Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 11/21/16

Δευτέρα 21 Νοεμβρίου 2016

PROGRESSIVE MASSIVE FIBROSIS IN A CASE OF SILICOSIS- A CASE REPORT

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Vishnukanth Govindaraj, Ravindrachary Mulkoju, BallaNagamalli Kumar, Vishal Kumar Chitkeshi, Adimulam Ganga Ravindra.
Aim: Silicosis also known as potters rot is the most common occupational lung disease. People employed in occupations like sandblasting, surface drilling, tunneling, silica flour milling, ceramic making are predisposed to developing silicosis. We report a case of progressive massive fibrosis secondary to silicosis in a stone quarry worker. Case Report: A forty five year old stone quarry worker presented with chronic dry cough and breathlessness. His chest CT showed presence of multiple calcified mediastinal lymphnodes with irregular mass like areas. Based on the occupational exposure and radiographic images, a diagnosis of progressive massive fibrosis due to silicosis was made. Discussion: Pneumoconiosis is group of lung diseases related to occupational exposure to inhaled dust. The most common among pneumoconiosis is silicosis. Based on the amount and duration of exposure the clinical and radiological features of silicosis vary. Progressive massive fibrosis is a potentially fatal stage in complicated silicosis. In a majority of cases, a positive occupational history and radiological features are sufficient to make a diagnosis. Conclusion: There is no specific treatment for silicosis. Avoidance of further exposure, using personal protective measures, periodic medical checkup and strict legislations to protect employees and a system to check compliance should be ensued.

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INVESTIGATION ON THE SOLAR CYCLE SIGNATURE ON THE HADLEY CIRCULATION BASED ON THE INTENSITY AND DURATION OF THE SOLAR CYCLE

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
C. Vedavathi, M. Venkat Ratnam, V.V.M. Jagannadha Rao, N. Venkwateswara Rao, and S. VijayaBhaskara Rao.
It is well known that there are profound effects of solar cycle (SC) on the tropical deep convection and hence the atmospheric circulations. However, it is unknown how the intensity and duration of SC is going to affect the circulation patterns. In the present study, the effect of SC on the Hadley circulation (HC) is investigated based on intensity and duration of the SC using ERA-Interim dataset obtained during 1979-2012. Maximum and minimum SC is differentiated based on sunspot number (SSN) with cut-off at >=100 and

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POSTPARTUM ACUTE KIDNEY INJURY: FALLING TREND IN DEVELOPING WORLD

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Nikunj Navadiya, Hina V. Oza, Pallavi Ninama, Hafsa Vohra.
Aims and Objectives: To study epidemiological factors, risk factors, morbidity and mortality among patients in postpartum period having acute kidney injury at a tertiary care centre. Materials and Methods: This is a Retrospective Study based on obstetric patients with oliguria/anuria or referred for high s.creatinine to Civil Hospital, Ahmadabad, Gujarat, India from July 2014 to January 2015. Details of these patients like history, examination and investigation findings were recorded and final data analysis done. Results: All of the patients with postpartum AKI had oliguria/anuria and /or high serum creatinine. Most of the patients were anaemic. Most of the AKI occurred in early (

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RELATIONSHIP OF GRIP AND PINCH STRENGTH TO BODY MASS INDEX AMONG DENTAL PROFESSIONALS - CROSS SECTIONAL STUDY

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Fazin Abdul Salam, Thangadurai Chinnakalai.
Aim: To determine the relationship of grip and pinch strength to body mass index among dental professionals. Methodology: In this cross sectional study total number of 150 dental professionals, aged 22 to 40 years, who fulfilled selection criteria, were recruited through Purposive sampling. Participants height, weight, body mass index, grip strength, lateral pinch strength, Pad to Pad pinch strength and Tip to Tip pinch strength were then assessed. All measurements were taken by using standardized procedures. The data collected was analyzed by using Pearsons correlation test. Results: The inferential statistics had shown that there was a significant positive correlation between body mass index and grip strength with correlation coefficient (r) value of 0.233 (p = 0.004), body mass index and lateral pinch strength with of r value 0.259 (p value = 0.01), body mass index and pad to pad pinch strength with r value of 0.209 (p value = 0.05), body mass index and tip to tip pinch strength with r value of 0.169(p value = 0.05). Conclusion: The study shows that there is a significant weak positive correlation between body mass index and Grip strength, body mass index and lateral pinch strength, body mass index and pad to pad pinch strength & body mass index and tip to tip pinch strength.

