Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic.

PURPOSE: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

Volatile N-nitrosamines in gastric juice of patients with various conditions of the gastrointestinal tract determined by gas chromatography-mass spectrometry and related to intragastric pH and nitrate and nitrite levels.

Gastric juice samples of 71 patients undergoing upper gastrointestinal endoscopy were collected as well as saliva samples from 40 of these patients. Age, sex, endoscopic diagnosis and medication were recorded. The gastric juice samples were analyzed for the presence and quantity of individual volatile N-nitrosamines, which were detected by gas chromatography-mass spectrometry, without prior derivatization. The samples were screened for eight nitrosamines, i.e. N-nitrosodimethylamine, N-nitrosoethylmethylamine, N-nitrosodiethylamine, N-nitrosodi-n-propylamine, N-nitrosodi-n-butylamine, N-nitrosopyrrolidine, N-nitrosopiperidine and N-nitrosomorpholine. The pH of the fresh gastric juice as well as nitrate and nitrite levels of gastric juice and saliva were determined. The mean total level of volatile N-nitrosamines in gastric juice was found to be 4.84 nmol/l (range 0-17.7 nmol/l). The main N-nitrosamines found were N-nitrosodiethylamine (mean concentration 3.1 nmol/l), N-nitrosodimethylamine (mean concentration 0.90 nmol/l) and N-nitrosopyrrolidine (mean concentration 0.38 nmol/l). Significant correlations between mean intragastric pH values and mean N-nitrosodi-n-butylamine level (P = 0.005) and total volatile N-nitrosamine contents (P = 0.009) were observed.

Short-term results of Na131I treatment of hyperthyroidism evaluated using an extended dosimetric method.

OBJECTIVE: To assess and evaluate the short-term results of radio-iodine treatment using an extended dosimetric method. METHODS: Sixty-five patients with Graves disease (GD) and 32 patients with toxic multinodular goitre (TMG) received a pre-therapeutic dosage of Na123I. The overall indicative radiation dose (Dind) and the indicative dosage (Aind) was calculated for the individual patient using the dosimetric results found. In the therapeutic setting dosimetric measurements were performed again. The quotient of the administered dose (A) and the indicative dosage and the quotient of the absorbed radiation dose (Dabs) and the indicative radiation dose were used to evaluate treatment results after 1 year of follow-up. RESULTS: Clinical outcome after 1 year for GD was 26% hyper-, 48% eu- and 26% hypothyroidism and for TMG 32, 59 and 9%, respectively. Within the percentile range P25-P75 of A/Aind these results were 27, 46 and 27% for GD and 36, 64 and 0% for TMG. Within the percentile range P25-P75 of Dabs/Dind these results were 23, 59 and 18% for GD and 33, 67 and 0 for TMG. Correlation coefficients between pre- and therapeutic dosimetric measurements in GD and TMG were 0.76 and 0.38, respectively. CONCLUSIONS: The short-term outcome after 1 year of follow-up is 48 and 59% euthyroidism for GD and TMG, respectively. Clinical outcome within the percentile range P25-P75 of A/Aind did not change these results. Within the percentile range P25-P75 of Dabs/Dind euthyroidism was achieved in 59% and 67% for GD and TMG, respectively. The pre-therapeutic values inaccurately represent the therapeutic values for GD and even more for TMG.

The effect of premedication on the induction dose of propofol in dogs and cats.

The effect of premedication on the induction dose of propofol was determined in 15 cats and 25 dogs undergoing elective surgical procedures. The induction dose of propofol in dogs younger than 8 years old was 6.9 +/- 0.9 mg kg-1 (n = 4) without premedication and 4.3 +/- 1.4 mg kg-1 (n = 12) with premedication with acetylpromazine maleate. The induction dose in cats younger than 3 years old was 7.8 +/- 1.1 mg kg-1 (n = 8) with atropine alone and 7.1 +/- 0.9 mg kg-1 (n = 7) with the inclusion of acetylpromazine maleate. The reduction in the induction dose of propofol was statistically significant in dogs, but not in cats. When atropine was used together with a fentanyl-droperidol combination or pethidine and acetylpromazine maleate in dogs, the mean induction dose of propofol was reduced to 2.1 +/- 0.1 mg kg-1 (n = 4) and 2.4 +/- 0.3 mg kg-1 (n = 5), respectively. Propofol was also evaluated as an induction agent in patients undergoing non-elective surgical procedures.

