузі 120-650 кГц. На четвертому місці матеріали трибоелементів та трибологічні властивості змащувальних матеріалів. Інформативні частоти знаходяться в смузі 210-420 кГц.Аналіз отриманих залежностей підтверджує теоретичний висновок, що вибір інформативних частот сигналів акустичної емісії з урахуванням конструктивних, технологічних і експлуатаційних факторів дозволить підвищити робастність і інформативність методу АЕ в процесі діагностування. Даний аналіз може бути основою для розробки методики діагностування трибосистем під час їх експлуатації.
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EASTER, Melanie J., e Janice M. MARSHALL. "Contribution of prostanoids to endothelium-dependent vasodilatation in the digital circulation of women with primary Raynaud's disease". Clinical Science 109, n.º 1 (23 de junho de 2005): 45–54. http://dx.doi.org/10.1042/cs20040262.
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In 15 women with PR (primary Raynaud's) disease and in 15 matched control women, ACh (acetylcholine) was delivered by iontophoresis to the dorsum of the finger (seven 20 s pulses of 0.1 mA, followed by one 20 s pulse of 0.2 mA, applied at 60 s intervals). Cutaneous RCF (red cell flux) was recorded from the same site by the laser Doppler technique. ACh evoked progressive increases in RCF that were comparable in pre- and post-menopausal women with PR [maxima of 294±113 and 259±59 pu (perfusion units) respectively, n=7 and 8 respectively], and in pre-menopausal controls (225±92 pu, n=7), but smaller in post-menopausal controls (140±63 pu, n=8; P<0.05). Aspirin (600 mg, orally), a COX (cyclo-oxygenase) inhibitor, potentiated the ACh-evoked dilator responses in pre- and post-menopausal women with PR (343±129 and 311±48 pu respectively) and post-menopausal controls (277±124 pu; P<0.05), but had no effect in pre-menopausal controls (225±92 pu). These results suggest that vasoconstrictor COX products limit ACh-evoked endothelium-dependent cutaneous dilatation in the digits in pre- and post-menopausal women with PR and in post-menopausal, but not pre-menopausal, control women. We propose that PR disease is associated with abnormality in the ability of oestrogen to modulate the synthesis of endothelium-dependent vasodilator and/or vasoconstrictor COX products.
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Marquez-Rodas, Ivan, Sara Perez Ramirez, Mercedes Cavanagh Podesta, Beatriz Moya, Ana Belen Ruperez Blanco, Daniel Lopez-Trabada Ataz, Sara Custodio Cabello, Maria Orera Clemente, Felipe A. Calvo e Miguel Martin. "Family history record and hereditary cancer risk perception after the creation of a heredofamilial cancer unit in a Spanish hospital." Journal of Clinical Oncology 30, n.º 15_suppl (20 de maio de 2012): e12003-e12003. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12003.
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e12003 Background: A comprehensive family history and consideration of the criteria for hereditary cancer risk are essential for oncology practice, since patients and relatives at risk could benefit from further genetic counseling (GC). The objective of this work is to compare the family history record and the hereditary cancer perception risk according to national cancer institute (NCI) criteria before and after the creation of a heredofamilial cancer unit (HFCU). Methods: We retrospectively analyze the clinical records from new incoming patients of our medical oncology service in two cohorts: Cohort 1, from January 2009 to December 2009 (before HFCU creation); and cohort 2, from May 2010 to August 2010 (first four months after HFCU creation). Family history record (yes/no) and NCI general hereditary cancer criteria (unusually early age; one or more first-degree relatives affected with the same or a related tumor; synchronous, bilateral or metachronous cancer in the same individual; atypical presentations; suggestive pathology report) were collected. Results were compared using chi-square test. p <0.05 was considered significant. Results: The table summarizes the results. In cohort 1, 28% (175/621) of clinical records contained the family history, while in cohort 2 this percentage increased to 54% (92/171), (p<0.001). 17% (106/621) patients in cohort 1 and 23% (40/171) in cohort 2, met NCI risk criteria (N.S.) In cohort 1, 13% (14/106) of these patients were referred to GC, while in cohort 2 this percentage increased to 38% (15/40) (p<0.01). Conclusions: The creation of a multidisciplinary HFCU significantly increased the quality of family history records and the referral of patients at risk to GC. However, the percentages still remain limited and further efforts must be made in order to remark the importance of family history in oncology. [Table: see text]
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Lemos, Samara M. C., Luiz F. C. Fonçatti, Romain Guyot, Alexandre R. Paschoal e Douglas S. Domingues. "Genome-Wide Screening and Characterization of Non-Coding RNAs in Coffea canephora". Non-Coding RNA 6, n.º 3 (11 de setembro de 2020): 39. http://dx.doi.org/10.3390/ncrna6030039.
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Coffea canephora grains are highly traded commodities worldwide. Non-coding RNAs (ncRNAs) are transcriptional products involved in genome regulation, environmental responses, and plant development. There is not an extensive genome-wide analysis that uncovers the ncRNA portion of the C. canephora genome. This study aimed to provide a curated characterization of six ncRNA classes in the Coffea canephora genome. For this purpose, we employed a combination of similarity-based and structural-based computational approaches with stringent curation. Candidate ncRNA loci had expression evidence analyzed using sRNA-seq libraries. We identified 7455 ncRNA loci (6976 with transcriptional evidence) in the C. canephora genome. This comprised of total 115 snRNAs, 1031 snoRNAs, 92 miRNA precursors, 602 tRNAs, 72 rRNAs, and 5064 lncRNAs. For miRNAs, we identified 159 putative high-confidence targets. This study was the most extensive genomic catalog of curated ncRNAs in the Coffea genus. This data might help elaborating more robust hypotheses in future comparative genomic studies as well as gene regulation and genome dynamics, helping to understand the molecular basis of domestication, environmental adaptation, resistance to pests and diseases, and coffee productivity.
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Oshita, Daniele, Adriana Paiva De Oliveira, José Anchieta Gomes Neto e Mercedes De Moraes. "Determinação direta e simultânea de Al, As, Fe, Mn e Ni em cachaça por espectrometria de absorção atômica em forno de grafite". Ecletica Quimica 28, n.º 1 (8 de dezembro de 2003): 91–96. http://dx.doi.org/10.26850/1678-4618eqj.v28.1.2003.p91-96.
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Este trabalho propõe um método simples, rápido e confiável para determinação direta e simultâneade Al, As, Fe, Mn e Ni em cachaça por espectrometria de absorção atômica em forno de grafite (GFAAS).A superfície superior da plataforma do tubo de grafite foi revestida com filme à base de tungstênio(W x C y O z ).O programa de aquecimento otimizado (temperatura, tempo de rampa, tempo de patamar) foi oseguinte: secagem 1 (100 o C, 5 s, 5 s); secagem 2 (120 o C, 5 s, 5 s); pirólise (1300 o C, 10 s, 30 s); atomização(2200 o C, 1 s, 6 s) e limpeza (2550 o C, 1 s, 3s). Os desvios padrões relativos (n=3) foram £ 4,4%, £ 0,7%, £11%, £ 6,0%, £ 1,2% para os elementos Al, As, Fe, Mn e Ni, respectivamente. A exatidão foi avaliada pormeio de testes de adição e recuperação dos analitos em 8 amostras de cachaças comerciais, e as recuperaçõessituaram-se nos seguintes intervalos: 80 - 105% (Al), 81 - 92% (As), 82 - 108% (Fe), 83 - 106% (Mn), 83- 108% (Ni).
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Beauverd, Yan, Jean-Christophe Ianotto, Kyaw Htin Thaw, Marta Sobas, Parvis Sadjadian, Natalia Curto-Garcia, Lee-Yung Shih et al. "Impact of Cytoreductive Drugs upon Outcomes in a Contemporary Cohort of Adolescent and Young Adults with Essential Thrombocythemia and Polycythemia Vera". Blood 142, Supplement 1 (28 de novembro de 2023): 748. http://dx.doi.org/10.1182/blood-2023-185108.
