Relationship between chronic rhinosinusitis exacerbation frequency and asthma control

Objectives/Hypothesis

To determine the association between the frequency of acute chronic rhinosinusitis (CRS) exacerbations (AECRS) and the degree of asthma control in asthmatic CRS patients.

Study Design

Cross-sectional study.

Methods

We prospectively recruited 108 asthmatic CRS patients as participants. Asthma control was assessed using the Asthma Control Test (ACT). The frequency of AECRS was assessed using three previously described indirect metrics for AECRS: the frequency of patient-reported sinus infections, CRS-related antibiotics use, and CRS-related oral corticosteroids use in the last 3 months. CRS symptom severity was measured using the 22-item Sinonasal Outcome Test (SNOT-22). Associations between ACT score and metrics for AECRS were performed using linear regression while controlling for clinical and demographic characteristics, including SNOT-22 score.

Results

ACT score was significantly and negatively associated with the frequency of patient-reported sinus infections (adjusted linear regression coefficient [β] = −1.2, 95% confidence interval [CI]: −2.3 to −0.1, P = .033), CRS-related antibiotics courses (adjusted β = −1.4, 95% CI: −2.3 to −0.5, P = .004), and CRS-related oral corticosteroid courses (adjusted β = −1.5, 95% CI: −2.5 to −0.5, P = .004) in the last 3 months, independent of characteristics including SNOT-22 score. Poor asthma control could be detected using one or more sinus infections (70.6% sensitivity, 47.3% specificity), CRS-related antibiotics (50.0% sensitivity, 73.0% specificity), or CRS-related oral corticosteroids (58.8% sensitivity, 71.6% specificity) in the last 3 months.

Conclusions

AECRS are negatively associated with the level of asthma control in asthmatic CRS patients, independent of CRS symptom severity. These results highlight AECRS as a distinct clinical manifestation of CRS that should be routinely assessed in CRS patients.

Level of Evidence

2c. Laryngoscope, 2017

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A 5-year prospective study on regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen-enriched bovine-derived xenograft

Abstract

Aim

The primary objective of this study was (1) to evaluate the 5-year clinical outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and a collagen-enriched bovine-derived xenograft and (2) to identify predictors for clinical attachment level (CAL) gain and vertical radiographic bone (RB) gain.

Materials and methods

Ninety-five non-smoking patients with ≤ 25% full-mouth plaque and bleeding presenting ≥ 6 months after initial periodontal therapy with ≥ 1 isolated interdental infrabony defect were recruited. Minimally invasive surgery (MIST or M-MIST) and a collagen-enriched bovine-derived xenograft were used in all patients. Patients were surgically treated by the same clinician and evaluated up to 5 years of follow-up. Multivariate analyses were used to identify predictors for CAL gain and RB gain.

Results

Before surgery, mean probing depth (PD) was 7.8 mm, CAL was 10.0 mm, and defect depth amounted to 5.2 mm. Seventy-one patients (33 men, 38 women, mean age 52) could be evaluated at 5 years. Mean PD reduction was 3.3 mm (SD 2.2), CAL gain was 3.0 mm (SD 2.1), and RB gain was 57% (SD 38). Forty-five percent showed ≥ 4 mm CAL gain, whereas 24% were considered failures (≤ 1 mm CAL gain). Forty-eight percent showed considerable RB gain (≥ 75%). Regression analyses showed that plaque was a significant predictor for CAL gain (p = 0.001) and RB gain (p = 0.005). Patients' compliance had a significant impact on RB gain (p < 0.001).

Conclusion

Only patients with perfect oral hygiene and excellent compliance should be considered for RPT. Especially, the latter can only be assessed after sufficient follow-up following initial periodontal therapy.

Clinical relevance

RPT failed in 24% of the patients after 5 years. Regression analyses demonstrated a significant impact of plaque and patients' compliance on the long-term outcome. Only patients with perfect oral hygiene and excellent compliance should be considered for RPT. Patients should not be treated too soon following initial therapy, since compliance can only be reliably assessed after sufficient follow-up.

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Rational design of novel, fluorescent, tagged glutamic acid dendrimers with different terminal groups and in silico analysis of their properties

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Noncovalent interaction-assisted drug delivery system with highly efficient uptake and release of paclitaxel for anticancer therapy

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Glycogen–gold nanohybrid escalates the potency of silymarin

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Factor analyses of the Chinese Zarit Burden Interview among caregivers of patients with schizophrenia in a rural Chinese community

Objective

This study aimed to evaluate the factor structure of the Chinese version of the 22-item Zarit Burden Interview (ZBI) among family caregivers of patients with schizophrenia in China.

Methods

Using one-stage cluster-sampling design, 324 primary caregivers of patients with schizophrenia in Ningxiang County, Hunan Province, China, completed the Zarit Burden Interview face-to-face. Confirmatory factor analysis (CFA) was first performed based on existing models to check model fit. Owing to an unsatisfactory result of CFA, exploratory factor analysis (EFA) was then conducted to explore a new factor structure, and a subsequent CFA was run to examine its model fit.

Results

The CFA results showed that none of the existing models fit the data reasonably well. The EFA results suggested five dimensions: negative emotion (10 items), interpersonal relationship (4 items), time demand (3 items), patient's dependence (2 items) and self-accusation and guilt (2 items). The following CFA confirmed the five-factor solution in this study, and the goodness-of-fit for this model fell within the acceptable range. The overall internal consistency (Cronbach's alpha) was 0.88, and the internal consistency coefficients of individual dimensions were 0.68 to 0.84.

Conclusion

This study supported a 22-item ZBI scale, with a five-factor structure when applied to Chinese caregivers of patients with schizophrenia.

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Does laryngeal reinnervation or type I thyroplasty give better voice results for patients with unilateral vocal fold paralysis (VOCALIST): study protocol for a feasibility randomised controlled trial

Introduction

A functioning voice is essential for normal human communication. A good voice requires two moving vocal folds; if one fold is paralysed (unilateral vocal fold paralysis (UVFP)) people suffer from a breathy, weak voice that tires easily and is unable to function normally. UVFP can also result in choking and breathlessness. Current treatment for adults with UVFP is speech therapy to stimulate recovery of vocal fold (VF) motion or function and/or injection of the paralysed VF with a material to move it into a more favourable position for the functioning VF to close against. When these therapies are unsuccessful, or only provide temporary relief, surgery is offered. Two available surgical techniques are: (1) surgical medialisation; placing an implant near the paralysed VF to move it to the middle (thyroplasty) and/or repositioning the cartilage (arytenoid adduction) or (2) restoring the nerve supply to the VF (laryngeal reinnervation). Currently there is limited evidence to determine which surgery should be offered to adults with UVFP.

Methods and analysis

A feasibility study to test the practicality of running a multicentre, randomised clinical trial of surgery for UVFP, including: (1) a qualitative study to understand the recruitment process and how it operates in clinical centres and (2) a small randomised trial of 30 participants recruited at 3 UK sites comparing non-selective laryngeal reinnervation to type I thyroplasty. Participants will be followed up for 12 months. The primary outcome focuses on recruitment and retention, with secondary outcomes covering voice, swallowing and quality of life.

Ethics and dissemination

Ethical approval was received from National Research Ethics Service—Committee Bromley (reference 11/LO/0583). In addition to dissemination of results through presentation and publication of peer-reviewed articles, results will be shared with key clinician and patient groups required to develop the future large-scale randomised controlled trial.

Trial registration number

ISRCTN90201732; 16 December 2015.

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Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden

Objectives

We examined the risk of disability pension before and after ischaemic heart disease (IHD) or stroke event, the burden of stroke compared with IHD and which factors predicted disability pension after either event.

Design

A population-based cohort study with follow-up 5 years before and after the event. Register data were analysed with general linear modelling with binary and Poisson distributions including interaction tests for event type (IHD/stroke).

Setting and participants

All people living in Sweden, aged 25-60 years at the first event year, who had been living in Sweden for 5 years before the event and had no indication of IHD or stroke prior to the index event in 2006-2008 were included, except for cases in which death occurred within 30 days of the event. People with both IHD and stroke were excluded, resulting in 18 480 cases of IHD (65%) and 9750 stroke cases (35%).

Primary outcome measures

Disability pension.

Results

Of those going to suffer IHD or stroke event, 25% were already on disability pension a year before the event. The adjusted OR for disability pension at first postevent year was 2.64-fold (95% CI 2.25 to 3.11) for people with stroke compared with IHD. Economic inactivity predicted disability pension regardless of event type (OR=3.40; 95% CI 2.85 to 4.04). Comorbid mental disorder was associated with the greatest risk (OR=3.60; 95% CI 2.69 to 4.83) after an IHD event. Regarding stroke, medical procedure, a proxy for event severity, was the largest contributor (OR=2.27, 95% CI 1.43 to 3.60).

Conclusions

While IHD event was more common, stroke involved more permanent work disability. Demographic, socioeconomic and comorbidity-related factors were associated with disability pension both before and after the event. The results help occupational and other healthcare professionals to identify vulnerable groups at risk for permanent labour market exclusion after such an event.

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Effect of weekend admission on process of care and clinical outcomes for the management of acute coronary syndromes: a retrospective analysis of three UK centres

Objectives

The effect of weekend versus weekday admission following acute coronary syndrome (ACS) on process of care and mortality remains controversial. This study aimed to investigate the 'weekend-effect' on outcomes using a multicentre dataset of patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction/unstable angina (NSTEMI/UA).

