Relationship between obsessive compulsive symptomatology and severity of psychotic symptoms in schizophrenia: Meta-analysis and meta-regression analysis.

BACKGROUND: Schizophrenia patients often show obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) and their presence has been associated with poorer prognosis. However, the impact of OCS/OCD on psychotic severity remains unclear. The aim of this study is twofold: 1) to investigate the effect of OCS/OCD on the severity of positive, negative, and global psychotic symptoms of schizophrenia patients and 2) to analyze the effect of patient and study-related covariates on moderating this relationship. METHODS: A systematic review and meta-analysis (SRMA) of studies comparing the severity of psychotic symptoms among schizophrenia patients with and without OCS/OCD was performed. Standardized mean difference (SMD) was calculated for positive, negative, and global psychotic symptoms. The difference of SMD (Diff SMD) was calculated to analyze the effect of covariates on study outcomes using meta-regression. RESULTS: Sixty-seven studies involving 7740 patients were included. Patients with schizophrenia and OCS/OCD showed a slightly higher severity of positive (SMD = 0.17, p value = 0.0089) and global psychotic symptoms (SMD = 0.24, p value = 0.0104) than patients without OCS/OCD but no differences in negative symptoms were found between groups (SMD = 0.11, p value = 0.0367). Only one covariate "proportion of patients without antipsychotics (AP)" was found to modify the effect on psychotic severity (Diff SMD = -0.008, p value = 0.002). CONCLUSIONS: Comorbid OCS/OCD in schizophrenia has, at most, a minor impact on psychotic severity. Variability in this effect was considerable and was poorly explained by the covariates analyzed.

Risk factors for lymphedema after breast surgery: A prospective cohort study in the era of sentinel lymph node biopsy.

INTRODUCTION: The Objective was to investigate the incidence of lymphedema after breast cancer treatment and to analyze the risk factors involved in a tertiary level hospital. METHODS: Prospective longitudinal observational study over 3 years post-breast surgery. 232 patients undergoing surgery for breast cancer at our institution between September 2013 and February 2018. Sentinel lymph node biopsy (SLNB) or axillary lymphadenectomy (ALND) were mandatory in this cohort. In total, 201 patients met the inclusion criteria and had a median follow-up of 31 months (range, 1-54 months). Lymphedema was diagnosed by circumferential measurements and truncated cone calculations. Patients and tumor characteristics, shoulder range of motion limitation and local and systemic therapies were analyzed as possible risk factors for lymphedema. RESULTS: Most cases of lymphedema appeared in the first 2 years. 13.9% of patients developed lymphedema: 31% after ALND and 4.6% after SLNB (p < 0.01), and 46.7% after mastectomy and 11.3% after breast-conserving surgery (p < 0.01). The lymphedema rate increased when axillary radiotherapy (RT) was added to radical surgery: 4.3% for SLNB alone, 6.7% for SLNB + RT, 17.6% for ALND alone, and 35.2% for ALND + RT (p < 0.01). In the multivariate analysis, the only risk factors associated with the development of lymphedema were ALND and mastectomy, which had hazard ratios (95% confidence intervals) of 7.28 (2.92-18.16) and 3.9 (1.60-9.49) respectively. CONCLUSIONS: The main risk factors for lymphedema were the more radical surgeries (ALND and mastectomy). The risk associated with these procedures appeared to be worsened by the addition of axillary radiotherapy. A follow-up protocol in patients with ALND lasting at least two years, in which special attention is paid to these risk factors, is necessary to guarantee a comprehensive control of lymphedema that provides early detection and treatment.

Use of different proportions of rice milling fractions as strategy for improving quality parameters and nutritional profile of gluten-free bread.

The growing consumer exigency and the lack of gluten-free (GF) bakery products with good technological and nutritional characteristics in the market have increase the need of researching in this area. Few studies have analysed the simultaneous influence of different flour fractions from rice dry milling to formulate GF bread and its effects on rheology and product quality. The aim of this study was to characterize the chemical and physical properties of rice milling fractions (flour, coarse, bran); and to evaluate the effect of these fractions on rheology, and quality of GF bread. High fibre content (31.5%) and good hydration and functional properties demonstrated the suitability of bran for food development. A mixture design with three components was used. Pasting parameters, bread specific volume (BSV), firmness and colour intensity (Chr) responses were fitted to linear and quadratic polynomial models. The presence of bran in the blends reduced almost all pasting parameters. The optimal mixture proportion was flour:coarse:bran (45:35:20), presenting a BSV 1.7 ± 0.1 cm3/g; firmness 0.23 ± 0.01 MPa, and Chr 23.8 ± 0.4. A portion (50 g) of GF bread increased four times the dietary fibre intake. The utilization of different rice fractions to formulate GF bread improved the product quality and enhance the nutritional profile.

