The Utility of CONUT Score in Diffuse Large B Cell Lymphoma Patients.

BACKGROUND: Assessment of nutritional status is gaining more importance in cancer patients because nutritional status is associated with response to chemotherapy, side effects of cancer treatment and disease progression. Several studies that were performed on patients with solid malignancies have shown the clinical significance of CONUT score (Controlling nutritional status). AIMS: Therefore we tried to show the utility of CONUT score in newly diagnosed Diffuse Large B Cell Lymphoma (DLBCL) patients which is the most frequently seen B Cell Lymphoma type. METHODS: Data of the 81 patients diagnosed with DLBCL were retrospectively evaluated. The primary endpoint of our study was to evaluate and classify newly diagnosed DLBCL patients according to the CONUT score and secondary endpoint was to show any relationship with CONUT score and overall survival. Patients' demographics, treatment details, stages, extranodal involvements, the presence of bulky disease, response to treatment options and overall survivals were evaluated from medical recordings. RESULTS: Univariate cox regression analysis CONUT score was associated with overall survival (HR: 2.34-95% CI: 1.55-3.24 P = 0.040). On multivariate Cox regression analysis model CONUT score ≥5 was found to be an independent prognostic factor for overall survival (HR: 4.96-95% CI: 1.77-13.97- P = 0.002). CONCLUSION: The value of obtaining nutritional status in cancer patients is underestimated and CONUT score is simple, easily applicable and in our opinion is going to fill the gap especially in DLBCL patients.

Rain Area Detection in South-Western Kenya by Using Multispectral Satellite Data from Meteosat Second Generation.

This study presents a rain area detection scheme that uses a gradient based adaptive technique for daytime and nighttime rain area detection and correction from reflectance and infrared (IR) brightness temperatures data of the Meteosat Second Generation (MSG) satellite. First, multiple parametric rain detection models developed from MSG's reflectance and IR data were calibrated and validated with rainfall data from a dense network of rain gauge stations and investigated to determine the best model parameters. The models were based on a conceptual assumption that clouds characterised by the top properties, e.g., high optical thickness and effective radius, have high rain probabilities and intensities. Next, a gradient based adaptive correction technique that relies on rain area-specific parameters was developed to reduce the number and sizes of the detected rain areas. The daytime detection with optical (VIS0.6) and near IR (NIR1.6) reflectance data achieved the best detection skill. For nighttime, detection with thermal IR brightness temperature differences of IR3.9-IR10.8, IR3.9-WV73 and IR108-WV62 showed the best detection skill based on general categorical statistics. Compared to the Global Precipitation Measurement (GPM) Integrated Mult-isatellitE Retrievals for GPM (IMERG) and the gauge station data from the southwest of Kenya, the model showed good agreement in the spatial dynamics of the detected rain area and rain rate.

Effects of vitamin D levels on asthma control and severity in pre-school children.

OBJECTIVE: Prevalence of asthma and vitamin D deficiency has been increasing and leading to significant morbidities. This study aimed to compare the vitamin D levels in the pre-school children with asthma and in healthy controls and to assess the relationship between vitamin D levels and asthma clinical parameters and control. PATIENTS AND METHODS: Vitamin D [25(OH)D3] levels were measured in 102 pre-school children, aged 1-4 years with asthma and 102 healthy controls in winter. The patients with asthma were grouped according to serum vitamin D levels as sufficient, insufficient and deficient. Asthma control was classified according to the Global Initiative for Asthma (GINA) guidelines and the Test for Respiratory and Asthma Control in Kids (TRACK) in 1-4 years-old children. RESULTS: Serum vitamin D levels were 22.64 (9.96) ng/ml in the asthma group and 32.11 (14.74) ng/ml in the control group (p = 0.001). Total number of exacerbations during the previous year were significantly lower in the vitamin D sufficient group, compared to the deficient and insufficient groups (p = 0.03). Frequency of patients with controlled asthma was higher in the sufficient group compared to the deficient and insufficient groups (p = 0.001 and p = 0.001, respectively). There was a positive correlation between serum vitamin D levels and asthma control. CONCLUSIONS: The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Therefore, we suggest that lower levels of vitamin D are associated with poor asthma control and increased asthma severity.

The role of anxiety in the perception of technological hazards - a cross-sectional study on cell phones and masts.