Design

This retrospective observational study used propensity score (PS) stratification to adjust estimates of weekend effect for observed confounding. Logistic regression was used to estimate odds ratios (ORs) for binary outcomes and time-to-event endpoints were modelled using Cox proportional hazards to estimate hazard ratios (HRs).

Setting

Three tertiary cardiac centres in England and Wales that contribute to the Myocardial Ischaemia National Audit Project.

Participants

Between January 2010 and March 2016, 17 705 admissions met the study inclusion criteria, 4327 of which were at a weekend.

Primary and secondary outcomes

Associations were studied between weekend admissions and the following primary outcome measures: in-hospital mortality, 30-day mortality and long-term survival; secondary outcomes included several processes of care indicators, such as time to coronary angiography.

Results

After PS stratification adjustment, mortality outcomes were similar between weekend and weekday admission across patients with STEMI and NSTEMI/UA. Weekend admissions were less likely to be discharged within 1 day (HR 0.72, 95% CI 0.66 to 0.78), but after 4 days the length of stay was similar (HR 0.97, 95% CI 0.90 to 1.04). Fewer patients with NSTEMI/UA received angiography between 0 and 24 hours at a weekend (HR 0.71, 95% CI 0.65 to 0.77). Weekend patients with STEMI were less likely to undergo an angiogram within 1 hour, but there was no significant difference after this time point.

Conclusion

Patients with ACS had similar mortality and processes of care when admitted on a weekend compared with a weekday. There was evidence of a delay to angiography for patients with NSTEMI/UA admitted at the weekend.

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Study protocol for a longitudinal study evaluating the impact of rape on womens health and their use of health services in South Africa

Introduction

South Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.

Methods and analysis

This longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.

Ethics and dissemination

The South African Medical Research Council's Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

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How health service delivery guides the allocation of major trauma patients in the intensive care units of the inclusive (hub and spoke) trauma system of the Emilia Romagna Region (Italy). A cross-sectional study

Objective

To evaluate cross-sectional patient distribution and standardised 30-day mortality in the intensive care units (ICU) of an inclusive hub and spoke trauma system.

Setting

ICUs of the Integrated System for Trauma Patient Care (SIAT) of Emilia-Romagna, an Italian region with a population of approximately 4.5 million.

Participants

5300 patients with an Injury Severity Score (ISS) >15 were admitted to the regional ICUs and recorded in the Regional Severe Trauma Registry between 2007 and 2012. Patients were classified by the Abbreviated Injury Score as follows: (1) traumatic brain injury (2) multiple injuriesand (3) extracranial lesions. The SIATs were divided into those with at least one neurosurgical level II trauma centre (TC) and those with a neurosurgical unit in the level I TC only.

Results

A higher proportion of patients (out of all SIAT patients) were admitted to the level I TC at the head of the SIAT with no additional neurosurgical facilities (1083/1472, 73.6%) compared with the level I TCs heading SIATs with neurosurgical level II TCs (1905/3815; 49.9%). A similar percentage of patients were admitted to level I TCs (1905/3815; 49.9%) and neurosurgical level II TCs (1702/3815, 44.6%) in the SIATs with neurosurgical level II TCs. Observed versus expected mortality (OE) was not statistically different among the three types of centre with a neurosurgical unit; however, the best mean OE values were observed in the level I TC in the SIAT with no neurosurgical unit.

Conclusion

The Hub and Spoke concept was fully applied in the SIAT in which neurosurgical facilities were available in the level I TC only. The performance of this system suggests that competition among level I and level II TCs in the same Trauma System reduces performance in both. The density of neurosurgical centres must be considered by public health system governors before implementing trauma systems.

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Evolution of pain at 3 months by oral resveratrol in knee osteoarthritis (ARTHROL): protocol for a multicentre randomised double-blind placebo-controlled trial

Introduction

Osteoarthritis (OA) pathophysiology is driven in part by joint inflammation. Resveratrol has in vitro anti-inflammatory properties. We aim to assess the efficacy of oral resveratrol for knee pain at 3 months in people with knee OA.

Methods and analysis

We will conduct a randomised double-blind placebo-controlled trial. Overall, 164 individuals with knee OA fulfilling 1986 American College of Rheumatology criteria will be recruited in three tertiary care centres in France and randomised to receive oral resveratrol, 40 mg (two caplets) two times per day for 1 week, then 20 mg (one caplet) two times per day or a matching placebo for a total of 6 months. Randomisation will be centralised and stratified by centre. The allocation ratio of assignments will be 1:1. The primary outcome will be the mean change from baseline in knee pain on a self-administered 11-point pain Numeric Rating Scale at 3 months. Secondary outcomes will be the mean change in knee pain at 6 months, the function subscore of the Western Ontario and McMaster Universities Arthritis Index score, patient global assessment, proportion of responders according to the Osteoarthritis Research Society International–Outcome Measures in Rheumatology criteria at 3 and 6 months, and self-reported number of intra-articular injections of corticosteroids or hyaluronic acid and consumption of analgesics and non-steroidal anti-inflammatory drugs since the last contact. Other interventions will be allowed and self-reported. Adherence will be monitored by capsule counts and a booklet and adverse events recorded at 3 and 6 months. Statisticians, treating physicians and participants will be blinded to the allocated treatment.

Ethics and dissemination

The oral resveratrol in knee osteoarthritis (ARTHROL) trial has been authorised by the AgenceNationale de Sécurité du Médicament et des Produits de Santé and ethics were approved by the Comité deProtection des Personnes Île-de-France III. The findings of the study will be published in a peer-reviewed journal and disseminated at conferences. The design of ARTHROL will warrant the translation of its findings into clinical practice.

Trial registration number

ClinicalTrials.gov identifier: NCT02905799. Pre-results. First received: 14 September 2016. Last updated: 16 September 2016. Status: not yet recruiting.

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Understanding patients experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography

Objectives

Patients with advanced disease sometimes express a wish to hasten death (WTHD). In 2012, we published a systematic review and meta-ethnography of qualitative studies examining the experience and meaning of this phenomenon. Since then, new studies eligible for inclusion have been reported, including in Europe, a region not previously featured, and specifically in countries with different legal frameworks for euthanasia and assisted suicide. The aim of the present study was to update our previous review by including new research and to conduct a new analysis of available data on this topic.

Setting

Eligible studies originated from Australia, Canada, China, Germany, The Netherlands, Switzerland, Thailand and USA.

Participants

Studies of patients with life-threatening conditions that had expressed the WTHD.

Design

The search strategy combined subject terms with free-text searching of PubMed MEDLINE, Web of Science, CINAHL and PsycInfo. The qualitative synthesis followed the methodology described by Noblit and Hare, using the 'adding to and revising the original' model for updating a meta-ethnography, proposed by France et al. Quality assessment was done using the Critical Appraisal Skills Programme checklist.

Results

14 studies involving 255 participants with life-threatening illnesses were identified. Five themes emerged from the analysis: suffering (overarching theme), reasons for and meanings and functions of the WTHD and the experience of a timeline towards dying and death. In the context of advanced disease, the WTHD emerges as a reaction to physical, psychological, social and existential suffering, all of which impacts on the patient's sense of self, of dignity and meaning in life.

Conclusions

The WTHD can hold different meanings for each individual—serving functions other than to communicate a genuine wish to die. Understanding the reasons for, and meanings and functions of, the WTHD is crucial for drawing up and implementing care plans to meet the needs of individual patients.

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Check Out This Massive Floating Solar Farm in China

The world's largest floating solar farm spans is the size of 160 football fields and is now generating electricity atop a former coal mine in China.

-- Read more on ScientificAmerican.com

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Variation in foliar uptake of polycyclic aromatic hydrocarbons in six varieties of winter wheat

Abstract

To investigate intraspecific variations of foliar uptake of polycyclic aromatic hydrocarbons (PAHs) of winter wheat (Triticum aestivum L.), leaves of six varieties including Changwu 521 (CW), Hedong TX-006 (HD), Jiaomai 266 (JM), Xiaoyan 22 (XY), Yunong 949 (YN), and Zhongmai 175 (ZM) were exposed to three levels of (0, 0.25, and 1.5 mg L⁻¹) mixture of six selected PAHs (phenanthrene, anthracene, pyrene, benz[a]anthracene, benzo[a]pyrene, and benzo[g,h,i]perylene). After 10 consecutive days of application, all the six selected PAHs (Σ₆ PAHs) were determined in the leaves of the six varieties of the winter wheat. There were apparent intraspecific differences in foliar uptake of PAHs in the winter wheat. The highest concentrations of Σ₆ PAHs in the leaves of YN variety (64.6 mg kg⁻¹) were approximate two times of the lowest concentrations in the leaves of HD variety (29.6 mg kg⁻¹). Both individual PAHs and Σ₆ PAHs in the cuticular waxes were significantly (p < 0.01) higher than those in leaves and far higher than those in roots, indicating that the cuticular waxes could play significant role in foliar uptake of PAHs. The present results also showed that the concentrations PAHs in leaves were positively (p < 0.05) correlated with the water solubility of the six selected PAHs. In addition, the present study suggested that there was basipetal translocation of PAHs in the winter wheat after foliar application of PAHs, although the mechanism was yet to be further studied.