100% peer review in radiation oncology: is it feasible?

PURPOSE: Peer review has been proposed as a strategy to ensure patient safety and plan quality in radiation oncology. Despite its potential benefits, barriers commonly exist to its optimal implementation in daily clinical routine. Our purpose is to analyze peer-review process at our institution. METHODS AND MATERIALS: Based on our group peer-review process, we quantified the rate of plan changes, time and resources needed for this process. Prospectively, data on cases presented at our institutional peer-review conference attended by physicians, resident physicians and physicists were collected. Items such as time to present per case, type of patient (adult or pediatric), treatment intent, dose, aimed technique, disease location and receipt of previous radiation were gathered. Cases were then analyzed to determine the rate of major change, minor change and plan rejection after presentation as well as the median time per session. RESULTS: Over a period of 4 weeks, 148 cases were reviewed. Median of attendants was six physicians, three in-training-physicians and one physicist. Median time per session was 38 (4-72) minutes. 59.5% of cases presented in 1-4 min, 32.4% in 5-9 min and 8.1% in ≥ 10 min. 79.1% of cases were accepted without changes, 11.5% with minor changes, 6% with major changes and 3.4% were rejected with indication of new presentation. Most frequent reason of change was contouring corrections (53.8%) followed by dose or fractionation (26.9%). CONCLUSION: Everyday group consensus peer review is an efficient manner to recollect clinical and technical data of cases presented to ensure quality radiation care before initiation of treatment as well as ensuring department quality in a feedback team environment. This model is feasible within the normal operation of every radiation oncology Department.

Reducing milking frequency in early lactation improved the energy status but reduced milk yield during the whole lactation of primiparous Holstein cows consuming a total mixed ration and pasture.

To investigate the immediate and long-term performance effects of milking frequency during early lactation of primiparous dairy cows consuming a total mixed ration and pasture, 20 Holstein cows were assigned in a randomized block design to either once-daily (1×) or twice-daily (2×) milking during the first 8 wk of lactation (treatment period). After the treatment period, all cows were milked 2× until wk 43 of lactation. Cows were fed a total mixed ration (approximately 15 kg of DM/cow per day) and allowed to graze an oat pasture (Avena sativa). Dry matter intake was 19.1 kg of DM/cow per day on average and was not affected by treatments. Milk yield was 40% lower in cows milked 1× during the treatment period, and a carryover effect existed until wk 21 of lactation, resulting in a final reduction of 15% of milk yield in the whole lactation. Milk lactose concentration decreased, whereas fat and protein concentrations increased for cows milked 1×. Mobilization of energy reserves during the treatment period occurred in both groups, but cows milked 1× showed greater body condition score and greater backfat thickness. In conclusion, milking 1× during the first 8 wk of lactation resulted in immediate and carryover negative effects on milk and milk solid yield without affecting feed intake, resulting in the improved energy status of primiparous dairy cows.

The functional and organoleptic characterization of a dairy-free dessert containing a novel probiotic food ingredient.

New eating habits and diversification of tastes of consumers have led to the scientific community and the food industry to expand the range of probiotic foods and novel probiotic ingredients. Scant information is available about the viability and functionality of probiotics during shelf life and its effect on the nutritional characteristics of dairy-free products. The aim of the study was to formulate a fermented dairy-free dessert using a novel food ingredient based on a pumpkin by-product and containing Lactobacillus casei (ATCC®393™) (NFI). The effect of NFI and the soluble solids (SS) of soy milk on the probiotic viability, physical stability, colour, and firmness of dairy-free dessert was studied using a response surface methodology. The different levels of SS and NFI significantly (p < 0.05) affected the response variables. Thereafter, two formulations were selected and the physico-chemical, nutritional and organoleptic characterization were evaluated. The L. casei count reached the desired therapeutic level (>107 UFC mL-1) after gastrointestinal digestion at 21 days of storage. In general, both the fermentation process and storage reduced (p < 0.05) the content of phytic acid, raffinose and stachyose, which implies a nutritional improvement of the final product. Scores above 5.0 on a 9-point scale were obtained for colour, odour, texture and overall acceptability in the consumer acceptance test. Therefore, a dairy-free dessert with good physical properties, suitable nutritional characteristics, and sensorial acceptability could be successfully formulated with the NFI.

