bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of long-term infliximab use and impact of treatment adherence on disease control in refractory, non-infectious pediatric uveitis
Authors: Miraldi Utz Virginia , Bulas Sabrina , Lopper Sarah , Fenchel Matthew , Sa Ting , Mehta Mitul , Ash Daniel , Lovell Daniel J. , Kaufman Adam H.
Published: November 2019

Background

Refractory non-infectious uveitis is a serious condition that leads to ocular complications and vision loss and requires effective systemic treatment to control disease. The effectiveness of long-term infliximab [IFX] in refractory non-infectious childhood uveitis and the impact of treatment adherence on disease control were evaluated.

Methods

Retrospective, single-center study between December 2002 and April 2016 of 27 children with refractory non-infectious uveitis [17 with juvenile idiopathic arthritis, JIA] treated with long-term IFX [9+ months]. Disease activity was assessed prior to and while on IFX using the Standardization of Uveitis Nomenclature [SUN]. Number of visits per year with active uveitis was analyzed by repeated measures logistic regression analysis from 2 years prior to IFX initiation or from onset of uveitis until most recent visit on IFX. Incomplete treatment adherence was assessed for each visit and defined as any deviance in corticosteroid use, prescribed infusion frequency, and/or follow-up examination frequency.

Results

Primary outcomes were sustained uveitic and systemic disease control prior to and during IFX treatment and the impact of incomplete adherence on uveitic disease control while on IFX. Secondary outcomes included corticosteroid and glaucoma medication requirement, ocular complications and need for surgical intervention. Mean age at IFX initiation was 10.4 ± 4.5 years; initial mean dose was 6.6 ± 2.2 mg/kg [and given at weeks 0, 2, 4 and q4 weeks thereafter for 93%]. Median duration on IFX was 35 [range 9–128] months. Prior to IFX, 14/27 patients had failed adalimumab ± methotrexate [MTX]; 21/27 failed MTX. IFX led to uveitis control in 89% and arthritis control in 76% (13/17). The odds ratio of having controlled disease after IFX was 4.1 (2.6, 6.4) compared to pre-treatment visits. Topical corticosteroids and glaucoma medications were statistically decreased (p = 0.007 right eye [OD], 0.003 left eye [OS] andp = 0.001 OD,p = 0.028 OS respectively). Incomplete adherence to treatment showed 10.3 times greater odds (7.1, 15.0) of having disease activity than full adherence.

Conclusions

This study adds significantly to the IFX literature by documenting outstanding uveitis control with long-term IFX treatment in non-infectious pediatric uveitis patients. Higher dosage and shorter interval were utilized without adverse effects. Importantly, this is the first study, to our knowledge, to document the significant impact of treatment adherence on uveitis control.
Immunovirological markers in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)
Authors: Enose-Akahata Yoshimi , Jacobson Steven
Published: November 2019

Human T cell lymphotropic virus 1 (HTLV-1) is a human retrovirus and infects approximately 10–20 million people worldwide. While the majority of infected people are asymptomatic carriers of HTLV-1, only 4% of infected people develop HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP is a chronic, progressive, neurological disease which usually progresses slowly without remission, and is characterized by perivascular inflammatory infiltrates in chronic inflammatory lesions of the central nervous system (CNS), primarily affecting the spinal cord. A high HTLV-1 proviral load, high levels of antibodies against HTLV-1 antigens, and elevated concentration of proteins are detected in cerebrospinal fluid (CSF) of HAM/TSP patients. These chronically activated immune responses against HTLV-1 and infiltration of inflammatory cells including HTLV-1 infected cells into the CNS contribute to clinical disability and underlie the pathogenesis of HAM/TSP. Since the disease development of HAM/TSP mainly occurs in adults, with a mean age at onset of 40–50 years, it is important for HTLV-1-infected carriers and HAM/TSP patients to be monitored throughout the disease process. Recent advances in technologies and findings provide new insights to virological and immunological aspects in both the CNS as well as in peripheral blood. In this review, we focus on understanding the inflammatory milieu in the CNS and discuss the immunopathogenic process in HTLV-1-associated neurologic diseases.
Influenza A virus hemagglutinin mutations associated with use of neuraminidase inhibitors correlate with decreased inhibition by anti-influenza antibodies
Authors: Ilyushina Natalia A. , Komatsu Takashi E. , Ince William L. , Donaldson Eric F. , Lee Nicolette , O’Rear Julian J. , Donnelly Raymond P.
Published: November 2019

Background

Vaccination and the use of neuraminidase inhibitors (NAIs) are currently the front lines of defense against seasonal influenza. The activity of influenza vaccines and antivirals drugs such as the NAIs can be affected by mutations in the influenza hemagglutinin (HA) protein. Numerous HA substitutions have been identified in nonclinical NAI resistance-selection experiments as well as in clinical specimens from NAI treatment or surveillance studies. These mutations are listed in the prescribing information (package inserts) for FDA-approved NAIs, including oseltamivir, zanamivir, and peramivir.