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TREND IN EXTRAPULMONARY TUBERCULOSIS WITH SPECIAL REFERENCE TO LYMPH NODES-A FIVE YEARS STUDY

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Pammy Sinha, K. Sivakami, R. Thamilselvi.
Introduction: Tuberculosis is still one of the most frequently occurring infectious diseases worldwide. The term extrapulmonary tuberculosis has been used to describe the isolated occurrence of TB at body sites other than the Lung. In India extrapulmonary tuberculosis comprises 20% of all cases of tuberculosis. Aim & Objective: To study the clinicomorphological pattern of lymphnode pathology. Material & Methods: Our study is a retrospective analysis of all lymphnode excision cases received in the Department of Pathology for a period of 5 years (January 2007 to December 2011). Result: We received a total of 98 cases, of which 36 were tubercular lymphadenitis. Maximum number of cases was in the age group of 22-31 years and females outnumbered males. Conclusion: Cervical group of lymphnodes were most commonly involved and cases w ere at peak in 2011 after which it reduced.

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CLINICAL STUDY OF CONTEMPORARY PATTERN AND OUTCOME OF HYPERTENSION IN PREGNANCY AMONG PRIMIPAROUS AND MULTIPAROUS WOMEN IN A TERTIARY CARE CENTRE

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Renukadevi B., Kavitha G., Rathna Ramamurthy, Raja rajeshwari.
Introduction: Hypertension complicates 10% of all pregnancies. Various adverse outcomes of hypertension in pregnancy include antepartum hemorrhage, postpartum hemorrhage, acute renal and hepatic failure, maternal death, preterm birth, intrauterine growth retardation, and neonatal death. Despite various screening tools, there is high prevalence of hypertension in pregnancy and its related complications. Periodical analysis such cases are of utmost importance as it may help in early identification of the problem and measures to prevent its complications. Objectives: The objectives of this study is to identify the difference in pattern of hypertension in primiparous and multiparous women and its maternal and fetal outcomes and differences in lab parametersin both groups. Methodology: This was a retrospective study conducted among 88 women with hypertension and /or proteinuria complicating pregnancy who were admitted for delivery in the department of obstetrics and gynaecology, Velammal Medical College over a period of 1 year (Aug 2015 July 2016). The data were collected from the patients records. The patients were divided into two groups, primiparous and multiparous. The data were collected in terms of age, parity, gestational age, mode of delivery, birth weight of baby and complications. The results were statistically analysed with IBM SPSS statistics software 23.0 version. Results: The frequency of hypertensive disorders of pregnancy was 11.6 % in our study. The prevalance of eclampsia was 0.7%. The mean gestational age of babies was 39 weeks and 36 weeks in mild and severe preeclampsia in primiparous women and 37.5 and 34.2 weeks in multiparous women. The mean platelet count in mild and severe cases were 2.5 and 1.8 lakhs/cu mm in primiparous and 2.4 and 1.9 lakhs/cu mm in multiparous women. Conclusion: Though the prevalence of hypertension in primiparous women is more, the prevalence of severe preeclampsia in more common in multiparous women. Almost all cases of eclampsia occurred in primiparous women. A different pathophysiology could be a cause of hypertension in pregnancy in primiparous and multiparous women, as implied by significant differences in both groups.

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OBJECTIVE ASSESSMENT OF PHYSIOLOGIC AGEING CHANGES BY PATTERN REVERSAL VISUAL EVOKED POTENTIALS

2016-11-21T23-12-26Z
Source: International Journal of Current Research and Review
Sangeeta Gupta, Gaurav Gupta.
Background: Impairment of visual information processing is one of the profound physiologic effects of ageing. Visual evoked potentials can record electrophysiological alterations in the visual pathways that can occur due to ageing and the nature of the impact in the older adults can be evaluated. Rapidly increasing size of the older population further emphasizes the acquisition of the data for this proportion of population optimizing the clinical evaluation in this group. Methods: Pattern-reversal visual evoked potentials (PRVEP) were recorded in 120 healthy subjects in the age-group of 20-80 years (60 males and 60 females). Mean P100 latencies and N75-P100 amplitudes were compared in different age-groups by one way ANOVA. Correlations of latencies and amplitudes with age were performed using Pearson correlation coefficient. Gender differences were studied by unpaired t test. P value

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Noninvasive monitoring of early antiangiogenic therapy response in human nasopharyngeal carcinoma xenograft model using MRI with RGD-conjugated ultrasmall superparamagnetic iron oxide nanoparticles

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An evaluation of inpatient morbidity and critical care provision in Zambia

Summary

The aim of this study was to objectively measure demand for critical care services in a southern African tertiary referral centre. We carried out a point prevalence study of medical and surgical admissions over a 48-h period at the University Teaching Hospital, Lusaka, recording the following: age; sex; diagnosis; Human Immunodeficiency Virus (HIV) status and National Early Warning Score. One-hundred and twenty medical and surgical admissions were studied. Fifty-four patients (45%) had objective evidence of a requirement for critical care review and potential or probable admission to an intensive care unit, according to the Royal College of Physicians (UK) guidelines. A greater than expected HIV rate was also noted; 53 of 75 tested patients (71%). When applied to the estimated 17,496 annual acute admissions, this would equate to 7873 patients requiring critical care input annually at this hospital alone. In contrast to this demand, we identified 109 critical care beds nationally, and only eight at this institution.

