bluuebunny/crossref_metadata_2025 huggingface dataset:
Cistopessi mediante rete in polypropylene
Authors: Pierini P. , Croci A. , Bertolin R. , Thiébat P. , Allegri C.
Published: November 2018

Surgical therapy of serious cystocele must aim at restoring the area of support of the aponeurotic-muscular sheet of the pelvic floor and, if necessary, the supporting ligaments (round, utero-sacral). However it is not always easy to carry out this therapy, especially in the case of patients who have already been operated on using more or less complicated procedures. In such cases it is important to “limit the damage” i.e. to resolve the symptomatology without perfect anatomical correction, rather than undertake complex procedures which might be destined to fail or result in painful, dysuric symptomatology. With this aim in mind a simple operation is proposed which, on its own or combined with a hysterectomy with stabilizing of the vaginal cupola, depending on the case, has always obtained the desired results. The technique is that of putting a polypropylene mesh between the vagina and bladder.
Modello interdisciplinare nella diagnosi andrologica
Authors: Pagliano G.L. , Cerrato M.T. , Ferrando U. , Paia S. Ramella , Puleo V.
Published: November 2018

The Authors report on their experience in the evaluation of andrological disorders. The interdisciplinary approach, combining medical and psychological specialisations, leads to a diagnosis which integrates various elements and clinical data, so that a correct therapeutic programme may be set up based on effective needs while taking into account the personal resources on which the patient can draw. The Authors comment on some data resulting from their work method, reflecting on their utility in routine diagnosis and therapy.
Il predeposito di sangue nella prostatectomia radicale
Authors: Rossi G. , Fini M. , Marzocchi M. , Misuriello G. , Monti E. , Passardi C.A. , Perrone G.A. , Vagliani G.F.
Published: November 2018

The authors have carried out a retrospective analysis of all patients who underwent radical prostatectomy during the last 3 years, to evaluate autologous blood predeposit in urological surgery. Even if all the patients underwent preoperative blood predeposit and on average 2.45 units were collected per patient, the patients transfused with homologous blood were 41.6%. To reduce the percentage of patients who are transfused with homologous blood, the authors believe that, accepting a haemoglobin threshold value of 11 g/dl in the immediate preoperative stage and through a blood letting programme, which respects the physiological time for the organism's recovery, it is possible to reach the goal of 4 bleedings in selective urological surgery. In this study, 4 units of autologous blood predeposit on average are able to cover 60% of the estimated losses.
Fattori prognostici clinici nel carcinoma prostatico localizzato: Clinical prognostic factors in localised prostatic carcinoma
Authors: Bono A.V. , Giussani L. , Vio P.
Published: November 2018

An analysis has been made of the clinical prognostic factors of localised prostatic cancer (stages A, B and C) in 108 patients, who underwent radical prostatectomy and have a recorded follow-up. Results show that age, urological symptoms, performance status and basal testosterone cannot be used for prognosis. Only creatinine, among the biohumoral tests, was at a statistically significant level, which could be explained by obstructions during progression of the disease. This study has shown that PSA can be considered of prognostic value and can be correlated to the clinical and pathological stage; it is predictive in stage C with basal PSA > 10. The volume of the primitive neoplasm related to the T category gives both a clinical and histopathological classification; local extension of the disease is a significant clinical factor. Lastly, grading according to Mostofi indicates progression of disease in direct proportion to the degree of differentiation.
Il follow-up longitudinale del paziente sottoposto a screening per carcinoma prostatico: Follow-up of patients submitted to screening for prostate cancer
Authors: Fini M. , Vagliani G.F. , Perrone A. , Salvi G.C. , Misuriello G. , Di Silverio A.
Published: November 2018

Early-stage prostate cancer is usually asymptomatic and therefore, in the past, has often gone undetected, unless diagnosed by a digital rectal examination. Recently, in order to improve the detection of early stage disease, new tests have been introduced, namely prostate specific antigen and transrectal ultrasound. Considerable debate exists not only about the usefulness of the screening but also about the routine use of these tests. In this article the features of these tests, single or in combination are discussed, and how to perform follow-up of the patient already submitted to screening for prostatic carcinoma.
Effetto terapeutico degli LH-RH analoghi nei pazienti con IPB inoperabili portatori di catetere a dimora: LH-RH analogs in patients with urinary retention due to BPH carrying an indwelling catheter
Authors: Brausi M.
Published: November 2018

From March to December 1991, 10 patients with BPH and urinary retention, not elegible for surgery were treated with Leuprolide at the Department of Urology of B. Ramazzini Hospital in Carpi. The drug was administered subcutaneously or i.m. every 30 days for at least 12 months. The average number of injections was 5. All the patients could void spontaneously after 1-2 injections of the drug. The prostate volume was controlled by digital palpation and rectal ultrasound. A reduction in volume of 25% was observed after 3 months on transrectal ultrasound. PSA was determined and controlled in 5 patients only. All the patients had a decreased PSA value after administration of the drug. No important side effects were observed in the study. We believe that LH-RH injection is a useful therapy in patients with BPH and urinary retention, who are not candidates for surgery.
I nuovi supporti audiovisivi e la didattica interattiva: New audiovisual media and interactive teaching
Authors: Abbolito A.
Published: November 2018