Methods

NAI treatment-emergent H1 HA mutations were mapped onto the H1N1 HA1 trimeric crystal structure and most of them localized to the HA antigenic sites predicted to be important for anti-influenza immunity. Recombinant A/California/04/09 (H1N1)-like viruses carrying HA V152I, G155E, S162 N, S183P, and D222G mutations were generated. We then evaluated the impact of these mutations on the immune reactivity and replication potential of the recombinant viruses in a human respiratory epithelial cell line, Calu− 3.

Results

We found that the G155E and D222G mutations significantly increased viral titers ~ 13-fold compared to the wild-type virus. The hemagglutination and microneutralization activity of goat and ferret antisera, monoclonal antibodies, and human serum samples raised against pandemic A(H1N1)pdm09 viruses was ~ 100-fold lower against mutants carrying G155E or D222G compared to the wild-type virus.

Conclusions

Although the mechanism by which HA mutations emerge during NAI treatment is uncertain, some NAI treatment-emergent HA mutations correlate with decreased immunity to influenza virus.
Long-course neoadjuvant chemoradiotherapy with versus without a concomitant boost in locally advanced rectal cancer: a randomized, multicenter, phase II trial (FDRT-002)
Authors: Wang Jingwen , Guan Yun , Gu Weilie , Yan Senxiang , Zhou Juying , Huang Dan , Tong Tong , Li Chao , Cai Sanjun , Zhang Zhen , Zhu Ji
Published: November 2019

Background

This study was designed to explore whether an intensified chemoradiotherapy (CRT) led to a better clinical outcome in locally advanced rectal cancer.

Methods

Patients with stage II/III rectal cancer were randomly allocated to receive either pelvic intensity-modulated radiation therapy (IMRT) of 50 Gy/25Fx concurrently with capecitabine and oxaliplatin (Arm A), or pelvic radiation of 50 Gy/25Fx with a concomitant boost of 5 Gy to the primary lesion, followed by a cycle of XELOX 2 weeks after the end of CRT (Arm B). All patients were planned to receive a definitive operation 8 weeks after the completion of CRT and a total of six perioperative chemotherapy cycles of capecitabine and oxaliplatin regardless of pathological result. Pathological complete response (ypCR) was the primary endpoint.

Results

From February 2010 to December 2011, 120 patients from three centers were enrolled in this study. Ninety-five percent patients completed a full-dose chemoradiotherapy as planning. Then 53 and 57 patients received a radical surgery, and 8 and 14 cases were confirmed as ypCR in two groups (P = 0.157). The other 10 patients failed to receive a definitive resection because of unresectable disease. Similar toxicities were observed between two groups and more incision healing delay were found in Arm B (3 vs.13, P = 0.011). No statistical differences were observed in local-regional control (P = 0.856), disease-free survival (P = 0.349) and overall survival (P = 0.553). Mesorectal fascia (MRF) involvement was an independent prognostic factor for survival in multivariate analysis.

Conclusions

A concomitant boost to oxalipatin-combined preoperative chemoradiotherapy demonstrated a slightly higher pCR rate but delayed incision healing after surgery. The impact of MRF involvement on survival merits further investigations.

Trial registration

NCT01064999 (ClinicalTrials.gov).
The serum level of D-Dimer is not suitable for distinguishing between prosthetic joint infection and aseptic loosening
Authors: Huang Jincheng , Zhang Yongchao , Wang Zhen , Dong Yonghui , Zhao Yongqiang , Zheng Jia , Lian Hongkai , Jin Yi
Published: November 2019

Background

To evaluate the meaning of serum CRP, ESR, and D-Dimer in the diagnosis of prosthetic joint infection.

Methods

In a retrospective study, 101 patients presented with osteoarthritis, PJI, and aseptic loosening were divided into three groups according to the type of operation they received in our department from June 2016 to December 2018: group A, 44 patients treated with primary arthroplasty; group B, 31 PJI patients treated with resection arthroplasty and spacer insertion surgery; group C, 26 aseptic loosening patients treated with revision arthroplasty. Data such as gender, age, preoperative serum CRP, ESR, and D-Dimer level were compared among the three different groups.

Results

There are no statistically significant differences when comparing general data such as gender and age in patients from the three different groups. However, Serum CRP level in group B (43.49 ± 10.00 mg/L) is significantly higher than in group A (2.97 ± 0.75 mg/L) and C (4.80 ± 1.26 mg/L). Serum ESR level in group B (49.84 ± 5.48 μg/L) is significantly higher than those in group A (15.28 ± 2.63 μg/L) and C (22.50 ± 3.47 μg/L). Serum D-Dimer level in group B (1.58 ± 0.17 μg/L) is significantly higher than that in group A (0.51 ± 0.50 μg/L), but similar with group C (1.22 ± 0.29 μg/L). There are no statistically significant differences when compared with sensitivity and specificity of CRP, ESR, and D-Dimer in the diagnosis of PJI among patients from the three different groups when D-Dimer > 0.85 μg/L was set as the optimal threshold value for the diagnosis of PJI.