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The average concentration function of dissolved copper in Hun River, Liaoning province, Northeastern China

Abstract

Water samples were collected from Hun River to research the change in the concentration of dissolved copper and its distribution as well as accumulation during the dry season in 2013. The mean concentrations of dissolved copper in Hun River were 0.1057–0.1533 mg/l during the dry season. The results indicated that the most severe dissolved copper pollution were associated with the mining area, industrial area, and living area along the Hun River. The results also indicated that controlling the sources of copper pollution effectively reduced the concentration of dissolved copper in Hun River. The concentration function about time and spatial coordinate, average concentration function about time coordinate, average concentration function about spatial coordinate, and bounded mean oscillation space were used to evaluate the extent of copper pollution in Hun River. The error function, quartiles, and curve fitting tool were performed to determine the stations with high concentration of dissolved copper in Hun River. We furthermore obtained the upper and lower bounds of the error between two kinds of bounded mean oscillation spaces to explore the migration of copper pollution in Hun River. The results of the average concentration function and bounded mean oscillation space revealed that the long-term control measures of copper pollution and short-term control measures of copper pollution, the control of copper pollution in large watershed, and the control of copper pollution in small watershed in Hun River should be combined with each other. The strict policy and pollution control strategy should be implemented to ensure that the water of the Hun River meets the natural environment standard for the growth of aquatic life and human.

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Influence of rapid rural-urban population migration on riverine nitrogen pollution: perspective from ammonia-nitrogen

Abstract

China is undergoing a rapid transition from a rural to an urban society. This societal change is a consequence of a national drive toward economic prosperity. However, accelerated urban development resulting from rapid population migration from rural to urban lands has led to high levels of untreated sewage entering aquatic ecosystems directly. Consequently, many of these regions have been identified as hot spots of riverine nitrogen (N) pollution because of the increasing level of urban point-source discharge. In order to address this concern, we assessed effects of urban development on ammonia-nitrogen (AN) loads using a panel data regression model. The model, expressed as an exponential function of anthropogenic N inputs multiplied by a power function of streamflow, was applied to 20 subwatersheds of the Huai River Basin for the years 2003–2010. The results indicated that this model can account for 81% of the variation in annual AN fluxes over space and time. Application of this model to three scenarios of urban development and sewage treatment (termed urbanization priority, sustainable development, and environmental priority) suggests that future N pollution will inevitably deteriorate if current urban environmental management and investment are not significantly improved. Stronger support for environmental management is very critical to alleviate N pollution and improve water quality. More effort should focus on improving sewage treatment and the N removal rate of the current sewage system in light of the increasing degree of urbanization.

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Imprinted gene expression in maize starchy endosperm and aleurone tissues of reciprocal F1 hybrids at a defined developmental stage

Abstract

Imprinted gene expression in flowering plants predominantly occurs in the triploid endosperm of developing seed. However, endosperm is composed of distinct tissue types. For example, the maize (Zea mays) endosperm is constituted by two major tissues, starchy endosperm and aleurone. Previous studies in imprinted gene expression have generally assumed that the different tissues constituting endosperm would behavior the same, and hence have not examined them separately. Here, to examine parental-specific expression of imprinted genes in different parts of the seed, eight previously reported maize protein-coding imprinted genes were selected, and analyzed by cleaved amplified polymorphic sequence (CAPS) coupled with Sanger sequencing for transcripts from the various seed tissues collected at 18 days after pollination (DAP). The studied tissues included seed coat, embryo, starchy endosperm and aleurone, which were collected from a pair of reciprocal F1 hybrids produced by crossing inbred lines B73 and Mo17. Six of these eight analyzed imprinted genes showed the same imprinted expression pattern between the starchy endosperm and aleurone, but two showed imprinted expression only in the starchy endosperm. Comparison of the expression pattern of 20 selected imprinted genes in multiple seed tissues and vegetative tissues indicated that the majority (~ 75%) of these imprinted genes exhibited seed-specific or endosperm-specific expression. Our results also uncovered that imprinted genes have a high propensity to be alternatively spliced via intron retention in the developing embryo compared with the other tissues.

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Spatial distribution of HIV, HCV, and co-infections among drug users in the southwestern border areas of China (2004–2014): a cohort study of a national methadone maintenance treatment program

A methadone maintenance treatment (MMT) program to curb the dual epidemics of HIV/AIDS and drug use has been administered by China since 2004. Little is known regarding the geographic heterogeneity of HIV and ...

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Estimating the number of people who inject drugs in Australia

Injecting drug use is associated with considerable morbidity and mortality. Estimates of the size of the population of people who inject drugs are critical to inform service planning and estimate disease burde...

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Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015

Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particular...

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Association of informal caregiving with body mass index and frequency of sporting activities: evidence of a population-based study in Germany

While most studies focused solely on the comparison between informal caregivers and non-caregivers, little is known about the relation between caregiving time or caregiving activities and lifestyle factors. Th...

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Assessment of the HBV vaccine response in a group of HIV-infected children in Morocco

Since its development in the early 1980s, Hepatitis B virus (HBV) vaccine has been proven to be highly protective. However, its immunogenicity may be ineffective among HIV-infected children. In Morocco, HBV va...

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Overt Skeletal Metastases in a Patient of Occult (Microscopic) Follicular Thyroid Carcinoma: a Rare Case

Abstract

Occult follicular thyroid carcinoma (FTC) presenting as distant metastases is a rare occurrence. However, despite being occult in majority of these cases, primary tumor can be detected on thyroid imaging or during surgery. Here, we present an extremely rare case of an occult FTC with overt skeletal metastases in which primary tumor was discernible only on microscopic examination.

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Prokaryote

Prokaryote: An organism whose cells lack a discrete nucleus and other special subcellular compartments. Bacteria and viruses are prokaryotes. Humans are not prokaryotes, but rather eukaryotes.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
We Bring Doctors' Knowledge To You

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Sexual Dimorphism in Innate Immunity

Abstract

Sexual dimorphisms account for differences in clinical manifestations or incidence of infectious or autoimmune diseases and malignancy between females and males. Females develop enhanced innate and adaptive immune responses than males and are less susceptible to many infections of bacterial, viral, parasitic, and fungal origin and malignancies but in contrast, they are more prone to develop autoimmune diseases. The higher susceptibility to infections in males is observed from birth to adulthood, suggesting that sex chromosomes and not sex hormones have a major role in sexual dimorphism in innate immunity. Sex-based regulation of immune responses ultimately contributes to age-related disease development and life expectancy. Differences between males and females have been described in the expression of pattern recognition receptors of the innate immune response and in the functional responses of phagocytes and antigen presenting cells. Different factors have been shown to account for the sex-based disparity in immune responses, including genetic factors and hormonal mediators, which contribute independently to dimorphism in the innate immune response. For instance, several genes encoding for innate immune molecules are located on the X chromosome. In addition, estrogen and/or testosterone have been reported to modulate the differentiation, maturation, lifespan, and effector functions of innate immune cells, including neutrophils, macrophages, natural killer cells, and dendritic cells. In this review, we will focus on differences between males and females in innate immunity, which represents the first line of defense against pathogens and plays a fundamental role in the activation, regulation, and orientation of the adaptive immune response.

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Rembrandt Rolls Out Whitening Kits

Rembrandt, the original teeth whitening brand, advances the at-home whitening category with the launch of a new 1 Week Whitening Kit and 3 Day Whitening Boost Kit that provide visibly whiter smiles from the comfort of home in half the time of traditional 14-day kits. Ideal for whitening with short notice before a big event or special occasion, the kits arrive online at Rembrandt.com this month at a suggested retail price of $24.99 and $6.99 each, respectively.

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Innovative use of contegra valved conduit in left iliocaval stent thrombosis

Abstract

Thrombosis of an iliofemoral vein accounts for 25% of all lower extremity deep vein thrombosis (DVT) and is associated with an increased risk of pulmonary embolism (PE), limb malperfusion, and post-thrombotic syndrome (PTS). Endothelial injury, hypercoagulability and stasis constitute Virchow's triad of thrombogenesis. Common predisposing conditions include the postoperative state, prolonged immobility (e.g., travel, hospitalization), malignancy, pregnancy, and inherited hypercoagulable conditions. Long-term complications of DVT include persistent lower extremity edema, venous claudication, hyperpigmentation, and ulceration—collectively called as PTS and are associated with a reduced quality of life with increased health care expenses. The indications for open surgical revascularization are rare and usually reserved for patients whose symptoms are refractory to anticoagulation and endovascular treatment. Here, we report a successful decompression of severe venous edema of left lower limb post left iliocaval stent thrombosis in a 50-year-old female patient. We used two contegra valved conduits which were sutured end to end with each other in the same direction as a bypass graft. Proximal end of the conduit was anastomosed to left common femoral vein and the distal end to the distal inferior vena cava (IVC). It provided prompt and effective venous outflow with complete resolution of the venous edema of left lower limb. computed tomography (CT) venogram done after 3 months of surgery showed patent contegra valved conduit with thrombosed iliocaval stent.

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2017 LASID Meeting Abstracts

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Extracellular Matrix and Integrin Expression Profiles in Fuchs Endothelial Corneal Dystrophy Cells and Tissue Model

Tissue Engineering Part A , Vol. 0, No. 0.


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Stromal Cell-Derived Factor-1 Accelerates Cartilage Defect Repairing by Recruiting Bone Marrow Mesenchymal Stem Cells and Promoting Chondrogenic Differentiation

Tissue Engineering Part A , Vol. 0, No. 0.


