bluuebunny/crossref_metadata_2025 huggingface dataset:
Estrogen and Progesterone Receptors in Colorectal Cancer and Surrounding Mucosa
Authors: Raigoso P. , Sanz L. , Vizoso F. , Llana B. , Quintela I. , Roibás A. , Vérez P. , García-Muñiz J.L.
Published: March 2018

In this prospective study we have quantified by means of ELISA-methods the cytosolic content of estrogen (ER) and progesterone receptors (PgR) in tumoral tissue and paired normal mucosa from 163 patients with resectable colorectal cancer. Survival analysis was performed in a subgroup of 120 patients and the mean follow-up period was 24.9 months. The cutoff for ER and PgR levels was set at 1 fmol/mg protein. On the basis of this cutoff 20.9% of the cancers were ER positive and 25.8% were PgR positive; normal adjacent tissue presented ER in 18.4% and PgR in 24.5%. Our results did not show any significant correlation between ER and PgR levels in neoplastic tissues. Howewer, a correlation was found in normal mucosa samples (p=0.02). Statistical analysis showed that there was no correlation between tumor ER and PgR content and patient age or sex, tumor location, Dukes’ stage, histological differentiation, DNA ploidy status and S-phase fraction. Furthermore, the results did not show any statistical differences in relapse-free and overall survival curves calculated for patients classified according to the hormone receptor content of their tumors.

ER and PgR were detected at low levels in normal and neoplastic colorectal tissues without any significant relationship to either clinicopathological tumor characteristics or patient outcome. Their possible role in colorectal cancer remains to be elucidated.
Serum Neutrophil Gelatinase-Associated Lipocalin in Patients with Colorectal Liver Metastases: Preliminary Results of An Exploratory Prospective Study
Authors: Martí Josep , Fuster Josep , Hotter Gina , Solà Anna M. , Deulofeu Ramón , Modolo Maria Marta , Loera Marco Antonio , Ferrer Joana , Fondevila Constantino , García-Valdecasas Juan Carlos
Published: March 2018

Purpose

To quantify preoperative serum neutrophil gelatinase-associated lipocalin (NGAL) levels in patients undergoing curative resection of colorectal liver metastases and to assess the relationship between NGAL levels and prognostic features in these patients.

Methods

From April 2005 to August 2007, 32 patients operated on for first curative resection of colorectal liver metastases underwent determination of preoperative serum NGAL. Patients were divided into four homogeneous clinical groups and into two risk groups based on their clinical risk scores. NGAL levels were corrected by simultaneous creatinine levels to avoid bias due to renal failure.

Results

Higher values of corrected NGAL levels (CNL) were found in patients of the high-risk group (94.53±56.18 vs 57.87±24.49, p=0.014). Patients with more than three tumor nodules had higher values of CNL compared to patients with three or fewer nodules (101.78±56.35 vs 58.57±27.24, p=0.008). Patients with disease involving both hepatic lobes had higher CNL levels than those with involvement of a single lobe (106.5±59.13 vs 59.01±26.69, p=0.005). Patients with higher clinical risk scores had significantly higher CNL.

Conclusions

CNL are associated with the considered prognostic clinical factors and scores, suggesting a possible role for CNL as a prognosis-related indicator and a neoplastic tissue volume marker in patients with colorectal liver metastases.
CA-549 Serum Levels in Breast Cancer Monitoring
Authors: Zamagni C. , Martoni A. , Cacciari N. , Bellanova B. , Vecchi F. , Pannuti F.
Published: March 2018

CA-549 serum levels were assessed in 288 patients, 156 with early breast cancer (after surgery) and 132 with advanced breast cancer.

CA-549 was abnormal (> 12 U/ml) in 25/156 patients (16%) without clinical signs of disease after surgery (median 9 U/ml), in 49/60 patients (82%) with disease in progression (P) (median 50 U/ml), in 19/27 patients (70%) with stationary disease (NC) (median 14 U/ml), in 25/33 patients (76%) with partial remission (PR) (median 18 U/ml) and in 4/12 patients (33%) with complete remission (CR) (median 9 U/ml).

CA-549 serum levels correlated mainly with the extent of disease and secondarily with the prevalent metastatic site, higher values being observed in patients with visceral involvement (median 32.5 U/ml). CA-549 serum levels were also assessed in 51 patients at the start of treatment and at the time of objective evaluation: the results underline the concordance of CA-549 behavior with the clinical outcome in 71% of the cases. We conclude that CA-549 is a useful marker for monitoring breast cancer patients during the advanced stages of the disease.
Evaluation of the Behavior of Carcinoembryonic Antigen in Cirrhotic Patients
Authors: Collazos J. , Genollà J. , Ruibal A.
Published: March 2018

Benign liver diseases are a cause of increased serum levels of CEA. We studied the behavior of CEA in 86 patients with liver cirrhosis who underwent extensive clinical and laboratory evaluation. We found abnormal CEA levels in 38.4% of the patients (28.6% Child's grade A, 40.6% Child's B, and 42.4% Child's C) with a mean of 4.75 ng/ml. Significant differences were found between patients and controls. There was a trend towards higher levels of CEA in more severe cirrhosis according to Child's classification, although this was not significant. We found significant correlations between CEA and some liver tests, including glycocholic acid (r = 0.264., p = 0.012), a marker of severity in liver diseases. The increase of CEA in these patients is probably due to alterations in its metabolic processing caused by hepatocellular dysfunction. Moderate elevations of serum CEA can be expected in cirrhotic patients independently of malignancy.
CA 549 and SP2 in postoperative breast cancer patients. Comparison with CA 15.3, CEA and TPA
Authors: Torres M. , Pacheco C. , Valverde A. , Rebollo A.C. , Moral A. , Vallejo J.A. , Mateo A.
Published: March 2018