Conclusion

D-Dimer is not a parameter to distinguish between aseptic loosening and PJI.
Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis - a randomized, double-blind trial protocol
Authors: Ribeiro Adriana B. , de Araújo Camila B. , Silva Luiz Eduardo V. , Fazan-Junior Rubens , Salgado Helio C. , Ribeiro Aline B. , Fortes Caroline V. , Bueno Frank L. , de Oliveira Viviane C. , de F. O. Paranhos Helena , Watanabe Evandro , da Silva-Lovato Cláudia H.
Published: November 2019

Background

Denture-related stomatitis (DS) is chronic multifactorial inflammation, strongly related to the presence of the biofilm that is the complex structure formed by microorganisms held together by a mucus-like matrix of carbohydrate that adheres to different surfaces, including the denture surface. DS has recently been correlated with deleterious cardiovascular alterations. The potential effect of hygiene protocols in the control of DS and randomized clinical trials that address this oral condition with cardiovascular complications are important in clinical decision-making.

Material/design

A clinical trial, randomized, double-blind, and with parallel groups, will be conducted in Brazil The sample will consist of 100 patients without teeth in both arches, users of at least maxillary complete dentures, and diagnosed with DS, who will be allocated to groups (n = 25 per group) according to the different hygiene protocols: (1) brushing of the palate and immersion of the prosthesis in 0.25% sodium hypochlorite solution (positive control); (2) brushing of the palate and immersion of the prosthesis in 0.15% triclosan solution; (3) brushing of the palate and immersion of the prosthesis in lactose monohydrate; or (4) brushing the palate with citric acid and immersing the prosthesis in lactose monohydrate. The response variables will be heart rate variability and alteration of blood pressure (systemic level), remission of DS, removal of biofilm, reduction of microbial load (colony-forming units (CFU)), mouth and prosthesis odor level, expression of MUC1, proinflammatory cytokines, C-reactive protein (CRP), viscosity, pH and salivary flow (locally); patient-centred qualitative analysis will also be undertaken. Measurements will be performed at baseline and 10 days after the interventions. The results obtained will be statistically analyzed as pertinent, with a level of significance of 0.05.

Discussion

This study will provide a guideline for clinical practice regarding the use of hygiene protocols in the treatment of oral diseases (DS) mediated by biofilm. Also, it may provide evidence of correlation of oral manifestation with cardiac risk.

Trial registration

Brazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.
Assessment of multiplex Onchocerca volvulus peptide ELISA in non-endemic tropical regions
Authors: Lagatie Ole , Granjon Elodie , Odiere Maurice R. , Zrein Maan , Stuyver Lieven J.
Published: November 2019

Background

Currently, serodiagnosis of infection with the helminth parasiteOnchocerca volvulusis limited to the Ov-16 IgG4 test, a test that has limited sensitivity and suboptimal specificity. In previous studies, we identified several linear epitopes that have the potential to supplement the diagnostic toolbox for onchocerciasis.

Methods

In this study three peptides, bearing in total six linear epitopes were transferred to a multiplex ELISA platform. This multiplex ELISA was used to assess the clinical utility of the peptide serology markers by analyzing sample sets from bothO. volvulusendemic and non-endemic regions.

Results

The multiplex platform was shown to be reproducible and data obtained on the multiplex platform were comparable to the singleplex ELISA data. The clinical utility assessment showed that in a population of school-aged children from western Kenya, a virtuallyO. volvulus-free area, significant cross-reactivity with an as-yet to be determined immunogen was detected.

Conclusions

The observations made in this study invalidate the usefulness of the peptide serology markers for onchocerciasis detection. We discuss what could be the origin of this unexpected serological response, but also highlight the need for better characterized biobanks for biomarker discovery activities.
Characteristics of seismic activity before and after the 2018 M6.7 Hokkaido Eastern Iburi earthquake
Authors: Kumazawa Takao , Ogata Yosihiko , Tsuruoka Hiroshi
Published: November 2019

We applied the epidemic type aftershock sequence (ETAS) model, the two-stage ETAS model and the non-stationary ETAS model to investigate the detailed features of the series of earthquake occurrences before and after the M6.7 Hokkaido Eastern Iburi earthquake on 6 September 2018, based on earthquake data from October 1997. First, after the 2003 M8.0 Tokachi-Oki earthquake, seismic activity in the Eastern Iburi region reduced relative to the ETAS model. During this period, the depth ranges of the seismicity were migrating towards shallow depths, where a swarm cluster, including a M5.1 earthquake, finally occurred in the deepest part of the range. This swarm activity was well described by the non-stationary ETAS model until the M6.7 main shock. The aftershocks of the M6.7 earthquake obeyed the ETAS model until the M5.8 largest aftershock, except for a period of several days when small, swarm-like activity was found at the southern end of the aftershock region. However, when we focus on the medium and larger aftershocks, we observed quiescence relative to the ETAS model from 8.6 days after the main shock until the M5.8 largest aftershock. For micro-earthquakes, we further studied the separated aftershock sequences in the naturally divided aftershock volumes. We found that the temporal changes in the background rate and triggering coefficient (aftershock productivity) in respective sub-volumes were in contrast with each other. In particular, relative quiescence was seen in the northern deep zones that includes the M5.8 largest aftershock. Furthermore, changes in the b-values of the whole aftershock activity showed an increasing trend with respect to the logarithm of elapsed time during the entire aftershock period, which is ultimately explained by the spatially different characteristics of the aftershocks.
Hydrological changes after the 2016 Kumamoto earthquake, Japan
Authors: Koizumi Naoji , Minote Shinsuke , Tanaka Tatsuya , Mori Azumi , Ajiki Takumi , Sato Tsutomu , Takahashi Hiroshi A. , Matsumoto Norio
Published: November 2019