Over the last few years technological development has given the doctor a complete new set of instruments for diagnosing and treating patients, but they have not yet been used for teaching purposes. The author describes the advantages of interactive didactics and then lists the new audiovisual media suitable for teaching, plus their main features. Lastly a new method of teacher-class interaction is presented, which uses radio-frequency responders and special software.
La citogenetica e la genetica molecolare nella prognosi del carcinoma della vescica: Cytogenetics and molecular genetics in bladder carcinoma prognosis
Authors: D'Amico A. , Ficarra V. , Mastroeni F. , Caleffi G. , Porcaro A. , Schiavone D. , Mobilio G.
Published: November 2018

The use of cytogenetics in the characterization of bladder tumours has made it possible to demonstrate that chromosomal alterations are correlated with stage and grade of the tumour and have a predictive value as regards both tumour recurrences and progression. In the last decade the chromosomes involved in the main aberrations have been identified, and a negative prognostic significance has been suggested for some chromosomal aberrations. The knowledge of cytogenetics has been deepened by the sophisticated methods of molecular genetics, that have discovered many oncogenes and suppressor genes probably involved in the development of bladder tumours. The most characteristic molecular alterations of these tumours are losses of genetic information on chromosomes 9, 11 and 17, as a consequence of deletions and/or mutations. Such alterations probably cause the loss and/or the inactivation of suppressor genes (partly hypothetic still) and could represent important predictive factors of tumour progression.
Epidemiology and relationship with transitional bladder cancer
Authors: Lozzi C. , Annoscia S. , Boccafoschi C.
Published: November 2018

— After a brief description of the various and most frequent histological kinds of neoplasms of the upper urinary tract, the Authors report on the recognised and hypothetical risk factors such as Balkan nephropathy, phenacetin nephropathy, thorotrast, chemical substances, smoke etc. They then examine the relationship between upper urinary tract transitional cancer and bladder cancer. They stress the difference between the incidence of upper urinary tract transitional cancer after a bladder cancer (very low, about 2.7%) and the incidence of bladder cancer after an upper urinary tract transitional cancer (very high, about 28%). Finally they examine some prognostic factors such as grading, staging, the relevance of cytology, positive nodes and hydronephrosis.
Endourological treatment of transitional cell tumours of the upper urinary tract
Authors: Tasca A. , Zattoni F. , Levorato C.A.
Published: November 2018

— 30 patients with transitional cell tumour of the upper urinary tract (TCTUT) underwent endourological treatment in our Institute in the last 10 years. 8 patients were submitted to percutaneous electroresection of a tumour of the renal pelvis, which was followed in 4 of them by endocavitary chemo or immunotherapy. The remaining 22 patients with tumour involving the renal pelvis (2 cases), the ureter (18 cases) and both the renal pelvis and the ureter (2 cases) were treated using electroresection, forceps removal or laser irradiation during transurethral ureterorenoscopy. The 5-year disease-free survival rate (DFS) was 27% and appeared to be lower than that of a comparable series of patients who underwent conservative open surgery. Moreover 5-year DFS was significantly higher for the patients with tumours of the renal pelvis compared to those with tumours of the pelvic ureter. Our experience confirms the feasibility of the endourological approach to TCTUT in selected cases. A rigid follow-up is suggested for the patients with a tumour involving the pelvic ureter.
Topical chemo-immunotherapy in upper urinary tract transitional cell carcinomas
Authors: Bassi P. , Abatangelo G. , Piazza N. , Oliva G.
Published: November 2018

— Intracavitary chemo or immunotherapy for upper urinary tract transitional cell carcinomas has been recently introduced. From published data, Bacillus Calmette-Guerin appears to give significant and durable response rates (70% as prophylaxis, 81% as therapy) with acceptable side effects. The anecdotal use of chemotherapeutical agents prevents any conclusion being made about the therapeutical impact. To date, intracavitary percutaneous Bacillus Calmette-Guerin treatment is suggested for patients with “in situ” or occult carcinoma of the upper urinary tract, bilateral and synchronous tumors and/or with severe renal failure or not suitable for radical surgery.
Vesico-puborectalis reflex. Description of a new reflex and its clinical significance. Preliminary report
Authors: Shafik A.
Published: November 2018

