bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Inhibitory Cytokines Induce Deregulated Progenitor Growth and Apoptosis in Hematopoietic Cells From Fac−/− Mice
Authors: Haneline Laura S. , Broxmeyer Hal E. , Cooper Scott , Hangoc Giao , Carreau Madeleine , Buchwald Manuel , Clapp D. Wade
Published: April 2020

We used a murine model containing a disruption of the murine homologue (Fac) of Fanconi Anemia group C (FAC) to evaluate the role of Fac in the pathogenesis of bone marrow (BM) failure. Methylcellulose cultures of BM cells fromFac−/− and Fac+/+ mice were established to examine the growth of multipotent and lineage-restricted progenitors containing inhibitory cytokines, including interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and macrophage inflammatory protein-1α (MIP-1α). Clonogenic growth of Fac−/− progenitors was reduced by 50% at 50- to 100-fold lower concentrations of all inhibitory cytokines evaluated. We hypothesized that the aberrant responsiveness to inhibitory cytokines in clonogenic cells may be a result of deregulated apoptosis. To test this hypothesis, we performed the TUNEL assay on purified populations of primary BM cells enriched for hematopoietic progenitors or differentiated myeloid cells. After stimulation with TNF-α, accentuated apoptosis was observed in both populations of Fac−/− cells. In addition, deregulated apoptosis was also noted in the most immature phenotypic population of hematopoietic cells after stimulation with MIP-1α.Together these data suggest a role of Fac in affecting the signaling of multiple cytokine pathways and support cytokine-mediated apoptosis as a major mechanism responsible for BM failure observed in FA patients.
Infection With Human Immunodeficiency Virus-1 Increases Expression of Vascular Endothelial Cell Growth Factor in T Cells: Implications for Acquired Immunodeficiency Syndrome-Associated Vasculopathy
Authors: Ascherl G. , Hohenadl C. , Schatz O. , Shumay E. , Bogner J. , Eckhart L. , Tschachler E. , Monini P. , Ensoli B. , Stürzl M.
Published: April 2020

Alterations in the vascular system and the onset of angioproliferative lesions such as Kaposi’s sarcoma (KS) are common traits of human immunodeficiency virus-1 (HIV-1)–infected patients. To investigate possible factors involved in acquired immunodeficiency syndrome (AIDS)-associated vasculopathy and vascular malfunction, expression of vascular endothelial cell growth factor-A (VEGF-A) was analyzed in HUT 78 T lymphocytes upon infection with HIV-1. VEGF-A was found to be increased in supernatants from infected cells as compared with uninfected cells. In addition, VEGF-A mRNA expression and protein secretion were significantly increased in HUT 78 cells incubated with conditioned medium (CM) derived from HIV-1 chronically infected HUT 78 cells (HIV-TCM) as compared with CM from uninfected cells (TCM). Increase of VEGF-A production in T cells was promoted by inflammatory cytokines (IC) present in HIV-TCM, including tumor necrosis factor  (TNF), interferon γ (IFNγ), interleukin-1β (IL-1β), and IL-6. These IC that have been shown to be increased in sera of HIV-1–infected patients and to be increased by HIV-1 infection or cell activation in these individuals as well as HIV-TCM also increased VEGF-A expression in primary T lymphocytes. Consistent with this, VEGF-A concentrations were found to be higher in sera of HIV-1–infected patients with (mean, 357.1 ± 197.9 pg/mL) and without KS (mean, 256.7 ± 137.5 pg/mL) as compared with uninfected individuals (mean, 188.6 ± 91.7 pg/mL). These data suggest that increased secretion of VEGF-A by T lymphocytes of HIV-1–infected individuals may induce vascular leakage and stimulate proliferation of vascular endothelial cells, which are hallmarks of AIDS-associated vasculopathy and especially of KS development.
TRK-Fused Gene (TFG) Is a New Partner of ALK in Anaplastic Large Cell Lymphoma Producing Two Structurally DifferentTFG-ALK Translocations
Authors: Hernández Luis , Pinyol Magda , Hernández Silvia , Beà Silvia , Pulford Karen , Rosenwald Andreas , Lamant Laurence , Falini Brunangelo , Ott German , Mason David Y. , Delsol Georges , Campo Elias
Published: April 2020

Anaplastic large cell lymphoma (ALCL) is associated with the t(2;5)(p23;q35), which generates the NPM-ALK fusion gene encoding an 80-kD protein. Several studies have suggested that genes other than NPM may be fused to theALK gene. Here we have identified TRK-fused gene (TFG) as a new ALK partner in 2 ALCL, 1 of which exhibited a t(2;3)(p23;q21). In these cases, TFG was involved in 2 different fusion genes, TFG-ALKS andTFG-ALKL, coding respectively 85-kD and 97-kD chimeric proteins. The ALK breakpoint in these translocations was the same as in the classic t(2;5) translocation. These 2 proteins were both active in an in vitro tyrosine kinase assay showing that the new cloned cDNA sequences are translated into chimeric proteins with functional activity. These findings indicate thatTFG can provide an alternative to NPM as a fusion partner responsible for activation of the ALK and the pathogenesis of ALCL.
Molecular cloning of a novel type 1 cytokine receptor similar to the common gamma chain
Authors: Fujio Keishi , Nosaka Tetsuya , Kojima Tetsuo , Kawashima Toshiyuki , Yahata Takashi , Copeland Neal G. , Gilbert Debra J. , Jenkins Nancy A. , Yamamoto Kazuhiko , Nishimura Takashi , Kitamura Toshio
Published: April 2020