The levels of CA 549 and SP2 were measured in 430 subjects: 100 healthy blood donors, 130 patients with benign diseases and 200 postoperative breast cancer patients. In the latter group, the serum levels of CA 15.3, CEA and TPA were also measured. The Kolmogorov-Smirnov, Mann Whitney and McNemar tests were used for statistical analysis. The upper normal limits were established on the basis of the values obtained in the healthy blood donors group, the benign diseases group and R.O.C. analysis of the breast cancer group. They were: CA 549 = 13 U/ml, SP2 = 14 U/ml, CA 15.3 = 35 U/ml, CEA = 5 ng/ml and TPA = 110 U/ml. The sensitivity, specificity and accuracy in the breast cancer group were, respectively: CA 549 = 78.1%, 97.1% and 88%; SP2 = 21.9%, 90.4% and 57.5%; CEA = 66.7%, 95.2% and 81.5%; CA 15.3 = 80.2%, 98.1% and 89.5%, and TPA = 73.9%, 78.8% and 76.5%. Statistical analysis showed significant differences only between CA 15.3, the marker which gave the best results, and SP2 (p<0.001). There were no significant differences with the association of two or three tumor markers.
Epidermal Growth Factor Receptor in Human Breast Cancer: Comparison with Steroid Receptors and other Prognostic Factors
Authors: Cerra M. , Cecco L. , Montella M. , Tuccillo F. , Bonelli P. , Botti G.
Published: March 2018

The relationship between epidermal growth factor receptor (EGFR) status and various prognostic factors was investigated in 70 human breast cancer specimens. Epidermal growth factor receptor was determined by radioligand binding assay, standardized by the EORTC Receptor Study Group, using hydroxyapatite to separate receptor-bound and free ligand. The percentage of EGFR positivity was 80% when the cutoff was set at 5 fmol/mg of membrane protein; this percentage was among the highest hitherto reported. Regression analysis of EGFR versus ER and PR levels confirmed an inverse relationship between EGFR and ER (p = 0.022) as well as between EGFR and PR (p = 0.024). Univariate analysis of the EGFR data stratified according to steroid hormone receptor status showed EGFR to be negatively associated with ER and PR. No association was found between EGFR and menopausal status, axillary lymph node involvement, tumor size, and differentiation grade. A direct association between EGFR status and Ki-67 positive cell rate could be demonstrated.
Third-Generation Psa: Ultrasensitive or Ultraprecise Assay?
Authors: Mione R. , Barichello M. , Sartorello P. , Leon A. , Barioli P. , Gion M.
Published: March 2018

The ultrasensitive PSA assay has been recently acknowledged as a useful tool for the monitoring of patients prostatectomized for prostatic cancer. We have evaluated a commercially available ultrasensitive PSA assay (Immulite Third Generation PSA - DPC - Los Angeles CA) in comparison with the routinely used PSA (Immulite PSA - DPC - Los Angeles CA). When evaluated with different approaches, the analytical sensitivity of ultrasensitive PSA ranged between 0.0029 and 0.0038 ng/ml. The biological detection limit was 0.0098 ng/ml. Dilution of samples with low PSA levels showed a good recovery (from 88 to 113%) up to 1:128 dilution factor (final PSA levels ranging from 0.004 to 0.016 ng/ml in different samples). The assay precision was excellent in the low dose range, the highest interassay interadjustment CV among replicates being 5.84% when assaying serum samples with PSA lower than 1.0 ng/ml.

Besides its role in the follow-up of prostatectomized patients, the evaluated ultrasensitive PSA could be reliably used for the detection of clinically meaningful PSA variations in the low dose range, and it could therefore be a candidate for the assessment of PSA velocity.
Neuron-Specific Enolase in Non-Neoplastic Lung Diseases, a Marker of Hypoxemia?
Authors: Szturmowicz M. , Burakowski J. , Tomkowski W. , Sakowicz A. , Filipecki S.
Published: March 2018