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The 2017 complete overhaul of adjuvant therapies for high-risk melanoma and its consequences for staging and management of melanoma patients

Publication date: November 2017
Source:European Journal of Cancer, Volume 86
Author(s): Alexander M.M. Eggermont, Reinhard Dummer
The spectacular outcomes of the phase III trials regarding nivolumab versus ipilimumab in fully resected stage IIIB/C–IV and of the combination of dabrafenib (D) plus trametinib (T) in BRAF-mutant stage III patients demonstrate that effective treatments in advanced melanoma are also highly effective in the adjuvant setting. In 2016, an overall survival benefit with adjuvant high-dose ipilimumab was demonstrated, and the European Organisation for Research and Treatment of Cancer trial 1325 comparing pembrolizumab versus placebo will complete the picture in the early 2018. Toxicity profiles are in line with the experience in advanced melanoma, i.e. favourable for the anti-PD1 agents and for D + T and problematic for ipilimumab. The 2017 outcomes are practice changing and put an end to the use of interferon (IFN) and ipilimumab. In countries with only access to IFN, its use can be restricted to patients with ulcerated melanoma, based on the individual patient data meta-analysis recently published. Because of the results of the Melanoma Sentinel Lymph node Trial-2 (MSLT-2) trial, completion lymph node dissection (CLND) will decrease sharply, leading to a lack of optimal prognostic information. Prognosis in sentinel node–positive stage IIIA/B patients is extremely heterogeneous with 5-year survival rates varying from 90% to 40% and depends mostly on the number of positive nodes identified by CLND. This information is crucial for clinical decision-making. How to guarantee optimal staging information needs to be discussed urgently. Further improvements of adjuvant therapies will have to address all these questions as well as the exploration of neoadjuvant use of active drugs and combination approaches. Important paradigm shifts in the management of high-risk melanoma patients are upon us.



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Multidisciplinary quality assurance and control in oncological trials: Perspectives from European Organisation for Research and Treatment of Cancer (EORTC)

Publication date: November 2017
Source:European Journal of Cancer, Volume 86
Author(s): Members of EORTC QACDenisLacombeCorneelCoensChristinede BalincourtLisaLicitraMarcelden DulkJean-PascalMachielsDamienWeberMartinSpahnRobertoSalgadoBerndKasperPeterHau.Working Groups of Scientific ExpertsFayBetsouKozoKataokaCarmelaCaballeroYanLiuCoenHurkmansSergeEvrard
Quality assurance (QA) programmes are one of the mainstays of clinical research and constitute the pillars on which European Organisation for Research Treatment of Cancer (EORTC) delivers multidisciplinary therapeutic progress. Changing practice treatments require solid evidence-based data, which can only be achieved if integral QA is part of the infrastructure sustaining research projects. Cancer treatment is a multimodality approach, which is often applied either in sequence and/or in combination. Each modality plays a key role in cancer control. The modalities by which QA is applied varies substantially within and across the disciplines. In addition, translational and diagnostic disciplines take an increasing role in the era of precision medicine. Building on the structuring effect of clinical research with fully integrated multidisciplinary QA programmes associated with the solutions addressing the chain of custody for biological material and data integrity as well as compliance ensure at the same time validity of clinical research output but also have a training effect on health care providers, who are more likely to apply such principles as routine. The principles of QA are therefore critical to be embedded in multidisciplinary infrastructure to guarantee therapeutic progress. These principles also provide the basis for the functioning of multidisciplinary tumour board. However, technical, operational and economic challenges which go with the implementation of such programmes require optimal know-how and the coordination of the multiple expertise and such efforts are best achieved through centralised infrastructure.



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Ecological risk assessment of heavy metals in salt-affected soils in the Natura 2000 area (Ciechocinek, north-central Poland)

Abstract

This paper aimed to evaluate the ecological risk posed by the accumulation of heavy metals in the salt-affected soils of the habitat covered by the EU Natura 2000 program in relation to the activity of soil redox enzymes. The research was carried out in the halophyte reserve in Ciechocinek (north-central Poland) which is a very specific habitat as it undergoes a long-term human impact related to both the operation of the medical spa town and the agricultural use of soils in the adjacent areas. The obtained results showed that the content of Zn, Cu, Pb, and Cd in the studied soils exceeded the Polish standards. Based on the obtained data and statistical analysis, it was found that metals may come from two different sources: emission from household boiler rooms (Pb, Cd) and corroded brine sewage pipeline (Zn, Cu).They are characterized by limited mobility due to alkaline environment and strong sorption properties of the clay fraction and organic matter. The correlation analysis indicates that the dehydrogenase activities were negatively correlated with soil electrical conductivity (EC_1:5) (r = − 0.665, P < 0.05). Taking into account the protective status of the area, it is difficult to indicate definitely the solution concerning the land management. However, according to the authors, one should pay special attention to a possibility of using halophytes which occur within the reserve for phytoremediation.

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Assessment and modeling of E-waste generation based on growth rate from different telecom companies in the State of Kuwait

Abstract

The present work assesses the production rate of cell phone e-waste in Kuwait by comparing the number of clients in three telecommunication service providers like Zain, Ooredoo, and Viva in the state of Kuwait over a period of 7 years from 2008 to 2015. An online survey was conducted to evaluate the growth in the number of clients in three cell phone companies, and the data analysis was carried out using statistical package for the social sciences (SPSS) software. The prediction of the growth percentage of the number of clients in each telecommunication company was analyzed using analysis of variance (ANOVA) test and followed by the regression model. The study shows that there is an increase in the number of clients in all three companies (Zain, Ooredoo, and Viva) between year 2008 and 2015, and it was estimated that approximately 7.9 million cell phone users would be achieved in the first quarter of 2015. Based on this predicted number of cell phone users, the production of e-waste would be 3 kt per year with an average growth of 12.7%.

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Impact of an invasive weed, Parthenium hysterophorus , on a pasture community in south east Queensland, Australia

Abstract

Parthenium weed is a highly invasive alien species in more than 40 countries around the world. Along with severe negative effects on human and animal health and crop production, it also causes harm to ecosystem functioning by reducing the native plant species biodiversity. However, its impacts on native plant species, especially in pasture communities, are less known. Given parthenium weed causes substantial losses to Australian pastures' productivity, it is crucial to estimate its impact on pasture communities. This study evaluates the impact of parthenium weed upon species diversity in a pasture community at Kilcoy, south east Queensland, Australia. Sub-sites containing three levels of parthenium weed density (i.e. high, low and zero) were chosen to quantify the above- and below-ground plant community structure. Species richness, diversity and evenness were all found to be significantly reduced as the density of parthenium weed increased; an effect was evident even when parthenium weed was present at relatively low densities (i.e. two plants m⁻²). This trend was observed in the summer season as well as in winter season when this annual weed was absent from the above-ground plant community. This demonstrates the strong impact that parthenium weed has upon the community composition and functioning throughout the year. It also shows the long-term impact of parthenium weed on the soil seed bank where it had displaced several native species. So, management options used for parthenium weed should also consider the reduction of parthenium weed seed bank along with controlling its above-ground populations.

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Recovery of 3-Iodothyronamine and Derivatives in Biological Matrixes: Problems and Pitfalls

Thyroid Oct 2017, Vol. 27, No. 10: 1323-1331.


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Do Lower-Risk Thyroid Cancer Patients Who Live in Regions with More Aggressive Treatments Have Better Outcomes?

Thyroid Oct 2017, Vol. 27, No. 10: 1246-1257.


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Future Meetings

Thyroid Oct 2017, Vol. 27, No. 10: 1339-1339.


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87th Annual Meeting of the American Thyroid Association October 18–22, 2017, Victoria, British Columbia, Canada

Thyroid Oct 2017, Vol. 27, No. 10: 1213-1214.


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Thyroid Hormone Receptor Alpha is Essential to Maintain the Satellite Cell Niche During Skeletal Muscle Injury and Sarcopenia of Aging

Thyroid Oct 2017, Vol. 27, No. 10: 1316-1322.


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Referral Trends for Surgical Management of Graves' Disease

Thyroid Oct 2017, Vol. 27, No. 10: 1337-1338.


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Occurrence of cases with peri-implant mucositis or peri-implantitis in a 21-26 years follow-up study

Abstract

Aim

to determine the prevalence and development of peri-implant mucositis and peri-implantitis and to assess risk factors over time.

Materials and Methods

The study is a longitudinal case series assessing the occurrence and diagnosis of peri-implant mucositis and peri-implantitis.

Results

218/294 patients who had received dental implants between 1988-1992 were examined between 2000-2002 (exam II; 9-14 years after the first exam). At exam III (20-26 years after exam I, on average 23.3 years), 86 individuals were re-examined. The diagnosis of peri-implant mucositis and peri-implantitis at exam III was 23.8% and 13.7% respectively. Surgical treatment of peri-implantitis after exam II resulted in a bone gain for 2/12 individuals. Individuals with ≥ 3 implants at exam II were at risk for peri-implantitis at exam III (χ2=7.9, p <0.01, LR: 11.6, 95%CI: 1.5, 92.5, p < 0.01). A history of periodontitis (p=0.07), a diagnosis of peri-implant mucositis (p =0.77), or smoking (p=0.86) at exam II, were not predictive of peri-implantitis at exam III.

Conclusions

The diagnosis and occurrence of peri-implantitis and peri-implant mucositis was high. Healthy conditions at implants after 9-14 years were predictive of future implant health.

This article is protected by copyright. All rights reserved.