In a complementary DNA (cDNA) screening of murine Th2-skewed lymphocytes with our recently developed signal sequence trap method termed SST-REX, a novel type 1 cytokine receptor, Delta1 (δ1), was identified. Although δ1 is ubiquitously expressed in multiple tissues, the expression level is higher in Th2-skewed lymphocytes than in Th1-skewed ones. The δ1 cDNA encodes a 359–amino acid type 1 membrane protein. The extracellular domain of 206 amino acids showed 24% identity with the murine common γ receptor that is shared among the receptors for interleukin(IL)-2, IL-4, IL-7, IL-9, and IL-15. The membrane-proximal region of δ1 includes a box1 motif, which is important for association with Janus kinases (JAKs), and showed a significant homology with that of the mouse erythropoietin receptor (EPOR). A box2 motif was also found in close proximity to the box1 region. Dimerization of the cytoplasmic region of δ1 alone did not transduce proliferative signals in IL-3–dependent cell lines. However, the membrane-proximal region of δ1 could substitute for that of human EPOR in transmitting proliferative signals and activating JAK2. These results suggest that δ1 is a subunit of cytokine receptor that may be involved in multiple receptor systems and play a regulatory role in the immune system and hematopoiesis.
Serum level of soluble urokinase-type plasminogen activator receptor is a strong and independent predictor of survival in human immunodeficiency virus infection
Authors: Sidenius Nicolai , Sier Cornelis F. M. , Ullum Henrik , Pedersen Bente Klarlund , Lepri Alessandro Cozzi , Blasi Francesco , Eugen-Olsen Jesper
Published: April 2020

Human immunodeficiency virus-1 (HIV-1) infection has been shown to result in up-regulation of the urokinase-type plasminogen activator receptor (uPAR/CD87) on leukocytes in vitro and in vivo. The objective of this study was to investigate whether this up-regulation is paralleled by higher serum levels of soluble uPAR (suPAR) in patients with advanced HIV-1 disease and whether the serum level of suPAR is predictive of clinical outcome. Using an enzyme-linked immunosorbent assay, the level of suPAR was measured retrospectively in serum samples from 314 patients with HIV-1 infection. By Kaplan-Meier and Cox regression analyses, the serum suPAR levels were correlated to survival with AIDS-related death as the end point. High levels of serum suPAR (greater than median) were associated with poor overall survival, and Kaplan-Meier analysis on patients stratified by suPAR level demonstrated a continuous increase in mortality rates with higher suPAR levels. After adjustment for accepted prognostic markers—including Centers for Disease Control and Prevention–defined clinical stages, CD4 counts, viral load, β2-microglobulin, and age—the prognostic strength of suPAR remained highly significant, indicating that the serum suPAR level is a novel, strong, and independent predictor of survival in HIV-1 infection. This report is the first to demonstrate an important association between the plasminogen activator system and disease progression in HIV-1 infection.
Management of acute COPD exacerbations in Australia: do we follow the guidelines?
Authors: Cousins Joyce L. , Wood-Baker Richard , Wark Peter A.B. , Yang Ian A. , Gibson Peter G. , Hutchinson Anastasia , Sajkov Dimitar , Hiles Sarah A. , Samuel Sameh , McDonald Vanessa M.
Published: April 2020

Objective

We aimed to assess adherence to the Australian national guideline (COPD-X) against audited practice, and to document the outcomes of patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (COPD) at discharge and 28 days after.

Methods

A prospective clinical audit of COPD hospital admission from five tertiary care hospitals in five states of Australia was conducted. Post-discharge follow-up was conducted via telephone to assess for readmission and health status.

Results

There were 207 admissions for acute exacerbation (171 patients; mean 70.2 years old; 50.3% males). Readmission rates at 28 days were 25.4%, with one (0.6%) death during admission and eight (6.1%) post-discharge within 28 days. Concordance to the COPD-X guidance was variable; 22.7% performed spirometry, 81.1% had blood gases collected when forced expiratory volume in 1 s was <1 L, 99.5% had chest radiography performed, 95.1% were prescribed systemic corticosteroids and 95% were prescribed antibiotic therapy. There were 89.1% given oxygen therapy and 92.6% when arterial oxygen tension was <80 mmHg; 65.6% were given ventilatory assistance when pH was <7.35. Only 32.4% were referred to pulmonary rehabilitation but 76.8% had general practitioner follow-up arranged.