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Intensive care medicine in rural sub-Saharan Africa

Summary

We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).

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Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes

The HiFocus Mid-Scala (MS) electrode array has recently been introduced onto the market. This precurved design with a targeted mid-scalar intracochlear position pursues an atraumatic insertion and optimal distance for neural stimulation. In this study we prospectively examined the angular insertion depth achieved and speech perception outcomes resulting from the HiFocus MS electrode array for 6 months after implantation, and retrospectively compared these with the HiFocus 1J lateral wall electrode array. The mean angular insertion depth within the MS population (n = 96) was found at 470°. This was 50° shallower but more consistent than the 1J electrode array (n = 110). Audiological evaluation within a subgroup, including only postlingual, unilaterally implanted, adult cochlear implant recipients who were matched on preoperative speech perception scores and the duration of deafness (MS = 32, 1J = 32), showed no difference in speech perception outcomes between the MS and 1J groups. Furthermore, speech perception outcome was not affected by the angular insertion depth or frequency mismatch.
Audiol Neurotol 2016;21:316-325

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Involvement of Dpp IV/CD26 in Cutaneous Wound Healing Process in Mice

ABSTRACT

Dipeptidyl peptidase IV (DPP IV/CD26) is a widely distributed multifunctional protein that plays a significant role in different physiological as well as pathological processes having a broad spectrum of bioactive substrates and immunomodulative properties. It has potential influence on different processes crucial for wound healing, including cell adhesion, migration, apoptosis and extracellular matrix degradation. However, despite its known enzymatic and immunomodulative functions, limited data characterize the role of DPP IV/CD26 in cutaneous wound healing mechanisms. The aim of this study was to investigate the process of wound healing in conditions of CD26 deficiency in order to obtain better insights on the role of DPP IV/CD26 in cutaneous regeneration. Experimental wounds were made on the dorsal part of CD26 deficient (CD26^-/-) and wild-type mice (C57BL/6). The process of cutaneous wound healing was monitored on defined time-schedule post wounding by macroscopic, microscopic, and biochemical analyses. Obtained results revealed a better rate of wound closure, revascularization and cell proliferation in CD26^-/- mice, with enhanced local expression of hypoxia-inducible factor 1α and vascular endothelial growth factor. CD26 deficiency induced prompt macrophage recruitment at the site of skin damage but did not influence mobilization of T-cells in comparison to wild-type mice. CD26^-/- mice have significantly higher values of IP-10 in serum and control skins compared to wild-type mice but values in wounds did not differ significantly on days 2, 4 and 7 of wound healing. DPP IV/CD26 activity was found to be decreased 4 days post-wounding in serum and 2, 4 and 7 days post-wounding in wounds of wild-type animals compared to control skins. These findings contribute to better understanding of wound healing mechanisms and could give a support in finding new therapeutic approaches for wound healing and tissue regeneration. This article is protected by copyright. All rights reserved.

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The transcriptional responses of cultured wound cells to the excretions and secretions of medicinal Lucilia sericata larvae

Abstract

Maggots, through their excretions and secretions (ES), promote wound healing by removing necrotic tissue, counter bacterial infection, and activate wound associated cells.

We investigated the effects of a physiological dose of maggot ES on four wound-associated cell types in vitro with Affymetrix gene expression arrays; keratinocytes, endothelial cells, fibroblasts and monocytes. Keratinocytes showed the fewest (n=5; p<0.05, fold-change ±2) and smallest fold-changes (up to 2.32x) in gene expression and conversely THP1 monocytes had the most (n=233) and greatest magnitude (up to 44.3x). There were no genes that were altered in all four cell-lines. Gene pathway analysis identified an enrichment of immune response pathways in three of the treated cell-lines. Analyses by quantitative RT-PCR found many genes dynamically expressed in ES dose dependent manner during the three day treatments. Phenotype analyses however found no effects of ES on cell viability, proliferation, migration and angiogenesis. ES was 100x less potent at triggering IL-8 secretion than fibroblasts treated with purified bacterial lipopolysaccharide (LPS; in equivalent amounts to that found in ES; ∼40EU/mL). Furthermore, co-treatment with LPS and ES decreased the LPS-alone triggered IL-8 secretion by 13%. Although ES had no direct effect on wound cell phenotypes it did partially reduce the immune response to bacterial LPS exposure. These observations were consistent with the profile of transcriptional responses that were dominated by modulation of immune response genes. Maggot therapy may therefore improve wound healing through the secondary effects of these gene changes in the wound cells. This article is protected by copyright. All rights reserved.

