Κυριακή, 24 Ιουλίου 2016

Potential Role of PAX5 in Breast Cancer: Relation to CD19

Source: Journal of Investigational Biochemistry
Manal Basyouni Ahmed, Muneera Al-Sheeha, Maha Imam Ahmed, Enas Samir Nabih.
Background: PAX5 is a transcriptional factor that considered as one of the key molecules for regulation of many cancer associated genes. Objectives: The aim of this study was to examine status of PAX5 in human breast carcinoma through assessment its relation to CD19 expression. Patients and Methods: PAX5 and CD19 expression in breast tissue samples were measured by RT-PCR in 90 female breast specimens including 50 cases of invasive ductal carcinoma, 25 cases with fibroadenoma and 15 non-pathological breast tissue as control group. Results: The best cut-off values for the investigated markers were determined by ROC curve. PAX5 at 0.05 was 92.0% sensitivity and 92.5% specificity while CD19 at 0.62 was 94.0% sensitivity and 95.0% specificity. Moreover, positivity rates and mean levels for PAX5 and CD19 showed significant difference among the three investigated groups (p

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Survivor helps groups promote CPR training, organ donation

By Lauren Rosenblatt
The Pittsburgh Post-Gazette

PITTSBURGH, Pa. — On the morning of January 20, 2010, Eileen Kline didn't wake up. As they waited for the paramedics to arrive, her son and her husband performed CPR, ultimately saving her life.

Ms. Kline had been a cardiopulmonary resuscitation instructor for over 25 years, but her son had just learned the technique in school.

"I'm very thankful but as a mother, I wish I had been there to support them," Ms. Kline, 56, from Upper St. Clair, said. "I feel like I need to spread the word. I feel like I was a lucky one."

As part of spreading the word, Ms. Kline told her story at "Save Lives to the Beat," an advocacy event to promote hands-only CPR training and organ donation.

With Zumba and Frisbees, representatives from the American Heart Association and CORE, the Center for Organ Recovery and Education, encouraged people to learn hands-only CPR so they would be prepared in the face of an emergency. At Saturday's event in Schenley Plaza in Oakland, nurses demonstrated the procedure and then participants practiced the technique on a dummy. Representatives from CORE also spoke about the importance of organ donation and its ability to save lives for people like Ms. Kline, who eventually needed a heart transplant.

The goal of the hands-only CPR training is to make bystanders feel comfortable to act in an emergency situation, said Brenda Parks, director of multicultural initiatives at the American Heart Association. "If people know the basics, it's a life saving technique," she said.

Hands-only CPR is meant to keep blood flowing through the body if the heart can no longer do so. Unlike traditional CPR, this does not involve mouth-to-mouth resuscitation because it does not give the victim as much oxygen as once thought and is not always necessary, according to Linda Fleming Heath, a retired nurse from the Western Psychiatric Institute and Clinic in Oakland. Hands-only CPR focuses on blood circulation and Ms. Fleming Heath said the chest must rise between each compression in order to maximize the amount of blood that reaches the heart.

The goal is to reach 100 to 120 pumps per minute and each compression should be about two inches deep. Ms. Fleming Heath said if the compressions are not hard enough, the blood won't make it to the brain.

"You can break ribs, you can puncture a lung," she said. "But you can't fix dead."

CPR can double the chances of survival for someone like Ms. Kline, who was in cardiac arrest, which is when the heart has an abnormal rhythm and can no longer pump blood. Annually, there are more than 350,000 cardiac arrests that occur outside of the hospital, according to data from the American Heart Association, but only 46 percent of those victims get CPR from a bystander. To try to increase bystander participation, representatives from the heart association are working to require that students receive hands-only CPR training before they graduate from high school.

Annamore Matambanadzo of Crafton said she went to the event so she would be educated enough to encourage others to get the training, including students, immigrants and refugees. When she saw two medical students perform CPR for a man who had collapsed on the street, she said it was their confidence in their ability to perform CPR that allowed them to act so quickly.

"I'm going to be the ambassador," she said. "I'm going to say 'hey you need this training, it saves lives.'"