Conclusion

When compared against clinical practice guidelines, we found important gaps in management of patients admitted with COPD throughout tertiary care centres in Australia. Strategies to improve guideline uptake are needed to optimise care.
Cough-provocation tests with hypertonic aerosols
Authors: Koskela Heikki O. , Nurmi Hanna M. , Purokivi Minna K.
Published: April 2020

Recent advances in cough research suggest a more widespread use of cough-provocation tests to demonstrate the hypersensitivity of the cough reflex arc. Cough-provocation tests with capsaicin or acidic aerosols have been used for decades in scientific studies. Several factors have hindered their use in everyday clinical work:i.e.lack of standardisation, the need for special equipment and the limited clinical importance of the response. Cough-provocation tests with hypertonic aerosols (CPTHAs) involve provocations with hypertonic saline, hypertonic histamine, mannitol and hyperpnoea. They probably actviadifferent mechanisms than capsaicin and acidic aerosols. They are safe and well tolerated and the response is repeatable. CPTHAs can assess not only the sensitivity of the cough reflex arc but also the tendency of the airway smooth muscles to constrict (airway hyper-responsiveness). They can differentiate between subjects with asthma or chronic cough and healthy subjects. The responsiveness to CPTHAs correlates with the cough-related quality of life among asthmatic subjects. Furthermore, the responsiveness to them decreases during treatment of chronic cough. A severe response to CPTHAs may indicate poor long-term prognosis in chronic cough. The mannitol test has been stringently standardised, is easy to administer with simple equipment, and has regulatory approval for the assessment of airway hyper-responsiveness. Manual counting of coughs during a mannitol challenge would allow the measurement of the function of the cough reflex arc as a part of clinical routine.
Highly Selective Detection of Metronidazole by Self-Assembly via 0D/2D N–C QDs/g-C3N4 Nanocomposites Through FRET Mechanism
Authors: Wang Shan , Fu Jing , Zhang Fang , Huan Ruirui , Liu Ting , Zeng Xingguo
Published: April 2020

A 0D/2D (0-dimensional/2-dimensional) nanostructure was designed by self-assembly of N–C QDs and carboxylated g-C3N4 nanosheets and used as a fluorescence resonance energy transfer (FRET) fluorescent sensor. The N–C QDs/g-C3N4 nanosheets were synthesized via the amino group on the N–C QD surface and the –COOH of the carboxylated g-C3N4 nanosheets. The mechanism of detection of metronidazole (MNZ) by N–C QDs/g-C3N4 nanocomposites is based on FRET between negatively charged N–QDs and positively charged carboxylated g-C3N4 nanoparticles. N–C QDs/g-C3N4 nanostructures displayed good responses for the detection of MNZ at normal temperature and pressure. The decrease in the fluorescence intensity showed a good linear relationship to MNZ concentration within 0–2.6 × 10−5 mol/L, and the detection limit was 0.66 μM. The novel FRET sensor will have a great potential in clinical analysis and biological studies.

Graphical Abstract
Genome of extreme halophyte Puccinellia tenuiflora
Authors: Guo Rui , Zhao Long , Zhang Kaijian , Gao Dan , Yang Chunwu
Published: April 2020

Background

Puccinellia tenuiflora, a forage grass, is considered a model halophyte given its strong tolerance for multiple stress conditions and its close genetic relationship with cereals. This halophyte has enormous values for improving our understanding of salinity tolerance mechanisms. The genetic information ofP. tenuifloraalso is a potential resource that can be used for improving the salinity tolerance of cereals.

Results

Here, we sequenced and assembled theP. tenuifloragenome (2n = 14) through the combined strategy of Illumina, PacBio, and 10× genomic technique. We generated 43.2× PacBio long reads, 123.87× 10× genomic reads, and 312.6× Illumina reads. Finally, we assembled 2638 scaffolds with a total size of 1.107 Gb, contig N50 of 117 kb, and scaffold N50 of 950 kb. We predicted 39,725 protein-coding genes, and identified 692 tRNAs, 68 rRNAs, 702 snRNAs, 1376 microRNAs, and 691 Mb transposable elements.

Conclusions

We deposited the genome sequence in NCBI and the Genome Warehouse in National Genomics Data Center. Our work may improve current understanding of plant salinity tolerance, and provides extensive genetic resources necessary for improving the salinity and drought tolerance of cereals.
A regulatory role for CD72 expression on B cells and increased soluble CD72 in primary Sjogren’s syndrome
Authors: Shen Yuqi , Ma Yuhua , Xie Jingyuan , Lin Li , Shi Yifan , Li Xiao , Shen Pingyan , Pan Xiaoxia , Ren Hong
Published: April 2020

Background

CD72, a co-receptor of B cell receptor (BCR), has been reported to have both positive and negative effects on B cell functions in several immunological diseases. The B cell plays an important role in the pathogenesis of primary Sjogren’s syndrome (pSS). However, whether CD72 is involved in the process remains unknown. This study aimed to observe the possible role of CD72 in the pathogenesis of pSS.

Results

A total of 60 cases who fulfilled the American-European Consensus Group (AECG) criteria for the diagnosis of pSS and 61 gender and age-matched healthy controls were recruited in this study. The percentage of CD72+ B cells was 85.31 ± 8.37% in pSS patients and 76.91 ± 8.50% in healthy controls(p < 0.001). The percentage of CD72+ B cells was correlated to serum IgG levels in patients [β = 0.018(0.001–0.036),p = 0.034]. The level of serum soluble CD72 was significantly higher in pSS patients than the one in healthy controls (0.41 (0.29) vs 0.07 (0.08) ng/mL,p < 0.001).