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E-cigarettes raise teens’ risk of persistent cough and wheeze, study finds

Teenagers who use e-cigarettes have twice the risk of respiratory symptoms such as persistent cough, bronchitis, and wheeze as those who have never used the devices, a large US study has found.1Use...

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Final appeal seeks to block minimum alcohol price in Scotland

A final legal challenge is to be made to try to block the introduction in Scotland of a minimum price on a unit of alcohol, in a move that has been roundly condemned by health campaigners.The Scotch...

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A high number of stromal tumor-infiltrating lymphocytes is a favorable independent prognostic factor in M0 (stages I–III) esophageal squamous cell carcinoma

Summary

Esophageal cancer is a highly invasive tumor with a poor prognosis. Lymphocytes play an important role in systemic immune responses, but their role in cancers varies depending on the specific tumor microenvironment. The aim of this study was to provide evidence for tumor-infiltrating lymphocytes (TILs) as a prognostic biomarker in esophageal squamous cell carcinoma. TIL analysis was retrospectively performed on full-face hematoxylin and eosin-stained sections from 127 patients. A majority (92.6%) of tumors had at least 10% stromal TILs (sTILs) (range, 10%–90%), and 84.3% of cancers had at least 10% intraepithelial TILs (iTILs) (range, 10%–40%). Multivariate analysis showed progressively better overall survival (P < 0.001, hazard ratio = 0.968, 95% confidence interval 0.955–0.981) and disease-free survival (P = 0.005, hazard ratio = 0.982, 95% confidence interval 0.970–0.995) in patients with higher sTILs. Marginal increases in overall survival and disease-free survival were found in the higher iTILs cohort versus the lower iTILs cohort, but the difference was not significant. In conclusion, in addition to tumor stage increasing stromal lymphocytic infiltration is an independent prognostic factor for esophageal squamous cell carcinoma treated by radical resection.

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Outcomes of definitive chemoradiation in patients with esophageal cancer

Summary

The incidence of esophageal cancer has risen dramatically in the Western world. Although surgical resection of esophageal tumors is considered the cornerstone of curative approaches in localized esophageal cancer, approximately 40% of patients who undergo chemoradiation followed by surgery will experience a recurrence. Additionally, surgical resection is not a viable option for many patients with locally advanced unresectable disease, poor general condition or whose condition deteriorated following chemoradiation. Several investigators have, therefore, attempted to evaluate the outcomes of definitive chemoradiation in patients with localized or locally advanced esophageal cancer. The outcomes of concurrent chemoradiation remain a matter of debate given the heterogenous study design and treatment regimens used in recent trials. Understanding the clinical benefit of chemoradiation is essential prior to recommending it as an alternative to surgery. In our review, we present the most recent studies evaluating the role of chemoradiation to better define the clinical outcomes of patients with special attention to overall survival.

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Effects of eosinophilic oesophagitis on quality of life in an adult UK population: a case control study

Summary

Eosinophilic oesophagitis (EoE) is a chronic immune-mediated esophageal disease, characterized by symptoms related to esophageal dysfunction and histologically by eosinophil predominant inflammation. Current evidence for an adverse impact on quality of life (QoL) is conflicting and there are no data from a UK population regarding QoL. We conducted a prospective cross-sectional observational study using the Short Form-36 Health Survey, Hospital Dysphagia/Odynophagia Questionnaire, and the EoE Adult Quality of Life Questionnaire to assess QoL and severity of dysphagia in EoE patients, compared to age and gender matched healthy control subjects. Data were also collected on comorbidity and medication use. Eighty-eight subjects were recruited (44 patients). Patients had higher rates of antihistamine and topical (swallowed) corticosteroid use. Physical QoL did not differ between patients and controls, although patients did report a statistically significant lower mental QoL, with small absolute magnitude of difference. Patients reported higher dysphagia scores and these were negatively correlated with both physical and mental QoL. Higher rates of dysphagia and medication use in patients may among other things account for lower mental QoL. However, a higher rate of dysphagia in patients is not associated with a reduced physical QoL. Our findings are of clinical value, particularly when a new diagnosis of EoE is made, as clinicians can reassure patients that their general physical health should not be greatly affected by the diagnosis. Moreover, it may also be useful for patients to be aware that EoE may have an impact on their mental health, but this effect is likely to be small. We therefore advocate education and reassurance in this respect for all patients at diagnosis.