BACKGROUND: Risk perception is determined by parameters related to the nature of the risk, as well as inherent to the individual perceiving this risk. This study was designed to provide a better understanding of the role of personality, especially anxiety traits, on risk perception. It compared representations of two different risks, smoking (with known and generally accepted adverse health effects) and cell phones (whose hazardous potency is still controversial), each presented in two different forms of exposure, active (smokers and cell phone users) and passive (passive smoking and exposure to cell phone masts). METHODS: A self-administered questionnaire sent to volunteer subjects collected sociodemographic and exposure data. It measured the perceived risk as well as 11 psychometric properties of risk using visual analogue scales (values ranging from 0 to 10). An anxiety trait was evaluated by the Spielberger questionnaire. RESULTS: In all, 72% of the questionnaires sent were returned. Mean declared risk scores attributed to passive and active smoking were higher (8.75 and 8.31 respectively) than those attributed to cell phones and masts (4.44 and 4.73 respectively). However, scores for the 11 psychometric properties of the risk attributed to cell phones were higher than those associated with smoking, especially for dissatisfaction with information (6.71 and 7.36 respectively for cell phones and masts versus 1.75 and 2.18 for passive and active smoking) and the capacity of authorities to master the risk (6.45 and 6.65 for cell phones and masts versus 4.72 and 4.40 for passive and active smoking). Anxiety did not directly influence the risk scores attributed to these 4 forms of exposure but was predictive of the way in which subjects perceived the risk in terms of two essential properties: uncertainty concerning the effects on health and the potential to trigger health catastrophes. Indeed anxious subjects are more certain about the hazards of cell phones and masts than non-anxious subjects (P=0.008 et P≤0.001) and attributed a higher catastrophic potential (P=0.02 and P=0.004). CONCLUSION: This study suggests that subjects with an anxious profile are affected by the destabilizing nature of uncertain knowledge concerning the hazardous potency of new technologies and of the controversies concerning this hazard.

Thiamine-responsive megaloblastic anemia syndrome: a novel mutation.

The thiamine-responsive megaloblastic anemia syndrome (TRMA) is an autosomal recessive disorder characterized by diabetes mellitus, megaloblastic anemia and sensorineural hearing loss due to mutations in SLC 19A2 that encodes a thiamine transporter protein. The disease can manifest at any time between infancy and adolescence, and not all cardinal findings are present initially. The anemia typically improves significantly with pharmacological doses of thiamine. Variable improvement in diabetes is also noted. However, the hearing loss is apparently irreversible, although a delay in the onset of deafness may be possible. We present a 2-year old girl with non-autoimmune diabetes mellitus and anemia in whom we found a novelc.95T>A (leu32X) mutation in the SLC19A2 gene in this study.Our patient with this new mutation did not suffer from hearing loss.

Combination antifungal therapy with voriconazole for persistent candidemia in very low birth weight neonates.

The purpose of this article is to report our experience with intravenous voriconazole therapy in the treatment of persistent Candida septicemia in very low birth weight (VLBW) neonates. Candidiasis was defined if an infant had a positive blood culture. Ten VLBW newborns developed Candida sepsis, and candidemia persisted in 6 of them despite 3 to 21 days of antifungal therapy with amphotericin B, either conventional or liposomal, and fluconazole. After the addition of voriconazole, clearance of Candida was achieved within 3-7 days of treatment. Antifungal therapy combination with liposomal amphotericin B and voriconazole was continued for at least two weeks after two negative cultures 48 hours apart. We conclude that considering the hazardous effects of Candida infections in preterm newborns, voriconazole can be added to the treatment of fungal sepsis in newborns who still have persistent candidemia despite conventional antifungal management. More clinical information is needed before voriconazole can be used as a first-line drug in antifungal therapy in newborns.

A complete kinetic study of GG versus AG plantination suggests that the doubly aquated derivatives of cisplatin are the actual DNA binding species.

The hairpin-stabilized double-stranded oligonucleotides d(TATGGTATT4ATACCATA) (I) and d(TATAGTATT4ATACTATA) (II) were allowed to react with the three aquated forms of the antitumor drug cisplatin (cis-[PtCl2(NH3)2], 1) which are likely candidates for DNA binding, that is, cis-[PtC1(NH3)2(H2O)]+ (2), cis-[Pt(NH3)2(H2O)2]2+ (3), and its conjugate base cis-[Pt(OH)(NH3)2(H2O)]+ (4). The reaction between I and [Pt(NH3)3(H2O)]2+ (5) was also studied for comparison. All reactions were monitored by HPLC. The platination reactions of I and II were carried out in NaClO4 (0.1M) at 293 K and at a constant pH of 4.5 +/- 0.1 for 2, 3, and 5. The data relative to the platination by 4 were obtained from measurements in unbuffered NaClO4 solutions (0.1M) at a starting pH close to neutrality, where 3 and 4 are present in equilibrium. In this case, a fit function describing the pH-time curve allowed the determination of the actual concentrations of 3, 4, and the dihydroxo complex. The platination rate constants characterizing the bimolecular reactions between either I or II and 2, 3, and 4 were individually determined along with the rate constants for hydrolysis of the chloro-monoadducts and for the chelation reactions of the aqua-monoadducts. The reactivity of compounds 2-5, which have the general formula cis-[Pt(NH3)2(H2O)(Y)]2+/-, decreases in the order 3>4>5>>2, that is, Y= H2O > OH- >NH3 >> Cl-, which is the order of decreasing hydrogen-bond donating ability of Y. Deprotonation of 3 to 4 reduces the reactivity of the platinum complex only by a factor of approximately equals 2, and both complexes discriminate between the different purines of I and II in the same manner. Whereas 3 and 4 react approximately three times faster with the GG sequence of I than with the AG sequence of II, 2 shows a similar reactivity towards both sequences. In view of the well-established preferential binding of cisplatin to GG sequences of DNA in vivo and in vitro, this result suggests that the actual DNA platination species are derived from double hydrolysis of cisplatin.