Conclusions

The percentage of CD72+ B cells was upregulated in pSS patients and was correlated to the serum IgG level, which revealed the hyperactivity of B cells in this disease. The serum soluble CD72 level was also increased in pSS patients. These results indicated a potential role of CD72 in the pathogenesis of pSS.
Low dose combined oral contraceptives induced thrombotic anterior wall myocardial infarction: a case report
Authors: Rahhal Alaa , Khir Fadi , Adam Mohammad , Aljundi Amer , Mohsen Mohammed Khalil , Al-Suwaidi Jassim
Published: April 2020

Background

Combined oral contraceptive pills are associated with an established risk for venous thrombosis; however, their risk for arterial thrombosis remains uncertain, especially with the development of low dose new generations of combined oral contraceptive. Arterial thrombosis is less likely to occur with the use of oral contraceptive pills in the absence of cardiovascular risk factors.

Case presentation

We report a 35-year old female with no cardiovascular risk factors who presented with thrombotic anterior wall myocardial infarction 6 months after using a third generation low dose combined oral contraceptive pills (Marvelon; ethinylestradiol 30 mcg and desogestrel 150 mcg).

Conclusion

Third generation low dose combined oral contraceptives may lead to myocardial infarction in young women, even in the absence of other cardiovascular risk factors.
Prostaglandin E-major urinary metabolite versus fecal immunochemical occult blood test as a biomarker for patient with ulcerative colitis
Authors: Ishida Natsuki , Miyazu Takahiro , Takano Ryosuke , Tamura Satoshi , Tani Shinya , Kagami Takuma , Yamade Mihoko , Hamaya Yasushi , Iwaizumi Moriya , Osawa Satoshi , Furuta Takahisa , Miyajima Hiroaki , Sugimoto Ken
Published: April 2020

Background

Prostaglandin E-major urinary metabolite (PGE-MUM) may be a novel biomarker for evaluating disease activity in ulcerative colitis (UC). We compared its usefulness to that of the fecal immunochemical occult blood test (FIT).

Methods

PGE-MUM and FIT measurements were performed of 92 urinary and fecal samples obtained from 60 patients with UC. Endoscopic activity was determined by Mayo endoscopic subscore (eMayo) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score.

Results

PGE-MUM levels and FIT results showed a significant correlation with respect to eMayo (P <  0.001 and P < 0.001, respectively), and there was a significant difference in PGE-MUM values between the groups below eMayo1 and above eMayo2 (P = 0.012). Both biomarkers were significantly correlated with the UCEIS score (P < 0.001 and P < 0.001, respectively), and the PGE-MUM values were significantly different between groups below UCEIS1 and above UCEIS2 (P = 0.012). PGE-MUM and FIT were significantly correlated with eMayo in the group with a disease duration < 5 years (P = 0.041 and P < 0.001, respectively). Although PGE-MUM and eMayo differed significantly between groups over 5 years (P = 0.012), FIT was not correlated with eMayo (P = 0.101).

Conclusions

PGE-MUM is useful as a biomarker as FIT for evaluating the endoscopic activity, particularly in long-term affected patients with UC.
Initially elevated arterial lactate as an independent predictor of poor outcomes in severe acute pancreatitis
Authors: Shu Wenqing , Wan Jianhua , Chen Jie , He Wenhua , Zhu Yong , Zeng Hao , Liu Pi , Zhu Yin , Xia Liang , Lu Nonghua
Published: April 2020

Background

The present study aimed to investigate the relationships between arterial lactate levels and outcomes in severe acute pancreatitis.

Methods

The study retrospectively analyzed the medical data of 329 patients with severe acute pancreatitis from January 2014 to February 2019. We compared baseline characteristics, laboratory data, severity scores, types of persistent organ failure, and primary and secondary outcomes of patients with and without elevated arterial lactate levels at admission. A multivariate logistic regression analysis model and receiver operating characteristic curve were adopted to evaluate the value of arterial lactate ≥4 mmol/L for identifying high-risk patients. Trends in arterial lactate levels were compared between patients in the survivor and nonsurvivor groups over a period of 7 days.

Results

Compared to normal arterial lactate levels, patients with elevated arterial lactate levels show significantly higher incidences of multiple persistent organ failure (3% vs 30%, P < 0.01), death (2% vs 11%, P < 0.01), septic shock (4% vs 24%, P < 0.01), pancreatic infection (12% vs 37%, P < 0.01), abdominal compartment syndrome (3% vs 20%, P < 0.01), pancreatic necrosis (41% vs 63%, P < 0.01), and a need for ventilator support (26% vs 54%, P < 0.01). For predicting mortality, arterial lactate levels ≥4 mmol/L had a high hazard ratio (10, 95% CI; 3.7–27; P < 0.01) and the highest area under the curve (0.78).

Conclusions

Our results indicate that initially elevated arterial lactate is independently associated with poor outcomes and death in patients with severe acute pancreatitis and may serve as an early high-risk stratification indicator.
Stenting as a bridge to surgery for extra-colonic malignancy induced colorectal obstruction: preliminary experience
Authors: Kim Eui Joo , Han Sang Hoon , Kim Kyoung Oh , Chung Jun-Won , Park Dong Kyun , Kwon Kwang An , Kim Jung Ho
Published: April 2020

Background

The majority of colonic obstructions result from colorectal cancer. However, malignancies of extra-colonic origin can also disrupt colorectal patency, and the efficacy of self-expanding metal stents (SEMS) insertion as a bridge to surgery in these patients are still in debate. The aim of this study is to evaluate the efficacy of endoscopic stenting as a bridge to surgery (BTS) for extra-colonic malignancy (ECM)-induced colonic obstruction.