This paper reports a new reflex which I call “vesico-puborectalis reflex” and which was studied in 18 healthy volunteers with an average age of 43.2 years. The technique comprised the introduction of a balloon-tipped catheter into the empty urinary bladder. A concentric needle electrode was introduced into the puborectalis muscle. The vesical balloon was inflated with air in increments of 50 ml and the puborectalis myoelectric activity was recorded by a standard EMG apparatus. The vesical balloon was then removed and the puborectalis EMG response to suprapubic vesical compression was recorded while the urinary bladder was empty and while it was filled with saline in increments of 50 ml. Vesical balloon distension evoked puborectalis contraction provided the inflated volume was above 50 ml of air. The duration of puborectalis contraction increased with increased vesical distension. The reflex puborectalis response did not occur when the muscle was anesthetized. The latency of the reflex was calculated. Suprapubic manual compression evoked puborectalis contraction with both a full urinary bladder and sudden compression. The vesico-puborectalis reflex seems to play an important role in urinary continence. The puborectalis contracts reflexly upon increased vesical distension or sudden compression of a full bladder. It thus guards against involuntary leak of urine. Detectable changes in latency, amplitude or duration of the evoked response would indicate a defect in the reflex pathway. The vesico-puborectalis reflex could thus be included as an investigative tool in the study of micturition disorders.
Laparoscopic nephrectomy: Our personal experience on 39 cases
Authors: Breda G. , Silvestre P. , Gherardi L. , Xausa D. , Tamai A. , Giunta A.
Published: November 2018

The authors, six years after the first laparoscopic nephrectomy by Clayman and five years after their own first case in Italy, review the literature and their personal experience in 39 cases. In their opinion, today's situation can be summed up by the conclusion that laparoscopic nephrectomy for benign disease is a safe, reproducible, cost-effective procedure and can be recommended as the procedure of choice for young ladies with a small, afunctional kidney. The same is not true for malignant diseases which, in the authors’ opinion, must be a matter for prospective, randomised and well-controlled clinical trials in reference centres.
Aspetti economici nella chirurgia urologica dell'anziano: Economical aspects of urological surgery in the elderly
Authors: Fini M. , Perrone A. , Misuriello G. , Salvi G.C. , Vagliani G.F. , Di Silverio A.
Published: November 2018

To assess whether urological surgery in the elderly involves a significant increase in expenses, the consumption of resources was analysed (days of hospitalisation, request for intermediate services, greater request for integrative care, longer operation times, etc.) for patients not yet 70 years old, aged between 70 and 75 and lastly the over-75s who were operated in 1996 in the authors’ unit. Data show that urological surgery in the elderly leads to no greater use of the above resources.
La neoplasia renale parenchimale nell'anziano: Renal cell carcinoma in the elderly
Authors: Caramuta U. , Bianco S. , Milocani M.L. , Maganja C. , Bianchi G.
Published: November 2018

This study examines the cases of 49 patients with renal carcinoma, all aged over 75 years old, who underwent nephrectomy. Data regarding the post-operative period, the morbility and death rare connected with the operation and the neoplasm were assessed and compared with those of a control group. It has been concluded that age is not an absolute contraindication and nor are the associated pathologies. The pre and post-operative management of the patient is, however, important.
La fibrosi retroperitoneale idiopatica: Terapia laparoscopica: Idiopathic retroperitoneal fibrosis: Laparoscopic treatment
Authors: Bianchi G. , Beltrami P. , Giusti G.
Published: November 2018

The experience reported in literature on laparoscopic ureterolysis is reviewed. Patients currently treated by this procedure are limited due to the low number of cases which are eligible and the difficult technique the procedure entails. In the pilot centres where laparoscopy is routine, laparoscopic ureterolysis has given excellent results. Advantages over open surgery include low invasiveness and a rapid return to normal activity.
Comparison of Clostripain and Neutral Protease as Supplementary Enzymes for Human Islet Isolation
Authors: Brandhorst Heide , Johnson Paul R. , Mönch Johanna , Kurfürst Manfred , Korsgren Olle , Brandhorst Daniel
Published: November 2018

Although human islet transplantation has been established as valid and safe treatment for patients with type 1 diabetes, the utilization rates of human pancreases for clinical islet transplantation are still limited and substantially determined by the quality and composition of collagenase blends. While function and integrity of collagenase has been extensively investigated, information is still lacking about the most suitable supplementary neutral proteases. The present study compared islet isolation outcome after pancreas digestion by means of collagenase used alone or supplemented with either neutral protease (NP), clostripain (CP), or both proteases. Decent amounts of islet equivalents (IEQ) were isolated using collagenase alone (3090 ± 550 IEQ/g), or in combination with NP (2340 ± 450 IEQ/g) or CP (2740 ± 280 IEQ/g). Nevertheless, the proportion of undigested tissue was higher after using collagenase alone (21.1 ± 1.1%, P < 0.05) compared with addition of NP (13.3 ± 2.2%) or CP plus NP (13.7 ± 2.6%). Likewise, the percentage of embedded islets was highest using collagenase only (13 ± 2%) and lowest adding NP plus CP (4 ± 1%, P < 0.01). The latter combination resulted in lowest post-culture overall survival (42.7 ± 3.9%), while highest survival was observed after supplementation with CP (74.5 ± 4.8%, P < 0.01). An insulin response toward glucose challenge was present in all experimental groups, but the stimulation index was significantly decreased using collagenase plus NP (2.0 ± 0.12) compared with supplementation with CP (3.16 ± 0.4, P < 0.001). This study demonstrates for the first time that it is possible to isolate significant numbers of human islets combining collagenase only with CP. The supplementation with CP is an effective means to substantially reduce NP activity, which significantly decreases survival and viability after culture. This will facilitate the manufacturing of enzyme blends with less harmful characteristics.
Educational Technology in India: The Field and Teacher’s Sensemaking
Authors: Miglani Neha , Burch Patricia
Published: November 2018