Neuron-specific enolase (NSE) is a glycolytic enzyme localized within neuronal and neuroendocrine tissues. Serum NSE is widely used as a marker of neuroendocrine tumors. Moderate serum NSE elevation has been reported in some patients with benign lung diseases. We decided to investigate whether the elevation of serum NSE in non-neoplastic lung diseases is connected with hypoxemia and to what extent the recovery of sufficient ventilation with a respirator may influence NSE concentrations. Serum NSE was estimated by means of radioimmunoassay in 83 patients with various non-neoplastic lung diseases. Serum NSE exceeding 12.5 μg/L was significantly more frequent in patients with marked hypoxemia (PaO2<6.67 kPa; p=0.03) than in others. The median NSE value in the group of patients without respiratory failure (Ro) was 7.2 μg/L (10% >12.5 μg/L), in the group of patients with respiratory failure not requiring mechanical ventilation (Rf) it was 8.5 μg/L (24%>12.5 μg/L), and in the group of patients with respiratory failure requiring mechanical ventilation (Rfv) 13.1 μg/L (60%>12.5 μg/L). The differences between the Rfv group and the other two groups (Rf and Ro) were significant (p=0.049 and p=0.0004, respectively). During successful mechanical ventilation elevated serum NSE decreased to values below the cutoff in 8/10 patients. We conclude that serum NSE elevation is a frequent event in patients with terminal hypoxemia in the course of benign lung diseases. Normalization of serum NSE is observed in the majority of patients during the first week of mechanical ventilation.
Immunometric Assays of Ras and c-erbB-2/Neu Overexpression in Breast Cancer: A Pilot Study
Authors: Pelizzola D. , Malagutti R. , Giovannini G. , Indelli M. , Carcoforo P. , Piffanelli A.
Published: March 2018

The expression of the ras and c-erbB2 oncoproteins (p21 and p185, respectively), together with estrogen receptor (ER) and progesterone receptor (PgR) determination, has been retrospectively analyzed in 68 primary breast carcinomas and in 19 normal breast tissue samples. The aims of this study were: a) to explore the association between ras and c-erbB2 expression; b) to evaluate the relationship between ras and c-erbB2 expression and both steroid receptor status and the classical clinical and pathological parameters; and c) to compare two different methods for p185 determination.

p185 and p21 were measured by enzyme immunoassay (EIA); p185 was also determined by Western blotting (WB); ER and PgR were assayed by radioligand binding assay. The highest value of p185 in benign breast lesions was used as the threshold to distinguish between positive and negative samples. With this threshold the c-erbB2 oncoprotein was overexpressed in 41.2% (with EIA) and in 50% (with WB) of cancer samples. The concordance rate between the two methods was 79.4. No significant association was found between p21 and p185 levels either in cancer or in normal breast tissue samples. Increasing levels of tumor p21 were associated with a shorter time to recurrence and overall survival. Increasing levels of p185 were associated with a significantly shorter time to recurrence (p185 EIA: p=0.04, p185 WB: p=0.029) and overall survival (p185 EIA: p=0.04, p185 WB: p=0.029).
Walt Disney Treasures or Mickey Mouse DVDs? Animatophilia, Nostalgia, and the Competing Representations of Theatrical Cartoon Shorts on Home Video
Authors: McGowan David
Published: March 2018

Theatrical-era short animation has often acquired a complex, even contradictory, textual identity: most cartoons were originally produced for a general audience, but were then marketed almost exclusively towards children as repeats on television. The rise of DVD has further complicated the status of these films. On the one hand, the format has facilitated the release of a lot of rare animated material, most notably within a series of multi-volume special editions entitled the Walt Disney Treasures, explicitly aimed at the previously marginalized adult viewer. However, Disney has also produced lower priced, ‘family friendly’ discs featuring many of the same cartoons. Unlike the Treasures volumes, the latter sets tend to censor problematic content and generally lack contextualizing bonus features. The choice to watch one of these collections over the other can thus have a significant impact upon one’s interpretation of the collected films. Thomas Elasasser argues that film culture – embodied most fervently by the devoted cinephile (and, for the purposes of this study, the equivalent figure of the animatophile) – has often failed to recognize itself as a product of generational memory. It is frequently implied by such groups that DVD special editions are the most ‘authentic’ because they privilege the original cinematic experience, without acknowledging the degree to which the format itself serves to remediate its contents. For instance, while the Treasures discs generally present the films uncut – sometimes ‘restoring’ footage unseen since the 1930s and 40s – these are often prefaced with mandatory disclaimers providing historical context for contentious elements such as racism. The sheer volume of material that these collections provide, including opportunities for binge-watching with ‘play all’ functions, similarly alters the portioned availability of these texts in the theatrical sphere. This article will suggest that both the special edition and ‘family friendly’ DVD options ultimately reflect a nostalgic struggle to appropriate and define the present and future reception of the films, rather than to truly reclaim the past.
Coercive, mimetic and normative: Interdiscursivity in Malaysian CSR reports
Authors: Rajandran Kumaran
Published: March 2018

Malaysian corporations have to disclose corporate social responsibility (CSR), and a typical genre for disclosure is CSR reports. These reports incorporate other discourses which indicate the presence of interdiscursivity. The article examines interdiscursivity in Malaysian CSR reports. It selects the CSR reports of 10 major corporations and pursues an interdiscursive analysis which involves four sequential stages. CSR reports contain discourses of public relations, sustainability, strategic management, compliance and financial accounting. Although the discourses are often multisemiotic, language maintains primacy in content, while image tends to exemplify or simplify content. These discourses constitute an interdiscursive profile, and it has central and auxiliary discourses. The central discourse is public relations discourse, and it promotes corporations helping and not harming society. The auxiliary discourses are sustainability, strategic management, compliance and financial accounting discourses, and these discourses mitigate the promotional focus. Interdiscursivity enables the primarily promotional CSR reports to not seem overtly promotional. The choice of discourses is probably influenced by coercive, mimetic and normative reasons. These discourses enhance the reliability of CSR reports because their disclosure is anchored to various CSR aspects, international or reporting practices and professional domains. Interdiscursivity helps to build stakeholders’ confidence in disclosure and, therefore, in corporations. It joins other functions in CSR reports to convey corporations as agents of positive social change. The article also probes the relationship between interdiscursivity and intertextuality and advances a matrix of intertextual–interdiscursive use.
The fourth industrial revolution: How the EU can lead it
Authors: Schäfer Matthias
Published: March 2018