Methods

Thirty-three patients with colonic obstruction due to ECM who received self-expanding metal stents (SEMS) insertion at a single academic tertiary medical center between 2004 and 2015 were included. The purpose of SEMS insertion was determined based on whether the patient’s medical records indicated any surgical plans before SEMS insertion. Technical success was defined as a patent SEMS covering the entire length of the obstruction. Bridging success was defined as elective surgical procedures after the first SEMS insertion.

Results

Among the 33 patients who underwent SEMS insertion for colorectal obstruction due to ECM, nine underwent SEMS as a BTS. Technical success was achieved in 100% (9/9). Seven patients underwent elective surgery after successful decompression with the first SEMS, and the bridging success rate was 77.8% (7/9). Two patients needed secondary stent insertion before elective surgery. However, none of them required emergent surgery. No major complications occurred, including death related to colorectal endoscopic procedures, perforation, or bleeding.

Conclusion

SEMS insertion as a BTS is a good treatment option to avoid emergent surgery in patients with colonic obstruction caused by extra-colonic malignancy.
Prevalence and factors associated with frailty in hospitalized older patients
Authors: Hammami Sonia , Zarrouk Amira , Piron Cecile , Almas Ioana , Sakly Nabil , Latteur Veronique
Published: April 2020

Background

Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters.

Methods

A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n = 19), frail (n = 25) and severely frail patients (n = 80).

Results

The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA.

score was negatively correlated to albumin levels (r = − 0.30; p < 0.001) and positively correlated to CRP, polypharmacy and age (r = 0.28, r = 0.37, r = 0.33 and p < 0.01 respectively). Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home.

Conclusion

Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.
Non-exercise based estimation of cardiorespiratory fitness is inversely associated with metabolic syndrome in a representative sample of Korean adults
Authors: Lee Inhwan , Kim Shinuk , Kang Hyunsik
Published: April 2020

Background

This study investigated the association between non-exercise based estimation of cardiorespiratory fitness (eCRF) and metabolic syndrome (Mets) in Korean adults aged 18 years and older (13,400 women and 9885 men).

Methods

Data from the 2008 and 2011 Korea National Health and Nutrition Examination Surveys IV and V in South Korea were analyzed. eCRF was assessed with a previously validated procedure. Participants were classified into 5 categories from the lowest quantile to the highest quantile based on individual eCRF distributions.

Results

The findings showed an independent and inverse association between eCRF and Mets in women and men separately. Individuals in the highest eCRF category (quantile 5) had a significantly lower prevalence of Mets (14.5 and 14.8% for women and men, respectively) compared with their counterparts (40.4 and 46.4% for women and men, respectively) in the lowest eCRF category (quantile 1), and the association showed a graded response, with the quantiles 2, 3, and 4 also significantly associated with a lower prevalence of Mets compared with the quantile 1. Furthermore, the prevalence of Mets in the highest quantile compared with the lowest quantile remained statistically significant in both men (p < 0.05) and women (p < 0.05) even after adjustments for age, body mass index, skeletal muscle index, smoking, heavy drinking, vitamin D, caloric intake, and dietary intakes of carbohydrates, fats, and proteins.

Conclusion

The findings support a preventive role for eCRF against Mets in Korean adults.
A case report of optic neuropathy following dacryocystorhinostomy in a 57-year-old female patient with May-Hegglin anomaly
Authors: Lee Seung Uk , Huh Hyoun Do , Cho Hyun Kyung , Kim Su Jin
Published: April 2020

Background

We report a rare case of optic neuropathy following dacryocystorhinostomy (DCR) in a 57-year-old female patient with May-Hegglin anomaly.

Case presentation

The patient was presented with sudden onset of vision loss for the left eye after DCR under general anesthesia. Her best corrected visual acuity was light perception in the left eye. Relative afferent pupillary defect was detected in her left eye. Magnetic resonance imaging of the orbit revealed an hyperintensity at the intra-orbital segment of the left optic nerve on T2-weighted image and Flair image. The patient was diagnosed with acute postoperative optic neuropathy and treated with methylprednisolone. Although her vision partially improved, she was left with a visual field defect in the left eye.

Conclusions

In patients with hematologic diseases, postoperative vision loss can occur following even minor surgery under general anesthesia, such as DCR. Therefore, preoperative counseling regarding the risk of visual loss should be given to high-risk patients.
Cognitive behavioural group therapy versus mindfulness-based stress reduction group therapy for intimate partner violence: a randomized controlled trial
Authors: Nesset Merete Berg , Lara-Cabrera Mariela Loreto , Bjørngaard Johan Håkon , Whittington Richard , Palmstierna Tom
Published: April 2020

Background

Violence in close relationships is a global public health problem and there is a need to implement therapeutic programs designed to help individuals who voluntarily seek help to reduce recurrent intimate partner violence. The effectiveness of such interventions in this population remains inconclusive. The aim of the present study was to compare the effectiveness of cognitive-behavioural group therapy (CBGT) vs mindfulness-based stress reduction (MBSR) group therapy in reducing violent behavior amongst individuals who are violent in intimate partnerships and who voluntarily seek help.