The educational technology (EdTech) is being viewed as one of the hopes for failing government schools in India. Huge investments are being made in EdTech by the market, philanthropies and the government, and several organisations are partnering in order to improve student learning outcomes and teachers’ instruction. This article is an attempt to understand this phenomenon from the vantage point of teachers’ work. We use the theoretical lens of the new institutionalism in organisational analysis for broadly mapping the EdTech field, as well as understanding how teachers make sense and purpose of EdTech in their classrooms. We argue that investigating the phenomenon in its macro form, while important in itself, significantly informs the study of individual EdTech implementations.
The relationship between chemokines CCL2, CCL3, and CCL4 with the tumor microenvironment and tumor-associated macrophage markers in colorectal cancer
Authors: De la Fuente López Marjorie , Landskron Glauben , Parada Daniela , Dubois-Camacho Karen , Simian Daniela , Martinez Maripaz , Romero Diego , Roa Juan Carlos , Chahuán Isidora , Gutiérrez Rocío , Lopez-K Francisco , Alvarez Karin , Kronberg Udo , López Sebastian , Sanguinetti Antonella , Moreno Natalia , Abedrapo Mario , González María-Julieta , Quera Rodrigo , Hermoso-R Marcela A
Published: November 2018

A complex network of chemokines can influence cancer progression with the recruitment and activation of hematopoietic cells, including macrophages to the supporting tumor stroma promoting carcinogenesis and metastasis. The aim of this study was to investigate the relation between tissue and plasma chemokine levels involved in macrophage recruitment with tumor-associated macrophage profile markers and clinicopathological features such as tumor–node–metastases stage, desmoplasia, tumor necrosis factor-α, and vascular endothelial growth factor plasma content. Plasma and tumor/healthy mucosa were obtained from Chilean patients undergoing colon cancer surgery. Chemokines were evaluated from tissue lysates (CCL2, CCL3, CCL4, CCL5, and CX3CL1) by Luminex. Statistical analysis was performed using Wilcoxon match-paired test ( p  < 0.05). Macrophage markers (CD68, CD163, and iNOS) were evaluated by immunohistochemistry samples derived from colorectal cancer patients. Correlation analysis between chemokines and macrophage markers and clinicopathological features were performed using Spearman’s test. Plasmatic levels of chemokines and inflammatory mediators’ vascular endothelial growth factor and tumor necrosis factor-α were evaluated by Luminex. Tumor levels of CCL2 (mean ± standard deviation = 530.1 ± 613.9 pg/mg), CCL3 (102.7 ± 106.0 pg/mg), and CCL4 (64.98 ± 48.09 pg/mg) were higher than those found in healthy tissue (182.1 ± 116.5, 26.79 ± 22.40, and 27.06 ± 23.69 pg/mg, respectively p < 0.05). The tumor characterization allowed us to identify a positive correlation between CCL4 and the pro-tumor macrophages marker CD163 ( p  = 0.0443), and a negative correlation of iNOS with desmoplastic reaction ( p  = 0.0467). Moreover, we identified that tumors with immature desmoplasia have a higher CD163 density compared to those with a mature/intermediated stromal tissue ( p  = 0.0288). Plasmatic CCL4 has shown a positive correlation with inflammatory mediators (tumor necrosis factor-α and vascular endothelial growth factor) that have previously been associated with poor prognosis in patients. In conclusion High expression of CCL4 in colon cancer could induce the infiltration of tumor-associated macrophages and specifically a pro-tumor macrophage profile (CD163+ cells). Moreover, plasmatic chemokines could be considered inflammatory mediators associated to CRC progression as well as tumor necrosis factor-α and vascular endothelial growth factor. These data reinforce the idea of chemokines as potential therapeutic targets or biomarker in CRC.
Two Rapid Screens for Detecting Probable Post-Traumatic Stress Disorder and Interpersonal Violence Exposure: Predictive Utility in a Juvenile Justice Sample
Authors: Grasso Damion J. , Doyle Christine , Koon Ron
Published: November 2018