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International Journal of Otolaryngology and Head & Neck Surgery Vol.6,No.5 (September 2017)

Orbital Injury in Endoscopic Sinus Surgery for Sinonasal Inflammatory Disorders: Juntendo's Ten-Year Experience
Orbital Injury, Orbital Complications, Endoscopic Sinus Surgery, Orbital Fat
Paper Information Full Paper: PDF (Size:336KB)
DOI: 10.4236/ijohns.2017.65009

Catheter in Antrochoanal Polyp: Functions Intact
Antrochoanal Polyp, Catheter
Paper Information Full Paper: PDF (Size:835KB)
DOI: 10.4236/ijohns.2017.65008

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Editorial Board/Reviewing Committee

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Transfusion-acquired hepatitis E infection misdiagnosed as severe critical illness polyneuromyopathy in a heart transplant patient

Abstract

This is the case of a 56-year-old man who underwent heart transplantation. Within the first postoperative days, his respiratory and limb muscles weakened, which was attributed to critical illness polyneuromyopathy (CIPM). At day 70 post transplantation, he had increased liver enzyme levels and acute hepatitis E virus (HEV) infection was diagnosed. HEV RNA was found in the serum, stools, and cerebrospinal fluid. Results of further investigations suggested a possible HEV-related polyradiculoneuropathy. At transplantation, the patient was negative for immunoglobulin (Ig)G, IgM, and HEV RNA. A trace-back procedure identified the source of infection and concluded that HEV infection was contracted from blood transfusion 12 days prior to transplantation from an HEV RNA-positive donor. Tests of the organ donor for HEV were negative. Phylogenetic analysis revealed sequence homology between the HEV-3 strain of the patient and the HEV-3 strain of the blood donor. Despite ribavirin treatment, the patient died on day 153 post transplantation from multiorgan failure. In conclusion, patients with hepatitis or neuropathic illness that have received blood products should be screened for HEV.

This article is protected by copyright. All rights reserved.

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Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI

Abstract

Enterocutaneous fistulas (ECFs) represent abnormal communications between the gastrointestinal tract and the skin. Nowadays, the majority (~80%) of ECFs develops secondary to abdominal surgeries; alternative, less common causes include chronic inflammatory bowel diseases (IBD) such as Crohn's disease, tumours, and radiation enteritis in descending order of frequency. These rare disorders require thorough patient assessment and multidisciplinary management to limit the associated morbidity and mortality. This pictorial review includes an overview of causes, clinical manifestations, complications and management of ECFs. Afterwards, the imaging appearances, differential diagnoses, and therapeutic options of post-surgical, IBD-related, and malignant ECFs are presented with case examples. Most of the emphasis is placed on the current pivotal role of CT and MRI, which comprehensively depict ECFs providing cross-sectional information on the underlying postsurgical, neoplastic, infectious, or inflammatory conditions. Radiographic fistulography remains a valid technique, which rapidly depicts the ECF anatomy and confirms communication with the bowel. The aim of this paper is to increase radiologists' familiarity with ECF imaging, thus allowing an appropriate choice between medical, interventional, or surgical treatment, ultimately resulting in higher likelihood of therapeutic success.

Teaching Points

• Enterocutaneous fistulas may complicate abdominal surgery, sometimes Crohn's disease and tumours.

• The high associated morbidity and mortality result from sepsis, malnutrition and metabolic imbalance.

• The multidisciplinary management of ECFs requires thorough imaging for correct therapeutic choice.

• Radiographic fistulography rapidly depicts fistulas and communicating bowel loops in real-time.

• Multidetector CT and MRI provide cross-sectional information on fistulas and underlying diseases.

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Clinical interpretation of copy number variants in the human genome

Abstract

Molecular methods, by which copy number variants (CNVs) detection is available, have been gradually introduced into routine diagnostics over the last 15 years. Despite this, some CNVs continue to be a huge challenge when it comes to clinical interpretation. CNVs are an important source of normal and pathogenic variants, but, in many cases, their impact on human health depends on factors that are not yet known. Therefore, perception of their clinical consequences can change over time, as our knowledge grows. This review summarises guidelines that facilitate correct classification of identified changes and discusses difficulties with the interpretation of rare, small CNVs.

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Association between mammographic density and tumor marker-defined breast cancer subtypes: a case-control study.

High mammographic density (MD) is the most important risk factor for breast cancer. This study aimed to clarify the relationship between MD and breast cancer subtypes defined by tumor markers. We enrolled 642 women with breast cancer (69% premenopausal) and 1241 controls matched for age and menopausal status. Absolute mammographic dense area (ADA), percent mammographic dense area (PDA), and nondense area were assessed using a computer-assisted thresholding technique. We classified breast cancer cases into four subtypes using information on tumor marker expression such as estrogen receptor (ER), progesterone receptor (PR), and Cerb2 receptor (HER2); luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2-overexpressing (ER-, PR-, and HER2+), and triple-negative (ER-, PR-, and HER2-). Analysis was carried out using a conditional logistic regression model with adjustment for covariates. ADA and PDA were associated positively with the risk of breast cancer overall. Both ADA and PDA tended to have a positive association with breast cancer with any ER, any PR, or HER2-, but not for HER2+. The risk of luminal A breast cancer increased significantly 1.11 times (95% confidence interval: 1.01-1.23) for ADA and 1.12 times (95% confidence interval: 1.01-1.24) for PDA, estimated per 1 SD of the age and BMI-adjusted MD. However, the risk of breast cancer with luminal B, HER2-overexpressing, and triple-negative subtypes did not differ (P>0.10). Differential associations between MD measures and breast cancer by tumor marker status or tumor marker-defined subtypes were not detected. These findings suggested that the association between MD and breast cancer subtype may be because of other causal pathways. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Bright-Emitting Perovskite Films by Large-Scale Synthesis and Photoinduced Solid-State Transformation of CsPbBr3 Nanoplatelets

ACS Nano

DOI: 10.1021/acsnano.7b04761

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The Mechanism of Electrolyte Gating on High-Tc Cuprates: The Role of Oxygen Migration and Electrostatics

ACS Nano

DOI: 10.1021/acsnano.7b03978

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High-Resolution Graphene Films for Electrochemical Sensing via Inkjet Maskless Lithography

ACS Nano

DOI: 10.1021/acsnano.7b03554

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Statistically controlled identification of differentially expressed genes in one-to-one cell line comparisons of the CMAP database for drug repositioning

The Connectivity Map (CMAP) database, an important public data source for drug repositioning, archives gene expression profiles from cancer cell lines treated with and without bioactive small molecules. Howeve...

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Tumor PD-L1 expression is associated with improved survival and lower recurrence risk in young women with oral cavity squamous cell carcinoma

In this study, genomic and immune-based metrics were correlated with long-term outcomes for a young patient population treated at a single institution. A fully clinically annotated, retrospective cohort of 81 patients aged ≤45 years with OCSCC is described, and the impact of clinicopathological features on long-term survival outcomes is reported. Genomic and immune parameters were integrated utilizing a whole-exome sequencing and immunohistochemical approach among females in the cohort. (Source: International Journal of Oral and Maxillofacial Surgery)

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Prognostic factors in head and neck mucoepidermoid carcinoma: experience at a single institution based on 64 consecutive patients over a 28-year period

The objective of this study was to determine the clinicopathological predictors of recurrence and survival in patients with head and neck MEC. The medical records of 64 patients who underwent surgical treatment for head and neck MEC between 1982 and 2010 were reviewed. The main outcome measures were disease-free survival (DFS) and overall survival (OS). (Source: International Journal of Oral and Maxillofacial Surgery)

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Bedside transcranial sonography monitoring in a patient with hydrocephalus post subarachnoid hemorrhage

Abstract

Background

Development of hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in patients with craniotomy which removes the acoustic interference of the skull and allows a closer up visualization of brain structures through the skin.

Case presentation

We report a 73-year-old woman who was hospitalized for SAH and developed acute hydrocephalus requiring an external ventricular drain (EVD). In this patient, detection and monitoring of hydrocephalus was done and monitored with a small pocket-sized TCS device. Nine days after surgery, weaning of the EVD was attempted. Prior to EVD closure and removal, TCS showed a measurement of the 3rd ventricle at around 1.16 cm. On the third day, the patient deteriorated clinically and the TCS showed a dilated 3rd ventricle measuring 1.37 cm which correlated well with computed tomography and with clinical signs of active hydrocephalus as both her sensorium and communication were affected. Subsequently following EVD re-installation, on the next day, TCS showed that the 3rd ventricle dimension was reduced to 0.99 cm and the following day it went down to 0.69 cm.

Conclusions

Patients with SAH and in particular those with a craniotomy can be monitored easily at the bedside with hand-held TCS for the development and monitoring of hydrocephalus.

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A new concept for implant-borne dental rehabilitation; how to overcome the biological weak-spot of conventional dental implants?

Abstract

Background

Every endosseous dental implant is dependent on an adequate amount and quality of peri-implant hard and soft tissues and their fully functional interaction. The dental implant could fail in cases of insufficient bone and soft tissues or due to a violation of the soft to hard tissues to implant shoulder interface with arising of a secondary bone loss.

Method

To overcome this biological weak-spot, we designed a new implant that allows for multi vector endosseous anchorage around the individual underlying bone, which has to be scanned by computed tomography (CT) or Cone beam CT (CBCT) technique to allow for planning the implant. We developed a workflow to digitally engineer this customized implant made up of two planning steps. First, the implant posts are designed by prosthodontic-driven backward planning, and a wireframe-style framework is designed on the individual bony surface of the recipient site. Next, the two pieces are digitally fused and manufactured as a single piece implant using the SLM technique (selective laser melting) and titanium-alloy-powder.