The fourth industrial revolution is different from the previous three. This is because machines and artificial intelligence play a significant role in enhancing productivity and wealth creation, which directly changes and challenges the role of human beings. The fourth industrial revolution will also intensify globalisation. Therefore, technology will become much more significant, because regions and societies that cope positively with the technological impact of the fourth industrial revolution will have a better economic and social future. This article argues that the EU can play an important role in developing an environment appropriate for the fourth industrial revolution, an environment that is vibrant and open to new technologies. Member states would profit from an EU-wide coordinated framework for this area. The EU has to establish new common policies for the market-oriented diffusion and widespread use of new technologies.
Short-Term Radiographic Outcome After Distal Chevron Osteotomy for Hallux Valgus Using Intramedullary Plates With an Amended Algorithm for the Surgical Management of Hallux Valgus
Authors: Matsumoto Takumi , Gross Christopher E. , Parekh Selene G.
Published: March 2018

Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively. Correction of the hallux valgus angle averaged 17.8°, intermetatarsal angle 7.4°, distal metatarsal articular angle 2.7°, and sesamoid position 1.4 stages at 3 months postoperatively. The average lateral shift of the capital fragment was 6.5 mm. All patients achieved bone union, and there were no cases of dislocation, displacement, or avascular necrosis of the metatarsal head fragment. In conclusion, a distal Chevron osteotomy using an intramedullary plate was a favorable method for the correction of mild to moderate hallux valgus deformity.

Levels of Evidence: Level IV: Case series
Nucleoside analogs as a rich source of antiviral agents active against arthropod-borne flaviviruses
Authors: Eyer Luděk , Nencka Radim , de Clercq Erik , Seley-Radtke Katherine , Růžek Daniel
Published: March 2018

Nucleoside analogs represent the largest class of small molecule-based antivirals, which currently form the backbone of chemotherapy of chronic infections caused by HIV, hepatitis B or C viruses, and herpes viruses. High antiviral potency and favorable pharmacokinetics parameters make some nucleoside analogs suitable also for the treatment of acute infections caused by other medically important RNA and DNA viruses. This review summarizes available information on antiviral research of nucleoside analogs against arthropod-borne members of the genus Flavivirus within the family Flaviviridae, being primarily focused on description of nucleoside inhibitors of flaviviral RNA-dependent RNA polymerase, methyltransferase, and helicase/NTPase. Inhibitors of intracellular nucleoside synthesis and newly discovered nucleoside derivatives with high antiflavivirus potency, whose modes of action are currently not completely understood, have drawn attention. Moreover, this review highlights important challenges and complications in nucleoside analog development and suggests possible strategies to overcome these limitations.
Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials
Authors: Gong Wei , Li Aobo , Ai Hui , Shi Han , Wang Xiao , Nie Shaoping
Published: March 2018

Background

Early discharge after successful primary angioplasty is common, but the evidence supporting the practice is still lacking. We therefore performed a meta-analysis assessing the safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction (STEMI).

Methods

Randomised controlled trials were identified and extracted from PubMed, Embase, Cochrane Library databases and reference lists of relevant papers. Heterogeneity was analysed using the I2 test. If there was a lack of heterogeneity, fixed effects models would be used for the meta-analysis, otherwise random effects models were used. Statistical analyses were performed using Review Manager 5.3.

Results

Five randomised controlled trials involving 1575 STEMI patients met the criteria. Meta-analysis showed that the early discharge strategy group had a significantly shortened length of hospital stay compared to the conventional discharge strategy group (standardised mean difference −1.46, 95% confidence interval (CI) −2.04 to −0.88; P < 0.0001), and there was no difference in mortality and readmission rates between the two groups (risk ratio 0.78, 95% CI 0.50 to 1.22; P = 0.41).

Conclusions

The findings of this meta-analysis suggested that the early discharge strategy after successful primary angioplasty is safe among selected low-risk STEMI patients. A shorter hospital stay could benefit both the patients and the healthcare systems.
Two patients with rare mixed adenoneuroendocrine carcinomas of the rectum
Authors: Gül-Klein Safak , Sinn Marianne , Jurmeister Philipp Sebastian , Biebl Matthias , Weiß Sascha , Rau Beate , Bläker Hendrik , Pratschke Johann , Aigner Felix
Published: March 2018