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Introduction Essential thrombocythemia (ET) and polycythemia vera (PV) are well described in adolescent and young adults (AYA) patients (pts); the most prevalent complications are thrombotic events, but progression to myelofibrosis (MF) is also associated with significant morbidity and mortality and this risk is time-dependent. Here we investigated the impact of cytoreductive drugs on outcomes in a well-defined cohort of AYA pts. Method and objectives Patients with a diagnosis (Dx) of ET or PV established at less than 25 years (yrs) of age and having known driver mutation status were included from a collaborative group of centers within the EHA MPN special working group. Patients were classified by the first cytoreductive treatment they received or no cytoreduction (NoCYTO). Main endpoints were thrombosis free survival (TFS) and, for those who received a minimum of 2 years of treatment, myelofibrosis free survival (MFS). Kaplan-Meier and log-rank tests were used to compare groups. Results Overall we included 348 pts (278 ET, 70 PV) with median age 20 yrs at Dx (IQR: 18-23). Median age at Dx for ET was 21 yrs (18-23) and for PV 20 yrs (16-23). 249 pts were female (216 ET, 33 PV). Median follow-up was 9 yrs (4-15). Overall, 237/348 (68%) started a cytoreductive therapy. First treatment was hydroxycarbamide (HU) in 126 pts (100 ET, 26 PV), IFN in 55 pts (33 ET, 22 PV), anagrelide (ANA) in 52 pts (51 ET, 1 PV) and other in 4 pts (1 ET, 3 PV). 111 pts (32 %) did not receive cytoreduction (93 ET, 18 PV) deemed NoCYTO. According to ELN risk group at Dx, 39/43 pts (26 ET, 13 PV) receiving a cytoreductive drug were high-risk and 197/304 pts (159 ET, 38 PV) were low-risk. Reason for treatment initiation was thrombotic event in 32 pts (24 ET, 8 PV), platelets >1000x10 9/L in 96 pts (87 ET, 9 PV), MPN-related symptoms 12 pts (7 ET, 5 PV), and other/unknown for 97 pts (67 ET, 30 PV). Ten year TFS was 87% (95%CI: 82-91%) overall, 87% (82-92%) for ET and 86% (77-96%) for PV. In multivariate analysis, elevated WBC (>11x10 9/L) was associated with higher thrombosis risk (HR: 2.8, 95%CI: 1.2-6.2, p=0.01) and splenomegaly with a lower risk (HR: 0.2, 95%CI: 0.1-0.9, p=0.04). In the ELN low-risk group, 10yrs TFS was 82% (73-90%) for HU, 84% (70-98%) for IFN, 93% (84-100%) for ANA and 94% (88-100%) for noCYTO, suggesting no benefit for cytoreduction, p=0.04. For high-risk patients, 10yrs TFS was 78% (56-100%) for HU, 67% (35-98%) for IFN, and 86% (59-100%) for ANA, p=0.689 (Fig 1A). Ten year MFS was 95% (92-98%) overall, 95% (91-98%) for ET, 93% (85-100%) for PV. On multivariate analysis, CALR mutation (HR: 6.0, 95%CI: 2.3-16.1, p<0.05) and interestingly thrombotic history at Dx (HR 3.8, 95%CI: 1.3-11, p=0.02) were associated with increased risk of MF progression overall. For ET: CALR mutation (HR 4.1, 95%CI: 1.6-10.5, p <0.05) and splenomegaly (HR: 2.9, 95% CI: 1.1-7.7, p=0.03) were associated with MF progression, but only CALR mutation was significant on multivariate analysis (HR: 4.2, 95% CI: 1.6-11.6, p<0.05). For PV, we did not identify risk factors associated with MF progression. Finally, we investigated the impact of cytoreductive therapy on MF progression. Overall, 10yrs and 20yrs MFS for IFN was 100%, for HU 10yrs and 20yrs MFS were 93% (86-99%) and 74% (57-92%), for ANA 10yrs and 20yrs MFS were 92% (82-100%) and 73% (40-100%), and for NoCYTO patients 10yrs and 20yrs MFS were 94% (88-100%) and 74% (47-100%), respectively (Fig 1b). Log-rank test comparing IFN vs. other management (HU, ANA or NoCYTO) was significantly in favour of IFN (p=0.046). Finally, during the follow-up there was only one MDS-progression and four deaths (1 of GVHD following HSCT 34 yrs after Dx, 1 of CMV disease 15 yrs after Dx, 2 of unknown cause, 4 yrs and 41 yrs after Dx). Discussion This study is the largest of its kind in contemporary young ET and PV patients focusing on specifically upon the impact of treatment. We demonstrate that early initiation of cytoreduction in low-risk patients does not impact TFS and that the choice of drug does not impact TFS in high-risk patients. In addition, importantly our data demonstrate that IFN specifically compared to other cytoreductive agents yields significantly better MFS compared to other treatments. These results support the use of IFN as a currently available disease-modifying agent to improve long-term MFS and also warrant reconsideration of earlier treatment in patients with ET and PV with IFN to improve MFS potentially as a primary aim.
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Benjamongkolchai, Kirana, Paweena Phaliwong, Jenny Kim, Pichita Prasongvej, Buppa Smanchat, Sinart Prommas, Kornkarn Bhamarapravatana e Komsun Suwannarurk. "Effects of N-Acetylcysteine Supplementation on Semen Analysis, Hormonal Profile and Spontaneous Pregnancy Rate in Idiopathic Infertile Men: Before and After Clinical Trial". Siriraj Medical Journal 76, n.º 3 (1 de março de 2024): 125–34. http://dx.doi.org/10.33192/smj.v76i3.266477.
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Objective: To compare sperm quality and quantity, hormonal profiles and spontaneous pregnancy rates before and after administering a 3 months course of N-Acetylcysteine (NAC) Material and Methods: This prospective clinical trial was conducted at the Infertility Unit of the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, Thailand. The study period was from June 1, 2023 to September 30, 2023. Subjects were idiopathic infertile males aged between 20 and 50 years old. All subjects received 600 mg of NAC orally per day. Semen analysis (SA) and male hormonal profiles (MHP; testosterone, LH, FSH and prolactin) were performed before and three months after NAC administration. Demographic, clinical characters and laboratory change were recorded. Results: The 92 participants were recruited. The mean age of couples was 34.5 years old. The average duration of infertility was 3.6 years. Increase of semen volume (2.1 vs 2.4 ml, p < 0.001), semen concentration (30.5 vs 43.1 x 106/mL, p < 0.001), total motility (59.57 vs 72.38 %, p < 0.001), progressive motility (59 vs 69.8 %, p < 0.001), normozoospermia (60 vs 83 %, p < 0.001), testosterone (452.8 vs 479.0 ng/dL, p = 0.038), LH (4.6 vs 5.3 mIU/mL, p = 0.004) and FSH (4.4 vs 4.6 mIU/mL, p = 0.009) were observed after three months of NAC administration. No changes in sperm morphology and prolactin level. One-third (27/92) of each participant’s spouse conceived spontaneously. Conclusion: NAC potentially enhances male hormonal profiles, sperm quality and quantity with an impressive spontaneous pregnancy rate.
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Hochhaus, Andreas, Andreas Burchert, Susanne Saussele, Gabriela M. Baerlocher, Jiří Mayer, Tim H. Brümmendorf, Paul La Rosée et al. "Treatment Free Remission after Nilotinib Plus Peg-Interferon Alpha Induction and Peg-Interferon Alpha Maintenance Therapy for Newly Diagnosed Chronic Myeloid Leukemia Patients; The Tiger Trial". Blood 142, Supplement 1 (28 de novembro de 2023): 446. http://dx.doi.org/10.1182/blood-2023-182792.