Copyright 2016 the Pittsburgh Post-Gazette

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The Study on Creating of the Awareness about Substance Addiction through Context-Based Learning

Source: Bağımlılık Dergisi - Journal of Dependence
Esra Özay Köse, Şeyda Gül, Bülent Keskin.
The aim of this study is to create awareness about substance addiction for secondary school students. For this aim, it was examined the difference between awareness levels about substance addiction of the students who attended the course prepared with context-based learning and the students who attended to the course with traditional method. It was also examined the status of the students awareness scores in terms of gender and grade. The study was implemented with total of 229 students who attended t 9-12th grade from secondary school in Erzincan. In the study used in quasi-experimental research design, the data collection tool was Substance Addiction Awareness Scale (SAAS) developed by the researchers. The data were analyzed with mean score, standard deviation, independent sample t test and one way ANOVA. The findings indicated that there was a significant difference between the awareness levels of the students in experimental and control group in favor of experimental group. And also, there was no difference between the awareness levels of the students in terms of gender and grade.

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Epidemiological Analysis of Ocular Melanoma in University Clinic Center in Tuzla, Bosnia and Herzegovina

Source: Materia Socio Medica
Amra Nadarevic Vodencarevic, Vahid Jusufovic, Svjetlana Terzic, Musfaha Burgic, Meliha Halibasic, Mersiha Sinanovic.
Aim: Melanoma represents a malignant tumour arising from melanocytes. Uveal melanoma is the most common primary ocular malignancy among the adult population. The aim of the study was to examine epidemiological characteristics of ocular melanoma in University Clinic Centre in Tuzla, Bosnia and Herzegovina from January 2001 till November 2015. Methods and Materials: In this retrospective study we used all available medical documentation to investigate the clinical findings which included age, gender, tumour size, histopathological features and the precise anatomic origin of the ocular melanoma. Results: Over the 14 year period of this study, there were 32 patients with microscopically confirmed ocular melanoma at the Department of Pathology. All malignant melanoma were uveal origin. Discussion and conclusion: For early detection of the disease, regular checkups are necessary, especially in older population. As there is a limited number of reports on the epidemiology of malignant tumors of eye and ocular adnex in our region, this is very important study. We conclude that this is a first study in Bosnia and Herzegovina that document the number of uveal melanomas.

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Bologna Model of Medical EducationUtopia or Reality

Source: Materia Socio Medica
Lejla Zunic, Doncho Donev.
Higher education in Europe and in the Balkans countries is undergoing major reforms. The Bologna Process was a major reform created with the claimed goal of providing responses to issues such as the public responsibility for higher education and research, higher education governance, the social dimension of higher education and research, and the values and roles of higher education and research in modern, globalized, and increasingly complex societies with the most demanding qualification needs. Changes in the curricula, modernization of facilities and their alignment with the programs of other European universities, employment of a larger number of assistants, especially in the clinical courses at our universities are necessary. Also, it is necessary to continue to conduct further detailed analysis and evaluation of teaching content and outcomes in the future. In this review authors expressed their views and experience of using Bologna model of education in the Balkans countries with emphasis on Bosnia and Herzegovina and the Republic of Macedonia.

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The Quantitative Study of the Faculty Members Performance in Documentation of the Medical Records in Teaching Hospitals of Mazandaran University of Medical Sciences

Source: Materia Socio Medica
Zolaykha Asghari, Alireza Mardanshahi, Ebrahim Bagherian Farahabadi, Hasan Siamian, Ali Morad Heidari Gorji, Benyamin Mohseni Saravi, Esmaeil Rezazadeh, Seyyed Payam Paymard.
Introduction: Documentation of patients medical records has been always emphasized because medical records are as a means to be applied by patients, all medical staff, quality evaluations of health care, lawsuits, medical education and, etc. Regarding to this, each of the data elements available in the sheets of medical records has their own values. The rate of completion indicates the importance of the medical recorders for faculty member. So in this article the researcher evaluates the completion of medical records in the teaching hospitals of Mazandaran University of Medical Sciences. Methods and Materials: This cross- sectional study has been conducted to review the patients medical cases in five teaching university hospitals. To collect data, a check list was mode based on data element arrangement in four main sheets of admission and discharge, summery, patients history and clinical examination and progress note sheets. Recorded data were defined as Yes with the value 1, not recorded data were defined as No with the value 2, and not used data were defined for cases in which the mentioned variable had no use with the value Zero. The overall evaluation of the rate of documentation was considered as %95 -100 equal to good, 75-94% equal to average and under 75% was considered as poor. Using the sample volume formula, 281 cases were randomly stratified reviewed. The data were analyzed by the software SPSS version 19 and descriptive statistical scales. Results: The results have shown that the overall documentation rate in all the four sheets was 62% and in a poor level. There was no big difference in the average documentation among the hospital. Among the educational group, the gynecology and infection groups are equal to each other and had the highest record average (68%). Within the all groups, the highest rate has belonged to the documentation of signatures (91%). Conclusion: Regarding to the overall assessment that documentation rate was in a poor level, more attempt should be made to achieve a better condition. Even if a data element of the sheets seems meaningless, unnecessary and duplicated, it should not be ignored and skipped. In order to solve such problems, it is suggested that medical records sheets and the elements that seem unnecessary, should be reviewed in relevant committees.