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P21, COX-2, and E-cadherin are potential prognostic factors for esophageal squamous cell carcinoma

Summary

Much research effort has been devoted to identifying prognostic factors for esophageal squamous cell carcinoma (ESCC) by immunohistochemistry; however, no conclusive findings have been reached thus far. We hypothesized that certain molecules identified in previous studies might serve as useful prognostic markers for ESCC. Therefore, the aim of the current study was to validate the most relevant markers showing potential for ESCC prognosis in our prospective esophageal cancer database. A literature search was performed using the PubMed database for papers published between 1980 and 2015 using the following key words: ‘esophageal cancer,’ ‘prognosis,’ and ‘immunohistochemistry.’ Literature selection criteria were established to identify the most widely studied markers, and we further validated the selected markers in a cohort from our single-surgeon team, including 153 esophageal cancer patients treated from 2000 to 2010. A total of 1799 articles were identified, 82 of which met the selection criteria. Twelve markers were found to be the most widely studied, and the validation results indicated that only P21, COX-2, and E-cadherin were independent prognostic factors for ESCC patients in this series. The systemic review and cohort validation suggest that P21, COX-2, and E-cadherin are potential prognostic factors for ESCC, paving the way for more targeted prospective validation in the future.

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Development of a nomogram for the prediction of pathological complete response after neoadjuvant chemoradiotherapy in patients with esophageal squamous cell carcinoma

Summary

Nomograms incorporating multiple prognostic factors are useful for individualized estimation of survival in cancer patients. However, nomograms for the prediction of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with esophageal cancer are scarce. Here, we describe the development of a nomogram for predicting pCR after nCRT in patients with esophageal squamous cell carcinoma (ESCC). We retrospectively reviewed the records of 392 ESCC patients who underwent nCRT followed by esophagectomy. Seventy percent of the participants (n = 274) were randomly assigned to a training cohort, whereas the remaining 30% were included in a validation cohort (n = 118). Data from the training cohort were subjected to multivariate logistic regression analyses for selecting variables to be included in the nomogram. The performance of the resulting nomogram was internally and externally validated by calculating the bias-corrected concordance statistic (c-statistic) and the area under the receiver operating characteristics curve (AUROC) in the training and validation cohorts, respectively. After surgery, 25.77% of the study patients achieved pCR. The following variables were included in the nomogram: (i) age, (ii) pretreatment tumor length, (iii) history of head and neck cancer, (iv) post-nCRT albumin levels, and (v) post-nCRT endoscopic findings coupled with endoscopic biopsy results. The bias-corrected c-statistic and AUROC of the internal and external validation sets were 0.77 and 0.747, respectively. Our nomogram showed a good performance for predicting pCR after nCRT in ESCC patients.

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Review of chemotherapeutic approaches for operable and inoperable esophageal squamous cell carcinoma

Summary

The predominant histological types of esophageal cancer are adenocarcinoma and squamous cell carcinoma. Since these two histological types present as different diseases in terms of their epidemiology, pathologenesis, and tumor biology, separate therapeutic approaches should be developed against each type. While surgical resection remains the dominant therapeutic intervention for patients with operable esophageal squamous cell carcinoma (ESCC), their high rates of tumor recurrence have prompted investigation of multimodality therapies that combine surgery with chemotherapy, radiotherapy, and chemoradiotherapy. In Japan, preoperative chemotherapy with cisplatin (CDDP) plus 5-fluorouracil (5-FU) followed by radical esophagectomy has been accepted as the standard therapeutic approach for resactable clinical Stage II/III ESCC. Similarly, the CDDP and 5-FU regimen has been accepted as the first-line treatment for metastatic and unresectable ESCCs in Japan. Thus, in Japan chemotherapy is an indispensable component of therapy for both resectable and unresectable ESCCs. This review discusses the current knowledge, rationale, and available data regarding chemotherapy for resectable and unresectable ESCCs.