The 2016 Kumamoto earthquake, whose main shock was an M7.3 event on April 16, 2016, 28 h after a foreshock of M6.5, caused severe damage in and around Kumamoto Prefecture, Japan. It also caused postseismic hydrological changes in Kumamoto Prefecture. In this study, we analyzed daily streamflow data collected by eight observation stations from 2001 to 2017 in regions that experienced strong ground motion during the 2016 Kumamoto earthquake. We also surveyed 11 water springs in the region several times after the main shock. Streamflow had no or slight change immediately after the earthquake; however, large increases were recorded at some of the eight stations following a heavy rainfall that occurred 2 months after the earthquake. A decrease in the water-holding capacity of the catchment caused by earthquake-induced landslides can explain this delayed streamflow increase. Conversely, earthquake-related changes to the spring flow rate were not so clear. Water temperature and chemical composition of spring waters were also hardly changed. Only the concentration of NO3−, which is usually considered to be supplied from the surface, changed slightly just after the earthquake. These results show that the postseismic hydrological changes were caused mainly by earthquake-induced surface phenomena and that there was little contribution from hydrothermal fluid.
Epidemiology of animal bite in Iran during a 20-year period (1993–2013): a meta-analysis
Authors: Abedi Maliheh , Doosti-Irani Amin , Jahanbakhsh Fatemeh , Sahebkar Amirhossein
Published: November 2019

Background

Rabies is a fatal disease that still kills 2–6 people a year in Iran. A meta-analysis was conducted in order to generate accurate data on animal bite exposure, and to estimate the incidence of animal bite across the country.

Materials and methods

Major national and international electronic databases were searched using the keywords “animal bite,” rabies, prevalence, incidence, and Iran. Web of Knowledge, PubMed, Scopus, Ovid, and ScienceDirect were used as international databases, and the national databases included Science Information Database, MagIran, and IranDoc. Descriptive cross-sectional studies addressing the incidence of animal bite were selected and screened by two authors, and pre-specified data were extracted. The population of provinces or cities of studies was extracted from the Statistical Centre of Iran. The overall incidence of animal bite in Iran was estimated using a random-effects model with 95% confidence interval (CI). Study quality was assessed using the STROBE recommended checklist.

Results

A total of 34 studies were selected for the meta-analysis out of 1215 retrieved studies. The number of animal bites in the studies during 1993–2013 was 230,019 cases. The overall estimated incidence rate of animal bite in Iran was 13.20/1000 (95%, CI 12.10, 14.30) and the mean age of people was 26.23 (SD = 5.02) year. The incidence rate of animal bite among males (14.90/1000) was much higher than females (4.55/1000), and was higher in rural areas (17.45/1000) compared with urban areas (4.35/1000). The incident rate was highest among students compared with other reported occupations. The incidence rate of dogs was 10.40/1000 followed by cats, cows, wolves, jackals, and foxes. Domestic animals had a higher incidence rate than stray and wild animals. The incidence rate of animal bite during spring was 4.90/1000; however, the incidence rate in other seasons had no significant difference. In the retrieved studies, the highest incidence rate of animal bite was found in the West Azerbaijan Province (146.83/1000).

Conclusion

The current study is the first comprehensive analysis of the published animal bite studies in Iran. Accurate data on animal bite incidence may lead to more effective policy-decisions towards more efficient resource allocation to primary health care for reducing rabies case. Such information is a primary and major necessity for rabies control program in the country. Animal bite reduction can significantly minimize the risk of rabies infection, thereby reducing public health costs for the expensive post-exposure treatment.
Non-FDG PET/CT in Diagnostic Oncology: a pictorial review
Authors: Giammarile Francesco , Castellucci Paolo , Dierckx Rudi , Estrada Lobato Enrique , Farsad Mohsen , Hustinx Roland , Jalilian Amirreza , Pellet Olivier , Rossi Susana , Paez Diana
Published: November 2019

Positron emission tomography/computed tomography (PET/CT) is currently one of the main imaging modalities for cancer patients worldwide. Fluorodeoxyglucose (FDG) PET/CT has earned its global recognition in the modern management of cancer patients and is rapidly becoming an important imaging modality for patients with cardiac, neurological, and infectious/inflammatory conditions.

Despite its proven benefits, FDG has limitations in the assessment of several relevant tumours such as prostate cancer. Therefore, there has been a pressing need for the development and clinical application of different PET radiopharmaceuticals that could image these tumours more precisely. Accordingly, several non-FDG PET radiopharmaceuticals have been introduced into the clinical arena for management of cancer. This trend will undoubtedly continue to spread internationally. The use of PET/CT with different PET radiopharmaceuticals specific to tumour type and biological process being assessed is part of the personalised precision medicine approach.