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Microbiota metabolite short chain fatty acids, GPCR, and inflammatory bowel diseases


Gut microbiota has been well recognized in regulation of intestinal homeostasis and pathogenesis of inflammatory bowel diseases. However, the mechanisms involved are still not completely understood. Further, the components of the microbiota which are critically responsible for such effects are also largely unknown. Accumulating evidence suggests that, in addition to pathogen-associated molecular patterns, nutrition and bacterial metabolites might greatly impact the immune response in the gut and beyond. Short chain fatty acids (SCFA), which are metabolized by gut bacteria from otherwise indigestible fiber-rich diets, have been shown to ameliorate diseases in animal models of inflammatory bowel diseases (IBD) and allergic asthma. Although the exact mechanisms for the action of SCFA are still not completely clear, most notable among the SCFA targets is the mammalian G protein-coupled receptor pair of GPR41 and GPR43. In addition to the well-documented inhibition of histone deacetylases activity mainly by butyrate and propionate, which causes anti-inflammatory activities on IEC, macrophages, and dendritic cells, SCFA has recently been implicated in promoting development of Treg cells and possibly other T cells. In addition to animal models, the beneficial effects have also been reported from the clinical studies that used SCFA therapeutically in controlled trial settings in inflammatory disease, in that application of SCFA improved indices of IBD and therapeutic efficacy was demonstrated in acute radiation proctitis. In this review article, we will summarize recent progresses of SCFA in regulation of intestinal homeostasis as well as in pathogenesis of IBD.

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A novel intestinal organoid-based in vitro co-culture system to dissect out the initial host defense system

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Comparison of Thrombelastography-Derived Fibrinogen Values at Rewarming and Following Cardiopulmonary Bypass in Cardiac Surgery Patients.


BACKGROUND: The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consuming standard laboratory assays. The thrombelastography (TEG)-based functional fibrinogen level (FLEV) provides an assessment of whole blood clot under platelet inhibition to report calculated fibrinogen levels in significantly less time. If FLEV values obtained on cardiopulmonary bypass (CPB) during rewarming are similar to values obtained immediately after the discontinuation of CPB, then rewarming values could be used for preemptive ordering of appropriate blood product therapy. METHODS: Fifty-one cardiac surgery patients were enrolled into this prospective nonrandomized study to compare rewarming fibrinogen values with postbypass values using TEG FLEV assays. Baseline, rewarming, and postbypass fibrinogen values were recorded for all patients using both standard laboratory assay (Clauss method) and FLEV. Mixed-effects regression models were used to examine the change in TEG FLEV values over time. Bland-Altman analysis was used to examine bias and the limits of agreement (LOA) between the standard laboratory assay and FLEVs. RESULTS: Forty-nine patients were included in the analysis. The mean FLEV value during rewarming was 333.9 mg/dL compared with 332.8 mg/dL after protamine, corresponding to an estimated difference of -1.1 mg/dL (95% confidence interval [CI], -25.8 to 23.6; P = 0.917). Rewarming values were available on average 47 minutes before postprotamine values. Bland-Altman analysis showed poor agreement between FLEV and standard assays: mean difference at baseline was 92.5 mg/dL (95% CI, 71.1 to 114.9), with a lower LOA of -56.5 mg/dL (95% CI, -94.4 to -18.6) and upper LOA of 242.4 mg/dL (95% CI, 204.5 to 280.3). The difference between assays increased after CPB and persisted after protamine administration. CONCLUSIONS: Our results revealed negligible change in FLEV values from the rewarming to postbypass periods, with a CI that does not include clinically meaningful differences. These findings suggest that rewarming samples could be utilized for ordering fibrinogen-specific therapies before discontinuation of CPB. Mean FLEV values were consistently higher than the reference standard at each time point. Moreover, bias was highly heterogeneous among samples, implying a large range of potential differences between assays for any 1 patient. (C) 2016 International Anesthesia Research Society

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Cardiac Embryology and Molecular Mechanisms of Congenital Heart Disease: A Primer for Anesthesiologists.