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Background: The TIGER-trial (NCT01657604) is a multicenter, randomized phase III study to evaluate efficacy and tolerability of nilotinib (NIL) vs NIL+pegylated interferon alpha2b (IFN) combination therapy with IFN maintenance as first-line treatment for patients (pts) with chronic myeloid leukemia (CML) in chronic phase. Methods: A total of 717 pts were recruited from 110 sites in Germany, Switzerland, and the Czech Republic. A pilot phase (n=25) validated the feasibility of the combination of NIL 300 mg BID and IFN (30-50µg/week according to tolerability and commenced after ≥6 weeks NIL monotherapy). In the main phase, 692 pts were randomly assigned to NIL (n=353) and NIL/IFN (n=339). Achievement of major molecular remission (MMR, BCR::ABL1 ≤0.1% on the International Scale, IS) after >24 months (mo) of therapy was the trigger to start the maintenance phase; treatment-free remission (TFR) started in pts with ≥12 mo persistence of MR 4 ( BCR::ABL1 ≤0.01% IS) after >36 mo total therapy. Quality of life (QoL) was evaluated using EORTC QLQ-C30 and CML24 questionnaires. Results: From 692 randomized pts, 411 were male (59%), median age was 51 years (range, 18-85). In the monotherapy arm, median treatment duration with NIL was 3.1 years (0.02-8.9), median daily dose 600 mg (183-764). In the combination arm, median treatment duration with NIL was 2.3 years (0.02-9.1), median daily dose 600 mg (106-792). Median duration of IFN therapy was 2.4 years (0-9.0). A median of 77 (0-485) IFN injections were administered, the median dose of IFN per injection was 30µg (0-50). Probabilities of MMR and MR 4.5 ( BCR::ABL1 ≤0.0032% IS, Fig 1) by 24 mo were 89% (95% CI: 85-92%) and 49% (44-55%) vs 93% (89-95%) and 64% (59-69%) with NIL vs NIL/IFN, respectively. In 356 pts (53%) qualifying for the discontinuation phase (NIL, n=197; NIL/IFN, n=159), probabilities of maintained MMR by 24 mo were 53% (45-60%) and 62% (54-70%) after NIL and NIL/IFN, respectively, in an intention-to-treat-analysis (p=0.13). 273 (40%) eligible pts actually discontinued therapy (per-protocol-analysis, NIL, n=163; NIL/IFN, n=110). Probabilities of TFR by 24 mo were 53% (45-61%) vs 59% (49-68%) for NIL and NIL/IFN, respectively (Fig 2). Fifteen pts (2.2%) with atypical BCR::ABL1 transcripts (e1a2, n=7; e19a2, n=4; e8a2, n=2; e13a3 and e14a3, n=1 each) were randomized to receive NIL (n=7) or NIL/IFN (n=8). After a median treatment period of 37 mo (36-39) 9 pts achieved and maintained a BCR::ABL1 reduction of at least 4 orders of magnitude and were eligible for TFR. 6 pts failed to achieve an individual transcript decline by at least 3 logs. TFR was commenced in 7 and maintained in 6 pts after 32 (range, 20-84) mo. Adverse events of special interest grades 3-5 were arterio-vascular disorders in 9 vs 8%, fatigue in 2 vs 4%, thrombocytopenia in 8 vs 8%, and alanine aminotransferase elevation in 4 vs 9% of pts in the NIL vs NIL/IFN arms, respectively. QoL analyses revealed the perception of a decreased cognitive function and higher rates of fatigue in pts in the NIL/IFN arm, particularly in pts older than 40 years. In total, 24 pts (NIL, n=13; NIL/IFN, n=11) progressed to advanced disease. By 8 years, progression-free survival was 94% (95% CI: 90-96%) and 92% (88-95%), overall survival 95% (92-97%) and 94% (91-97%) in the NIL and NIL/IFN arms, respectively. 28 pts (3.9%) received an allogeneic stem cell transplantation, 14 after disease progression. 35 pts died (NIL, n=18; NIL/IFN, n=17), 9 related to CML. Conclusions: Survival of CML pts has reached probabilities close to normal. The combination of NIL with IFN is associated with a higher rate of molecular responses but also impaired tolerability. IFN maintenance is feasible, and resulted in a trend towards higher rates of long-term TFR. The study was conducted on behalf of the German CML Study Group in cooperation with the East German Study Group on Hematology and Oncology (OSHO) and the Swiss Group for Clinical Cancer Research (SAKK).
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Ji, B., T. Wahafu, G. Li, X. Zhang, Y. Wang, M. Momin e L. Cao. "Single-stage treatment of chronically infected total hip arthroplasty with cementless reconstruction". Bone & Joint Journal 101-B, n.º 4 (abril de 2019): 396–402. http://dx.doi.org/10.1302/0301-620x.101b4.bjj-2018-1109.r1.
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Aims Single-stage revision is not widely pursued due to restrictive inclusion criteria. In this study, we evaluated the results of single-stage revision of chronically infected total hip arthroplasty (THA) using broad inclusion criteria and cementless implants. Patients and Methods Between 2010 and 2016, 126 patients underwent routine single-stage revision with cementless reconstruction with powdered vancomycin or imipenem poured into the medullary cavity and re-implantation of cementless components. For patients with a culture-negative hip, fungal infections, and multidrug-resistant organisms, a direct intra-articular infusion of pathogen-sensitive antibiotics was performed postoperatively. Recurrence of infection and clinical outcomes were evaluated. Three patients died and 12 patients (none with known recurrent infection) were lost to follow-up. There were 111 remaining patients (60 male, 51 female) with a mean age of 58.7 (sd 12.7; 20 to 79). Results Of these 111 patients, 99 (89.2%) were free of infection at a mean follow-up time of 58 months (24 to 107). A recurrent infection was observed in four of the 23 patients (17.4%) with culture-negative infected hip. The success rate in patients with multidrug-resistant organisms was 84.2% (16/19). The mean postoperative Harris hip score was 79.6 points (63 to 92) at the most recent assessment. Conclusion Routine single-stage revision with cementless reconstruction can be a viable option for the treatment of chronically infected THA. The results of this study will add to the growing body of evidence supporting routine use of single-stage revision for the treatment of chronically infected THA. Cite this article: Bone Joint J 2019;101-B:396–402.
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Bushinsky, David A., Paolo Raggi, Jordi Bover, Markus Ketteler, Antonio Bellasi, Mariano Rodriguez, Smeeta Sinha et al. "Effects of Myo-inositol Hexaphosphate (SNF472) on Bone Mineral Density in Patients Receiving Hemodialysis". Clinical Journal of the American Society of Nephrology 16, n.º 5 (7 de abril de 2021): 736–45. http://dx.doi.org/10.2215/cjn.16931020.
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Background and objectivesIn the CaLIPSO study, intravenous administration of SNF472 (300 or 600 mg) during hemodialysis significantly attenuated progression of coronary artery and aortic valve calcification. SNF472 selectively inhibits formation of hydroxyapatite, the final step in cardiovascular calcification. Because bone mineral is predominantly hydroxyapatite, we assessed changes in bone mineral density in CaLIPSO.Design, setting, participants, & measurementsPatients with coronary artery calcification at screening (Agatston score of 100–3500 U) were randomized 1:1:1 to receive placebo, 300 mg SNF472, or 600 mg SNF472 as an intravenous infusion during hemodialysis three times weekly for 52 weeks. Dual-energy x-ray absorptiometry (DXA) scans were obtained at baseline (screening) and end of treatment, and between-group changes from baseline were compared using analysis of covariance.ResultsAmong 274 randomized patients, 202 had evaluable DXA scans at baseline and postrandomization (the DXA-modified intention-to-treat population). Mean (95% confidence interval) changes in total-hip bone mineral density from baseline to week 52 were −1.5% (−2.7% to −0.3%), −1.5% (−2.7% to −0.4%), and −2.5% (−3.8% to −1.2%) in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively. Mean (95% confidence interval) changes in femoral-neck bone mineral density from baseline to week 52 were −0.3% (−1.6% to 1.0%), −1.0% (−2.3% to 0.2%), and −2.6% (−4.0% to −1.3%), respectively. Regression analyses showed no correlation between change in coronary artery calcium volume and change in bone mineral density at either location. Changes in serum alkaline phosphatase, calcium, magnesium, phosphate, and intact parathyroid hormone levels were similar across treatment groups. Clinical fracture events were reported for four of 90, three of 92, and six of 91 patients in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively.ConclusionsBone mineral density decreased modestly in all groups over 1 year. In the 600 mg SNF472 group, the reduction appeared more pronounced. Reported fractures were infrequent in all groups.Clinical Trial registry name and registration number:Effect of SNF472 on Progression of Cardiovascular Calcification in End-Stage-Renal-Disease (ESRD) Patients on Hemodialysis (HD), NCT02966028
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Dauvilliers, Yves, Isabelle Arnulf, Nancy Foldvary-Schaefer, Patricia Chandler, Rupa Parvataneni, Dan Chen, Franck Skobieranda e Richard Bogan. "494 Placebo-Controlled, Double-Blind, Randomized Withdrawal Study of Lower-Sodium Oxybate in Adults With Idiopathic Hypersomnia". Sleep 44, Supplement_2 (1 de maio de 2021): A195. http://dx.doi.org/10.1093/sleep/zsab072.493.