Mixed adenoneuroendocrine carcinomas of the gastrointestinal tract are until today poorly understood and thus very challenging for interdisciplinary therapy. We herewith report the first case series of patients with a primary mixed adenoneuroendocrine carcinoma of the rectum. Both cases were initially diagnosed as adenocarcinoma and only secondarily with mixed adenoneuroendocrine carcinoma and had a poor outcome due to a rapid tumor progression and resistance to chemotherapy. A 65-year-old female presented with local tumor recurrence and hepatopulmonary metastasis 1 year after primary surgery for adenocarcinoma of the rectum and consecutive radiochemotherapy regimen. Fluorouracil (5-FU) was followed by bevacizumab- and capecitabine-based chemotherapy but had to be discontinued due to side effects and progressive disease. Progressive local pain syndrome accompanied by recurrent bleeding episodes led to a local tumor-debulking operation. Afterward, mixed adenoneuroendocrine carcinoma as the underlying diagnosis in the final histopathological examination was detected. The patient died 3 months after the operation in the context of a fulminant tumor progress. A 63-year-old male patient underwent neoadjuvant radiochemotherapy and laparoscopic rectum resection. After 5 months, postoperative oxaliplatin/capecitabine-based adjuvant chemotherapy was switched to carboplatin/etopsid due to a progressive polyneuropathy and biopsy-proven pulmonary metastasis. The patient then had to be switched to local radiation of cerebral metastases and Topotecan due to cerebral bleeding episodes but died 18 months after the initial diagnosis. In conclusion of our case series, mixed adenoneuroendocrine carcinomas of the rectum should be considered as a rare but aggressive tumor entity. An early and detailed histopathological diagnosis is required in order to establish an individual interdisciplinary treatment concept.
Comparison of erectile dysfunction guidelines between the UK (BSSM/NICE) and Europe (EAU)
Authors: Rai Jaskarn , Terry Tim
Published: March 2018

Erectile dysfunction is a common and often debilitating condition. The National Institute of Clinical Excellence (NICE) and the British Society of Sexual Medicine (BSSM) in the UK and the European Association of the Urology (EAU) have guidelines on the management of ED. This article will look at the similarities of the guidelines commenting where and how they differ.
A Province-wide, Cross-sectional Study of Demographics and Medication Use of Patients in Hemodialysis Units Across Ontario
Authors: Battistella Marisa , Jandoc Racquel , Ng Jeremy Y. , McArthur Eric , Garg Amit X.
Published: March 2018

Background:

Hemodialysis patients are at an increased risk of polypharmacy as they have the highest pill burden of all chronically ill patient populations, with an estimated average of 12 medications per day.

Objectives:

The aim of this study was to evaluate prescribing patterns of outpatient medications in patients receiving in-center hemodialysis. This was done to identify potential candidate medications for future quality improvement initiations to optimize prescribing.

Design:

We conducted a descriptive retrospective cross-sectional study in the province of Ontario, Canada, using several linked health care databases housed at the Institute for Clinical Evaluative Sciences (ICES).

Setting:

We considered outpatient medications dispensed to patients eligible for the Ontario Drug Benefit program.

Patients:

Patients were receiving chronic in-center hemodialysis at one of the 69 facilities in the province of Ontario, Canada as of October 1, 2013.

Measurements:

We assessed whether any of our 28 study medications of interest were recently dispensed (within the prior 120 days), the type of prescribing physician, and the associated medication costs. The 28 included medications of interest (ie, proton pump inhibitors, benzodiazepines) were selected because they may not have a true indication for dialysis patients and/or there are safety concerns with their use in this population. Results are presented as median (25th, 75th percentile).

Methods:

We conducted this study at ICES according to a prespecified protocol approved by the Research Ethics Board at Sunnybrook Health Sciences Centre (Toronto, Ontario).

Results:

A total of 3094 patients on chronic in-center hemodialysis received a study drug of interest (age: 76.5 years [SD: 7.3]), 44% women). Patients were dispensed 11 (8, 14) unique medication products with more than two-thirds of patients dispensed 9 or more different medications. The median number of annual health care visits was 7 (3-15) with more than half the cohort receiving prescriptions from 3 or more specialists. The 10 most commonly dispensed study medications cost more than 3 million dollars in direct costs in 1 year.

Limitations:

Our study was also subjected to some limitations of health care databases.

Conclusions:

Polypharmacy is frequent in in-center hemodialysis patients. To decrease polypharmacy and its associated negative outcomes, health care providers need to implement tools to optimize medication use and deprescribe medications that lack evidence for efficacy and safety in hemodialysis patients. Therefore, strategies to improve prescribing and discontinue ineffective medications warrant testing for better patient outcomes and reduced health care costs.
High Prevalence of Antibiotic-Resistant Otitis Media–Associated Bacterial Flora of Asymptomatic People Living with HIV at Morogoro Hospital, Tanzania
Authors: Mwambete Kennedy Daniel , Eulambius Mathias
Published: March 2018

Objectives:

The study aimed to determine the prevalence of otitis media (OM)-associated bacterial flora of asymptomatic people living with HIV (PLH) on antiretroviral therapy (ART) and assess antibiotic resistance profiles of the bacteria.

Methodology:

Ear secretion specimens were collected by syringe or cotton swabs. Isolated bacteria were subjected to antibiotic sensitivity tests.

Results:

Of 290 recruited PLH, 81.7% were females and 18.3% males; their CD4+ counts ranged from 0 to 1770. Staphylococcus aureus, Klebsiella pneumonia, and Escherichia coli were the predominant bacteria. High antibiotic resistance was detected on Streptococcus pyogenes and Streptococcus pneumoniae. The prevalence rate of OM-associated bacteria (OAB) was 93.4%, and majority of the bacteria were resistant to multiple antibiotics. Linear association between the prevalence of OAB with both duration of ART and CD4+ counts was observed.