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Patterns of reflux in gastroesophageal reflux disease in pediatric population of New South Wales

Summary

This study is to determine the association of ambulatory pH monitoring (24hr pH) with symptoms of gastroesophageal reflux and its other investigations. The clinical and epidemiological profiles of subjects referred for reflux disorders are also studied. Symptoms or group of symptoms, profiles and prior investigations of 1259 consecutive pediatric subjects (with 1332 24hr pH studies performed) referred for evaluation of reflux disorders between 1988 and 2012 were retrospectively studied. Chi-square or fisher exact test was used for hypothesis testing, student t-test for the comparison of means and the Wilcoxon rank-sum test for comparing medians of continuous variables. Gastroesophageal reflux disease (GERD), defined as reflux causing major symptoms and complications, was diagnosed in 57.5% subjects of the total sample. Forty-three percent were girls and 56.7% were boys. The most common age group was between 4 months and 2 years (51.2%). Vomiting (64.4%) and irritability (74%) were the most common symptoms with the neurological conditions (23.2%) being the most frequent underlying condition. The parameters used in 24hr pH were significantly higher in those diagnosed with GERD (P < 0.0001). The prevalence of GERD was found to be significantly higher when both gastrointestinal and respiratory symptoms were present (P = 0.008) at 66.4% than when compared with gastrointestinal (56.5%) and respiratory (52.2%) symptoms in isolation. Symptoms alone were not reliable in diagnosing GERD. Only 57.5% had GERD among patients referred for reflux disorders. 24hr pH is reliable and should be considered routine in reflux disorders, as it identifies patients with pathologic reflux and avoids a needless surgery. © 2016 International Society for Diseases of the Esophagus

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Efficacy and safety of cisplatin-based versus nedaplatin-based regimens for the treatment of metastatic/recurrent and advanced esophageal squamous cell carcinoma: a systematic review and meta-analysis

Abstract

Cisplatin and nedaplatin show significant antitumor activity and have been widely used for esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether the efficacy and safety of nedaplatin-based regimens are comparable to those of cisplatin-based regimens in patients with metastatic/recurrent or advanced ESCC. Therefore, we conducted a systematic review and meta-analysis to compare the efficacy and safety of these two regimens for the treatment of metastatic/recurrent and advanced ESCC. We systematically searched Pubmed, Web of Science, and the Cochrane Database, as well as abstracts presented at conferences (all up to January 2015), for randomized-controlled and nonrandomized clinical trials that compared cisplatin-based and nedaplatin-based regimens in patients with metastatic/recurrent or advanced ESCC. Data were extracted from the original studies by two independent reviewers. This meta-analysis was performed using Review Manager (RevMan) Version 5.3 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014) software. Ten eligible trials, including 598 patients diagnosed with metastatic/recurrent or advanced ESCC, were included in our analysis. Our results demonstrated that the nedaplatin-based regimens were comparable to the cisplatin-based regimens in terms of overall survival (OS) (hazard ratio, HR: 1.22, 95% confidence interval, CI: 0.86–1.74, p = 0.26) and overall response rate (ORR) (risk ratio, RR: 0.92, 95% CI: 0.77–1.10, p = 0.37) and generated fewer grade 3 and 4 side effects including nausea (RR: 3.41, 95% CI: 1.67–6.96, p < 0.001) and vomiting (RR: 3.62, 95% CI: 1.77–7.40, p < 0.001) and fewer grade 1 and 2 adverse events including nausea (RR: 1.54, 95% CI: 1.23–1.93, p < 0.001), vomiting (RR: 1.76, 95% CI: 1.76–2.30, p < 0.001), peripheral neuropathy (RR: 1.75, 95% CI: 1.08–2.84, p = 0.02) and renal dysfunction (creatinine) (RR: 3.28, 95% CI: 1.37–7.84, p = 0.008). This systematic review and meta-analysis indicated that the efficacy of nedaplatin-based regimens was comparable to that of cisplatin-based regimens for patients with metastatic/recurrent or advanced ESCC, and that nedaplatin-based regimens were associated with less toxicity and better tolerability. However, this study was a meta-analysis of previously released data; therefore, there is a potential publication bias and heterogeneity among the included trials. Future, well-designed RCTs with large cohorts are warranted.

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Long-term benefit of transoral incisionless fundoplication using the esophyx device for the management of gastroesophageal reflux disease responsive to medical therapy