The Trauma-Related Symptoms and Impairment Rapid Screen (TSIRS) and the Dimensions of Violence Exposure Rapid Screen (DVERS) are two new tools designed to detect traumatic stress symptoms and high-risk characteristics of trauma exposure. Each screen contains 10 yes-or-no questions and is estimated to take approximately 2 min to complete. The rapid screens were developed to address the demand for efficient, effective, and user-friendly tools for use in settings where universal screening of trauma and related symptoms is recommended, but training and expertise in clinical assessment are generally lacking or absent. The purpose of the current study was to examine the predictive utility of the TSIRS and DVERS in detecting probable post-traumatic stress disorder and poly-victimization assessed via a validated self-report instrument. Data were collected on a sample of 218 detained adolescents. Results provide initial support for the predictive utility of the TSIRS and DVERS in a justice-involved sample.
Cultural and Individual Barriers to Palliative Care From Different Angles: Data Triangulation in Practice
Authors: Migala Silke , Flick Uwe
Published: November 2018

When a disease turns terminal, end-of-life care replaces questions of cure and healing. Patients and relatives face the transition from health care to end-of-life care and the decision for a type of care (family, hospital, hospice). When people with a specific cultural background tend not to use available institutional support, the question of barriers and their location should be raised. In a study, patients, relatives, and service providers were asked about such barriers in the access of palliative care for Russian-speaking immigrants in Germany. Barriers in the health care system and in the possible clients’ individual or cultural backgrounds and their diverging or overlapping perceptions as well as interpretive patterns of using hospices could be identified. This article demonstrates for what we need data in analyzing cultural and individual decision dilemmas in Neo-Liberal Times in the encounter of diverse cultural values for improving service situations.
Beyond the numbers: Social and emotional benefits of participation in the Imagination Library home-based literacy programme
Authors: Neyer Sara L , Szumlas Gregory A , Vaughn Lisa M
Published: November 2018

As home-based literacy programmes proliferate, stakeholders are asking for evidence that programme goals are being met and for information on what types of programming provide the best cost-to-benefit ratio. Most programmes analyse impact on learning through objective measures such as test scores and academic performance, but neglect to investigate further reaching benefits of their programmes. This qualitative study explores parent perceptions of the social and emotional benefits of participating in Dolly Parton’s Imagination Library (DPIL) home-based literacy programme. Interviews with 17 families in the programme revealed four key findings: (1) multiple members of families use and benefit from the books; (2) families take great pride in building their libraries; (3) families in the DPIL programme strongly associate reading with learning and academic success; and (4) the DPIL programme helps families build traditions and routines around reading. The social and emotional benefits of receiving books through this programme go far beyond cognitive and academic impact for the enrolled child and extend to the entire family.
Hidden voices: an interpretative phenomenological analysis of the experience of surviving breast cancer in Saudi Arabia
Authors: ALmegewly Wafa , Gould Dinah , Anstey Sally
Published: November 2018

Background

Women with breast cancer often have difficulties in making sense of and understanding their experiences, specifically the ways in which cultural sensitivities impact on and shape their lifeworlds.

Aims

The aim of this study is to explore the experience of being a breast cancer survivor in Saudi Arabia.

Methods

Qualitative, in-depth, semi-structured interviews were conducted with 18 Saudi breast cancer survivors aged between 30 and 50 years who had finished treatment 6–47 months before data collection. The data were transcribed verbatim, translated from Arabic into English and analysed using interpretative phenomenological analysis.

Results

Three themes emerged: the meaning of cancer; hidden survival; and the cultural meaning of survival. For women in Saudi, breast cancer has a cultural stigma linked to death. It changes the sense of self and of society, leading some women to hide their diagnosis from the public and their families. The meaning of survival in a Muslim context has a cultural and religious base, linked to God's will, normality and resumption of activities.

Conclusions

The study helps give Saudi women a ‘voice’ through the understanding of their experiences of surviving breast cancer. The unique cultural perspectives provide new insights, which can guide healthcare practice and inform the development of programmes to support women who survive breast cancer.
Fostering Share&Charge through proper regulation
Authors: Vanrykel Fanny , Ernst Damien , Bourgeois Marc
Published: November 2018

This article studies the emergence of Share&Charge, a German platform that organizes the sharing of charging stations for electric vehicles (EVs) and the billing for the energy transactions. Share&Charge follows a peer-to-peer fashion, enabling direct transactions between charging station owners and EV drivers. On the demand side, the platform, with its interactive map, makes it possible for EV owners to find a charging station in the most suitable location, for instance, at their place of work or where they live. On the offer side, Share&Charge enables station operators (private individuals or companies) to rent their charging stations and eventually to sell the electricity they produce. Charging tariffs within the charging station network are determined by the charging station operators themselves, but the platform provides indicative tariffs. Launched in September 2017, Share&Charge follows other initiatives, such as the French platforms Wattpop and ChargeMap, and the Swedish Elbnb. Share&Charge’s network is already proven to be successful with German citizens.