Perinephric extravasation of urine with pseudocyst formation in a cat.

A case of unilateral perinephric pseudocyst formation as a result of extravasation of urine is reported. The main presenting signs and the initial clinical examination did not directly indicate severe renal involvement. The subsequent development of pseudocysts as a result of chronic extravasation of urine was positively diagnosed by laboratory investigations and ancillary procedures. Treatment consisted of surgical removal of the affected kidney.

Hypodipsic hypernatraemia in a miniature schnauzer.

Normovolaemic hypernatraemia as a result of a suspected congenital primary hypodipsia was diagnosed in a young male Miniature Schnauzer. Despite an elevated serum sodium concentration, the dog did not appear dehydrated on physical examination and the urine osmolality: plasma osmolality ratio was greater than 4; antidiuretic hormone deficiency was therefore not suspected. Basal serum cortisol and thyroxine concentrations were normal. Plasma aldosterone concentration and plasma renin activity (37 pmol l-1 and 1.55 ng dl-1 h-1 respectively) were within normal range. A defective central thirst regulation mechanism was suspected as the dog was totally disinterested in drinking water despite the chronically elevated serum sodium concentration. Excessive ingestion of water mixed with food, and milk resulted in hyponatraemia and associated cerebral oedema. On stabilisation of the dog's condition, a calculated fluid intake based on daily maintenance fluid requirements was prescribed to prevent recurrence of hypernatraemia and hyponatraemia, and associated signs of central nervous system disease. The dog was in apparent good health with controlled fluid intake when examined 230 d later.

A craniopharyngioma in a seven-year-old dog.

A seven-year-old male Border Collie was presented with a history of lethargy, episodic circling, incoordination and polydypsia. Physical examination revealed depression, obesity and bradycardia. A neurological examination indicated the possible presence of a space-occupying lesion in the brain. Results of the clinical investigation revealed hyposthenuria, sinus bradycardia and increased concentration of protein in the cerebrospinal fluid. A computerised axial tomography scan revealed a mass in the region of the hypophysis. The dog was euthanased and a post mortem examination confirmed the presence of a craniopharyngioma.

Management of undifferentiated embryonal sarcoma of the liver in children: a case series and management review.

BACKGROUND: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare neoplasm, and the third-most common paediatric hepatic malignancy. However, no treatment guidelines exist. No randomised, controlled trials support specific combinations of therapy. OBJECTIVE: To compare presentation and management of UESL with other series, review the literature, and formulate treatment guidelines. METHODS: A retrospective chart review of all hepatic malignancies was conducted from 1996 to 2007 and 5 children with UESL were identified. Management and outcomes were documented. The literature regarding treatment modalities up to September 2012 was reviewed. RESULTS: Over a period of 11 years, 5 patients presented. All underwent surgery and 4 received chemotherapy. One received radiotherapy at relapse. Three are disease-free with follow-up of 58 - 184 months. One died after relapse, as did the patient whose family declined chemotherapy. CONCLUSION: The improved outcomes are consistent with the international experience and are probably related to combined treatment modalities and advances in supportive care. Pre-operative percutaneous biopsy provides no benefit if the lesion is resectable because it may not prove to be diagnostic, and may cause recurrence in the biopsy tract. If resectable, the recommended treatment is primary excision and adjuvant chemotherapy, with radiotherapy in selected cases. If unresectable, open biopsy is necessary to document histology, and neo- adjuvant chemotherapy is given prior to resection. If deemed unresectable, liver transplantation is considered.

Exposure and inhalation risk assessment in an aluminium cast-house.