Summary

Transoral incisionless fundoplication (TIF) using the EsophyX device has been shown to be effective and safe in patients with Gastroesophageal reflux disease (GERD); however, the subset of patients that would mostly benefit from this technique remains unknown. The aim of this study was to evaluate the long-term efficacy and safety of the TIF procedure in patients with a history of esophagitis or proven chronic GERD who have achieved symptom control with the administration of proton pump inhibitors (PPIs) but did not wish to continue receiving medications for life. Forty-five patients with typical GERD symptoms (heartburn, regurgitation, chest pain) and a history of esophagitis grade A and B or proven GERD by esophageal pH monitoring underwent TIF using Esophyx. Patients with eosphagitis C and D or those with large hiatal hernias (>2 cm in length) were excluded. The primary clinical effectiveness measure was GERD symptom elimination at follow up based on normalization of the GERD health related quality of life (GERD-HRQL) questionnaire. After a median follow up period of 59 months (36–75) the median GERD-HRQL scores improved significantly from 27 (2–45) at baseline to 4 (0–26) (P < 0.001) in the 44 patients completing the study. Heartburn was eliminated in 12 out of the 21 patients included (57.1%), regurgitation was eliminated in 15 out of the 17 patients included (88.2%) and finally chest pain was eliminated in 5 patients out of the six patients included (83.3%). Overall, 32 patients out of the 44 patients (72.7%) that completed the study follow up reported elimination of their main symptom, without the need for PPI administration (none PPI usage). Furthermore, six more patients (13.6%), five with heartburn, and one with regurgitation reported half PPI dose taken for <50% of the preceding follow up period (occasional PPI usage), while six more patients (four with heartburn, one with regurgitation, and one with chest pain) reported full or half PPI dose taken for more than 50% of the preceding follow up period (daily PPI usage). Creation of an esophagogastric fundoplication using the EsophyX device abolished reflux symptoms in 72.7% of PPI-responsive GERD patients at a median 59 month follow-up.

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Tagging polymorphisms of methyl-CpG binding domain 4 and gastric cardiac adenocarcinoma risk in a Chinese population

Summary

Potential effects of genetic factors on carcinogenesis of gastric cardiac adenocarcinoma (GCA) may exist. The present experiment specifically evaluated the genetic influence of single nucleotide in methyl-CpG binding domain 4 (MBD4) on GCA tumorigenesis. A case–control experiment based on hospital recruited 330 GCA patients and 608 non-cancer patients was carried out. We employed ligation detection reaction method to detect the genotypes. The results revealed that MBD4 rs3138373, rs2005618, and rs3138355 mutations had no significant association with the risk of GCA. However, a lower risk of GCA presented in male patients who carried the MBD4 rs3138355 G>A polymorphic loci by the stratified analyses. In general, The MBD4 gene polymorphism could not influence GCA hereditary predisposition. Nevertheless, whether the finding learned from our experiment could apply to other ethnic groups will remain vague until future multicenter studies further test and verify our conclusions.

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Viruses, Vol. 8, Pages 313: Erratum: Tahara, M., et al. Measles Virus Hemagglutinin Protein Epitopes: The Basis of Antigenic Stability. Viruses 2016, 8, 216

The authors wish to make the following change to their paper [1].[...]

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miR-125b and miR-100 Are Predictive Biomarkers of Response to Induction Chemotherapy in Osteosarcoma

Osteosarcoma is the most common primary malignancy in bone. Patients who respond poorly to induction chemotherapy are at higher risk of adverse prognosis. The molecular basis for such poor prognosis remains unclear. We investigated miRNA expression in eight open biopsy samples to identify miRNAs predictive of response to induction chemotherapy and thus maybe used for risk stratification therapy. The samples were obtained from four patients with inferior necrosis (Huvos I/II) and four patients with superior necrosis (Huvos III/IV) following induction chemotherapy. We found six miRNAs, including miR-125b and miR-100, that were differentially expressed > 2-fold () in patients who respond poorly to treatment. The association between poor prognosis and the abundance of miR-125b and miR-100 was confirmed by quantitative reverse transcriptase-polymerase chain reaction in 20 additional osteosarcoma patients. Accordingly, overexpression of miR-125b and miR-100 in three osteosarcoma cell lines enhanced cell proliferation, invasiveness, and resistance to chemotherapeutic drugs such as methotrexate, doxorubicin, and cisplatin. In addition, overexpression of miR-125b blocked the ability of these chemotherapy agents to induce apoptosis. As open biopsy is routinely performed to diagnose osteosarcoma, levels of miR-125b and miR-100 in these samples may be used as basis for risk stratification therapy.