Anxiety and depression in women with breast cancer: Social and clinical determinants and influence of the social network and social support (DAMA cohort).

BACKGROUND: Anxiety and depression are the most prevalent mental health pathologies among women with breast cancer. Social, clinical and contextual variables may influence emotional stress among women with breast cancer. The aim of this work is to study anxiety and depression in a cohort of women diagnosed with breast cancer between 2003 and 2013 in Barcelona. We evaluate social and clinical determinants. METHODS: We performed a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were the Hospital Anxiety and Depression questionnaire and hospital medical records. Dependent variables were anxiety and depression; independent variables were social class, age, employment status, tumour stage at diagnosis, time since diagnosis, social network and social support. We performed a descriptive analysis, a bivariate analysis, and a multivariate logistic regression analysis. RESULTS: A total of 1086 (48.6%) women had some degree of anxiety-related problem. As for depression. In the case of depression, 225 (15%) women had some degree of depression-related problem. Low emotional support and social isolation were clear risk factors for having more anxiety and depression. Low social class was also a risk factor, and age also played a role. DISCUSSION: Our results show that women long period of cancer survival have high prevalences of anxiety than depression, and this prevalence of anxiety is higher than the general population. In addition, we found inequalities between social classes and the isolation and social support are worse too in low social class.

Probiotic properties of native Lactobacillus spp. strains for dairy calves.

The use of native microorganisms with probiotic capacity is an alternative tool for the treatment and prevention of several diseases that affect animals, such as neonatal calf diarrhoea. The selection of probiotic strains within a collection is based on different in vitro and in vivo assays, which predict their potential. The aim of this study was to characterise a group of native Lactobacillus spp. strains isolated from faeces of healthy calves using an in vitro approach and to assess their ability to colonise the gastrointestinal tract (GIT) of calves. Native Lactobacillus spp. strains were evaluated on their capacity to survive low pH conditions and bile salts presence, biofilm formation and adhesion to both mucus and Caco-2 cells. Based on the in vitro characterisation, four strains (Lactobacillus johnsonii TP1.1, Lactobacillus reuteri TP1.3B, L. johnsonii TP1.6 and Lactobacillus amylovorus TP8.7) were selected to evaluate their capacity to colonise and persist in the GIT of calves. The assessment of enteric persistence involved an in vivo assay with oral administration of probiotics and quantification in faeces of the administered bacterial species with real-time quantitative PCR (qPCR). The study was conducted using 15 calves (1-month-old) which were divided into five groups of three animals, four of which were treated with four different selected strains and one was the control group. Strains TP1.3B and TP1.6 managed to persist in treated animals until ten days after the end of the administration period, indicating that they could be promising candidates for the design of probiotics for calves.

Evaluation of an Online Educational Program for Parents and Caregivers of Children With Food Allergies.

BACKGROUND AND OBJECTIVE: The increasing prevalence of food allergy affects both patients and their families. Objective: The aim of this study was to evaluate the impact of an online educational program designed for parents and caregivers of children with food allergies. The program was developed by a multidisciplinary group comprising health care professionals, researchers, and expert patients under the participatory medicine model. MATERIAL AND METHODS: Participants took a 2-week online educational program covering major topics in food allergy management. General knowledge about the disease, symptoms, treatment, and topics relevant to families' daily lives were evaluated. The contents included educational videos, online forums, and live video chats. A pretest/posttest questionnaire survey was used to evaluate the impact of the program. RESULTS: A total of 207 participants enrolled in the educational program, which was completed by 130 (62.8%). Knowledge acquisition improved significantly following participation in the program in 15 out of 30 items (50%), reaching P<.001 for 8 items (26.7%). Of the 207 participants who started the program, 139 (67.1%) visited online forums, and 27.5% attended video chats. Average overall satisfaction with the educational program was 8.78 (on a scale of 0 to 10). CONCLUSIONS: The results obtained show that parents improved their knowledge in all areas of food allergy. The high level of satisfaction among participants suggests that digital learning tools are effective and motivational, enabling patients to acquire appropriate knowledge and thus increasing their quality of life.

Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study.

BACKGROUND: Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics. METHODS: Women with invasive incident breast cancer identified from the Patient's Hospital Discharge Database [174.0-174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery. RESULTS: Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months' follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women. CONCLUSIONS: Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months' follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies.

Stem cell-like transcriptional reprogramming mediates metastatic resistance to mTOR inhibition.