The objective of this publication is to provide a case-based method of understanding normal biodistribution, variants, and pitfalls, including several examples of different imaging appearances for the main oncological indications for each of the new non-FDG PET radiopharmaceuticals. This should facilitate the interpretation and recognition of common variants and pitfalls to ensure that, in clinical practice, the official report is accurate and helpful.

Some of these radiopharmaceuticals are already commercially available in many countries (e.g. 68Ga-DOTATATE and DOTATOC), others are in the process of becoming available (e.g. 68Ga-PSMA), and some are still being researched. However, this list is subject to change as some radiopharmaceuticals are increasingly utilised, while others gradually decrease in use.
Literature review of Notch melanoma receptors
Authors: de Oliveira Filho Renato Santos , Soares Alexandre Lavorato , Paschoal Francisco Macedo , Rezze Gisele Gargantini , Oliveira Ebe , Macarenco Ricardo , Buzaid Antonio Carlos , Ferreira Lydia Masako
Published: November 2019

Despite the immunotherapeutics and target therapy agents, the survival of patients with advanced melanoma is still low. Notch signaling is able to regulate many aspects of melanomagenesis. Comparative analyses of common melanocytic nevi, dysplastic nevi and melanomas demonstrated increased expression of Notch1, Notch2 and their ligands, indicating that a positive regulation of these components may be related to the progression of melanoma. Some strategies such as gamma-secretase inhibitors (GSI) have been explored in patients with refractory metastatic disease or locally advanced disease of solid tumors. Two major classes of Notch inhibitors are currently in clinical development: GSI and monoclonal antibodies against Notch receptors or their ligands. Inhibition of Notch by GSI has been shown to decrease melanoma growth. GSI RO4929097 co-administered with cisplatin, vinblastine and temozolomide promotes greater elimination of tumor cells. The Notch pathway needs to be explored in the treatment of melanoma.
Models of tendon development and injury
Authors: Theodossiou Sophia K. , Schiele Nathan R.
Published: November 2019

Tendons link muscle to bone and transfer forces necessary for normal movement. Tendon injuries can be debilitating and their intrinsic healing potential is limited. These challenges have motivated the development of model systems to study the factors that regulate tendon formation and tendon injury. Recent advances in understanding of embryonic and postnatal tendon formation have inspired approaches that aimed to mimic key aspects of tendon development. Model systems have also been developed to explore factors that regulate tendon injury and healing. We highlight current model systems that explore developmentally inspired cellular, mechanical, and biochemical factors in tendon formation and tenogenic stem cell differentiation. Next, we discuss in vivo,in vitro,ex vivo,and computational models of tendon injury that examine how mechanical loading and biochemical factors contribute to tendon pathologies and healing. These tendon development and injury models show promise for identifying the factors guiding tendon formation and tendon pathologies, and will ultimately improve regenerative tissue engineering strategies and clinical outcomes.
Clinicopathological features and survival of colorectal cancer patients younger than 50 years: a retrospective comparative study
Authors: Ghodssi-Ghassemabadi Robabeh , Hajizadeh Ebrahim , Kamian Shaghayegh , Mahmoudi Mahmood
Published: November 2019

Background

Colorectal cancer (CRC) is a disease of old age, but its incidence has been rising among younger population compared to older ones. Nevertheless, there is a controversy over survival of younger patients compared to the older ones. Therefore, in the current study, we investigated the clinicopathological features and survival of the younger (< 50 years) versus older (≥ 50 years) CRC patients.

Results

The younger and older groups consisted of 39.4% and 60.6% of patients, respectively. Both age groups were comparable regarding the symptom presentation and duration, and pre-operative carcinoembryonic antigen (CEA). The younger patients were diagnosed with a higher proportion of poorly differentiated (14.7% vs. 8.3%; p < 0.001) and more advanced tumors (53.2% vs. 45.9%; p = 0.266). The rectum tumor site was significantly more common among the younger patients (p = 0.021). The overall survival (OS) (p = 0.278), the cancer-specific survival (CSS) (p = 0.233), and the disease-free survival (DFS) (p = 0.497) did not differ significantly between the two groups. Based on Cox regression model, elevated pre-operative CEA level (HR = 1.41; 95%CI of 1.01–1.97), advanced tumor stage (6.06; 95%CI of 3.03–12.15), and poorly differentiated tumor (HR = 1.69; 95%CI of 1.05–2.71) were associated with decreased survival.

Conclusions

The younger patients did not have poor prognosis compared to the older ones despite having an advanced tumor stage and a poor tumor differentiation.
Parental Multiple Endocrine Neoplasia Type 1 (MEN 1) Is Associated with Increased Offspring Childhood Mortality
Authors: Thompson Michael , Hogg Prudence , De Paoli Antonio , Burgess John
Published: November 2019

Context

Information regarding the impact of parental multiple endocrine neoplasia type 1 (MEN 1) on neonatal outcomes is limited to case reports.

Objective

To determine the impact of parental MEN 1 on neonatal outcomes.

Methods

Retrospective cohort analysis of the Tasman 1 MEN 1 kindred stratified by whether birth occurred before (“historical cohort”) or after (“contemporary cohort”) prospective screening commenced. The historical cohort included kindred members born between 1825 and 1984 (n = 341 children with a MEN 1 positive (MEN 1+) parent and n = 314 children with MEN 1 negative (MEN 1–) parents). The contemporary cohort included neonates (n = 52) of MEN 1+ women (n = 21) managed at a tertiary referral hospital between 1985 and 2018.