Methods

One hundred forty four participants were randomized using an internet-based computer system. Nineteen withdrew after randomization and 125 participants were randomly assigned to the intervention condition (CBGT, n = 67) or the comparator condition (MBSR, n = 58). The intervention condition involved two individual sessions followed by 15 cognitive-behavioural group therapy sessions. The comparator condition included one individual session before and after 8 mindfulness-based group sessions. Participants (N = 125) and their relationship partners (n = 56) completed assessments at baseline, and at three, six, nine and twelve months’ follow-up. The pre-defined primary outcome was reported physical, psychological or sexual violence and physical injury as measured by the revised Conflict Tactics Scale (CTS2).

Results

The intent-to-treat analyses were based on 125 male participants (intervention group n = 67; comparator group n = 58). Fifty-six female partners provided collateral information. Baseline risk estimate in the CBGT-group was .85 (.74–.92), and .88 (.76–.94) in the MBSR-group for physical violence. At 12-months’ follow-up a substantial reduction was found in both groups (CBGT: .08 (.03–.18); MBSR: .19 (.11–.32)).

Conclusion

Results provide support for the efficacy of both the cognitive-behavioural group therapy and the mindfulness-based stress reduction group therapy in reducing intimate partner violent behavior in men voluntarily seeking treatment.

Trial registration

NCT01653860, registered July 2012.
Lamotrigine, quetiapine and aripiprazole-induced neuroleptic malignant syndrome in a patient with renal failure caused by lithium: a case report
Authors: Szota Anna Maria , Radajewska Izabela , Grudzka Przemysław , Araszkiewicz Aleksander
Published: April 2020

Background

Neuroleptic malignant syndrome (NMS) may be induced by atypical antipsychotic drugs (AAPDs) such as aripiprazole, olanzapine, risperidone and quetiapine, either as a single treatment or in combination with other drugs. A case of NMS following the administration of lamotrigine, aripiprazole and quetiapine in a patient with bipolar disorder, and with renal failure caused by toxic lithium levels has not been reported.

Case presentation

A 51-year-old female patient with a 27-year history of bipolar disorder, being treated with lithium, fluoxetine, olanzapine, gabapentine, perazine and biperiden, was admitted to the hospital due to depressed mood and delusions. A urinary tract infection was diagnosed and antibiotic therapy was initiated. After 5 days of treatment her physical state deteriorated and she developed a fever of 38.4 °C. Her laboratory results revealed a toxic level of lithium (2.34 mmol/l). Acute renal failure was diagnosed and the lithium was withdrawn. After stabilization of her condition, and despite her antipsychotic treatment, further intensification of delusions and depressed mood were observed. All drugs being taken by the patient were withdrawn and lamotrigine and aripiprazole were initiated. Due to the insufficient effectiveness of aripiprazole treatment and because of problems with sleep, quetiapine was added, however further treatment with this drug combination and an increase of quetiapine to 400 mg/d eventually caused NMS. Amantadine, lorazepam and bromocriptine were therefore initiated and the patient’s condition improved.

Conclusion

This case report indicates that concurrent use of multiple antipsychotic drugs in combination with mood stabilizers in patients with organic disorders confers an increased risk of NMS development.
Effectiveness of the Healthy Start-Départ Santé approach on physical activity, healthy eating and fundamental movement skills of preschoolers attending childcare centres: a randomized controlled trial
Authors: Leis Anne , Ward Stéphanie , Vatanparast Hassan , Humbert M. Louise , Chow Amanda Froehlich , Muhajarine Nazeem , Engler-Stringer Rachel , Bélanger Mathieu
Published: April 2020

Background

Since young children spend approximately 30 h per week in early childcare centres (ECC), this setting is ideal to foster healthy behaviours. This study aimed to assess the effectiveness of the Healthy Start-Départ Santé (HSDS) randomized controlled trial in increasing physical activity (PA) levels and improving healthy eating and fundamental movement skills in preschoolers attending ECC.

Methods

Sixty-one ECC were randomly selected and allocated to either the usual practice (n = 30;n = 433 children) or intervention group (n = 31;n = 464 children). The HSDS intervention group was provided a 3-h on-site training for childcare educators which aimed to increase their knowledge and self-efficacy in promoting healthy eating, PA and development of fundamental movement skills in preschoolers. PA was measured during childcare hours for five consecutive days using the Actical accelerometer. Preschoolers’ fundamental movement skills were assessed using the standard TGMD-II protocol and POMP scores. Food intake was evaluated using digital photography-assisted weighted plate waste at lunch, over two consecutive days. All data were collected prior to the HSDS intervention and again 9 months later. Mixed-effect models were used to analyse the effectiveness of the HSDS intervention on all outcome measures.

Results

Total number of children who provided valid data at baseline and endpoint for PA, food intake and fundamental movement skills were 259, 670 and 492, respectively. Children in the HSDS intervention group had, on average, a 3.33 greater point increase in their locomotor motor skills scores than children in the control group (β = 3.33,p = 0.009). No significant differences in effects were observed for object control, PA and food intake. However, results demonstrated a marginal increase in portions of fruits and vegetables served in the intervention group compared to control group (β = 0.06,p = 0.05).