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Abstract Introduction Idiopathic hypersomnia (IH) is a rare central hypersomnolence disorder characterized by excessive daytime sleepiness, prolonged nighttime sleep, and sleep inertia. No US/EU medication is approved for treatment of IH. Lower-sodium oxybate (LXB; Xywav™; previously designated JZP-258) is a novel oxybate treatment with 92% less sodium than sodium oxybate (Xyrem®). The efficacy and safety of LXB was evaluated in adults with IH. Methods Eligible participants aged 18–75 years with IH began once- or twice-nightly LXB treatment entering an open-label titration and optimization period (10–14 weeks), followed by a 2-week, open-label, stable-dose period (SDP); they were then randomized to placebo or to continue LXB treatment during a 2-week, double-blind, randomized withdrawal period (DBRWP). The primary efficacy endpoint was change in Epworth Sleepiness Scale (ESS) score; key secondary endpoints were proportion of participants who reported worsening (minimally/much/very much worse) on Patient Global Impression of Change (PGIc) and change in Idiopathic Hypersomnia Severity Scale (IHSS) score, all from end of SDP to end of DBRWP. Results The study enrolled 154 participants (mean±SD age, 40±14 years; 68% female; mean±SD ESS, 16±3.6); mean±SD dose was 6.0±1.6 g/night. Mean±SD ESS score (n=115) decreased over open-label titration/optimization (15.7±3.8 at baseline, 9.8±4.5 at week 4, and 6.1±4.0 at the end of the SDP). At the end of the DBRWP, significant worsening was observed in participants randomized to placebo, compared with maintenance of improvement in participants randomized to continue LXB, in ESS scores (n=115; LS mean difference [95% CI] in change from SDP, −6.51 [−7.99, −5.03]; P<0.0001), in the PGIc (88.1% for placebo vs 21.4% for LXB; P<0.0001), and in IHSS scores (estimated median difference [95% CI], −12.00 [−15.0, −8.0]; P<0.0001). Common adverse events (AEs) included nausea (21.4%), headache (16.2%), anxiety (14.9%), dizziness (11.7%), insomnia (11.7%), and vomiting (10.4%). Serious AEs occurred in 4 participants (non-cardiac chest pain, rhabdomyolysis, syncope, and nephrolithiasis/pyelonephritis); none were reported related to study drug. Conclusion In participants with IH, LXB demonstrated a clinically meaningful effect on excessive daytime sleepiness, self-reported global change, and overall IH symptom severity. The overall safety profile was consistent with that of LXB in narcolepsy. Support (if any) Jazz Pharmaceuticals
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Pak, Jamie Sungmin, Philippa J. Cheetham, Aaron Katz e Sven Wenske. "Primary focal cryosurgery of the prostate: Long-term clinical and biochemical outcomes in a large cohort at a tertiary referral center." Journal of Clinical Oncology 33, n.º 7_suppl (1 de março de 2015): 114. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.114.
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114 Background: Modern primary focal cryosurgery (PFC) has emerged as a primary therapy option for localized and minimal low-risk prostate cancer (PCa), achieving good local cancer control and survival outcome. The aim of this analysis was to report on the experience of PFC in our tertiary referral center in the management of localized PCa. Methods: We identified a consecutive series of patients that underwent PFC for localized PCa at our institution between 8/2000 and 1/2014. Demographics, PSA levels and Gleason scores before primary treatment and at time of recurrence were assessed; BDFS, OS, and DSS were assessed. BCR was defined by the Phoenix (PD) and Stuttgart Definitions (SD). Results: A total of 126 patients were included in the analysis, with a median follow-up of 40.3 (0.8-116, IQR 41) months. Median age was 73.5 (range 45-92, IQR 9) years. Median initial serum PSA level was 6.0 (1-44.5, IQR 3) ng/ml. Median primary and secondary Gleason score on initial biopsy was 3 (3-5, IQR 1) with a median sum of 6 (6-10, 1), and 15% (2-95%, IQR 0) of biopsy tissue involved with cancer. Median number of biopsy cores was 12 (2-32), with a median of 1 (1-12, IQR 1) core affected by cancer. Median PSA nadir post-treatment was 1.3 (0.1-13.1, IQR 2) ng/ml. According to PD and SD, 24 and 37 patients had BCR after a median of 14.9 (3.4-91.3, IQR 17) and 13.0 (2.9-90.3, IQR 11) months. Overall 4-year-BDFS was 83% and 73% by PD and SD, respectively. 5-year OS and DSS was 95%, and 99.2%. Of patients that met BCR criteria, almost 25% were proven to be negative on biopsy, confirming over-estimation of failures. Patients that recurred had significantly higher initial median PSA levels (8.5 vs. 5.8 ng/ml; p<0.01) and PSA-nadir (2.1 vs. 1.0 ng/ml; p<0.05). Conclusions: Our analysis confirms PFC being a good option with low rate of morbidities for patients with localized PCa, with excellent BDFS and DSS at a long follow-up of 40 months. Controversy exists regarding criteria of BCR-definitions after focal therapies. More stringent definitions, such as the SD, especially in a focal cryosurgery setting, significantly over-estimate failure rates, and prostate biopsy seems to be the only reliable means to assess for recurrence at this point.
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Koseki, Shige, Maki Matsubara e Kazutaka Yamamoto. "Prediction of a Required Log Reduction with Probability for Enterobacter sakazakii during High-Pressure Processing, Using a Survival/Death Interface Model". Applied and Environmental Microbiology 75, n.º 7 (6 de fevereiro de 2009): 1885–91. http://dx.doi.org/10.1128/aem.02283-08.
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ABSTRACT A probabilistic model for predicting Enterobacter sakazakii inactivation in trypticase soy broth (TSB) and infant formula (IF) by high-pressure processing was developed. The modeling procedure is based on a previous model (S. Koseki and K. Yamamoto, Int. J. Food Microbiol. 116:136-143, 2007) that describes the probability of death of bacteria. The model developed in this study consists of a total of 300 combinations of pressure (400, 450, 500, 550, or 600 MPa), pressure-holding time (1, 3, 5, 10, or 20 min), temperature (25 or 40°C), inoculum level (3, 5, or 7 log10 CFU/ml), and medium (TSB or IF), with each combination tested in triplicate. For each replicate response of E. sakazakii, survival and death were scored with values of 0 and 1, respectively. Data were fitted to a logistic regression model in which the medium was treated as a dummy variable. The model predicted that the required pressure-holding times at 500 MPa for a 5-log reduction in IF with 90% achievement probability were 26.3 and 7.9 min at 25 and 40°C, respectively. The probabilities of achieving 5-log reductions in TSB and IF by treatment with 400 MPa at 25°C for 10 min were 92 and 3%, respectively. The model enabled the identification of a minimum processing condition for a required log reduction, regardless of the underlying inactivation kinetics pattern. Simultaneously, the probability of an inactivation effect under the predicted processing condition was also provided by taking into account the environmental factors mentioned above.
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Jain, Nitin, Audrey Lamb, Susan M. O'Brien, Farhad Ravandi, Marina Konopleva, Elias Jabbour, Zhuang Zuo et al. "Early T-Cell Precursor Acute Lymphoblastic Leukemia (ETP-ALL) Is a High-Risk Subtype in Adults". Blood 126, n.º 23 (3 de dezembro de 2015): 1418. http://dx.doi.org/10.1182/blood.v126.23.1418.1418.
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Abstract Background: Early T-cell precursor (ETP) acute lymphoblastic leukemia/lymphoma (ALL) is a recently recognized high-risk T-ALL subgroup. The optimal therapeutic approaches to adult patients with ETP-ALL are poorly characterized. In this study, we compared the outcomes of adults with ETP-ALL who received treatment on frontline regimens to those of patients with other T-ALL immunophenotypic subtypes. Methods: Patients with newly-diagnosed T-ALL who received frontline chemotherapy between the years 2000 and 2014 at The University of Texas MD Anderson Cancer Center (MDACC) were identified and immunophenotypically categorized into early, thymic, and mature per the European Group for the Immunologic Classification of Leukemia (EGIL)/WHO classification. Patients with ETP-ALL were identified on the basis of the following immunophenotype: CD1a(-), CD8(-), CD5(-/dim), and positivity for one or more stem cell or myeloid antigens. Patients received frontline treatment with the following chemotherapy regimens: hyper-CVAD alone (n=43), hyper-CVAD + nelarabine (n=44) or augmented BFM regimen (n=24). Results: A total of 111 patients with T-ALL with adequate immunophenotype data were identified. There was no difference in the outcomes of patients based on the EGIL/WHO subtypes (Fig 1). A total of 19 patients (17%) had ETP-ALL. The complete remission rate (CR)/CR with incomplete platelet recovery (CRp) rate in patients with ETP-ALL was significantly lower than that of non-ETP-ALL patients (73% vs. 91%; p=0.03). The median overall survival for patients with ETP-ALL was 20 months vs. not reached for the non-ETP-ALL patients (p = 0.008) (Fig 2). ETP-ALL remained a high-risk subgroup within the WHO 'Early' group (Fig 3). A subset of patients with early T-ALL had an immunophenotype that resembled that of ETP-ALL except for having ≥75% CD5 expression (ETP+CD5). The OS of patients with ETP+CD5 (n=19) was similar to that of non-ETP-ALL patients and differed from that of ETP-ALL patients (p=0.059). By univariate analysis, the following variables were significant for survival: age, WBC count (<50 vs. ≥50 x109 /L), platelet count (<100 vs. ≥100 x109 /L), LDH (<600 vs. ≥600 IU/L) and ETP-ALL (Table 1). By multivariate analysis, only age (HR: 2.862; 95%CI: 1.140-7.183; p=0.025) and ETP-ALL (HR: 2.275; 95%CI: 1.117-4.631; p=0.023) were significant. Conclusions: ETP-ALL represents a high-risk disease subtype of adult ALL. Allogeneic stem cell transplant in CR1 should be considered. Novel treatment strategies are needed to improve treatment outcomes in this T-ALL subset. Table 1. Univariate and multivariate analysis for survival Parameter Survival UVA MVA P P HR 95%CI Age ≥60 0.013 0.025 2.862 1.140-7.183 Gender 0.24 - - - Diagnosis (ALL vs. LBL) 0.13 - - - WBC < 50.0 (x 109 /L) 0.009 - - - Hemoglobin <10 (g/dL) 0.36 - - - Platelet <100 (x 109 /L) 0.036 - - - LDH <600 (IU/L) 0.045 - - - CNS involvement at Dx 0.18 - - - WHO classification (early, thymic, mature) 0.101 - - - ETP-ALL 0.008 0.023 2.275 1.117-4.631 Treatment received 0.43 - - - Figure 1. Overall survival of patients with T-ALL (N=111) categorized as Early, Thymic and Mature per EGIL/WHO Classification Figure 1. Overall survival of patients with T-ALL (N=111) categorized as Early, Thymic and Mature per EGIL/WHO Classification Figure 2. Overall survival of patients with ETP-ALL (N=19) compared to non-ETP ALL (N=92) Figure 2. Overall survival of patients with ETP-ALL (N=19) compared to non-ETP ALL (N=92) Figure 3. Overall survival of patients with WHO 'early' subcategorized as ETP vs. non-ETP, WHO 'thymic', and WHO 'mature' (N=111) Figure 3. Overall survival of patients with WHO 'early' subcategorized as ETP vs. non-ETP, WHO 'thymic', and WHO 'mature' (N=111) Disclosures Konopleva: Novartis: Research Funding; AbbVie: Research Funding; Stemline: Research Funding; Calithera: Research Funding; Threshold: Research Funding. Cortes:Astellas: Consultancy, Research Funding; BerGenBio AS: Research Funding; Novartis: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Ariad: Consultancy, Research Funding; Teva: Research Funding; Ambit: Consultancy, Research Funding; Arog: Research Funding; Celator: Research Funding; Jenssen: Consultancy.