Results

Historical cohort: compared with MEN 1– parents, children of MEN 1+ parents were more likely to die postpartum (HR 4.6, P = .046 at 6 months of age). Excess mortality at 15 years of age was observed for children of MEN 1+ mothers (HR 8.50, P = .002) and fathers (HR 3.82, P = .03). Contemporary cohort: neonates of MEN 1+ mothers were more likely to have low birth weight (28.9% vs 6.7%, P = .01), be admitted to a higher care nursery (40.4% vs 17%, P = .02), and require a longer median postnatal stay (5 vs 4 days, P = .009) than the Australian average. Isolated antenatal hypercalcemia did not significantly alter neonatal outcomes.

Conclusion

Children with a MEN 1+ parent are disproportionately vulnerable postpartum. Neonates of MEN 1+ mothers remain vulnerable despite contemporary care. The excess risk was not fully explained by maternal MEN 1 or antenatal hypercalcemia.
Frequency of Vertebral Fractures in Patients presenting with Hip Fractures
Authors: Chinoy Muhammad Amin , Javed Salman
Published: November 2019

Objective: To determine the frequency of vertebral fractures in patients presenting with hip fractures.

Methods: This prospective study was conducted at The Indus Hospital, Karachi, from May 2018 to November 2018. All patients above 40 years presenting with hip fractures were enrolled and a dorsal lumbar lateral view radiograph was obtained to investigate for vertebral fractures. Data was entered and analyzed using SPSS. Post-stratification, Chi-square/Fisher exact test was applied as appropriate to assess the significant association. P value of ≤0.05 was considered significant.

Results: Three hundred thirty five patients were enrolled. Of these, 189 (56.4%) were females and 165 (49.3%) presented with neck of femur fractures. Out of 335 hip fractures patients, 77 (23%) were found to have concomitant vertebral fractures, with 73 (96.1%) having a compression fracture. T12 was the most common vertebra involved and 68.8% of patients were asymptomatic. Co-morbid conditions were statistically significantly associated with vertebral fractures.

Conclusion: There is a high prevalence of asymptomatic vertebral fractures in our population, but low compared to studies from western countries. There is a need to evaluate these fractures separately for the prevention of morbidity and mortality.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1709

How to cite this:Chinoy MA, Javed S. Frequency of Vertebral Fractures in Patients presenting with Hip Fractures. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S44-S48. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1709

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Imaging of Pulmonary Post-Tuberculosis Sequelae
Authors: Rafeah Khan Rafeah , Malik Nuzhat Irfan , Razaque Abdul
Published: November 2019

Worldwide, tuberculosis (TB) is one of the top 10 causes of death, and the leading cause from a single infectious agent. Pakistan has an overwhelming burden of TB and it is a major health hazard for the majority of the rural population. The lung continues to be the most common site of involvement and even after completion of treatment residual changes remain which may affect quality of life.Complications of TB after treatment completion can often be misinterpreted for other active diseases so it is important to recognize and understand the radiologic manifestations of the thoracic sequelae. Post TB sequelae can be categorized into parenchymal, airway disease, pleural/chest wall, vascular and mediastinal. These residual changes can be minor however, some can be debilitating and even fatal.The purpose of this pictorial review is to show the spectrum of residual changes seen on chest radiography and/or computed tomography that persist after treatment completion and bacteriological cure.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1722

How to cite this:Khan R, Malik NI, Razaque A. Imaging of Pulmonary Post-Tuberculosis Sequelae . Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S75-S82. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1722

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Slipped capital femoral epiphysis after treatment of femoral neck fracture
Authors: Chinoy Muhammad Amin , Pal Sateesh , Khan Mansoor Ali
Published: November 2019

Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition. This complication should be recognized promptly and treated urgently. The risk of development of this complication can be minimized by anatomical reduction of the fracture and stable internal fixation of the fracture. Five years old male child sustained right sided femur neck fracture and was treated with closed reduction and Hip spica cast application. The fracture healed with a varus deformity. After 7 months, he developed slip of femoral epiphysis with a coxa vara deformity of proximal femur, which was treated with in situ fixation with Cannulated screws. His subsequent course remained uneventful up to five months.Slipped capital femoral epiphysis (SCFE) after treatment of femoral neck fracture in children is a rare complication that should be recognized and treated promptly. The onset of SCFE may show inadequate reduction or fixation of the fracture. Anatomic reduction and stable internal ﬁxation for femoral neck fracture in children provides best outcomes. Postoperative care and delayed weight bearing are also equally important to avoid complications.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725

How to cite this:Chinoy MA, Pal S, Khan MA. Slipped capital femoral epiphysis after treatment of femoral neck fracture. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S94-S97. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bridging the Gap in Emergency Medicine in Pakistan
Authors: Saleem Syed Ghazanfar , Haider Kaniz Farwa , Yasin Zayed , Rybarczyk Megan
Published: November 2019