Inhibitors of the mechanistic target of rapamycin (mTOR) are currently used to treat advanced metastatic breast cancer. However, whether an aggressive phenotype is sustained through adaptation or resistance to mTOR inhibition remains unknown. Here, complementary studies in human tumors, cancer models and cell lines reveal transcriptional reprogramming that supports metastasis in response to mTOR inhibition. This cancer feature is driven by EVI1 and SOX9. EVI1 functionally cooperates with and positively regulates SOX9, and promotes the transcriptional upregulation of key mTOR pathway components (REHB and RAPTOR) and of lung metastasis mediators (FSCN1 and SPARC). The expression of EVI1 and SOX9 is associated with stem cell-like and metastasis signatures, and their depletion impairs the metastatic potential of breast cancer cells. These results establish the mechanistic link between resistance to mTOR inhibition and cancer metastatic potential, thus enhancing our understanding of mTOR targeting failure.

Evaluation of an educational programme with workshops for families of children with food allergies.

BACKGROUND: When a child is diagnosed with a food allergy, prevention and patient education are the key interventions for maintaining the child's health and quality of life and that of his or her whole family. However, health education activities for the families of children with food allergies are very limited, and most of these activities have not been evaluated. Therefore, the objectives of the present study were to develop an educational programme, to empower its participants through workshops, and to evaluate its results. METHODS: Several types of educational materials were created specifically for the programme, called "Proyecto CESA" ("STOP-FAR Project: Stop Food-Induced Allergic Reactions"). The programme was carried out in seven Spanish cities and was attended by parents and caregivers. The workshops were led by physicians specialising in allergies and by expert patients. Afterwards, participant learning and satisfaction were evaluated based on questionnaires that were completed both before and after the workshops. RESULTS: A significant improvement was observed in 29 items out of 40 (McNemar's test). Participant satisfaction with the programme was also very high: 90% rated the course between 8 and 10 points out of a possible 10 (41% rated it as a 10). CONCLUSION: The face-to-face workshops, which included utilisation of educational materials, had positive results in terms of learning as well as in levels of satisfaction in participating families.

Lithium chloride antileukemic activity in acute promyelocytic leukemia is GSK-3 and MEK/ERK dependent.

We recently identified that the MEK/ERK1/2 pathway synergized with retinoic acid (RA) to restore both transcriptional activity and RA-induced differentiation in RA-resistant acute promyelocytic leukemia (APL) cells. To target the MEK/ERK pathway, we identified glycogen synthase kinase-3ß (GSK-3ß) inhibitors including lithium chloride (LiCl) as activators of this pathway in APL cells. Using NB4 (RA-sensitive) and UF-1 (RA-resistant) APL cell lines, we observed that LiCl as well as synthetic GSK-3ß inhibitors decreased proliferation, induced apoptosis and restored, in RA-resistant cells, the expression of RA target genes and the RA-induced differentiation. Inhibition of the MEK/ERK1/2 pathway abolished these effects. These results were corroborated in primary APL patient cells and translated in vivo using an APL preclinical mouse model in which LiCl given alone was as efficient as RA in increasing survival of leukemic mice compared with untreated mice. When LiCl was combined with RA, we observed a significant survival advantage compared with mice treated by RA alone. In this work, we demonstrate that LiCl, a well-tolerated agent in humans, has antileukemic activity in APL and that it has the potential to restore RA-induced transcriptional activation and differentiation in RA-resistant APL cells in an MEK/ERK-dependent manner.

Sensitive and label-free biosensing of RNA with predicted secondary structures by a triplex affinity capture method.

A novel biosensing approach for the label-free detection of nucleic acid sequences of short and large lengths has been implemented, with special emphasis on targeting RNA sequences with secondary structures. The approach is based on selecting 8-aminoadenine-modified parallel-stranded DNA tail-clamps as affinity bioreceptors. These receptors have the ability of creating a stable triplex-stranded helix at neutral pH upon hybridization with the nucleic acid target. A surface plasmon resonance biosensor has been used for the detection. With this strategy, we have detected short DNA sequences (32-mer) and purified RNA (103-mer) at the femtomol level in a few minutes in an easy and level-free way. This approach is particularly suitable for the detection of RNA molecules with predicted secondary structures, reaching a limit of detection of 50 fmol without any label or amplification steps. Our methodology has shown a marked enhancement for the detection (18% for short DNA and 54% for RNA), when compared with the conventional duplex approach, highlighting the large difficulty of the duplex approach to detect nucleic acid sequences, especially those exhibiting stable secondary structures. We believe that our strategy could be of great interest to the RNA field.