Circular dichroism spectra of the individual rotamers of [Pt(N,N-dmen)(GpG)]+ (N,N-dmen=N,N-dimethylethylenediamine) indicate that the base-base oscillator coupling is not the main source of ellipticity in cis-PtG2L2 head-to-head complexes.

The asymmetrical platinum complex [PtCl2(N,N-dmen)] (N,N-dmen = N,N-dimethylethylenediamine) reacts with the dinucleotide GpG to form two isomeric chelates of the formula [Pt(N,N-dmen)(GpG)]+ [9]. One of the isomers forms two stable rotamers separable by HPLC, whereas the other apparently prefers one single rotameric form. The favored conformations of these three forms were elucidated by means of molecular mechanics and dynamics techniques. In parallel, we have prepared the adduct, isolated the three rotamers, and recorded their solution circular dichroism (CD) spectra. For the first time we were thus able to correlate the CD features of individual rotamers of a cis-Pt(GpG) chelate with their structures. We show here that the two forms labeled in Inagaki's paper 1'e and 2e have the same right-handed helicoidal arrangement of the guanine bases but display different CD spectra in which the prominent bands have inverted signs. Thus, base-base interactions cannot be the principal cause of the CD of these compounds.

A single d(GpG) cisplatin adduct on the estrogen response element decreases the binding of the estrogen receptor.

Both cisplatin and the estrogen receptor (ER) are known to bend DNA. The influence of the bending of sequences by the d(GpG)cisPt adduct binding of ER to estrogen response element (ERE)-like sequences was examined. Three ERE-like oligonucleotides with different affinities for ER and which include a GG in the linker sequence were designed in order to form a single central d(GpG)cisPt adduct. Using electrophoretic mobility shift assay and Scatchard analysis, it was shown that the presence of a single d(GpG)cisPt adduct in the linker sequence decreases the ER affinity for DNA. These results do not support a critical role of a DNA bend in the initial recognition of ERE by ER. Then, the platination of DNA outside of the ERE half-sites decreases the interaction of ER with ERE.

[Hepatitis induced by alpidem (Ananxyl). Four cases, one of them fatal]. / Hépatite imputable à l'alpidem (Ananxyl). Quatre cas dont un mortel.

Acute hepatitis related to psychotropic drugs has been rarely reported with anxiolytic treatments. Alpidem (Ananxyl) is a new imidazopyridine derivative with anxiolytic properties which was launched in October 1991. Several cases of acute hepatitis, some severe, were described with this drug and its liver toxicity was questioned. Results of a study monitoring drug side-effects caused this drug to be withdrawn from the market for one year. We report four cases of acute hepatitis and discuss the role of alpidem. All but one case were presented as severe acute hepatitis with hepatic failure. One patient ran a fulminant course and died despite liver transplantation. The mechanism of liver toxicity remains unclear.

Stereologic analysis of histologic parameters of a twice-recurrent ameloblastic fibroma.

The behavior of the odontogenic tumors with time remains a subject of controversy. A case of ameloblastic fibroma with two recurrences is presented. It represents further evidence of the ability of the ameloblastic fibroma to recur, although recurrences may have resulted from incomplete initial removal. The volumetric density of the odontogenic epithelium (Vvoe) was evaluated stereologically for the initial tumor and for each recurrence. Analysis of the results shows that a maturation process, which was statistically significant, occurred between the initial tumor and the first recurrence but not between the first and second recurrences.

[Hemorrhage after stomach resection in ulcer disease]. / Krovotechenie posle rezektsii zheludka po povodu iazvennoi bolezni

Under observation were over 3 500 patients, subjected to gastric resection for the complicated ulcerous disease. In the early postoperative period hemorrhage was observed in 42 patients, including bleeding in the gastrointestinal tract--in 23, in free abdominal cavity--in 19. In cases, when early profuse bleeding following gastric resection would not respond to intensive conservative measures, then urgent relaparotomy with the aim of haemostasis, replenishment of blood loss and correction of the internal medium seem to be indicated. Bleeding from forcibly remained low duodenal ulcer in Billroth-II gastrectomy can be arrested by means of duodenotomy and suturing of the ulcer bottom with U-shape sutures. For establishing in early diagnosis of hemorrhage into the abdomen its drainage after gastric resection with a rubber strip, brought out through a separate incision in the anterior abdominal wall in the right subcostal space, seems to be rather effective.