Results

Preoperative FEM-stress-test of the individual implant is possible before it is inserted sterile in an out-patient procedure.

Conclusion

Unlike any other historical or current dental implant protocol, our newly developed "individual patient solutions dental" follows the principle of a fully functional and rigid osteosynthesis technology and offers a quick solution for an implant-borne dental rehabilitation in difficult conditions of soft and hard tissues.

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Chun Yuen Trading Co. Issues Allergy Alert On Undeclared Milk

Chun Yuen Trading Co. of South El Monte, California, is recalling its 12.7 oz of 4-in-1 Reishi Coffee due to a mislabeling of the outer packaging, which contains undeclared milk content. People who are allergic to milk run the risk of serious or life threatening allergic reaction if they consume these products.

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Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI

Abstract

Enterocutaneous fistulas (ECFs) represent abnormal communications between the gastrointestinal tract and the skin. Nowadays, the majority (~80%) of ECFs develops secondary to abdominal surgeries; alternative, less common causes include chronic inflammatory bowel diseases (IBD) such as Crohn's disease, tumours, and radiation enteritis in descending order of frequency. These rare disorders require thorough patient assessment and multidisciplinary management to limit the associated morbidity and mortality. This pictorial review includes an overview of causes, clinical manifestations, complications and management of ECFs. Afterwards, the imaging appearances, differential diagnoses, and therapeutic options of post-surgical, IBD-related, and malignant ECFs are presented with case examples. Most of the emphasis is placed on the current pivotal role of CT and MRI, which comprehensively depict ECFs providing cross-sectional information on the underlying postsurgical, neoplastic, infectious, or inflammatory conditions. Radiographic fistulography remains a valid technique, which rapidly depicts the ECF anatomy and confirms communication with the bowel. The aim of this paper is to increase radiologists' familiarity with ECF imaging, thus allowing an appropriate choice between medical, interventional, or surgical treatment, ultimately resulting in higher likelihood of therapeutic success.

Teaching Points

• Enterocutaneous fistulas may complicate abdominal surgery, sometimes Crohn's disease and tumours.

• The high associated morbidity and mortality result from sepsis, malnutrition and metabolic imbalance.

• The multidisciplinary management of ECFs requires thorough imaging for correct therapeutic choice.

• Radiographic fistulography rapidly depicts fistulas and communicating bowel loops in real-time.

• Multidetector CT and MRI provide cross-sectional information on fistulas and underlying diseases.

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Targeted microbicides for preventing sexual HIV transmission

Publication date: 28 November 2017
Source:Journal of Controlled Release, Volume 266
Author(s): Catarina Coutinho, Bruno Sarmento, José das Neves
Sexual transmission remains one of the most significant hurdles in the fight against HIV infection. The use of vaginal or rectal microbicides has been proposed for topical pre-exposure prophylaxis but available results from clinical trials of candidate products have been, at best, less than optimal. While waiting for the first product to get regulatory approval, novel approaches are being explored in order to enhance efficacy, as well as to assure safety. Strategies involving specific delivery of antiviral agents to key players involved in the early steps of sexual transmission have the potential to help achieving such purposes. Engineering systems that allow targeting cells, tissues or other biological structures of interest may provide a way to modulate local pharmacokinetics of promising microbicide molecules and, thus, maximize protection. This concise review discusses the identification and use of potential targets for such purpose, while detailing on several examples of targeted systems engineered as potential microbicide candidates. Furthermore, remaining challenges and hints for future work in the field of targeted microbicides are addressed.

Graphical abstract

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Cellular uptake of extracellular vesicles is mediated by clathrin-independent endocytosis and macropinocytosis

Publication date: 28 November 2017
Source:Journal of Controlled Release, Volume 266
Author(s): Helena Costa Verdera, Jerney J. Gitz-Francois, Raymond M. Schiffelers, Pieter Vader
Recent evidence has established that extracellular vesicles (EVs), including exosomes and microvesicles, form an endogenous transport system through which biomolecules, including proteins and RNA, are exchanged between cells. This endows EVs with immense potential for drug delivery and regenerative medicine applications. Understanding the biology underlying EV-based intercellular transfer of cargo is of great importance for the development of EV-based therapeutics. Here, we sought to characterize the cellular mechanisms involved in EV uptake.Internalization of fluorescently-labeled EVs was evaluated in HeLa cells, in 2D (monolayer) cell culture as well as 3D spheroids. Uptake was assessed using flow cytometry and confocal microscopy, using chemical as well as RNA interference-based inhibition of key proteins involved in individual endocytic pathways. Experiments with chemical inhibitors revealed that EV uptake depends on cholesterol and tyrosine kinase activity, which are implicated in clathrin-independent endocytosis, and on Na⁺/H⁺ exchange and phosphoinositide 3-kinase activity, which are important for macropinocytosis. Furthermore, EV internalization was inhibited by siRNA-mediated knockdown of caveolin-1, flotillin-1, RhoA, Rac1 and PAK1, but not clathrin heavy chain. Together, these results suggest that EVs enter cells predominantly via clathrin-independent endocytosis and macropinocytosis. Identification of EV components that promote their uptake via pathways that lead to functional cargo transfer might allow development of more efficient therapeutics through EV-inspired engineering.

Graphical abstract

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Intradermal vaccination with hollow microneedles: A comparative study of various protein antigen and adjuvant encapsulated nanoparticles

Publication date: 28 November 2017
Source:Journal of Controlled Release, Volume 266
Author(s): Guangsheng Du, Rania M. Hathout, Maha Nasr, M. Reza Nejadnik, Jing Tu, Roman I. Koning, Abraham J. Koster, Bram Slütter, Alexander Kros, Wim Jiskoot, Joke A. Bouwstra, Juha Mönkäre
In this study, we investigated the potential of intradermal delivery of nanoparticulate vaccines to modulate the immune response of protein antigen using hollow microneedles. Four types of nanoparticles covering a broad range of physiochemical parameters, namely poly (lactic-co-glycolic) (PLGA) nanoparticles, liposomes, mesoporous silica nanoparticles (MSNs) and gelatin nanoparticles (GNPs) were compared. The developed nanoparticles were loaded with a model antigen (ovalbumin (OVA)) with and without an adjuvant (poly(I:C)), followed by the characterization of size, zeta potential, morphology, and loading and release of antigen and adjuvant. An in-house developed hollow-microneedle applicator was used to inject nanoparticle suspensions precisely into murine skin at a depth of about 120μm. OVA/poly(I:C)-loaded nanoparticles and OVA/poly(I:C) solution elicited similarly strong total IgG and IgG1 responses. However, the co-encapsulation of OVA and poly(I:C) in nanoparticles significantly increased the IgG2a response compared to OVA/poly(I:C) solution. PLGA nanoparticles and liposomes induced stronger IgG2a responses than MSNs and GNPs, correlating with sustained release of the antigen and adjuvant and a smaller nanoparticle size. When examining cellular responses, the highest CD8⁺ and CD4⁺ T cell responses were induced by OVA/poly(I:C)-loaded liposomes. In conclusion, the applicator controlled hollow microneedle delivery is an excellent method for intradermal injection of nanoparticle vaccines, allowing selection of optimal nanoparticle formulations for humoral and cellular immune responses.

Graphical abstract

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Waste rice straw and coal fly ash composite as a novel sustainable catalytic particle electrode for strengthening oxidation of azo dyes containing wastewater in electro-Fenton process

Abstract

A novel catalytic particle electrode (CPE) was synthesized from waste rice straw and coal fly ash which was employed to strengthen electro-Fenton treating actual azo dyes containing wastewater. Results showed that the prepared CPE exhibited excellent electro-catalytic activity and significantly improved performance of pollutants removal at near-neutral pH condition, achieving over 73.5 and 90.5% of chemical oxygen demand (COD) and color removal percentages, respectively, allowing discharge criteria to be met. And the electro-Fenton with CPE improved the biodegradability of wastewater in terms of BOD₅/COD, resazurin dehydrogenase activity, and toxicity, indicating the potential application of integrated biosystem for this type of wastewater. On the basis of inhibition of different radical scavengers and fluorescence test, it was deduced that the main contribution of the novel CPE was responsible for catalyzing electro-generate H₂O₂ to produce more hydroxyl radicals in electro-Fenton, and the positive role of generation of superoxide anion at near-neutral pH was also proved, further the possible reaction mechanism was proposed. Moreover, CPE showed the advantages of superior stability and low cost at successive runs and the results offered new insights for sustainable use of waste materials.

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Mutagenic and genotoxic effects and metal contaminations in fish of the Amambai River, Upper Paraná River, Brazil

Abstract

The present study evaluated mutagenic and genotoxic effects and metal accumulation in the liver and musculature of Pterygoplichthys ambrosetti and Prochilodus lineatus in the Amambai River, a tributary of the Upper Paraná River in Brazil. We also evaluated the potential for these fish species as environmental bioindicators and performed risk assessment for conservation purposes. We found that P. ambrosetti had a higher frequency of micronuclei compared to P. lineatus (p < 0.0001). There were no significant differences between species in other erythrocyte nuclear abnormalities (ENA) (p > 0.05). For both species, the liver contained a higher concentration of metals (Cd, Pb, Cr, Cu, Fe, Zn, and Ni) than the musculature did (p < 0.0001). Of the two species, P. ambrosetti was more suitable to evaluate mutagenic and genotoxic effects and metal accumulation in the liver and musculature, likely due to its resident behavior; hence, we highlight the potential of this species for use as an environmental bioindicator. The concentrations of non-essential metals observed in the fish confirm conditions of environmental stress in the Amambai River, possibly related to the discharge of pollutants and exacerbated by lack of native vegetation cover along the watercourse.