Conclusion:

High prevalence rates of OAB and antibiotic resistance were observed. Negative correlation between CD4+ counts and prevalence of OAB was revealed.
Articular Cartilage Repair of the Knee in Children and Adolescents
Authors: Salzmann Gian M. , Niemeyer Philipp , Hochrein Alfred , Stoddart Martin J. , Angele Peter
Published: March 2018

Articular cartilage predominantly serves a biomechanical function, which begins in utero and further develops during growth and locomotion. With regard to its 2-tissue structure (chondrocytes and matrix), the regenerative potential of hyaline cartilage defects is limited. Children and adolescents are increasingly suffering from articular cartilage and osteochondral deficiencies. Traumatic incidents often result in damage to the joint surfaces, while repetitive microtrauma may cause osteochondritis dissecans. When compared with their adult counterparts, children and adolescents have a greater capacity to regenerate articular cartilage defects. Even so, articular cartilage injuries in this age group may predispose them to premature osteoarthritis. Consequently, surgery is indicated in young patients when conservative measures fail. The operative techniques for articular cartilage injuries traditionally performed in adults may be performed in children, although an individualized approach must be tailored according to patient and defect characteristics. Clear guidelines for defect dimension–associated techniques have not been reported. Knee joint dimensions must be considered and correlated with respect to the cartilage defect size. Particular attention must be given to the subchondral bone, which is frequently affected in children and adolescents. Articular cartilage repair techniques appear to be safe in this cohort of patients, and no differences in complication rates have been reported when compared with adult patients. Particularly, autologous chondrocyte implantation has good biological potential, especially for large-diameter joint surface defects.
Esterified lignins from Pinus caribaea as bentonite-dispersing agents
Authors: Delgado Nacarid , Ysambertt Fredy , Ochoa Raúl , Chávez Gerson , Bravo Bélgica , Santos Jorge , García Danny E.
Published: March 2018

Chemical modification of kraft lignin from Pinus caribaea (Sénécl.) W.H.G. was performed with cyclic anhydrides (succinic, maleic and glutaric) assisted by microwave radiation. Esterification of the lignin was proven by the mass increase and Fourier Transform Infrared (FTIR) spectroscopy. Aqueous suspensions of bentonite were prepared using unmodified lignin and the corresponding derivatives as dispersants. Suspensions were evaluated in term of stability, viscosity and dispersibility. The esterified derivatives showed better dispersing properties than the neat lignin because the derivatives-based suspensions were less viscous. The dispersing properties of lignin and the esterified derivatives were compared with those of a high-molecular-weight lignin fraction obtained by ultrafiltration. In addition, two commercial lignosulfonate dispersants commonly used for drilling muds were used as references. The high-molecular-weight esterified derivatives proved to be better dispersants than their unfractionated counterparts. In general, the esterified derivatives showed similar properties to those obtained with the commercial dispersants. Modified lignin based on succinic-, maleic- and glutaric-anhydride is expected to play a key role in the design of novel bio-based dispersants for drilling-mud applications.
Acute Complications After High-Dose Chemotherapy and Stem-Cell Rescue in Pediatric Patients With High-Risk Neuroblastoma Treated in Countries With Different Resources
Authors: Elzembely Mahmoud M. , Park Julie R. , Riad Khaled F. , Sayed Heba A. , Pinto Navin , Carpenter Paul A. , Baker K. Scott , El-Haddad Alaa
Published: March 2018

Purpose

High-dose chemotherapy with autologous stem-cell rescue (SCR) is a key component of high-risk neuroblastoma (HRNB) therapy. Carboplatin, etoposide, and melphalan (CEM) or busulfan and melphalan (Bu/Mel) are the most evaluated, effective high-dose chemotherapy for HRNB on the basis of results from major cooperative group studies. Toxicity profiles vary between these regimens, and practice variation exists regarding the preferred high-dose therapy (HDT). We sought to evaluate the safety of HDT and autologous SCR for HRNB in a resource-limited country (Egypt) compared with the resource-rich United States.

Patients and Methods

We performed a retrospective comparative review of single CEM-based HDT/SCR outcomes through day 100 for HRNB at the Fred Hutchinson Cancer Research Center (FH) in the United States (2005 to 2015) versus Bu/Mel-based HDT at El-Sheikh Zayed Specialized Hospital (SZ) in Egypt (2009 to 2015).

Results

Forty-four patients at FH and 77 patients at SZ were reviewed. Pretransplant hepatic comorbidities were significantly higher at SZ (29 of 77 v nine of 44; P = .05), with 19 of 77 patients at SZ having hepatitis infection. Engraftment was delayed after SZ-Bu/Mel therapy compared with FH-CEM therapy for neutrophils (median 12 days v 10 days, respectively; P < .001) and platelets (median 20 days v 18 days, respectively; P < .001). Sinusoidal obstruction syndrome occurred later, after SZ-Bu/Mel therapy (median 19 days v 7 days; P = .033), and four of eight cases were fatal (six of eight patients had underlying hepatitis infection), whereas three of three cases after FH-CEM therapy were moderately severe. Resource utilization associated with the number of days with fever, antibiotic use, and the number of transfusions administered was significantly higher after FH-CEM therapy than after SZ-Bu/Mel therapy.