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Corrigendum to “HDR Brachytherapy in the Management of High-Risk Prostate Cancer”

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Corrigendum to “Effect of Short-Term Stimulation with Interleukin-1β and Differentiation Medium on Human Mesenchymal Stromal Cell Paracrine Activity in Coculture with Osteoblasts”

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Comment on “Incidence of Type 1 Diabetes among Children and Adolescents in Italy between 2009 and 2013: The Role of a Regional Childhood Diabetes Registry”

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Comparative Evaluation of Anthelmintic Activity of Edible and Ornamental Pomegranate Ethanolic Extracts against Schistosoma mansoni

Due to the development of praziquantel (PZQ) schistosomes resistant strains, the discovery of new antischistosomal agents is of high priority in research. This work reported the in vitro and in vivo effects of the edible and ornamental pomegranate extracts against Schistosoma mansoni. Leaves and stem bark ethanolic extracts of both dried pomegranates were prepared at 100, 300, and 500 μg/mL for in vitro and 600 and 800 mg/kg for in vivo. Adult worms Schistosoma mansoni in RPMI-1640 medium for in vitro and S. mansoni infected mice for in vivo tests were obtained from Theodor Bilharz Research Institute, Cairo, Egypt. In vitro activity was manifested by significant coupled worms separation, reduction of motor activity, lethality, and ultrastructural tegumental alterations in adult worms. In vivo activity was manifested revealed by significant reduction of hepatic granulomas number and diameter, decreased number of bilharzial eggs in liver tissues, lowered liver inflammatory infiltration, decreased hepatic fibrosis, and inducible nitric oxide synthase (iNOS) expression. Ethanolic stem bark extract of edible pomegranate exhibited highest antischistosomal activities both in vitro and in vivo. Therefore, pomegranate showed a good potential to be used as a promising new candidate for the development of new schistosomicidal agents.

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Optimal Harvest Control in a Singular Prey-Predator Fishery Model with Maturation Delay and Gestation Delay

This paper presents a singular prey-predator fishery model, where maturation delay for prey and gestation delay for predator are considered. Fishing efforts are introduced to harvest prey and predator population, which are developed as control instruments to investigate optimal utilization of fishery resource. By analyzing associated characteristic equation, local stability analysis is studied due to combined variations of double time delays. Furthermore, Pontryagin’s maximum principle is utilized to characterize optimal harvest control, and the optimality system is numerically solved based on an iterative method.

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Residual Stresses Introduced to Composite Structures due to the Cure Regime: Effect of Environment Temperature and Moisture

Material behaviour of structural components is very important to understand. In fibre reinforced polymer composite materials, this is more difficult in comparison to isotropic materials as they are made up of two constituents: the fibre and the matrix. For aerospace composite materials, the matrix is usually an epoxy resin that cures at a high temperature. This curing regime is known to introduce residual stresses to the composite material as it cools from the high cure temperature. However, how to consider these residual stresses in a structural analysis is still widely debated. In this paper, the authors investigated the offset of thermal residual strains introduced by the cure regime by the swelling of the composite when exposed to moisture.

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Traditional Chinese Mind and Body Exercises for Promoting Balance Ability of Old Adults: A Systematic Review and Meta-Analysis

The purpose of this study was to provide a quantitative evaluation of the effectiveness of traditional Chinese mind and body exercises in promoting balance ability for old adults. The eligible studies were extensively searched from electronic databases (Medline, CINAHL, SportDicus, and Web of Science) until 10 May 2016. Reference lists of relevant publications were screened for future hits. The trials used randomized controlled approaches to compare the effects of traditional Chinese mind and body exercise (TCMBE) on balance ability of old adults that were included. The synthesized results of Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and static balance with 95% confidence intervals were counted under a random-effects model. Ten studies were selected based on the inclusion criteria, and a total of 1,798 participants were involved in this review. The results of the meta-analysis showed that TCMBE had no significant improvement on BBS and TUG, but the BBS and TUG could be obviously improved by prolonging the intervention time. In addition, the results showed that TCMBE could significantly improve the static balance compared to control group. In conclusion, old adults who practiced TCMBE with the time not less than 150 minutes per week for more than 15 weeks could promote the balance ability.

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Radiation Protection Practices during the Helium Circulator Maintenance of the 10 MW High Temperature Gas-Cooled Reactor-Test Module (HTR-10)

Current radiation protection methodology offers abundant experiences on light-water reactors, but very few studies on high temperature gas-cooled reactor (HTR). To fill this gap, a comprehensive investigation was performed to the radiation protection practices in the helium circulator maintenance of the Chinese 10 MW HTR test module (HTR-10) in this paper. The investigation reveals the unique behaviour of HTR-10’s radiation sources in the maintenance as well as its radionuclide species and presents the radiation protection methods that were tailored to these features. Owing to these practices, the radioactivity level was kept low throughout the maintenance and only low-level radioactive waste was generated. The quantitative analysis further demonstrates that the decontamination efficiency was over 89% for surface contamination and over 34% for dose rate and the occupational exposure was much lower than both the limits of regulatory and the exposure levels in comparable literature. These results demonstrate the effectiveness of the reported radiation protection practices, which directly provides hands-on experience for the future HTR-PM reactor and adds to the completeness of the radiation protection methodology.

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