Conclusion

Of the 12 outcome variables investigated in this study, 10 were not different between the study groups and two of them (locomotor skills and vegetables and fruits servings) showed a significant improvement. This suggests that HSDS is an effective intervention for the promotion of some healthy behaviours among preschoolers attending ECC.

Trial registration

Clinical TrialsNCT02375490. Registered on February 24, 2015; 77 retrospectively registered.
Rapid point-of-care CD4 testing at mobile units and linkage to HIV care: an evaluation of community-based mobile HIV testing services in South Africa
Authors: Sloot Rosa , Glenshaw Mary T. , van Niekerk Margaret , Meehan Sue-Ann
Published: April 2020

Background

Mobile HIV testing services (HTS) are effective at reaching undiagnosed people living with HIV. However, linkage to HIV care from mobile HTS is often poor, ranging from 10 to 60%. Point-of-care (POC) CD4 testing has shown to increase retention in health facilities, but little evidence exists about their use in mobile HTS. This study assessed the feasibility of POC CD4 test implementation and investigated linkage to HIV care among clients accepting a POC test at community-based mobile HTS.

Methods

This retrospective study used routinely collected data from clients who utilized community-based mobile HTS in the City of Cape Town Metropolitan district, South Africa between December 2014 and September 2016. A POC CD4 test was offered to all clients with an HIV positive diagnosis during this period, and a CD4 cell count was provided to clients accepting a POC CD4 test. Random effects logistic regression was used to assess factors associated with POC CD4 test uptake and self-reported linkage to care among clients accepting a POC test. Models were adjusted for sex, age, previous HIV test done, tuberculosis status and year of HIV diagnosis.

Results

One thousand three hundred twenty-five of Thirty-nine thousand seven hundred ninety clients utilizing mobile HTS tested HIV positive (3%). 51% (679/1325) accepted a POC test. The age group with the highest proportion accepting a POC test was 50+ years (60%). Females were less likely to accept a POC test than males (odds ratio = 0.7, 95%CI = 0.6–0.8). Median CD4 count was 429 cells/μl (interquartile range = 290–584). Among 679 clients who accepted a POC CD4 test, 491 (72%) linked to HIV care. CD4 cell count was not associated with linkage to care.

Conclusion

Our findings suggest that mobile HTS can identify early HIV infection, and show that a high proportion of clients with a POC test result linked to care. Future research should assess factors associated with POC test acceptance and assess the impact of POC CD4 testing in comparison to alternative strategies to engage HIV positive people in care.
Recent transmission of dengue virus and associated risk Facors among residents of Kassala state, eastern Sudan
Authors: Eldigail Mawahib H. , Abubaker Hazem A. , Khalid Fatima A. , Abdallah Tajeldin M. , Adam Ibrahim A. , Adam Gamal K. , Babiker Rabie A. , Ahmed Mohamed E. , Haroun Eltahir M. , Aradaib Imadeldin E.
Published: April 2020

Background

Acute arboviral infections are distributed worldwide including Sudan, and dengue fever (DENV) is not an exception. The virus activity has recently been frequently reported in Kassala State, eastern Sudan. However, an appropriate epidemiological study would be necessary to provide accurate and precise estimates of the magnitude of recent DENV transmission in this area of endemicity.

Methods

In the present investigation, a cross sectional study was conducted to advance beyond the current knowledge of the epidemiology of the disease in Kassala State. The prevalence of the disease was estimated and associated risk factors were determined. Sampled sera were collected and screened for recent dengue transmissionas as determined by DENV-IgM enzyme-linked immunosorbent assay (ELISA). The collection of data for risk assessment was supported by a well designed structured questionnaire.

Results

The prevalence of recent DENV infection was estimated to be (11.42%). Potential risk factors to DENV seropsitivity include, age (OR = 3.24, CI = 1.81–5.77,p-value = 0.001); low income (OR = 3.75, CI = 1.57–8.93, p-value = 0.027); mosquito control (OR = 4.18, CI = 2.33–7.51, p-value = 0.004); and localities.

Conclusion

The present study showed a high rate of circulating DENV IgM antibodies among the participants of the study (11.42%), suggesting recent transmission of DENV in Kassala State, eastern Sudan. The frequent occurrence of DENV infections necessitates the need for improved surveillance programs and prevention measures to combat this important arboviral disease in Sudan.
Implementation fidelity of hospital based directly observed therapy for tuberculosis treatment in Bhutan: mixed-method study
Authors: Dorji Kunzang , Lestari Trisasi , Jamtsho Sonam , Mahendradhata Yodi
Published: April 2020

Background

Direct observed treatment (DOT) has been implemented in Bhutan since 1997 and currently, it is offered in various model of delivery including a combination of hospital based, home based DOT and ambulatory DOT. Overall, treatment success rate for tuberculosis cases is higher than the global target; however, it is still need to be improved. Evaluation to the implementation fidelity of DOT is important to identify potential rooms for improvement. This study aimed to assess two major components of the program’s implementation fidelity: to assess patient’s adherence to DOT and explore factors for adherence; to assess provider’s compliance with DOT guideline and explore factors for compliance.