Conclusion

Use of autologous stem-cell transplantation is feasible in the context of a resource-limited country.
The Anesthesiologist-Informatician: A Survey of Physicians Board-Certified in Both Anesthesiology and Clinical Informatics
Authors: Poterack Karl A. , Epstein Richard H. , Dexter Franklin
Published: March 2018

All 36 physicians board-certified in both anesthesiology and clinical informatics as of January 1, 2016, were surveyed via e-mail, with 26 responding. Although most (25/26) generally expressed satisfaction with the clinical informatics boards, and view informatics expertise as important to anesthesiology, most (24/26) thought it unlikely or highly unlikely that substantial numbers of anesthesiology residents would pursue clinical informatics fellowships. Anesthesiologists wishing to qualify for the clinical informatics board examination under the practice pathway need to devote a substantive amount of worktime to informatics. There currently are options outside of formal fellowship training to acquire the knowledge to pass.
Degradation of cyclin B is critical for nuclear division inTrypanosoma brucei
Authors: Hayashi Hanako , Akiyoshi Bungo
Published: March 2018

Kinetoplastids have a nucleus that contains the nuclear genome and a kinetoplast that contains the mitochondrial genome. These single-copy organelles must be duplicated and segregated faithfully to daughter cells at each cell division. In Trypanosoma brucei, although duplication of both organelles starts around the same time, segregation of the kinetoplast precedes that of the nucleus. Cytokinesis subsequently takes place so that daughter cells inherit a single copy of each organelle. Very little is known about the molecular mechanism that governs the timing of these events. Furthermore, it is thought that T. brucei lacks a spindle checkpoint that delays the onset of nuclear division in response to spindle defects. Here we show that a mitotic cyclin CYC6 has a dynamic localization pattern during the cell cycle, including kinetochore localization. Using CYC6 as a molecular cell cycle marker, we confirmed that T. brucei cannot delay the onset of anaphase in response to a bipolar spindle assembly defect. Interestingly, expression of a stabilized form of CYC6 caused the nucleus to arrest in a metaphase-like state without preventing cytokinesis. We propose that trypanosomes have an ability to regulate the timing of nuclear division by modulating the CYC6 protein level, without a spindle checkpoint.
Formation of COPI-coated vesicles at a glance
Authors: Arakel Eric C. , Schwappach Blanche
Published: March 2018

The coat protein complex I (COPI) allows the precise sorting of lipids and proteins between Golgi cisternae and retrieval from the Golgi to the ER. This essential role maintains the identity of the early secretory pathway and impinges on key cellular processes, such as protein quality control. In this Cell Science at a Glance and accompanying poster, we illustrate the different stages of COPI-coated vesicle formation and revisit decades of research in the context of recent advances in the elucidation of COPI coat structure. By calling attention to an array of questions that have remained unresolved, this review attempts to refocus the perspectives of the field.
Hand pressures during arboreal locomotion in captive bonobos (Pan paniscus)
Authors: Samuel Diana S. , Nauwelaerts Sandra , Stevens Jeroen M. G. , Kivell Tracy L.
Published: March 2018

Evolution of the human hand has undergone a transition from use during locomotion to use primarily for manipulation. Previous comparative morphological and biomechanical studies have focused on potential changes in manipulative abilities during human hand evolution, but few have focused on functional signals for arboreal locomotion. Here, we provide this comparative context though the first analysis of hand loading in captive bonobos during arboreal locomotion. We quantify pressure experienced by the fingers, palm and thumb in bonobos during vertical locomotion, suspension and arboreal knuckle-walking. Results show that pressure experienced by the fingers is significantly higher during knuckle-walking compared with similar pressures experienced by the fingers and palm during suspensory and vertical locomotion. Peak pressure is most often experienced at or around the third digit in all locomotor modes. Pressure quantified for the thumb is either very low or absent, despite the thumb making contact with the substrate during all suspensory and vertical locomotor trials. Unlike chimpanzees, the bonobos do not show a rolling pattern of digit contact with the substrate during arboreal knuckle-walking but, instead, digits 3 and 4 typically touch down first and digit 5 almost always made contact with the substrate. These results have implications for interpreting extant and fossilised hand morphology; we expect bonobo (and chimpanzee) bony morphology to primarily reflect the biomechanical loading of knuckle-walking, while functional signals for arboreal locomotion in fossil hominins are most likely to appear in the fingers, particularly digit 3, and least likely to appear in the morphology of the thumb.
Patient predictors of poor drug sensitive tuberculosis treatment outcomes in Kyiv Oblast, Ukraine
Authors: Aibana Omowunmi , Slavuckij Andrej , Bachmaha Mariya , Krasiuk Viatcheslav , Rybak Natasha , Flanigan Timothy P. , Petrenko Vasyl , Murray Megan B.
Published: March 2018

Background: Ukraine has high rates of poor treatment outcomes among drug sensitive tuberculosis (DSTB) patients, while global treatment success rates for DSTB remain high.    

We evaluated baseline patient factors as predictors of poor DSTB treatment outcomes.

Methods: We conducted a retrospective analysis of new drug sensitive pulmonary TB patients treated in Kyiv Oblast, Ukraine between November 2012 and October 2014. We defined good treatment outcomes as cure or completion and poor outcomes as death, default (lost to follow up) or treatment failure. We performed logistic regression analyses, using routine program data, to identify baseline patient factors associated with poor outcomes.