Share&Charge adds certain elements of value at different stages of EV utilization. First, this model allows for a co-financing of charging infrastructures by individuals and businesses in the private sector by sharing the infrastructure costs among EV drivers. Besides the purchase price of EVs, the implementation of charging infrastructures and their financing represent a significant barrier to the rise of e-mobility. Share&Charge helps remove this obstacle without adding a further burden on the governmental budget. In addition, this approach follows the “user pays principle,” which engages in fair and effective financing. Second, the platform increases decentralized production value and facilitates its expansion. It also helps in avoiding grid congestion and energy loss, as well as increasing flexibility within the electricity market. Third, data use enables the optimization of energy demand and supply, and the optimal determination of tariffs, although these remain facultative. Models like Share&Charge could thus positively impact energy policy by tackling several upcoming obstacles associated with the development of EVs and decentralized energy production capacities. However, new forms of network structures (decentralized networks, sharing economy) and new actors (prosumers, platforms, etc.) also raise regulatory challenges. This article presents some of the legal issues associated with the development of models like Share&Charge. In particular, we study the tax framework applicable to this model, assuming that as such, it would be introduced into the Belgian market.
Late onset cardiac cirrhosis and portal hypertensive ascites after atrial fibrillation ablation
Authors: Fong Tse‐Ling , Fong Michael , Shinbane Jerold , Starnes Vaughn , Van Herle Helga
Published: November 2018

Pulmonary vein stenosis is a potential complication following catheter ablation of atrial fibrillation (AF). We report the case of a patient with refractory ascites late after multiple catheter ablation procedures for AF. This is the first case report of portal hypertensive ascites due to acquired multiple pulmonary vein stenoses resulting in pulmonary hypertension (PH) and cardiac cirrhosis late after AF ablation. Despite extensive surgical reconstruction of the affected pulmonary veins, the patient has PH and right heart failure with persistent ascites and lower extremity edema.
Right ventricular function in infants with bronchopulmonary dysplasia and pulmonary hypertension: a pilot study
Authors: Blanca Arabella J. , Duijts Liesbeth , van Mastrigt Esther , Pijnenburg Marielle W. , Ten Harkel Derk‐Jan D. , Helbing Willem A. , Bartelds Beatrijs , Reis Irwin , Koopman Laurens P.
Published: November 2018

Premature birth and bronchopulmonary dysplasia (BPD) are risk factors for the development of echocardiographic signs of pulmonary hypertension (PH) and are associated with changes in cardiac structure and function. It is unclear whether this association persists beyond early infancy. The aims of this study are to prospectively investigate the prevalence of PH in children with severe BPD and to investigate the effect of BPD and PH on myocardial structure and function at six months corrected age. Preterm infants (gestational age ≤ 32 weeks) with severe BPD were included. Echocardiography was used to define PH and to measure speckle tracking derived longitudinal and circumferential strain of the left ventricle (LV) and right ventricle (RV). Sixty‐nine infants with a median (interquartile range [IQR]) gestational age of 25.6 (24.9–26.4) weeks and a median birthweight of 770 (645–945) gram were included. Eight (12%) infants had signs of PH at six months corrected age. RV fractional area change was lower in infants with severe BPD and PH at six months compared to infants without PH (35% ± 9% vs. 43% ± 9%, P = 0.03). RV mean longitudinal systolic strain was lower in infants with severe BPD and PH compared to infants without PH (17.6% [−19.5%/−16.1%] vs. −20.9% [−25.9%/−17.9%], P = 0.04). RV size and LV longitudinal and circumferential strain in children with BPD with or without PH were similar. Signs of PH were found in 12% of infants with severe BPD at six months corrected age and the presence of PH is associated with reduced RV systolic function.
Editor’s Choice- Reperfusion cardiac arrhythmias and their relation to reperfusion-induced cell death
Authors: van der Weg Kirian , Prinzen Frits W , Gorgels Anton PM
Published: November 2018

Reperfusion does not only salvage ischaemic myocardium but can also cause additional cell death which is called lethal reperfusion injury. The time of reperfusion is often accompanied by ventricular arrhythmias, i.e. reperfusion arrhythmias. While both conditions are seen as separate processes, recent research has shown that reperfusion arrhythmias are related to larger infarct size. The pathophysiology of fatal reperfusion injury revolves around intracellular calcium overload and reactive oxidative species inducing apoptosis by opening of the mitochondrial protein transition pore. The pathophysiological basis for reperfusion arrhythmias is the same intracellular calcium overload as that causing fatal reperfusion injury. Therefore both conditions should not be seen as separate entities but as one and the same process resulting in two different visible effects. Reperfusion arrhythmias could therefore be seen as a potential marker for fatal reperfusion injury.
Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates
Authors: Senard Olivia , Bouchand Frédérique , Deconinck Laurene , Matt Morgan , Fellous Lesly , Rottman Martin , Perronne Christian , Dinh Aurélien , Davido Benjamin
Published: November 2018

Introduction:

Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice.

Methods:

We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance.

Results:

The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% ( n = 30/31) at day 30 and of 81.2% ( n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively ( p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up.