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1726
“Indus Kay Sitaray”: A novel hospital-based school at The Indus Hospital, Karachi
Authors: Akhtar Tooba Nadeem , Fareeduddin Muhammad , Ashraf Muhammad Shamvil
Published: November 2019

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1727
Effect of olive oil administration on the level of transforming growth factor β1 during orthodontic tooth movement in old and young guinea pigs
Authors: Suparwitri Sri , Noviasari Paramita
Published: November 2019

Background: Orthodontic tooth movement occurs due to continuous pressure on the teeth, causing the remodeling of the alveolar bone. The tissue will respond to bone growth factors, such as transforming growth factor β1 (TGF-β1), fibroblasts, and bone morphogenetic proteins, for new bone formation. The remodeling process is balanced in young adults, but there is an imbalance in older individuals due to decreased differentiation, activity, and life span of osteoblasts, and increased osteoclasts. Olive oil contains lots of antioxidants and can slow down the aging process. This study aims to study the differences in TGF-β1 levels between old and young guinea pigs, and the difference between olive oil administration on TGF-β1 levels in old and young guinea pigs with orthodontic tooth movement.

Methods: 12 guinea pigs divided into 4 groups: young guinea pigs (4-5 months) not given olive oil; young guinea pigs given olive oil; old guinea pigs (30-31 months) given olive oil; old guinea pigs given olive oil. The teeth were moved using an open coil spring mounted on the brackets on both lower incisors. Gingival sulcus fluid samples were taken on days 0, 7 and 14 of the movement of the teeth. TGF-β1 levels were analyzed using ELISA.

Results: Three-way ANOVA and post hoc statistical tests showed that TGF-β1 levels in young guinea pigs were significantly higher than old guinea pigs on days 0, 7 and 14 (p<0.05). TGF-β1 levels in both young and old guinea pigs who were given olive oil was significantly higher than those not given olive oil on days 0, 7 and 14 (p<0.05).

Conclusions: TGF-β1 levels in the younger age guinea pigs were higher than the older age, and olive oil could increase TGF-β1 levels in the older age guinea pigs.
Cognitive Interest As an Incentive and Condition for the Effective Formation of Organizational and Practical Skills of Students (on the Example of the Study of Mathematics)
Authors: Gedygusheva Tat'yana , Kipkeeva R.
Published: November 2019

The article analyzes the problem issues of the formation of cognitive interest in the process of teaching mathematics. Various motives of cognitive interest as a cognitive activity are considered. The signifi cance of organizational and practical training in the formation of methods for comprehending the conceptual and categorical apparatus of mathematical science is revealed. It reveals approaches to raising interest in mathematics, its methods and organizational capabilities by solving problems with cognitive organizational functions.
Personal Peculiarities of Development of Styles of Educational and Cognitive Activity of Students in Technological Park
Authors: Starchenko Sergey
Published: November 2019

The article deals with the development of the leading ways of educational and cognitive activity of students enrolled in programs of specialized education in the technological Park, which provides their pre-professional training for education in specialized universities. The author, based on stylistic approach to the development of educational-cognitive activity reveals personality traits of natural science, physics, mathematics and Humanities students determines the learning technology to ensure the linkages of learning and teaching in the technological Park. Quantum are presented, which ensure the development of educational research, educational search, educational design and educational project activities of students within the framework of functioning of the technological Park.
Some Aspects of the Commercial and Industrial Policy of S.Yu. Witte: Timeless Feedback
Authors: Dolakova M.
Published: November 2019

The article discusses the processes of transformation of economic policy in the Russian Empire in the late XIX — early XX centuries. It analyzes certain aspects of the fi nancial policy of S.Yu. Witte and their refraction at the regional level on the example of the Kazan province. The author turns to the theoretical foundations of the formation of a strategy for economic development in the period under review, notes the national characteristics of commercial and industrial development and the role of government policy.
Organization of Subject Oriented Educational Programme: Problems and Solutions
Authors: Frolova Svetlana , Nechaev Mikhail
Published: November 2019

Career guidance is the most important mission of the school and one of the priority areas of state educational policy in the Russian Federation. This is emphasized in federal state educational standards of general education and some other state documents. The fi rst stage of career guidance is the organization of specialized training at school. Despite the long-standing practice of organizing specialized training, teachers still have many questions. This article discusses some of the complex issues of organizing specialized education at school. For this, legal advice is used.
The Drivers for Investment Activity of Business: Does the Theory Explain the Russian Practice?
Authors: Львова Н. , L'vova N. , Семенович Н. , Semenovich N.
Published: November 2019

The article is devoted to the problem of shortage of investments in fixed assets of Russian enterprises (non-financial companies). Theoretical perspectives on the importance and determinants of investment activity of business are opposed to domestic practice. Thus, the provisions of the main investment theories are systematized, the norms of savings and savings in Russia are analyzed in comparison with the developed countries and other BRICS countries; the profile of domestic investment business (industry structure of investments in fixed capital, dynamics of investments by types of economic activity, depreciation and renewal of fixed assets) is considered; the factors hindering the implementation of investments identified by surveys of entrepreneurs are interpreted. The study showed that the causes of the protracted investment crisis in Russia correlate with the provisions of all the basic theories, but to reveal them more accurately allows post-Keynesian one with its emphasis on the phenomenon of uncertainty and the problem of investment financing.
Strategic Vision for Business Development in the Gas Industry
Authors: Баурина Светлана , Baurina Svetlana
Published: November 2019

