Identification and assessment of classification criteria attributes for systemic lupus erythematosus in a regional medical record data network.

OBJECTIVE: To assess the application and utility of algorithms designed to detect features of SLE in electronic health record (EHR) data in a multisite, urban data network. METHODS: Using the Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN), a Clinical Data Research Network (CDRN) containing data from multiple healthcare sites, we identified patients with at least one positively identified criterion from three SLE classification criteria sets developed by the American College of Rheumatology (ACR) in 1997, the Systemic Lupus International Collaborating Clinics (SLICC) in 2012, and the European Alliance of Associations for Rheumatology and the ACR in 2019 using EHR-based algorithms. To measure the algorithms' performance in this data setting, we first evaluated whether the number of clinical encounters for SLE was associated with a greater quantity of positively identified criteria domains using Poisson regression. We next quantified the amount of SLE criteria identified at a single healthcare institution versus all sites to assess the amount of SLE-related information gained from implementing the algorithms in a CDRN. RESULTS: Patients with three or more SLE encounters were estimated to have documented 2.77 (2.73 to 2.80) times the number of positive SLE attributes from the 2012 SLICC criteria set than patients without an SLE encounter via Poisson regression. Patients with three or more SLE-related encounters and with documented care from multiple institutions were identified with more SLICC criteria domains when data were included from all CAPriCORN sites compared with a single site (p<0.05). CONCLUSIONS: The positive association observed between amount of SLE-related clinical encounters and the number of criteria domains detected suggests that the algorithms used in this study can be used to help describe SLE features in this data environment. This work also demonstrates the benefit of aggregating data across healthcare institutions for patients with fragmented care.

Sensitivity of different rat tumour strains to photodynamic treatment with chlorin e6.

Transplantable rat tumours (sarcoma M-1, sarcoma 45, alveolar liver cancer PC-1 and Pliss' lymphosarcoma) were used to study chlorin e6 accumulation in tumours and its photodynamic effect. Tumours were irradiated by krypton ion laser light (647 and 676 nm; 90 J cm-2) 15 min and 24 h after chlorin e6 injection at doses of 5 and 10 mg kg-1. The relationship between some morphological peculiarities of these tumour strains, photosensitizer accumulation in tumours and their response to the photodynamic treatment is discussed.

Photodynamic therapy with chlorin e6. A morphologic study of tumor damage efficiency in experiment.

Morphological changes in rat sarcoma M-1 after photodynamic treatment with chlorin e6 were studied. The frequency of necrosis appearance and the depth of its spreading in tumor tissue were evaluated after intraperitoneal injection of chlorin e6 in doses of 1-10 mg kg-1 and subsequent irradiation by a krypton laser with light energy density 22.5-135 J cm-2, using the method of vital staining with Evans blue. It was found that the antitumoral effect of photodynamic treatment was strengthened by increasing the dose of the agent and light and reduced by increasing the time interval between chlorin e6 injection and light irradiation. The treatment being given in the parameters mentioned produced a depth of tumor necrosis which varied from 4.0 mm to 16.6 mm. The mechanisms of tumor tissue damage after photodynamic treatment in vivo are discussed.

[Effect of intravascular pressure changes on the induction of bone neoplasms in rats]. / Vliianie izmeneniia vnutrisosudistogo davleniia na induktsiiu opukholei kostei u krys.

The development of bone tumours induced by 3,4-benzpyrene in rats with arterial hypotension and venous congestion was studied. Six months after, osteogenous sarcomas were detected in 36% of animals with normal pressure, in 10%--with arterial hypotension and in 58%--with venous congestion. The differences in the antitumor tissue resistance under chemical blastomogenesis, as well as in cases of transplanted tumours, are supposed to depend on the character of compensatory rearrangements in the microcirculatory bed in response to the intravascular pressure change.

[Effect of induced hyperglycemia on the metastasis of RL-67 lung carcinoma]. / Vliianie iskusstvennoi giperglikemii na metastazirovanie kartsinomy legkikh RL-67.