Conclusion:

In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy.
Growth Factor Receptors in Hematopoietic Stem Cells: EPH Family Expression in CD34+ and CD133+ Cell Populations from Mobilized Peripheral Blood
Authors: Lazarova P. , Wu Q. , Kvalheim G. , Suo Z. , Haakenstad K. W. , Metodiev K. , Nesland J. M.
Published: November 2018

Cell-surface antigen expression of hematopoietic stem cells has a crucial role in characterizing cell subpopulation with distinct functional properties. The Eph receptors are the largest receptor tyrosine kinase family being involved in processes like vascular remodelling during development and physiological and pathological angiogenesis. Some Eph/Ephrin members are expressed in hematopoietic cells. The ability to isolate purified cell populations co-expressing CD34 and CD133 antigens as most commonly used markers for identification of hematopoietic progenitors has provided the opportunity to identify their surface-receptor profile. As positively expressed CD34 and CD133 cells take place not only in hematopoietic but also in endothelial differentiation, we aimed to define the Eph/Ephrin characteristic of these cells and relate these findings to new therapy strategies. Positive selections of CD34 and CD133 cells from PBPC in lymphoma patients were performed using magnetic beads and AutoMACS (Miltenyi Biotec) device. The purity of isolated cells was tested by flow cytometry. Immunocytochemistry was used to assess the Eph/Ephrin expression profile of positively selected samples. Our study revealed that all samples (10 from CD34+ and 8 from CD133+ cells) expressed one or more of Eph/Ephrin antigens in different proportions. All CD34 + cell samples, and 6 of 8 in the CD133+ cell fraction were strongly immunoreactive for EphA2. EphB2 was strongly expressed in all CD133+ cases, but 50% of the CD34 positive group lacked or weakly expressed this receptor. EphB4 was negative in 9 of 10 CD34+ cases and in all CD133 +cells. Thus, we have shown the surface marker profile of positively selected CD34 and CD133 cells in leukapheresis samples from lymphoma patients with regard to Eph/Ephrin receptors and discussed their biological clinical potential.
Evaluating Future School Counselors’ Competences for Inclusive Education
Authors: Mažgon Jasna , Jeznik Katja , Ermenc Klara Skubic
Published: November 2018

The article discusses results of a study that evaluated university students’ competencies related to inclusive education. The study aimed to find out how prospective school counselors, who were familiar with theories on inclusion as an educational concept and had some relevant field experience, analyzed and reflected upon inclusion-related, real-life situations. The authors also aimed to establish any differences in views and explanations depending on students’ average grades and whether students have experience working in inclusive settings. A questionnaire was developed that consisted of seven questions related to independent variables (e.g., average grade, experience with working in inclusive settings) and six open-ended questions related to a real-life situation. The results indicate that most students understand at least the basic elements of the broader definition of inclusion and can provide some ideas for improvement of practice. Interestingly, students’ grades do not seem to be a decisive factor, but field experience does play a role in students’ competencies related to inclusive education.
Islamo-nationalism, domestic politics, and Bangladesh’s policy of balancing against India since the 1990s
Authors: Mannan Md. Abdul
Published: November 2018

This article examines the connection between politics of Islamo-nationalism in Bangladesh and Bangladesh’s policy of balancing against India. In response to India’s regional supremacy in South Asia, especially India’s dominance over Bangladesh, policy makers in Bangladesh have constantly faced two options: either ‘bandwagoning’ with India, or ‘balancing’ against the regional hegemon. Interestingly, since the 1990s until 2013, Bangladesh’s response has always swung from one side to another – from bandwagoning to balancing – in connection with the rotation of Bangladesh regime between two major political parties: the Bangladesh Nationalist Party (BNP) and the Bangladesh Awami League (AL). Bangladesh – with the BNP’s hold on power – preferred a policy of balancing against India’s dominance. During the regime of the AL, such policy dramatically shifted towards bandwagoning with India. The BNP’s preference for a balancing policy constitutes a puzzle. Weak states – which are not capable of changing unequal outcomes in the face of a preponderant power – generally pursue a policy of bandwagoning. Thus, the puzzle is as to why Bangladesh – despite being a weak actor vis-a-vis India’s overwhelming regional supremacy – pursued a policy of balancing against India during the BNP’s hold on power. This article asserts that the BNP’s politics of Islamo-nationalism is a key variable that can answer the above puzzle. The ‘self–other’ notion of Islamo-nationalism defines the national ‘selfness’ of Bangladesh in terms of the Islamic identity for its overwhelming Muslim masses, and constructs India, henceforth in this article, ‘Hindu India’, as the ‘enemy–other’ to ‘Muslim Bangladesh’.
Arthroscopic Anatomic Glenoid Reconstruction: Analysis of the Learning Curve
Authors: Moga Iustin , Konstantinidis George , Coady Catherine , Ghosh Swagata , Wong Ivan Ho-Bun
Published: November 2018

Background:

Anatomic glenoid reconstruction involves the use of distal tibial allograft for bony augmentation of the glenoid surface. An all-arthroscopic approach was recently described to avoid damage to the subscapularis tendon and preserve the capsule and labrum.