To date the exposure, absorption and respiratory health effects of cast-house workers have not been described since most studies performed in the aluminium industry are focused on exposure and health effects of potroom personnel. In the present study, we assessed the external exposure and the absorbed dose of metals in personnel from the aluminium cast house. This was combined with an evaluation of respiratory complaints and the lung function of the personnel. 30 workers from an aluminium casting plant participated and 17 individuals of the packaging and distribution departments were selected as controls. The exposure was assessed by the quantification of total inhalable fume with metal fraction and by the determination of urinary aluminium, chromium, beryllium, manganese and lead concentration. Carbon monoxide (CO), carbon dioxide (CO2), aldehydes and polyaromatic hydrocarbons and man-made mineral fibres concentration were assessed as well. In order to evaluate their respiratory status each participant filled out a questionnaire and their lung function was tested by forced spirometry. Total inhalable fume exposure was maximum 4.37 mg m(-3). Exposure to the combustion gases, man-made mineral fibres and metal fume was well below the exposure limits. Beryllium could not be detected in the urine. The values of aluminium, manganese and lead in the urine were all under the respective reference value. One individual had a urinary chromium excretion above the ACGIH defined biological exposure index (BEI) of 30 microg g(-1) creatinine. There was no significant difference in any of the categories of the respiratory questionnaire and in the results of the spirometry between cast house personnel and referents (Chi-square, all p > 0.05). Exposure in cast houses seem to be acceptable under these conditions. However, peak exposure to fumes cannot be excluded and the potential risk of chromium and beryllium exposure due to the recycling of aluminium requires further attention.

Uptake of transcobalamin II-bound cobalamin by HL-60 cells: effects of differentiation induction.

Binding and uptake of transcobalamin II-bound cobalamin by HL-60 promyelocytic leukemia cells proceed through receptor-mediated endocytosis. The affinity constant of the receptor for transcobalamin II-cobalamin was found to be 6.1 liter/nmol and the maximal rate of uptake 12 pmol/10(9) cells/h. This uptake is mediated by about 3000 receptor sites per cell. Evidence is presented that the receptor recirculates from the cell surface to the lysosomes and vice versa. Upon differentiation induction of the cells by either DMSO in granulocytic direction or by 1,25-dihydroxy-vitamin D3 in monocytic direction a rapid decline in cellular uptake and cell surface binding of the protein-bound vitamin ensues. In particular the internalization of the complex decreases faster than all other observed signs of the ongoing differentiation process, such as reduction in the OKT9-reactive transferrin receptor, increase in lineage-specific surface markers, and decrease in [3H]thymidine incorporation and actual cell proliferation. The transcobalamin II receptor on the cell surface appears to be a proliferation-associated membrane component in human leukemic cells.

Involvement of low-calcium diet in the reduced bone mineral content of idiopathic renal stone formers.

The possibility that low-calcium intake in renal stone formers could lead to reduced bone mineral content was investigated in 123 male patients with idiopathic urolithiasis. Radius bone mineral content (BMC) was measured by single photon absorptiometry. Two groups of patients were analyzed: group 1 (n = 63) maintained on a free diet; group 2 (n = 60) maintained on a low-calcium diet (350 mg/day +/- 20 SEM) for 3.9 years +/- 0.6 SEM. The two groups of patients were investigated after a standard reduction of calcium intake for at least 1 week. The urinary excretion of calcium and of hydroxyproline, and the serum alkaline phosphatase activity were higher in both groups than in normal subjects submitted to the same low-calcium diet. Both groups of stone formers showed lowered radius BMC values at 3 cm (distal) and 8 cm (proximal) above the styloid process, but distal BMC was significantly lower in group 2 than in group 1. The results suggest that low-calcium intake could worsen the already decreased BMC of idiopathic renal stone formers.

Juxtapapillary duodenal diverticula and diverticula of the colon: is there a general "gastrointestinal diverticular disease"?

Both juxtapapillary duodenal diverticula and colon diverticula are acquired lesions, the pathogenesis of which is believed to involve the influence of high intraluminal pressure on loci minoris resistentiae in the gastrointestinal wall. We wanted to investigate whether juxtapapillary duodenal diverticula and colon diverticula occur independently, or whether they are part of a hypothetical general "gastrointestinal diverticular disease". 239 patients with juxtapapillary duodenal diverticula were identified in 2231 patients undergoing ERCP. Complete radiology data were available in 119/239 patients. Double contrast barium enema had been performed in 28/119 patients. In these patients, colon diverticula were present in 9/20 women and 1/8 men. The frequency of colon diverticula in these patients was compared with randomly chosen age- and sex-matched controls, for whom barium enema results were available. In these controls, 9/20 women and 1/8 men also had colon diverticula (n.s.). We conclude that after stratification for age and sex, the occurrence of colon diverticula is not higher in patients with juxtapapillary duodenal diverticula than in the general population. Juxtapapillary duodenal diverticula and colon diverticula thus occur independently. These data are not in favor of the existence of a general gastrointestinal diverticular disease.