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Jayanti, Desak Made Ari Dwi, e Dewa Putu Arwidiana. "The Ilustation of Physical Health and Scizofrenia Patients’ Independence in Performing Personal Hygiene at Bali Province’s Mental Hospital". Jurnal Keperawatan Respati Yogyakarta 7, n.º 2 (31 de maio de 2020): 66. http://dx.doi.org/10.35842/jkry.v7i2.539.
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Not only mental problem do the schizophrenia patients suffer, but also physical problems. a quantitative descriptive with a cross-sectional approach model was hired in this research. This research employed 113 schizophrenia patients at the psykiatric hospital in Bali Province as samples with simple random technique. The instrument used to measure independence in performing personal hygiene was an observation sheet with Gordon's assessment scale and physical health assessment used an observation sheet, sphigmomanometer, scales and a meter to measure height. The results showed from the physical health assessment of the Body Mass Index in the most schizophrenia patients with a normal weight were 83 persons (73.5%), the thin patients were 12 persons (10.6%), More Body Weight were 5 persons (4.4%), obesity were 13 persons (11.5%), without concomitant diseases were 104 persons (92%), hypertension patient were 9 persons (8%). Independence in performing self-care were 69 respondents (61.1%) in the category of needing help, the majority of respondents were 79 respondents (69.9%), the category of needing assistance, self-care eating were 94 respondents (83.2%,) the category of needing help, toileting were 70 respondents (62.0%), Independence in performing personal hygiene was at 64 respondents (56.6%)
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Nicholson, J. A., H. K. C. Searle, D. MacDonald e J. McBirnie. "Cost-effectiveness and satisfaction following arthroscopic rotator cuff repair". Bone & Joint Journal 101-B, n.º 7 (julho de 2019): 860–66. http://dx.doi.org/10.1302/0301-620x.101b7.bjj-2019-0215.r1.
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Aims The aim of this study was to investigate the influence of age on the cost-effectiveness of arthroscopic rotator cuff repair. Patients and Methods A total of 112 patients were prospectively monitored for two years after arthroscopic rotator cuff repair using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), the Oxford Shoulder Score (OSS), and the EuroQol five-dimension questionnaire (EQ-5D). Complications and use of healthcare resources were recorded. The incremental cost-effectiveness ratio (ICER) was used to express the cost per quality-adjusted life-year (QALY). Propensity score-matching was used to compare those aged below and above 65 years of age. Satisfaction was determined using the Net Promoter Score (NPS). Linear regression was used to identify variables that influenced the outcome at two years postoperatively. Results A total of 92 patients (82.1%) completed the follow-up. Their mean age was 59.5 years (sd 9.7, 41 to 78). There were significant improvements in the mean DASH (preoperative 47.6 vs one-year 15.3; p < 0.001) and OSS scores (26.5 vs 40.5; p < 0.001). Functional improvements were maintained with no significant change between one and two years postoperatively. The mean preoperative EQ-5D was 0.54 increasing to 0.81 at one year (p < 0.001) and maintained at 0.86, two years postoperatively. There was no significant difference between those aged below or above 65 years of age with regards to postoperative shoulder function or EQ-5D gains. Smoking was the only characteristic that significantly adversely influenced the EQ-5D at two years postoperatively (p = 0.005). A total of 87 were promoters and five were passive, giving a mean NPS of 95 (87/92). The total mean cost per patient was £3646.94 and the mean EQ-5D difference at one year was 0.2691, giving a mean ICER of £13 552.36/QALY. At two years, this decreased further to £5694.78/QALY. This was comparable for those aged below or above 65 years of age (£5209.91 vs £5525.67). Smokers had an ICER that was four times more expensive. Conclusion Arthroscopic rotator cuff repair results in excellent patient satisfaction and cost-effectiveness, regardless of age. Cite this article: Bone Joint J 2019;101-B:860–866.
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Ward, Leah G., Michael G. Heckman, Amy I. Warren e Kimberly Tran. "Dosing Accuracy of Insulin Aspart FlexPens after Transport through the Pneumatic Tube System". Hospital Pharmacy 48, n.º 1 (janeiro de 2013): 33–38. http://dx.doi.org/10.1310/hpj4801-33.
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Purpose The purpose of this study was to evaluate whether transporting insulin aspart FlexPens via a pneumatic tube system affects the dosing accuracy of the pens. Methods A total of 115 Novo Nordisk FlexPens containing insulin aspart were randomly assigned to be transported via a pneumatic tube system (n = 92) or to serve as the control (n = 23). Each pen was then randomized to 10 international unit (IU) doses (n = 25) or 30 IU doses (n = 67), providing 600 and 603 doses, respectively, for the pneumatic tube group. The control group also received random assignment to 10 IU doses (n = 6) or 30 IU doses (n = 17), providing 144 and 153 doses, respectively. Each dose was expelled using manufacturer instructions. Weights were recorded, corrected for specific gravity, and evaluated based on acceptable International Organization for Standardization (ISO) dosing limits. Results In the group of pens transported through the pneumatic tube system, none of the 600 doses of 10 IU (0.0%; 95% CI, 0.0 to 0.6) and none of the 603 doses of 30 IU (0.0%; 95% CI, 0.0 to 0.6) fell outside of the range of acceptable weights. Correspondingly, in the control group, none of the 144 doses at 10 IU (0.0%; 95% CI, 0.0 to 2.5) and none of the 153 doses at 30 IU (0.0%; 95% CI, 0.0 to 2.4) were outside of acceptable ISO limits. Conclusion Transportation via pneumatic tube system does not appear to compromise dosing accuracy. Hospital pharmacies may rely on the pneumatic tube system for timely and accurate transport of insulin aspart FlexPens.
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Bardin, T., Q. Nguyen, K. Tran, C. Tran, D. Huynh, D. M. Do, P. Richette, J. M. Correas e M. Resche-Rigon. "POS0086 A TRANSVERSAL STUDY OF 826 UNTREATED GOUT PATIENTS SHOWS THAT ECHOGENICITY OF THE RENAL MEDULLA INCREASES WITH GOUT DURATION/SEVERITY AND STEROID USE". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 255.1–256. http://dx.doi.org/10.1136/annrheumdis-2023-eular.3781.