The article is devoted to the strategic vision of business development in the gas industry. The existing problems are identified, primarily related to the provision of supplies. The strategic principles that will help preserve the business, regardless of market volatility in the short term, are outlined: managing the asset portfolio as a whole at significantly lower break-even prices, regardless of actual gas prices; strict financial discipline; emphasis on asset maintenance during investment and operations, etc.
Training System for Interdisciplinary Relationships
Authors: Хачатурова С. , Hachaturova S.
Published: November 2019

The article examines a learning system that allows the creation of electronic textbooks. In addition, when using a learning environment, it is often necessary to repeat a topic from previously studied basic disciplines, which form interdisciplinary relationships. In the course of learning, students often have to use a variety of information and reference materials, the essence of which is determined by the field of study. These can be regulations, standards, technical references of materials used, guides on the choice of certain parameters, regulatory — legal documents, financial advice or court practice, etc. Instrumental technologies based on a non-linear way of presenting information and contributing to the unity of disparate knowledge bases (interdisciplinary communication in learning) can improve the quality of education and become a significant motivation for studying related disciplines. Examples are given of working with a training system for interdisciplinary relationships.
Prevention of hooligan behavior at football stadiums
Authors: Kowalska Jolanta Elżbieta
Published: November 2019

This study attempts to present the problem of hooligan behavior at football stadiums in the context of the Council of Europe guidelines, preventive measures (including project method experience).
A vida à luz da ontologia fundamental e da metafísica da Vontade: uma aproximação hermenêutica
Authors: Dietrich Gabriel Henrique
Published: November 2019

No período de sua obra que ficou conhecido como “década fenomenológica”, Heidegger apresentou e desdobrou parcialmente o programa da ontologia fundamental, cujo centro de gravidade é a questão acerca do sentido do ser, canonicamente formulada em Ser e Tempo (1927). Dentre os desdobramentos parciais deste programa, destaca-se a tentativa de elucidação do sentido do ser da vida, empreendida no curso Os Conceitos Fundamentais da Metafísica: Mundo, Finitude e Solidão (1929). O objetivo principal deste trabalho é reconstruir em linhas gerais o programa da ontologia fundamental, especialmente em seu desdobramento na direção da elucidação do sentido do ser da vida. A partir dos elementos desta reconstrução será proposta uma breve aproximação hermenêutica com a interpretação da vida à luz da metafísica da Vontade, conforme desdobrada por Schopenhauer em O mundo como vontade e como representação (1818).
Decrease in physical performance during the hospitalisation phase of haematopoietic stem cell transplantation
Authors: Lumi Carine , Macagnan Fabrício Edler , Kessler Adriana , De Toni Priscila , Raffone Adriana Maisonnave
Published: November 2019

Background/Aims

The negative impact caused by haematopoietic stem cell transplantation still requires further investigation. This study aims to investigate the effects of this procedure on skeletal muscle strength, functional performance and fatigue sensation in the hospitalisation phase.

Methods

This prospective cohort study aimed to assess physical performance by measuring ventilatory muscle strength, peripheral muscle strength and fatigue in patients who underwent haematopoietic stem cell transplantation.

Results

The sample consisted of 30 patients of both sexes (63% men) with a mean age of 48.6 ± 13.2 years. Maximal inspiratory pressure and expiratory pressure decreased by 19% and 16%, respectively (P<0.001). There was a 16% reduction in handgrip strength in the second assessment (P<0.001), as well as a reduction of 30.6% in the 30-Second Chair Stand Test (P<0.001). The fatigue test score increased exponentially (60%) (P<0.001). Individuals with worse results in the 30-Second Chair Stand Test remained hospitalised for a longer period than those with better results (P=0.024).

Conclusions

This study concluded that after the transplantation of haematopoietic stem cells there was a relevant reduction in the results of the applied tests, as well as an increase in fatigue.
Collaborative service delivery to address public health issues within a musculoskeletal setting: evaluation of the Healthy Mind, Healthy Body project
Authors: Holehouse Kelly , Oliver Karen , Rawlinson Gillian , Roddam Hazel
Published: November 2019

Background/Aims

There is a need for greater focus on public health and its impact on musculoskeletal conditions within healthcare delivery. Physiotherapists are well positioned to support this. Outpatient physiotherapy musculoskeletal services traditionally focus on rehabilitation and physical exercise, yet many service users require support to improve both their mental and physical health. This innovative service improvement aimed to embed integrated health promotion within musculoskeletal physiotherapy service delivery.

Methods

A physiotherapy-led multidisciplinary team introduced patients to other community-based support services to address wider health needs.

Results

Service evaluation demonstrated a high uptake of self-referral to community services, validating the potential benefit for musculoskeletal condition management. Positive patient feedback indicates that patients valued the service and were well-supported to engage with health improvement.

Conclusions

Musculoskeletal physiotherapy services need to consider the wider aspects of health, putting public health at the heart of musculoskeletal service delivery.