Thrombosis: a major contributor to global disease burden.

BACKGROUND: Thrombosis is the common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused 1 in 4 deaths worldwide. GBD 2010 did not report data for VTE as a cause of death and disability. OBJECTIVE: To review the literature on the global burden of disease caused by VTE. APPROACH AND RESULTS: We performed a systematic review of the literature on the global disease burden because of VTE in low-, middle-, and high-income countries. Studies from Western Europe, North America, Australia, and Southern Latin America (Argentina) yielded consistent results with annual incidences ranging from 0.75 to 2.69 per 1000 individuals in the population. The incidence increased to between 2 and 7 per 1000 among those aged ≥70 years. Although the incidence is lower in individuals of Chinese and Korean ethnicity, their disease burden is not low because of population aging. VTE associated with hospitalization was the leading cause of disability-adjusted life-years lost in low- and middle-income countries, and second in high-income countries, responsible for more disability-adjusted life-years lost than nosocomial pneumonia, catheter-related blood stream infections, and adverse drug events. CONCLUSIONS: VTE causes a major burden of disease across low-, middle-, and high-income countries. More detailed data on the global burden of VTE should be obtained to inform policy and resource allocation in health systems and to evaluate whether improved use of preventive measures will reduce the burden.

Exploiting intrinsic triangular geometry in relativistic (3)He+Au collisions to disentangle medium properties.

Recent results in d+Au and p+Pb collisions at RHIC and the LHC provide evidence for collective expansion and flow of the created medium. We propose a control set of experiments to directly compare particle emission patterns from p+Pb, d+Au, and ^{3}He+Au or t+Au collisions at the same sqrt[s_{NN}] . Using a Monte Carlo Glauber simulation we find that a ^{3}He or triton projectile, with a realistic wave function description, induces a significant intrinsic triangular shape to the initial medium. If the system lives long enough, this survives into a significant third-order flow moment v_{3} even with viscous damping. By comparing systems with one, two, and three initial hot spots, one could disentangle the effects from the initial spatial distribution of the deposited energy and viscous damping. These are key tools for answering the question of how small a droplet of matter is necessary to form a quark-gluon plasma described by nearly inviscid hydrodynamics.

The role of single nucleotide polymorphisms of the ERCC1 and MMS19 genes in predicting platinum-sensitivity, progression-free and overall survival in advanced epithelial ovarian cancer.

OBJECTIVE: This study aims to assess the role of polymorphisms in DNA repair genes, excision repair cross-complementation group 1 (ERCC1) and methyl-methanesulfonate sensitivity 19 (MMS19), in tumor response to platinum-based chemotherapy and survival in advanced epithelial ovarian cancer (EOC). METHODS: Single nucleotide polymorphism (SNP) analysis was performed on the paraffin-embedded tumor tissue of women with advanced EOC, treated with platinum-based chemotherapy at the University of Oklahoma Health Sciences Center. Polymorphisms from two ERCC1 (codon-118 and C8092A) and three MMS19 (rs2211243, rs2236575 and rs872106) gene loci were evaluated by real time PCR Allelic Discrimination Assay. RESULTS: Genotyping was performed in 107 patients, 45 platinum-sensitive and 62 platinum-resistant. ERCC1, codon-118 and C8092A genotyping was evaluable in 98 and 106 patients respectively and in all 107 patients for MMS19 polymorphisms. No differences were observed in genotype between platinum-sensitive and platinum-resistant patients. Polymorphisms in the ERCC1, codon-118 and MMS19 genes did not correlate with overall survival (OS), although a trend toward improved progression free survival (PFS) was observed in patients expressing the minor (GG) alleles of the rs872106 MMS19 gene. Women homozygous for the ERCC1-C8092A minor (AA) alleles had a significant increase in PFS compared to AC and CC patients and both AA and AC genotypes conferred improved survival over the major (CC) genotype. CONCLUSIONS: Polymorphisms in ERCC1, codon-118 and MMS19 genes are not associated with clinical response to platinum or survival. The ERCC1-C8092A genotypes containing an "A" allele were associated with significant improvement in PFS and OS strengthening the value of this specific genotype in survival.

Global public awareness of venous thromboembolism.

BACKGROUND: Data on public awareness about thrombosis in general and venous thromboembolism (VTE) in particular are limited. We aimed to measure the global awareness of thrombosis to address this gap. METHODS: With Ipsos-Reid, from 22 July to 5 August 2014, we surveyed 800 respondents in their native language from each of Argentina, Australia, Canada, Germany, Japan, Thailand, the Netherlands, the United Kingdom and the United States to measure general awareness about thrombosis, including deep vein thrombosis (DVT) and pulmonary embolism (PE). In each country, respondents were distributed among three age groups: 18-39 years, 40-64 years, and over 65 years of age. Proportions and 95% confidence intervals (CIs) were calculated. RESULTS: Overall, the proportion of respondents that were aware of thrombosis, DVT and PE (68%, 44% and 54%, respectively) was lower than the proportion that was aware of other thrombotic disorders, such as heart attack and stroke (88% and 85%, respectively), and health conditions such as hypertension, breast cancer, prostate cancer and AIDS (90%, 85%, 82% and 87%, respectively). Although there was variation across countries, lower awareness was associated with younger age and being male. Only 45% (95% CI, 43.9-46.5) of respondents were aware that blood clots were preventable, and awareness of cancer, hospitalization and surgery as risk factors was low (16%, 25%, and 36%, respectively). CONCLUSIONS: On a global level, public awareness about thrombosis overall, and VTE in particular, is low. Campaigns to increase public awareness about VTE are needed to reduce the burden from this largely preventable thrombotic disorder.

Complications resulting from spurious fields produced by a microwave applicator used for hyperthermia.

Microwave hyperthermia applicators are generally characterized at two or three frequencies. These frequencies usually are at the extremes of the applicator's operating range. However, such applicators are often used at arbitrary frequencies within their range. The most common reason for choice of frequency is to achieve acceptable coupling in the clinical configuration with a given patient. Occasionally a spurious transmission pattern will result from the frequency chosen that can lead to undetected high power densities well away from the target volume. In the present report, such a situation is discussed. The transmission pattern resembled "horns" reported at the field edge of certain accelerators. This pattern resulted in the inability to heat the target volume and the production of thermal blisters outside that volume. Such an occurrence underscores the need to characterize the transmission characteristics of a microwave hyperthermia applicator at all the frequencies used.

A computer-assisted examination resource.

A computer program (MICHELE) has been written to facilitate preparation by medical faculty of reference examination questions based on a 'core curriculum'. Questions may be used by faculty to test student command of coursework and by students at their initiative to assess their progress. Students may also use the program to direct their future studies according to computer-generated suggestions. MICHELE is a medical-instructional, computer-handled evaluation and learning enhancement system which consists of access, executive, author-instruction, student and statistics subsystems. These subsystems guarantee security of the data base, generate examinations according to category, difficulty and format (true--false, multiple choice, case history), generate practice sessions for students and student self-tests, and analyze the individual and cumulative results of examination and self-test sessions. The program is directed primarily toward evaluation of performance and instruction in the clinical disciplines; in this setting it is desirable to develop a sequence of unique, equally weighted examinations throughout the academic year and, at the same time, encourage mastery of core material encompassed in the data base. MICHELE is written in CDC FORTRAN IV and utilizes an indexed sequential file organization for the data.