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BackgroundDiffuse hyperechogenicity of the kidney pyramids, detected by kidney ultrasound (US) scan, has been reported as a frequent finding in severe, untreated, tophaceous gout. It seemed related to crystal deposition in the renal medulla and correlated with kidney function decrease, reviving the concept of gouty microcrystalline nephropathy [1].ObjectivesTo confirm this finding and to detect its progression with gout duration.MethodsPatients fulfilled the ACR/EULAR criteria, were not treated by urate-lowering drugs (ULD) at the time of examination; 44 % had received short courses of ULD in the past. They underwent kidney US scans by an experienced radiologist, who classified each kidney into 3 grades according to the presence and degree of hyperechogenicity of the renal pyramids, as compared to the renal cortex. Grade 0 was defined as no medulla hyperechogenicity; grade 1 by the observation of hyperechogenic spots in 1 or 2 renal pyramids; grade 3 as a diffuse hyperechogenicity of at least 3 pyramids (out of 5 scanned). Demographic variables, comorbidities, gout and biochemical features were retrieved from electronic files. US scans of the MTP joints allowed gradation of double contours from 0 to 3. Links between patients ‘features and renal medulla staging were assessed by Fisher exact or Kruskall and Wallis tests according to the type of variables. Multivariable analysis included all statistically significant features, with model selection on p.value using a proportional odds logistic regression model. All test were two-sided.Results826 consecutive new patients were included from August 1 to December 24, 2022. 88 % were males, median age was 49 years, median BMI 24.22 kg/m2, median gout duration 5 years, 70 % of patients had clinical tophi, median uricemia was 488,6 µmol/l, median creatininemia 83.5 mmol/l, median eGFR 93 ml/min. Both kidneys were classified at the same grade in every all patients. 65.5% of patients were at grade 0, 17.8 % at grade 1 and 16.7 % at grade 3. Table 1 shows links of the extent of medulla hyperechogenicity with patients ‘features. By multivariable analysis, positive correlation was found with male sex, hypertension, gout duration, tophi, double contours and uricemia; BMI, eGFR and cortilsolemia negatively correlated.ConclusionHyperechogenicity of the renal medullas progressively increased with gout duration, MSU deposition and steroid treatment, and associated with decrease of renal function and hypertension. These observations reinforce the early indication of ULDs in gouty patients.Reference[1]Bardin T et al. Kidney Intern 2021;99: 218–226Table 1.Main features of gouty patients by grades of medulla hyperechogenicityGrade 0n = 541Grade 1n = 147Grade 2n = 138p valuep.value MultiAge (y) median [IQR]47 [38, 56]51 [44, 59]54 [45, 62]<0.001Males n (%)441 (81.7)147 (100.0)138 (100)<0.001<0.001BMI (kg/m2) median [IQR]24.4 [22.5, 26.7]24.1 [22.5, 26.1]23.3 [21.2, 25.8]0.003<0.001Hypertension n (%)145 (26.8)54 (36.7)88 (63.8)<0.0010.006CHD n (%)6 (1.1)7 (4.8)7 (5.1)0.003Type 2 diabetes n (%)62 (11.5)17 (11.6)27 (19.6)0.04Gout duration (y) median [IQR]4 [2, 7]7 [4, 11]11 [8, 17]<0.001<0.001Tophi n (%)298 (55.1)14 (95.9)137 (99.3)<0.001<0.001Urinary stone n (%)23 (4.3)18 (12.2)13 (9.4)0.001SUA (umol/l) median [IQR]437 [322, 548]533 [432, 602]558 [493, 618]<0.001<0.001Creatininemia (mmol/l) median [IQR]81 [67, 92]87 [76, 106]93 [79, 107]<0.001eGFR > 60 ml/min n (%)506 (93.5)128 (87.1)112 (81.2)<0.001Maximum double contours<0.001<0.001 0 n (%)17 (34.1)0 (0.0)0 (0.0) Thin n (%)86 (20.7)8 (5.4)1 (0.7) Medium n (%)306 (73.6)114 (77.6)66 (47.8) Thick n (%)7 (1.7)25 (17.0)71 (51.4)8 am cortisol median [IQR]7.55 [3.58,10.33]6.60 [1.95,10.72]1.91 [0,59,8.06]<0.0010.005y: years; IQR: interquartile range; BMI: body mass index; CHD: coronary heart disease; eGFR estimated glomerular filtration rate (MDRD)Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Hexter, A. T., T. Thangarajah, G. Blunn e F. S. Haddad. "Biological augmentation of graft healing in anterior cruciate ligament reconstruction". Bone & Joint Journal 100-B, n.º 3 (março de 2018): 271–84. http://dx.doi.org/10.1302/0301-620x.100b3.bjj-2017-0733.r2.
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AimsThe success of anterior cruciate ligament reconstruction (ACLR) depends on osseointegration at the graft-tunnel interface and intra-articular ligamentization. Our aim was to conduct a systematic review of clinical and preclinical studies that evaluated biological augmentation of graft healing in ACLR.Materials and MethodsIn all, 1879 studies were identified across three databases. Following assessment against strict criteria, 112 studies were included (20 clinical studies; 92 animal studies).ResultsSeven categories of biological interventions were identified: growth factors, biomaterials, stem cells, gene therapy, autologous tissue, biophysical/environmental, and pharmaceuticals. The methodological quality of animal studies was moderate in 97%, but only 10% used clinically relevant outcome measures. The most interventions in clinical trials target the graft-tunnel interface and are applied intraoperatively. Platelet-rich plasma is the most studied intervention, but the clinical outcomes are mixed, and the methodological quality of studies was suboptimal. Other biological therapies investigated in clinical trials include: remnant-augmented ACLR; bone substitutes; calcium phosphate-hybridized grafts; extracorporeal shockwave therapy; and adult autologus non-cultivated stem cells.ConclusionThere is extensive preclinical research supporting the use of biological therapies to augment ACLR. Further clinical studies that meet the minimum standards of reporting are required to determine whether emerging biological strategies will provide tangible benefits in patients undergoing ACLR. Cite this article: Bone Joint J 2018;100-B:271–84.
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Doherty, A., V. O. Sadras, D. Rodriguez e A. Potgieter. "Quantification of wheat water-use efficiency at the shire-level in Australia". Crop and Pasture Science 61, n.º 1 (2010): 1. http://dx.doi.org/10.1071/cp09157.
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In eastern Australia, latitudinal gradients in vapour pressure deficit (VPD), mean temperature (T), photosynthetically active radiation (PAR), and fraction of diffuse radiation (FDR) around the critical stage for yield formation affect wheat yield and crop water-use efficiency (WUE = yield per unit evapotranspiration). In this paper we combine our current understanding of these climate factors aggregated in a normalised phototermal coefficient, NPq = (PAR· FDR)/(T · VPD), with a shire-level dynamic model of crop yield and water use to quantify WUE of wheat in 245 shires across Australia. Three measures of WUE were compared: WUE, the ratio of measured yield and modelled evapotranspiration; WUEVPD, i.e. WUE corrected by VPD; and WUENPq, i.e. WUE corrected by NPq. Our aim is to test the hypothesis that WUENPq suits regional comparisons better than WUE or WUEVPD. Actual median yield at the shire level (1975–2000) varied from 0.5 to 2.8 t/ha and the coefficient of variation ranged from 18 to 92%. Modelled median evapotranspiration varied from 106 to 620 mm and it accounted for 42% of the variation in yield among regions. The relationship was non-linear, and yield stabilised at ~2 t/ha for evapotranspiration above 343 mm. There were no associations between WUE and rainfall. The associations were weak (R2 = 0.09) but in the expected direction for WUEVPD, i.e. inverse with seasonal rainfall and direct with off-season rainfall, and strongest for WUENPq (R2 = 0.40).We suggest that the effects of VPD, PAR, FDR, and T, can be integrated to improve the regional quantification of WUE defined in terms of grain yield and seasonal water use.
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Norcliffe-Kaufmann, Lucy, Jose-Alberto Palma, Jose Martinez e Horacio Kaufmann. "Carbidopa for Afferent Baroreflex Failure in Familial Dysautonomia". Hypertension 76, n.º 3 (setembro de 2020): 724–31. http://dx.doi.org/10.1161/hypertensionaha.120.15267.
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Afferent lesions of the arterial baroreflex occur in familial dysautonomia. This leads to excessive blood pressure variability with falls and frequent surges that damage the organs. These hypertensive surges are the result of excess peripheral catecholamine release and have no adequate treatment. Carbidopa is a selective DOPA-decarboxylase inhibitor that suppresses catecholamines production outside the brain. To learn whether carbidopa can inhibit catecholamine-induced hypertensive surges in patients with severe afferent baroreflex failure, we conducted a double-blind randomized crossover trial in which patients with familial dysautonomia received high dose carbidopa (600 mg/day), low-dose carbidopa (300 mg/day), or matching placebo in 3 4-week treatment periods. Among the 22 patients enrolled (13 females/8 males), the median age was 26 (range, 12–59 years). At enrollment, patients had hypertensive peaks to 164/116 (range, 144/92 to 213/150 mm Hg). Twenty-four hour urinary norepinephrine excretion, a marker of peripheral catecholamine release, was significantly suppressed on both high dose and low dose carbidopa, compared with placebo ( P =0.0075). The 2 co-primary end points of the trial were met. The SD of systolic BP variability was reduced at both carbidopa doses (low dose: 17±4; high dose: 18±5 mm Hg) compared with placebo (23±7 mm Hg; P =0.0013), and there was a significant reduction in the systolic BP peaks on active treatment ( P =0.0015). High- and low-dose carbidopa were similarly effective and well tolerated. This study provides class Ib evidence that carbidopa can reduce blood pressure variability in patients with congenital afferent baroreflex failure. Similar beneficial effects are observed in patients with acquired baroreflex lesions.