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Transcriptomic responses of the endangered freshwater mussel Margaritifera margaritifera to trace metal contamination in the Dronne River, France

Abstract

The freshwater pearl mussel Margaritifera margaritifera is one of the most threatened freshwater bivalves worldwide. In this study, we aimed (i) to study the processes by which water quality might affect freshwater mussels in situ and (ii) to provide insights into the ecotoxicological significance of water pollution to natural populations in order to provide necessary information to enhance conservation strategies. M. margaritifera specimens were sampled in two close sites located upstream or downstream from an illegal dumping site. The renal transcriptome of these animals was assembled and gene transcription determined by RNA-seq. Correlations between transcription levels of each single transcript and the bioaccumulation of nine trace metals, age (estimated by sclerochronology), and condition index were determined in order to identify genes likely to respond to a specific factor. Amongst the studied metals, Cr, Zn, Cd, and Ni were the main factors correlated with transcription levels, with effects on translation, apoptosis, immune response, response to stimulus, and transport pathways. However, the main factor explaining changes in gene transcription appeared to be the age of individuals with a negative correlation with the transcription of retrotransposon-related genes. To investigate this effect further, mussels were classified into three age classes. In young, middle-aged and old animals, transcription levels were mainly explained by Cu, Zn and age, respectively. This suggests differences in the molecular responses of this species to metals during its lifetime that must be better assessed in future ecotoxicology studies.

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Occurrence and source identification of perfluoroalkyl acids (PFAAs) in the Metedeconk River Watershed, New Jersey

Abstract

The Brick Township Municipal Utilities Authority (BTMUA), which relies on the Metedeconk River as its primary source of water supply, initiated a perfluoroalkyl acid (PFAA) source trackdown study in collaboration with the New Jersey Department of Environmental Protection (NJDEP) after discovering that the concentration of one PFAA, perfluorooctanoic acid (PFOA), was elevated at their raw surface water intake. Water samples were collected over eight sampling events between September 2011 and July 2014. Samples included surface water, groundwater, stormwater, sanitary sewer water, and commercial/industrial process water. Each sample was analyzed for ten PFAAs. Results from a set of samples collected from the 80 km² South Branch Metedeconk River watershed directed the focus of this study to a 7.5-km² area of interest. Within this area, a high concentration of PFAA contamination was documented in a localized zone. Subsequent groundwater sampling led to the identification of a plume of groundwater contamination emanating from an industrial/business park. The suspected source of PFAA detected in the river and drinking water intake was identified to a small industrial facility that used materials containing PFOA. Groundwater PFOA concentrations as high as 70,000 ng/L were found in samples taken within 200 m of the parcel and surface water concentrations as high as 130 ng/L were observed in the river. While various PFAAs were detected in the samples, particularly in groundwater samples, PFOA was identified as the primary contaminant of concern with respect to the river and the BTMUA water supply.

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Enhancement of anaerobic digestibility of waste activated sludge using photo-Fenton pretreatment

Abstract

Biological treatments, such as activated sludge process, are common methods to treat municipal and industrial wastewaters. However, they produce huge amounts of waste activated sludge (WAS). The excess sludge treatment and disposal are a challenge for wastewater treatment plants due to economic, environmental, and regulatory factors. In this study, photo-Fenton pretreatment (oxidation using hydrogen peroxide and iron catalyst aided with UV light) was optimized using response surface methodology (RSM) and central composite design (CCD) to determine the effects of three operating parameters (H₂O₂ dosage, H₂O₂/Fe²⁺ molar ratio, and irradiation time) on disintegration and dewaterability of WAS. MLVSS removal, capillary suction time (CST) reduction, sCOD, and EPS were obtained as 70%, 25%, 12,000 mg/L, and 500 mg/L, respectively, at the optimal conditions, i.e., 725 g H₂O₂/kg TS, H₂O₂/Fe²⁺ molar ratio 80, and irradiation time 40 min. Two batch-fed completely mixed mesophilic anaerobic digesters were then operated at 15-day solid retention time (SRT) and 37 ± 0.5 °C to compare the digestibility of untreated and photo-Fenton pretreated sludge in terms of volatile solids (VS) reduction, COD removal, and biogas production at steady-state operations. Photo-Fenton pretreatment followed by anaerobic digestion of WAS was very effective and yielded 75.7% total VS reduction, 81.5% COD removal, and 0.29–0.31 m³/kg VS_fed·d biogas production rate, compared to 40.7% total VS solid reduction, 54.7% COD removal, and 0.12–0.17 m³/kg VS_fed·d biogas production rate for control. Thus, photo-Fenton can be a useful pretreatment step in sludge management.

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A study on removing nitrogen from paddy field rainfall runoff by an ecological ditch–zeolite barrier system

Abstract

Ecological ditches and zeolite have been widely applied in the removal of farmland nonpoint source pollution separately; little research has been done on the effects of combining the two methods. Specifically, few studies have focused on the in situ regeneration of zeolite. A 2-year field experiment using an ecological ditch–zeolite barrier system was conducted in a paddy field of summer rice–winter wheat rotation in the Taihu Lake area. The system consisted of two zeolite barriers positioned at one third and two thirds of the length of the ditch. This study focused on the effect of the system on in situ nitrogen removal during the rice-growing season. Simultaneous laboratory kinetics experiments with natural zeolite and a series of adsorbed zeolites taken from the ditch at different time were also conducted. The concentration removal efficiencies of total nitrogen are averaged 24.66% in 2014 and 30.39% in 2015. Meanwhile, the cumulative adsorption quantity of ammonia nitrogen by the two barriers accounted for 49.27% of the ammonia nitrogen removed in 2014 and 54.35% of that in 2015. The amount of nitrogen adsorbed by plants was larger than that adsorbed by zeolite. The breakthrough curves of the zeolite and the characteristics of the zeolite surface structures from different periods all demonstrated that the zeolite can be regenerated in situ in the case of unsaturated zeolite within the ecological ditch. It can be concluded that an ecological ditch–zeolite barrier system is a realistic option for removing nitrogen from agricultural rainfall runoff in the Taihu Lake area.

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The effect of vitamin E, l -carnitine, and ginger on production traits, immune response, and antioxidant status in two broiler strains exposed to chronic heat stress

Abstract

The present study was designed to find the effect of natural and synthetic antioxidants on the performance of two broiler strains under high ambient temperature. A total of 320 day-old chicks of Hubbard and Cobb were reared for a period for 21 days under the same nutritional and management systems. On day 21 onward, one subgroup was kept as control while other subgroups were provided with vitamin E (250 mg/kg), ginger (2 g/kg), and l-carnitine (500 mg/kg) in basal diets. Body weight and feed conversion ratio (FCR) were significantly (P < 0.05) high in vitamin E-supplemented birds, while feed intake was significantly (P < 0.05) higher in l-carnitine supplemented birds irrespective of the strain. Antibody titer against infectious bursal disease (IBD) and paraoxonase (PON1) was significantly (P < 0.05) higher in vitamin E-supplemented birds compared to the other treatments. The number of heterophils and toal oxidant status (TOS) were significantly (P < 0.05) lower in vitamin E-supplemented birds. Blood glucose was significantly (P < 0.05) lower in vitamin E-supplemented birds, while total protein was significantly (P < 0.05) higher in vitamin E-supplemented group. In conclusion, the supplementation of vitamin E at the rate of 250 mg/kg improved the antioxidant status and immune response in the two broiler strains. Further, the two strains perform similarly in terms of performance and other health status parameters with no significant difference.

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Utilization of calcium-based and aluminum-based materials for the treatment of stabilized landfill leachate: a comparative study

Abstract

This study explored the efficiencies and mechanisms of refractory organic matters removal in the stabilized landfill leachate by adding different reagents. Calcium-based and aluminum-based materials were added into the leachate as comparing experiments. XRD, FTIR, and EEM were adopted to analyze the solid products and leachate. As a result, the in situ synthesized CaAl-LDHs were more beneficial for refractory organic matters removal, especially for benzodiazepines. When CaAl-LDHs were formed, the removal efficiencies of COD, UV254, and TOC were best and achieved 58.48, 81.22, and 71.30%, respectively. For fluorescent substances, humic acid-like and fulvic acid-like compounds were efficiently removed by CaAl-LDHs. In particular, CaAl-LDHs had selective removal effects on fulvic acid-like compounds, which were characteristic of small molecular weight and major carboxyl groups.

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Possible effects of melatonin against rat uterus exposure to bisphenol A during neonatal period

Abstract

The aim of this study was to investigate the possible effects of melatonin on rat uterine tissue against exposure with bisphenol A (BPA) in the neonatal period. Twenty-four female rats were divided into four groups, (n=6) per group. Group I was used as a control (sesame oil + ethanol), group II was injected daily with (100 mg/kg) BPA by subcutaneously (sc) daily postnatal days (PND 0–10), group III was injected daily with (10 mg/kg) melatonin by sc for 10 days (PND 20–30), and group IV was injected daily with (100 mg/kg) BPA (PND 0–10) and (10 mg/kg) melatonin (PND 20–30). All rats were sacrificed in the same day of metestrus cycle, approximately PND 70. Histological analyses, immunostaining of B cell lymphoma 2 (Bcl-2), and cytochrome c and TUNEL assays were performed. According to our results, neonatal exposure to BPA accelerates onset of puberty, causes degenerative and morphometric changes on rat uterus, and increases apoptotic reaction rates. The immunoreactivity of Bcl-2 was decreased after BPA administration. In addition, immunoreactivity of Bcl-2 showed an increase after melatonin treatment. However, cytochrome c immunoreactivity was decreased after melatonin administration. Our results suggest that melatonin may have positive effects against BPA-induced degenerative changes on rat uterus.