Results: Among 302 patients, 193 (63.9%) experienced good treatment outcomes while 39 (12.9%) failed treatment, 34 (11.3%) died, and 30 (9.9%) were lost to follow up. In the multivariate analysis, HIV positive patients on anti-retroviral therapy (ART) [OR 3.50; 95% CI 1.46 – 8.42; p 0.005] or without ART (OR 4.12; 95% CI 1.36 – 12.43; p 0.01) were at increased risk of poor outcomes. Frequent alcohol use (OR 1.81; 95% CI 0.93 - 3.55; p 0.08) and smear positivity (OR 1.75; 95% CI 1.03 - 2.97; p 0.04) were also associated with poor treatment outcomes.

Conclusions: High rates of poor outcomes among patients with newly diagnosed drug sensitive TB in Kyiv Oblast, Ukraine highlight the urgent need for programmatic interventions, especially aimed at patients with the highest risk of poor outcomes.
Repeated sessions of bilateral transcranial direct current stimulation on intractable tinnitus: a study protocol for a double-blind randomized controlled trial
Authors: Bayat Arash , Mayo Miguel , Rashidi Samaneh , Saki Nader , Yadollahpour Ali
Published: March 2018

Background: Transcranial Direct Current Stimulation (tDCS) is reportedly a potential treatment option for chronic tinnitus. The main drawbacks of previous studies are short term follow up and focusing on the efficacy of single session tDCS. This study aims to investigate the therapeutic efficacy, adverse effects (AEs) and tolerability of repeated sessions of bilateral tDCS over auditory cortex (AC) on tinnitus symptoms

Methods: This will be a double-blinded randomized placebo controlled parallel trial on patients (n=90) with intractable chronic tinnitus (> 2 years) randomly divided into three groups of anodal, cathodal, and sham tDCS. In the sham treatment, after 30 sec the device will be turned OFF without informing the patients. The tDCS protocol consists of 10 sessions (daily  20 min session; 2 mA current for 5 consecutive days per week and 2 consecutive weeks) applied through 35 cm2 electrodes. The primary outcome is tinnitus handicap inventory (THI) which will be assessed pre- and post-intervention and at one month follow-up. The secondary outcomes are tinnitus loudness and distress to be assessed using a visual analogue scale (VAS) pre-intervention, and immediately, one hour, one week, and one month after last stimulation. The AEs and tolerability of patients will be evaluated after each session using a customized questionnaire. Possible interactions between the disease features and treatment response will be evaluated.  

Discussion: To our knowledge this is the first study to investigate the effects of repeated sessions of tDCS on chronic tinnitus symptoms with one month follow-up. In addition, the AEs, and tolerability of patients will be studied. In addition, the possible interactions between the disease specific features including the hearing loss, laterality, type of tinnitus, and treatment response will be evaluated.  

Trial registration: The study has been registered as a clinical trial in Iranian Registry of Clinical Trial (IRCT2016110124635N6) on the 01/06/2017.
Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana
Authors: Ganyo Ebenezer Yaw , Boampong Johnson N , Masiga Daniel K , Villinger Jandouwe , Turkson Paa Kobina
Published: March 2018

Background: Animal trypanosomosis is a major cause of economic loss in livestock production in Africa. A suggested control measure is to use breeds with traits of trypanotolerance. The study examines the effect of natural Trypanosoma vivax challenge on haematological parameters in two trypanotolerant cattle [N’Dama and West African Short Horn (WASH)] herds.

Methods: T. vivax-specific primers were used to diagnose T. vivax infection in an N’Dama herd at Cape Coast in southern Ghana and a WASH herd at Chegbani in northern Ghana from May to July 2011 in a cross-sectional study. Levels of haematological parameters comprising packed cell volume (PCV), haemoglobin (Hb) concentration and total red blood cell (RBC) and white blood cell (WBC) counts; differential WBC counts (neutrophils, lymphocytes, eosinophils, monocytes and basophils); and RBC indices of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were determined in blood samples and then compared between infected and uninfected cattle.

Results: We found that haematological indices for infected and uninfected animals in both breeds were within the normal range. However, the mean PCV values for T. vivax-infected WASH and N’Dama were lower in infected compared to uninfected animals. The difference was significant (p< 0.05) in N’Dama but not in WASH. The RBC indices were higher in infected N’Dama compared to infected WASH with a significant difference in total RBC (p < 0.05).

Conclusion: We conclude from our findings that despite the presence of infection by T. vivax, N’Dama and WASH cattle maintained their haematological parameters within acceptable normal ranges, and this underscores the need for routine diagnosis and treatment so that such trypanotolerant cattle do not serve as potential reservoirs of trypanosome parasites.
Insects in the forest biocenoses of Kamchatka
Authors: Сметанин Анатолий , Smetanin Anatoliy
Published: March 2018

The regional fauna of insects from different taxonomical groups living in forest ecosystems of Kamchatka is described, where the stable consortium around the main tree species with the participation of insects was formed. Food specialization, biotic connections, participation and role of insects in forest biocenoses are shown. Insects-pests of forest plantings are described. For biologists, entomologists, ecologists, forestry specialists.