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Oshita, D., A. P. de Oliveira, J. A. Gomes Neto e M. de Moraes. "Determinação direta e simultânea de Al, As, Fe, Mn e Ni em cachaça por espectrometria de absorção atômica em forno de grafite". Eclética Química 28, n.º 1 (2003): 91–96. http://dx.doi.org/10.1590/s0100-46702003000100012.
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Este trabalho propõe um método simples, rápido e confiável para determinação direta e simultânea de Al, As, Fe, Mn e Ni em cachaça por espectrometria de absorção atômica em forno de grafite (GFAAS). A superfície superior da plataforma do tubo de grafite foi revestida com filme à base de tungstênio (WxCyOz).O programa de aquecimento otimizado (temperatura, tempo de rampa, tempo de patamar) foi o seguinte: secagem 1 (100ºC, 5 s, 5 s); secagem 2 (120ºC, 5 s, 5 s); pirólise (1300ºC, 10 s, 30 s); atomização (2200ºC, 1 s, 6 s) e limpeza (2550ºC, 1 s, 3s). Os desvios padrões relativos (n=3) foram < 4,4%, < 0,7%, < 11%, < 6,0%, < 1,2% para os elementos Al, As, Fe, Mn e Ni, respectivamente. A exatidão foi avaliada por meio de testes de adição e recuperação dos analitos em 8 amostras de cachaças comerciais, e as recuperações situaram-se nos seguintes intervalos: 80 - 105% (Al), 81 - 92% (As), 82 - 108% (Fe), 83 - 106% (Mn), 83 - 108% (Ni). Os limites de detecção calculados foram 9,7 µg L-1 Al, 2,3 µg L-1 As, 12 µg L-1 Fe, 14 µg L-1 Mn e 0,8 µg L-1 Ni.
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Huang, Xianghe, Jinhai Wang, Jianwei Yang, Yue Zhao e Yuzhu Wang. "Influence of Passenger Capacity on Fatigue Life of Gearbox Suspender of the Traction Transmission System in Urban Railway Vehicles". Sustainability 15, n.º 5 (28 de fevereiro de 2023): 4338. http://dx.doi.org/10.3390/su15054338.
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Fatigue damage is the most dangerous failure behavior for gearbox suspenders in urban railway vehicles, and passenger capacity is crucial to the dynamic load characteristics of the traction transmission system. Therefore, in this paper, a dynamic model of the motor car is established, and a numerical simulation is carried out under different speeds and curve radii to investigate the effect of passenger capacity on fatigue life. The research results show that passenger capacity is an essential factor affecting the fatigue life of suspenders. As the vehicle runs at an average speed, the fatigue life of the suspender is 1.07 × 106 km when the passenger capacity is 120 people; when there are 240 people, the fatigue life reduction is 60%, while it is 86% at 339 people and 92% at 389 people. The per capita fatigue damage under a straight line is 7.27 × 10−10 at 20 km/h but 1.23 × 10−8 at 60 km/h. The per capita fatigue damage under a curved line is 7.18 × 10−9 in the 600 m curve but 9.00 × 10−9 in the 400 m curve. It can be concluded that the effect of speed is more significant than the curve radius. This research achievement can provide theoretical support for vehicle design and maintenance decisions.
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Valerio, Jose E., Aizik Wolf, Xiaodong Wu, Noe Santiago Rea, Maria Fernandez Gomez, Matteo Borro e Andres M. Alvarez-Pinzon. "Assessment of Gamma Knife Stereotactic Radiosurgery as an Adjuvant Therapy in First-Line Management of Newly Diagnosed Glioblastoma: Insights from Ten Years at a Neuroscience Center". International Journal of Translational Medicine 4, n.º 2 (27 de maio de 2024): 298–308. http://dx.doi.org/10.3390/ijtm4020019.
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Gamma knife radiosurgery (GKRS), a form of stereotactic radiosurgery (SRS), has gained importance in treating glioblastoma alongside conventional chemotherapy. This study aims to assess the efficacy of combining GKRS with surgery and chemotherapy to enhance treatment outcomes for glioblastoma patients. This prospective clinical study, adhering to STROBE guidelines, assessed 121 glioblastoma patients from June 2008 to December 2022. All patients who had not undergone prior radiotherapy underwent open surgical tumor resection, GKRS, and adjuvant chemotherapy. In the analyzed cohort, the median survival post-diagnosis was 21.2 months (95% CI: 11.4–26.7) and the median progression-free survival was 13.6 months (95% CI: 12.5–28.3). The median time to first recurrence post-treatment was 14.5 months (range: 4–33 months). The median prescribed dose for GKRS was 12 Gy (range: 10–17 Gy), with a median target volume of 6.0 cm3 (range: 1.6–68 cm3). Post GKRS, 92 patients experienced local recurrence, 21 experienced distant recurrence, and 87 received additional treatment, indicating diverse responses and treatment engagement. This study evaluates the use of GKRS for glioblastomas, emphasizing its efficacy and complications in a single-center trial. It suggests integrating GKRS into initial treatment and for recurrences, highlighting the comparable survival rates but underscoring the need for further research.
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Fadgyas, Balázs, Gábor István Garai e Zoltán Ringwald. "Milyen hatása van a COVID–19-járványnak a gyermekkori akut appendicitisekre?" Orvosi Hetilap 162, n.º 16 (18 de abril de 2021): 608–10. http://dx.doi.org/10.1556/650.2021.32189.
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Összefoglaló. Bevezetés: A COVID–19-pandémia miatt a gyermekkori appendicitisek kezelésében számos változás történt (laparoszkópia helyett nyílt műtét, antibiotikumkezelés). Világszerte emelkedett a szövődményes appendicitisek aránya. Célkitűzés: Munkánk során a COVID–19-járványnak a gyermekkori akut appendicitisekre kifejtett hatását szerettük volna vizsgálni: lett-e több perforált eset? Módszerek: A 2012 és 2020 között akut vakbélgyulladás miatt operált gyermekeket vizsgáltuk, külön, havi bontásban a 2020-as eseteket. A szövettani diagnózis alapján perforált és nem perforált appendicitis csoportokat alkottunk. A 2020-ban operált betegek COVID–19-statusát is rögzítettük. Statisztikai analízisre a khi2-próbát (’chi2 test for trend’) és a Fisher-féle egzakt tesztet alkalmaztuk. Eredmények: A vizsgált időszakban 1343 appendectomia történt, többségében nem perforált akut appendicitis miatt (1166/1343). 2015-től kezdődően a perforált esetek aránya szignifikáns emelkedést mutat (p = 0,0002). Az igazoltan COVID–19-pozitív betegek között magasabb volt a perforáltak aránya (5/8), mint az igazoltan negatív betegek között (15/92) (p = 0,0075). Megbeszélés: A nemzetközi trendeknek megfelelően 2020-ban osztályunkon is magasabb volt a perforált appendicitisek aránya, mint a korábbi években. Ez az emelkedés 2015-től tart, a pandémiával nem mutat szoros összefüggést. A perforált appendicitisek COVID–19-pozitív betegek között észlelt magas arányának okát nem ismerjük. Következtetés: További vizsgálat indokolt annak feltárására, hogy mi okozza a perforált appendicitisek COVID–19-pozitív betegek között észlelt magas, illetve 2015 óta emelkedő rátáját. Orv Hetil. 2021; 162(16): 608–610. Summary. Introduction: As a result of the COVID-19 pandemic, the management of paediatric appendicitis has changed (open instead of laparoscopic appendectomy, antibiotic treatment). The number of complicated appendicitis cases increased worldwide. Objective: Our aim was to study the effect of the COVID-19 pandemic on paediatric acute appendicitis: has there been more perforated cases? Methods: Children operated because of acute appendicitis between 2012 and 2020 were studied. Cases from the year 2020 were analysed monthly. Patients were divided into perforated and non-perforated appendicitis groups according to their histological findings. COVID-19 status of patients in 2020 was studied. Chi2 test for trend and Fisher’s exact test were used for statistical analysis. Results: In the study period, 1343 appendectomies were performed. The majority of our cases were non-perforated (1166/1343). The rate of perforated appendicitis cases has been increasing from 2015 (p = 0.0002). The number of perforated cases was higher in COVID-19 positive patients (5/8) then in negative ones (15/92) (p = 0.0075). Discussion: In line with the international trend, more perforated appendicitis cases were treated in our departement in 2020. However, this increase started in 2015, and there is no correlation with the COVID-19 pandemic. The cause of the increased number of perforated cases in COVID-19 positive appendicitis patients is unknown. Conclusion: The causes of the high proportion of perforated cases in COVID-19 positive patients and the rising rate of perforated appendicitis cases since 2015 need further studies. Orv Hetil. 2021; 162(16): 608–610.