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Toxic metal tolerance in native plant species grown in a vanadium mining area

Abstract

Vanadium (V) has been extensively mined in China and caused soil pollution in mining area. It has toxic effects on plants, animals and humans, posing potential health risks to communities that farm and graze cattle adjacent to the mining area. To evaluate in situ phytoremediation potentials of native plants, V, chromium, copper and zinc concentrations in roots and shoots were measured and the bioaccumulation (BAF) and translocation (TF) efficiencies were calculated. The results showed that Setaria viridis accumulated greater than 1000 mg kg⁻¹ V in its shoots and exhibited TF > 1 for V, Cr, Zn and BAF > 1 for Cu. The V accumulation amount in the roots of Kochia scoparia also surpassed 1000 mg kg⁻¹ and showed TF > 1 for Zn. Chenopodium album had BAF > 1 for V and Zn and Daucus carota showed TF > 1 for Cu. Eleusine indica presented strong tolerance and high metal accumulations. S. viridis is practical for in situ phytoextractions of V, Cr and Zn and phytostabilisation of Cu in V mining area. Other species had low potential use as phytoremediation plant at multi-metal polluted sites, but showed relatively strong resistance to V, Cr, Cu and Zn toxicity, can be used to vegetate the contaminated soils and stabilise toxic metals in V mining area.

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On the Implausibility of Differing-Inputs Obfuscation and Extractable Witness Encryption with Auxiliary Input

Abstract

The notion of differing-inputs obfuscation (diO) was introduced by Barak et al. (CRYPTO, pp 1–18, 2001). It guarantees that, for any two circuits \(C_0, C_1\) for which it is difficult to come up with an input x on which \(C_0(x) \ne C_1(x)\) , it should also be difficult to distinguish the obfuscation of \(C_0\) from that of \(C_1\) . This is a strengthening of indistinguishability obfuscation, where the above is only guaranteed for circuits that agree on all inputs. Two recent works of Ananth et al. (Differing-inputs obfuscation and applications, http://eprint.iacr.org/, 2013) and Boyle et al. (Lindell, pp 52–73, 2014) study the notion of diO in the setting where the attacker is also given some auxiliary information related to the circuits, showing that this notion leads to many interesting applications. In this work, we show that the existence of general-purpose diO with general auxiliary input has a surprising consequence: it implies that a specific circuit \(C^*\) with specific auxiliary input \({\mathsf {aux}}^*\) cannot be obfuscated in a way that hides some specific information. In other words, under the conjecture that such special-purpose obfuscation exists, we show that general-purpose diO cannot exist. This conjecture is a falsifiable assumption which we do not know how to break for candidate obfuscation schemes. We also show similar implausibility results for extractable witness encryption with auxiliary input and for "output-only dependent" hardcore bits for general one-way functions.

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The importance of blood platelet lipid signaling in thrombosis and in sepsis

Publication date: Available online 29 September 2017
Source:Advances in Biological Regulation
Author(s): Fanny Vardon Bounes, Abdulrahman Mujalli, Claire Cenac, Sonia Severin, Pauline Lefaouder, Gaëtan Chicanne, Frédérique Gaits-Iacovoni, Vincent Minville, Marie-Pierre Gratacap, Bernard Payrastre
Blood platelets are the first line of defense against hemorrhages and are also strongly involved in the processes of arterial thrombosis, a leading cause of death worldwide. Besides their well-established roles in hemostasis, vascular wall repair and thrombosis, platelets are now recognized as important players in other processes such as inflammation, healing, lymphangiogenesis, neoangiogenesis or cancer. Evidence is accumulating they are key effector cells in immune and inflammatory responses to host infection. To perform their different functions platelets express a wide variety of membrane receptors triggering specific intracellular signaling pathways and largely use lipid signaling systems. Lipid metabolism is highly active in stimulated platelets including the phosphoinositide metabolism with the phospholipase C (PLC) and the phosphoinositide 3-kinase (PI3K) pathways but also other enzymatic systems producing phosphatidic acid, lysophosphatidic acid, platelet activating factor, sphingosine 1-phosphate and a number of eicosanoids. While several of these bioactive lipids regulate intracellular platelet signaling mechanisms others are released by activated platelets acting as autocrine and/or paracrine factors modulating neighboring cells such as endothelial and immune cells. These bioactive lipids have been shown to play important roles in hemostasis and thrombosis but also in vessel integrity and dynamics, inflammation, tissue remodeling and wound healing. In this review, we will discuss some important aspects of platelet lipid signaling in thrombosis and during sepsis that is an important cause of death in intensive care unit. We will particularly focus on the implication of the different isoforms of PI3Ks and on the generation of eicosanoids released by activated platelets.



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County Strike

"You wouldn't layoff a teacher and make them reapply every year," says Emily Miller, an expanded practice dental hygienist for Lane County Public Health.

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Save the Date! Lone Star Rhinology and Rhinoplasty Course Scheduled for November

The Department of Otorhinolaryngology-Head & Neck Surgery at UTHealth's McGovern Medical School is proud to sponsor 2017 Lone Star Rhinology... Read the full article...

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Dr. Amber Luong Receives 2017 Helen F. Krause, MD Memorial Trailblazer Award

Amber Luong, MD, PhD, associate professor of otorhinolaryngology, has been recognized with the 2017 Helen F. Krause, MD Memorial Trailblazer... Read the full article...

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ORL Frontiers 2017 Recap

More than 70 physicians and other healthcare professionals attended ORL Frontiers 2017, held last June at the Brown Foundation Institute... Read the full article...

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Unique interactome network signatures for PPAR{gamma} modulation by functional selective ligands [Research]

The nuclear receptor PPARg regulates adipogenesis and plays a central role in lipid and glucose homeostasis, and is the molecular target of the glitazones (TZDs), therapeutics used to treat insulin resistance and type-2 diabetes (T2D).  While the TZDs, which are PPARg agonists, demonstrated robust clinical efficacy in T2D, their use has been hampered by an array of untoward side effects.  Paradoxically, partial agonists (e.g., MRL24), antagonists (e.g., SR1664), and inverse agonists (e.g., SR10171 and SR2595), possess similar insulin-sensitizing efficacy as the TZDs in obese diabetic mice. Given the unique pharmacology of these modulators, we sought to identify the components of the PPARg transcriptional complex that is regulated by these ligands. To achieve this, we employed subcellular fractionation of adipocytes combined with either trapping of the receptor complex on biotinylated DNA oligonucleotide, or classical immunoprecipitation. Tandem mass spectrometry analysis revealed unique, partially overlapping, compound- and subcellular compartment-specific complexes. Components of these interactomes are putative co-regulators of PPARg.  Interestingly, complexes isolated in the cytosol contain sets of proteins involve in cellular assembly and extracellular matrix. Furthermore, the interactome observed for cytosolic non-DNA bound receptor was distinct from that observed from nuclear chromatin associated PPARg, suggesting cellular compartment-specific roles for this receptor.

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Proteomics identifies GOLPH3 with a link between Golgi structure, cancer, DNA damage and protection from cell death [Minireview]

GOLPH3 is the first example of a Golgi resident oncogene protein. It was independently identified in multiple screens; first in proteomic-based screens as a resident protein of the Golgi apparatus, and second as an oncogene product in a screen for genes amplified in cancer. A third screen uncovered the association of GOLPH3 with the Golgi resident phospholipid, phosphatidyl inositol 4 phosphate (PI4P) to maintain the characteristic ribbon structure of the Golgi apparatus favouring vesicular transport of secretory proteins.

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Agreement between self-reported and register-based cardiovascular events among Danish breast cancer survivors

Abstract

Purpose

We examined the degree of over- and under-reporting of cardiovascular diseases (CVDs) among female breast cancer survivors comparing self-reports to diagnostic codes from the Danish National Patient Register (NPR).

Methods

The study comprised 357 Danish breast cancer patients from the WECARE study who completed a telephone interview concerning CVDs. Disease diagnoses for these women were obtained from the NPR. Agreement was calculated as the number of diagnoses that were both self-reported and in the NPR divided by (1) number of self-reported diagnoses (over-reporting) or (2) number of diagnoses in the NPR (under-reporting).

Results

In total, 68 women reported 96 specific cardiovascular outcomes of which 56 (58%) were found in the NPR. Ninety cardiovascular diagnoses were found in the NPR of which 56 (62%) were specifically reported at the interview. There was 80% agreement as to the occurrence of a cardiovascular diagnosis overall. Of 289 women reporting no CVD, 273 (94%) had no diagnoses in the NPR.

Conclusions

Breast cancer survivors seem to report absence of CVD accurately, but they both over-report and under-report specific cardiovascular diagnoses. Using a broader definition of CVDs improves the agreement between self-reported and NPR data.

Implications for cancer survivors

Determining how cancer treatments affect the risk of cardiovascular morbidities is essential, and the development of high-quality methods for collecting such data is critical. While self-reported data are adequate for assessing the presence of any CVD condition, medical record review will yield higher quality data on specific CVD conditions.

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