The effect of multiple artificial hyperglycemia treatments on metastatic spreading and tumour growth depending on the stage of the tumour development is studied in experiments on mice with transplanted subcutaneous lung cancer LC-67. Intensification of the metastatic spreading and of the primary tumour growth under hyperglycemia treatment of early and advanced diseases is detected. Artificial hyperglycemia does not influence the tumour progress at the terminal stage of the disease.

Thyroid cancer in Belarus post-Chernobyl: improved detection or increased incidence?

There is debate on whether the reported increase in the number of cases of childhood thyroid cancer in Belarus is real and attributable to radiation released following the Chernobyl nuclear accident, or rather an artefact due to incorrect histological diagnosis, more complete case reporting and mass screening of children after the accident. We have scrutinised the histological slides of 120 (75%) of the 160 cases reported among children aged up to 15 years to the Belarus tumour registry from 1986 to 1992 and examined time trends and geographical patterns in incidence and tumour characteristics. Incidence based on reported cases increased from 0.041 per 100,000 in 1986 to 2.548 in 1992. Carcinoma was confirmed in 94% of reviewed tumours. Except for one medullary carcinoma all histologies were of the papillary type. Most of the tumours had spread beyond the organ capsule and measured over 10 mm in diameter. There was a weak and statistically non-significant trend (p = 0.19) towards smaller tumours in the later years. The proportion of cases with lymphnode or distant metastasis remained unchanged. Incidence based on histologically confirmed cases was highest adjacent and to the west and north of Chernobyl, matching best estimates of iodine-131 contamination. Our data thus strongly suggest that the observed increase is real but more data are needed in order to assess the impact of mass screening and to clarify the possible association with radiation released at Chernobyl in 1986.

[Thyroid pathomorphology in children of the Republic of Byelarus subjected to radiation exposure as a result of the accident at the Chernobyl Atomic Electric Power Station]. / Patomorfologiia shchitovidnoi zhelezy detei Respubliki Belarus', podvergshikhsia radiatsionnomu vozdeistviiu v rezul'tate avarii na Chernobyl'skoi AES.

Early and late effects of short-living iodine isotopes on the thyroid of children in Byelarus are described. Early effects manifested with an increase in the thyroid functional activity in children up to one year of age during 1986. Follicular cell hypertrophy is considered as a marker of the radiation effect at a dose level from 0.1 to 1 krad. Late effects are thyroid carcinomas the incidence of which in the country rose ten-fold within the last 5 years.

[Latent cancerous pathology of the thyroid]. / Skrytaia onkologicheskaia patologiia shchitovidnoi zhelezy.

Postmortem morphologic examination of the thyroid was performed in 122 residents of the Minsk Region, Byelorussian Republic. Various pathology underdiagnosed during life was found in 68%. Fourteen papillary carcinomas were detected in 11 (9.9%) of cases whereas 27 (22.1%) subjects revealed 46 follicular adenomas. Nodular goiter was established in 52.5%, thyroiditis--6.5% and cancer metastases--in 5.7% of cases. The male/female ratio for microcarcinoma was 8:3. All tumor-bearing subjects were over 41 years of age. Occurrence of the occult thyroid pathology in different regions of the country can be used to compare potential radiation and other hazards.

[Enhancement of the therapeutic effect of sarcolysine by arterial hypotension in sarcoma 45 trials]. / Usilenie terapevticheskogo éffekta sarkolizina posredstvom arterial'noi gipotonii v opytakh s sarkomoi 45.

Arterial hypotension was found to potentiate antitumor effect of sarcolysin on transplantable sarcoma 45 of rats. Induction of hypotension as modifying factor of chemotherapy of cancer is discussed.

[Complex treatment of locally advanced soft tissue sarcoma of the limbs]. / Kompleksnoe lechenie mestno-rasprostranennykh sarkom miagkikh tkanei konechnostei.