Congenital heart disease is diagnosed in 0.4% to 5% of live births and presents unique challenges to the pediatric anesthesiologist. Furthermore, advances in surgical management have led to improved survival of those patients, and many adult anesthesiologists now frequently take care of adolescents and adults who have previously undergone surgery to correct or palliate congenital heart lesions. Knowledge of abnormal heart development on the molecular and genetic level extends and improves the anesthesiologist's understanding of congenital heart disease. In this article, we aim to review current knowledge pertaining to genetic alterations and their cellular effects that are involved in the formation of congenital heart defects. Given that congenital heart disease can currently only occasionally be traced to a single genetic mutation, we highlight some of the difficulties that researchers face when trying to identify specific steps in the pathogenetic development of heart lesions. (C) 2016 International Anesthesia Research Society

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A Step Toward Balance: Thrombin Generation Improvement via Procoagulant Factor and Antithrombin Supplementation.


BACKGROUND: The use of prothrombin complex concentrates in trauma- and surgery-induced coagulopathy is complicated by the possibility of thromboembolic events. To explore the effects of these agents on thrombin generation (TG), we investigated combinations of coagulation factors equivalent to 3- and 4-factor prothrombin complex concentrates with and without added antithrombin (AT), as well as recombinant factor VIIa (rFVIIa), in a dilutional model. These data were then used to develop a computational model to test whether such a model could predict the TG profiles of these agents used to treat dilutional coagulopathy. METHODS: We measured TG in plasma collected from 10 healthy volunteers using Calibrated Automated Thrombogram. TG measurements were performed in undiluted plasma, 3-fold saline-diluted plasma, and diluted plasma supplemented with the following factors: rFVIIa (group rFVIIa); factors (F)II, FIX, FX, and AT (group "combination of coagulation factors" [CCF]-AT); or FII, FVII, FIX, and FX (group CCF-FVII). We extended an existing computational model of TG to include additional reactions that impact the Calibrated Automated Thrombogram readout. We developed and applied a computational strategy to train the model using only a subset of the obtained TG data and used the remaining data for model validation. RESULTS: rFVIIa decreased lag time and the time to thrombin peak generation beyond their predilution levels (P

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The Use of Standard Gastrointestinal Endoscopic Ultrasound to Assess Cardiac Anatomy.


In this prospective observational study, conducted at an academic medical center, we evaluated the feasibility of performing a basic transesophageal echocardiography (TEE) examination using endoscopic ultrasound (EUS) technology to determine what cardiac structures could be assessed. This may be potentially beneficial during hemodynamic emergencies in the endoscopy suite resulting from hypovolemia, depressed ventricular function, aortic dissection, pericardial effusions, or aortic stenosis. Of the 20 patients enrolled, 18 underwent EUS with a linear echoendoscope for standard clinical indications followed by a cardiac assessment performed under the guidance of a TEE-certified cardiac anesthesiologist. Eight of the 20 standard views of cardiovascular structures per the 1999 American Society of Echocardiography/Society of Cardiovascular Anesthesiologists guidelines for TEE could be obtained using the linear echoendoscope. The following cardiac valvular structures were visualized: aortic valve (100%), mitral valve (100%), tricuspid valve (33%), and pulmonic valve (11%). Left ventricular and right ventricular systolic function could be assessed in 89% and 67% of patients, respectively. Other structures such as the ascending and descending aorta, pericardium, left atrial appendage, and interatrial septum were identified in 100% of patients. Doppler-dependent functions could not be assessed. Given that the EUS images were not directly compared with TEE in these patients, we cannot comment definitively on the quality of these assessments and further studies would need to be performed to make a formal comparison. Based on this study, EUS technology can consistently assess the mitral valve, aortic valve, aorta, pericardium, and left ventricular function. Given its limitations, EUS technology, although not a substitute for formal echocardiography, could be a helpful early diagnostic tool in an emergency setting. (C) 2016 International Anesthesia Research Society

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