Purpose:

To explore and compare change in surgical time between 2 proposed methods used for the treatment of anterior shoulder instability—arthroscopic anatomic glenoid reconstruction (AAGR) and arthroscopic Latarjet (AL)—over successive procedures. We also compared graft positioning on the anterior glenoid surface between the 2 methods.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a single-surgeon retrospective review of 54 cases of surgically treated recurrent anterior shoulder instability: 27 had AAGR with distal tibial allograft, while the other 27 had AL. AAGR with the distal tibial allograft was the primary choice for the treatment of anterior shoulder instability; however, AL was performed when tibial allograft was not available from the bone bank. Thus, there was an overlapping period for those 2 procedures. Procedure start and end times were recorded, and duration was calculated. Postoperative 3-dimensional computed tomography scans were reviewed, and graft position was judged to be in the lower third (desired position), middle third, or upper third of the anterior glenoid surface. To assess learning, these data were organized in chronological order of surgery, and each surgical cohort was divided into 3 chronological clusters of 9 patients each. Learning was assessed through change in operative time over successive clusters, change in variability of operative time among clusters, and change in graft positioning among clusters. Statistical analysis comprised a 2-tailed independent-sample t test and the Levene test for equality of variance.

Results:

Our study found that AAGR was significantly faster to perform than AL in the early ( P = .001), middle ( P = .001), and late ( P = .05) clusters of each cohort. Duration of surgery did not significantly improve across clusters within each cohort ( P = .15-.79). There were no significant changes in the variability of surgical time in the AAGR group ( P = .09) or the AL group ( P = .13). Desired positioning of the bone graft on the anterior glenoid surface (lower third) was identified more commonly in the AAGR cohort.

Conclusion:

AAGR is faster to learn and perform than AL for the treatment of recurrent anterior shoulder instability with significant glenoid bone loss. The current study found higher rates of desired graft positioning for AAGR clusters.
Sodium channels
Authors: Wood John N. , Iseppon Federico
Published: November 2018

In 2000, with the completion of the human genome project, nine related channels were found to comprise the complete voltage-gated sodium gene family and they were renamed NaV1.1–NaV1.9. This millennial event reflected the extraordinary impact of molecular genetics on our understanding of electrical signalling in the nervous system. In this review, studies of animal electricity from the time of Galvani to the present day are described. The seminal experiments and models of Hodgkin and Huxley coupled with the discovery of the structure of DNA, the genetic code and the application of molecular genetics have resulted in an appreciation of the extraordinary diversity of sodium channels and their surprisingly broad repertoire of functions. In the present era, unsuspected roles for sodium channels in a huge range of pathologies have become apparent.
Spaces of post-disaster experimentation: Agile entrepreneurship and geological agency in emerging disaster countercartographies
Authors: Dickinson Simon
Published: November 2018

This article explores emergent spaces of social and political experimentation after the Canterbury, New Zealand, earthquakes of 2010–2011. Acknowledging that disasters generate distinctive spaces which reveal and provoke potentially disruptive imaginations and actions, I explore how the earthquakes gave rise to political experiments through which uncertainties were sensed, ordered and negotiated in the hopeful enactment of both conservative and radically alternative futures. Namely, I argue that the ruptures afforded by the earthquakes opened up the possibility for the dominant practices of a complex political conservatism in Christchurch to be challenged through the emergence of new and previously restrained claims to the city that have manifested, in part, through an emergent community organisation – the Canterbury Communities' Earthquake Recovery Network (CanCERN). Despite the earthquakes fuelling these repressed claims, this article explores the ways that these visions, claims and disquiets were shaped by evolving understandings of the nature and potential of the earthquake event. Analysis of CanCERN's activity reveals a kind of agile social entrepreneurship that remained alert to the opening and closing spaces of possibility within the disaster recovery landscape. Subsequently, this account works to not only draw attention to the discordant temporalities of possibility post-disaster, but also opens up discussion about the ways in which post-disaster experiments are shaped by unfolding senses of geological agency and indeterminacy.
When to obtain genomic data in acute myeloid leukemia (AML) and which mutations matter
Authors: Roloff Gregory W. , Griffiths Elizabeth A.
Published: November 2018

Mutational profiling has fundamentally changed our approach to patients with acute myeloid leukemia (AML). Patients with AML are routinely profiled for the presence of mutations in FLT3, NPM1, CEBPA, and, more recently, TP53. In this chapter, we review the role of mutational profiling to help define disease biology in AML, particularly among patients with putatively intermediate-risk disease. We describe the body of evidence supporting the utility of mutational profiling when performed at the time of diagnosis (to identify prognostic and targetable mutations), at the time of complete remission (to assess minimal residual disease as a marker for relapse), and at the time of relapse (to identify therapeutic targets and eligibility for clinical trials). We further identify particular mutations that have been shown to affect prognosis across the established European LeukemiaNet risk categories and discuss which mutational events might be used to alter the approach to patient care at various time points during the disease course. We also review the evidence in support of molecular profiling for assessment of minimal/measurable residual disease and describe the current landscape of studies designed to validate this approach.