The experience of treatment of 40 patients with locally-advanced soft tissue sarcoma of the limbs. Treatment included preoperative chemoradiotherapy in combination with electromagnetic hyperthermia. As a result, 38 (95%) patients showed marked response which allowed radical limb-saving surgery whereas in 2 (5%) amputation was performed. Adjuvant chemotherapy was used for anaplastic tumors. Five-year survival rate was 64.7 +/- 6.7%.

["Pathomorphosis" of skin melanomas in the comprehensive treatment using hyperthermia]. / "Patomorfoz" melanom kozhi pri kompleksnom lechenii s primeneniem gipertermii.

The writers examined histologically and histochemically the melanomas removed in 40 patients, subjected to general and local hyperthermia associated with radiation and chemotherapy. In such cases it was found that melanoma tissues exhibit grave destructive changes characterized by the morphological features, which are manifested by microcirculatory disorders in the tumor and metastases and are associated with extensive injuries of the neoplastic tissue.

[Diagnosis and treatment of mesenchymal chondrosarcoma]. / Diagnostika i lechenie mezenkhimal'noi khondrosarkomy.

Eight cases of mesenchymal chondrosarcoma (3 males and 5 females aged 15-65) are described. Morphological examination revealed in all cases biphasal tumor consisting of the chondroid tissue of varying maturity and undifferentiated tissue. Combination and complex treatment was given to 6 patients. In 4 cases, radiotherapy was carried out in combination with chemotherapy and local electromagnetic hyperthermia. Out of 8 patients, seven are still alive and are examined at 4 month - 11 year intervals (average of 39.7 months). One female patient died 12 months after the beginning of treatment. Combined and complex procedures should be recommended for treatment of such patients.

Survival of retinoblastoma in less-developed countries impact of socioeconomic and health-related indicators.

BACKGROUND: The survival of retinoblastoma in less-developed countries (LDCs) and the impact of socioeconomic variables on survival are not widely available in the literature. METHODS: A systematic review of publications from LDCs was performed. Articles were from multiple databases and written in seven languages. Results were correlated with socioeconomic indicators. Lower-income countries (LICs) and middle-income countries (MICs) were included in our analyses. RESULTS: An analysis of 164 publications including 14,800 patients from 48 LDCs was performed. Twenty-six per cent of the papers were written in languages other than English. Estimated survival in LICs was 40% (range, 23-70%); in lower MICs, 77% (range, 60-92%) and in upper MICs, 79% (range, 54-93%; p = 0.001).Significant differences were also found in the occurrence of metastasis: in LICs, 32% (range, 12-45); in lower MICs, 12% (range, 3-31) and in upper MICs, 9.5% (range, 3-24; p = 0.04). On multivariate analysis, physician density and human development index were significantly associated with survival and metastasis. Maternal mortality rate and per capita health expenditure were significantly associated with treatment refusal. CONCLUSIONS: Important information from LDCs is not always available in English or in major databases. Indicators of socioeconomic development and maternal and infant health were related with outcome.

Electron correlated ab initio study of amino group flexibility for improvement of molecular mechanics simulations on nucleic acid conformations and interactions.

High level ab initio studies demonstrate substantial conformational flexibility of amino groups of nucleic acid bases. This flexibility is important for biological functions of DNA. Existing force field models of molecular mechanics do not describe this phenomenon due to a lack of quantitative experimental data necessary for an adjustment of empirical parameters. We have performed extensive calculations of nucleic acid bases at the MP2/6-31G(d,p) level of ab initio theory for broad set of amino group configurations. Two-dimensional maps of energy and geometrical characteristics as functions of two amino hydrogen torsions have been constructed. We approximate the maps by polynomial expressions, which can be used in molecular mechanics calculations. Detailed considerations of these maps enable us to propose a method for determination of numerical coefficients in the developed formulae using restricted sets of points obtained via higher-level calculations.