Methods

This research used a sequential explanatory mixed method. The conceptual framework of implementation fidelity was adopted to guide this study design. The cross-sectional study of TB patients was enrolled in two hospitals with highest TB load, between September to November 2017 in Bhutan. Interviewer assisted survey was conducted with 139 TB patients who visited the hospital in continuation phase. In-depth interview was then conducted with nine TB patients and four health staffs to explore the barriers and enablers of DOT.

Results

Total of 61.9% (86/139) of patients has received DOT at intensive phase. Proportion was higher among MDR-TB cases (100%), and smear sputum positive TB cases (84.7%). In the continuation phase, 5.8% of patients took medicine at hospital, 48.9% at home and the rest 45.3% no longer practiced DOT. More than 90% of patient received correct dosage and standard regimen of anti-TB drugs according to the guideline. The key factors affecting poor adherence to DOT as perceived by patients were; lack of willingness to visit the clinic on daily basis due to long distance, financial implications and family support. However, patient’s satisfaction to the quality of TB treatment service delivery was high (98.6%). Providing incentives to the patient was most agreed enabler felt by both health workers and patients.

Conclusion

In the selected hospital sites, the patient’s adherence to DOT and provider’s compliance with DOT guideline is partially implemented; the coverage and the duration of DOT is very low, therefore, need to revise and improve DOT model and structure.
Power dynamics as a determinant of access and utilization of nutrition services by pregnant and lactating adolescent girls in Trans-Mara East Sub-County, Narok County, Kenya
Authors: Opiyo Charles O. , Okeyo David Omondi , Gumo Sussy , Munde Elly O. , Omungo Zablon O. , Olyaro Maureen , Ndirangu Rachel K. , Ogbureke Nanlop , Efange Sophie , Ouma Collins
Published: April 2020

Background

During pregnancy or lactating, adequate nutrition for adolescents becomes critical to reduce risks for both child and maternal-related morbidity and mortality. Power dynamics play a massive role in health outcomes. The main objective of this study was to examine the power dynamics in the families and communities and their impact on the pregnant and lactating adolescent girls’ access and utilization of nutrition services in Trans-Mara East Sub-County, Narok County.

Methods

A cross-sectional approach that employed mixed methods with both quantitative and qualitative research was adopted. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access pregnant or lactating adolescents. Data was collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and Z-test. Framework analysis was employed to analyze qualitative data.P ≤ 0.05 was considered statistically significant.

Results

In the power dynamics analyses, the intrinsic capability (Intrinsic capabilities are those adolescent driven initiatives that facilitate their access to nutrition services) was more likely to decrease awareness by half (OR = 0.52, 95% CI = 0.4–0.7,P < 0.01) whereas extrinsic dependency was likely to increase utilization by 1.2 times (OR = 1.2, 95% CI = 1.0–1.5,P = 0.055). From the stakeholder power matrix, the health personnel had observable visible power to influence access and utilization of nutrition services. Additional results revealed that adolescents who draw their support from significant others were more likely to utilize nutrition services as compared to those who attempted to make their own efforts to seek these services. Furthermore, health personnel have the most influential powers in ensuring adolescents access services and thus the most important actors in the stakeholder matrix. Other actors requiring focus included parents, political figures and governments while stakeholder engagement have higher potential of increasing access and utilization of services through dialogue.

Conclusions

Community access to nutritional services can be increased through use of multiple avenues to reach adolescents, including school-based, health system-based, community-based approaches and even marriage registries. A heightened engagement in the identified stakeholder network is necessary when planning community conversations, to ensure a multi-stakeholder approaches in meeting the nutrition needs of adolescents.
Tumor response and outcome after reverse treatment for patients with synchronous colorectal liver metastasis: a cohort study
Authors: Du Pasquier Céline , Roulin Didier , Bize Pierre , Sempoux Christine , Rebecchini Caterina , Montemurro Michael , Schäfer Markus , Halkic Nermin , Demartines Nicolas
Published: April 2020

Background

The reverse treatment of patients with synchronous colorectal liver metastases (CRLM) is a sequential approach with systemic chemotherapy first, followed by liver resection, and finally, primary tumor resection. The aim of this study was to assess the feasibility, the radiological and pathological tumor response to neoadjuvant therapy, recurrence rates and long-term survival after reverse treatment in a cohort study.

Methods

Data from patients with CRLM who underwent a reverse treatment from August 2008 to October 2016 were extracted from our prospective hepato-biliary database and retrospectively analyzed for response rates and survival outcomes. Radiological tumor response was assessed by RECIST (Response Evaluation Criteria In Solid Tumor) criteria and pathological response according to TRG (Tumor Regression Grade). Disease-free and overall survival were estimated with Kaplan-Meier survival curves.

Results

There were 44 patients with 19 rectal and 25 colonic tumors. The reverse treatment was fully completed until primary tumor resection in 41 patients (93%). Radiological assessment after chemotherapy showed 61% of complete/partial response. Pathological tumor response was major or partial in 52% of patients (TRG 1–3). Median disease-free survival after primary tumor resection was 10 months (95% CI 5–15 months). Disease-free survival at 3 and 5 years was 25% and 25%, respectively. Median overall survival was 50 months (95% CI 42–58 months). Overall survival at 3 and 5 years was 59% and 39%, respectively.

Conclusion

The reverse treatment approach was feasible with a high rate of patients with complete treatment sequence and offers promising long-term survival for selected patients with advanced simultaneous colorectal liver metastases.