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Ment, Laura R., Betty Vohr, William Oh, David T. Scott, Walter C. Allan, Michael Westerveld, Charles C. Duncan et al. "Neurodevelopmental Outcome at 36 Months' Corrected Age of Preterm Infants in the Multicenter Indomethacin Intraventricular Hemorrhage Prevention Trial". Pediatrics 98, n.º 4 (1 de outubro de 1996): 714–18. http://dx.doi.org/10.1542/peds.98.4.714.
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Objectives. Low-dose indomethacin has been shown to prevent intraventricular hemorrhage (IVH) in very low birth weight neonates, and long-term neurodevelomental follow-up data are needed to validate this intervention. We hypothesized that the early administration of low-dose indomethacin would not be associated with adverse cognitive outcome at 36 months' corrected age (CA). Methods. We enrolled 431 neonates of 600 to 1250 g birth weight with no IVH at 6 to 12 hours in a randomized, prospective trial to determine whether low-dose indomethacin would prevent IVH. A priori, neurodevelopmental follow-up examinations, including the Stanford-Binet Intelligence Scale and Peabody Picture Vocabulary Test-Revised, and standard neurologic examinations were planned at 36 months' CA. Results. Three hundred eighty-four of the 431 infants survived (192 [92%] of 209 infants receiving indomethacin versus 192 [86%] of 222 infants receiving saline), and 343 (89%) children were examined at 36 months' CA. Thirteen (8%) of the 166 infants who received indomethacin and 14 (8%) of 167 infants receiving the placebo were found to have cerebral palsy. There were no differences in the incidence of deafness or blindness between the two groups. For the 248 English-monolingual children for whom IQ data follow, the mean gestational age was significantly younger for the infants who received indomethacin than for those who received the placebo. None of the 115 infants who received indomethacin was found to have ventriculomegaly on cranial ultrasound at term, compared with 5 of 110 infants who received the placebo. The mean ± SD Stanford-Binet IQ score for the 126 English-monolingual children who had received indomethacin was 89.6 ± 18.92, compared with 85.0 ± 20.79 for the 122 English-monolingual children who had received the placebo. Although maternal education was strongly correlated with Stanford-Binet IQ at 36 months' CA, there was no difference in educational levels between mothers of the infants receiving indomethacin and the placebo. Conclusions. Indomethacin administered at 6 to 12 hours as prophylaxis against IVH in very low birth weight infants does not result in adverse cognitive or motor outcomes at 36 months' CA.
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Huonker, M., Y. O. Schumacher, A. Ochs, S. Sorichter, J. Keul e M. Rössle. "Cardiac function and haemodynamics in alcoholic cirrhosis and effects of the transjugular intrahepatic portosystemic stent shunt". Gut 44, n.º 5 (1 de maio de 1999): 743–48. http://dx.doi.org/10.1136/gut.44.5.743.
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BACKGROUNDA portosystemic stent shunt may impair cardiac function and haemodynamics.AIMSTo investigate the effects of a transjugular intrahepatic portosystemic shunt (TIPS) on cardiac function and pulmonary and systemic circulation in patients with alcoholic cirrhosis.PATIENTS/METHODS17 patients with alcoholic cirrhosis and recent variceal bleeding were evaluated by echocardiography and catheterisation of the splanchnic and pulmonary circulation before and after TIPS. The period of catheter measurement was extended to nine hours in nine of the patients. The portal vein was investigated by Doppler ultrasound before and nine hours after TIPS.RESULTSBaseline echocardiography showed the left atrial diameter to be slightly increased and the left ventricular volume to be in the upper normal range. Nine hours after TIPS, the left atrial diameter and left ventricular end diastolic volume were increased (by 6% (p<0.01) and 7% (p<0.01) respectively); end systolic volume had not changed significantly. Invasive measurements showed a sharp increase in right atrial pressure (by 101%; p<0.01), mean pulmonary artery pressure (by 92%; p<0.01), pulmonary capillary wedge pressure (by 111%; p<0.01), and cardiac output (8.1 (1.6) to 11.9 (2.4) l/min; p<0.01). Systemic vascular resistance decreased (824 (242) to 600 (265) dyn·s·cm−5 p<0.01), and total pulmonary resistance increased (140 (58.5) to 188 (69.5) dyn·s·cm−5; p<0.05). Total pulmonary resistance (12%; NS), cardiac output (1.4 l/min; p<0.05), and portal vein blood flow (1.4 l/min; p<0.05) remained elevated for nine hours after TIPS in the subgroup. Portoatrial pressure gradient (43%; p<0.05), portohepatic vascular resistance (72%; p<0.05), and systemic vascular resistance (27%; p<0.01) were consistently reduced.CONCLUSIONSThe increase in the left atrial diameter, the pulmonary capillary wedge pressure, and total pulmonary resistance observed after the TIPS procedure reflected diastolic dysfunction of the hyperdynamic left ventricle in patients with alcoholic cirrhosis. The haemodynamic effects of the portosystemic stent shunt itself on the splanchnic circulation seem to be mainly responsible for the further decrease in systemic vascular resistance. TIPS may unmask a coexisting preclinical cardiomyopathy in patients with alcoholic cirrhosis and portal hypertension.
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Gagnon, Richard, Ealia Khosh Kish, Sarah Cook, Kosuke Takemura, Brian Yu Chieh Cheng, Kamiko Bressler, Daniel Yick Chin Heng et al. "Prognostic biomarkers and clinical outcomes in neuroendocrine prostate cancer (NEPC)." Journal of Clinical Oncology 41, n.º 6_suppl (20 de fevereiro de 2023): 209. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.209.
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209 Background: NEPC includes both pure small cell carcinoma and mixed tumors with varying degrees of adenocarcinoma and neuroendocrine histology. It arises de novo or is treatment associated (TA) post androgen deprivation therapy. Clinical outcome data and prognostic biomarkers are limited and were thus explored. Methods: Patients with high grade prostate cancer and morphologic and/or immunohistochemical (IHC) NEPC features were included in this retrospective multicentre study. Clinical stage, Gleason score, and serum biomarkers were recorded. Kaplan-Meier method and log-rank test calculated and compared overall survival (OS) from time of NEPC diagnosis.Cox proportional hazards regression assessed prognostic impact of serum biomarkers at diagnosis and de novo vs TA status, adjusting for clinical stage and castration resistance. Results: 135 NEPC cases were identified. 124 (92%) were mixed tumors. 56 (41%) arose de novo. 79 (59%) were TA. 77% of those with a Gleason score (N=85/110) were grade group 5. Median PSA pre-NEPC biopsy was 11.6 ng/mL. At NEPC diagnosis, 19 (14%) had localized disease (median OS 123.0 mo); 33 (24%) non-metastatic castrate-sensitive disease (median OS 42.3 mo); 6 (4%) non-metastatic castrate-resistant disease (median OS 14.3 mo); 35 (26%) metastatic castrate-sensitive disease (median OS 17.6 mo); and 42 (31%) metastatic castrate-resistant disease (median OS 9.6 mo). Median OS for those with visceral metastases was 8.6 mo (95% CI 6.0 – 14.6), compared to patients with non-visceral metastases (11.1 mo; 95% CI 13.7 – 21.5) and no metastases (42.3 mo; 95% CI 47 – 89). Anemia (adjusted HR 1.66; 95% CI 1.05 - 2.16, p = 0.031) and NLR >3 (adjusted HR 1.51; 95% CI 1.01 - 2.52, p = 0.045) were associated with increased risk of death. De novo disease, elevated LDH, serum PSA, and Gleason score were not prognostic. Conclusions: This study identifies NEPC clinical outcomes by stage, with survival poorer than expected in pure prostate adenocarcinoma. Anemia and elevated NLR >3 are prognostic biomarkers that may help risk stratify and guide treatment intensification, including platinum-based chemotherapy. Further biomarker characterization of NEPC through IHC-staining pattern and genomic analysis is currently underway by this group.