Factors associated with initial participation in a population-based screening for colorectal cancer in Catalonia, Spain: a mixed-methods study.

OBJECTIVE: To identify barriers and facilitators associated with participation in the first round of a population-based program for colorectal cancer (CRC) in Catalonia, Spain and to identify strategies for motivating and supporting behavioral change. MATERIAL AND METHODS: A two-part, mixed-methods design was used. In first place, a prospective study of individuals aged 50-69 years (n=1961) was conducted in 2006-2007. Secondly, focus groups were undertaken with participants and non-participants of the CRC screening, in 2008. RESULTS: Intention to participate was an important determinant of participation (82.9% vs 65.9%, OR=2.56, 95%CI:1.95-3.36) in addition to knowledge about CRC and its early detection. Respondents who reported that CRC may be asymptomatic in early stages enrolled in the screening program more frequently than those who thought CRC is always symptomatic (49.4% vs 44.8%, OR:1.82; 95%CI:1.3-2.6). Barriers for participation mentioned in focus groups were competing perceived for other health problems and other demands as well as misunderstanding about personal relevance of the screening. CONCLUSION: Individuals' perceptions of CRC are amenable to change through education-based interventions. Increasing public knowledge related to the burden of CRC and its preventive potential may be an effective way for improving participation in a population-based screening program.

Importance of technical aspects in the beginnings of a pancreas transplantation program.

Pancreas and kidney transplantation is the treatment of choice for patients with type 1 diabetes mellitus and terminal renal insufficiency. Herein we have presented a series of 35 patients transplanted between 2002 and 2009 including periods before and after 2007 divided based on introduction of some technical aspects. In the first phase (learning period) we have noted complications related to pancreatic surgery with a morbidity among 12 of 18 patients (66.6%). In the second period (stabilization period), complications appeared in 6 out of 17 patients (35.2%; P < .028). The reoperation rate was 83.3% in the learning period and 23.5% in the stabilization period (P < .03). Seven transplantectomies were performed in the first period (P < .004). Five patients died, all of them in the learning group (P < .019). Changes in the technical aspects of the procedure were responsible for improved outcomes obtained among pancreas and kidney transplantations.

Evaluation of ISO enrichment real-time PCR methods with internal amplification control for detection of Listeria monocytogenes and Salmonella enterica in fresh fruit and vegetables.

AIMS: To provide with a quick method for qualitative detection, in less than three days, of Salmonella enterica and Listeria monocytogenes in fresh fruit and vegetables. METHODS AND RESULTS: The method was based on coupling International Standard Organization (ISO) enrichment to a real-time PCR with internal amplification control (IAC), in a duplex format, without additional DNA purification. The performance was tested on different plant products. Both bacterial pathogens were consistently detected with a limit of detection (LOD) of 1 CFU in 25 g after enrichment, except for soybean sprouts. Levels of S. enterica, ranging from 1 to 10 CFU in 25 g after enrichment were detected with different enrichment broths. CONCLUSIONS: For both pathogens, the LOD was similar to that of the corresponding ISO method, while decreasing the analysis time and handling needs. SIGNIFICANCE AND IMPACT OF THE STUDY: The agreement between standard ISO and the enrichment real-time PCR(IAC)-based methods make the latter method as a promising alternative for quick and reliable detection of food-borne pathogens in fresh fruit and vegetables in routine laboratories.

Effect of selection for growth rate on relative growth in rabbits.

The effect of selection for growth rate on relative growth of the rabbit body components was studied. Animals from the 18th generation of a line selected for growth rate were compared with a contemporary control group formed with offspring of embryos that were frozen at the seventh generation of selection of the same line. A total of 313 animals were slaughtered at 4, 9, 13, 20, and 40 wk old. The offal, organs, tissues, and retail cuts were weighed, and several carcass linear measurements were recorded. Huxley's allometric equations relating the weights of the components with respect to BW were fitted. Butterfield's quadratic equations relating the degree of maturity of the components and the degree of maturity of BW were also fitted. In most of the components studied, both models lead to similar patterns of growth. Blood was isometric or early maturing and skin was late maturing or isometric depending on the use of Huxley's or Butterfield's model. Full gastrointestinal tract, liver, kidneys, thoracic viscera, and head were early maturing, and the chilled carcass and reference carcass were late maturing. The retail cuts of the reference carcass showed isometry (forelegs) or late maturing growth (breast and ribs, loin, hind legs, and abdominal walls). Dissectible fat of the carcass and meat of the hind leg had a late development, whereas bone of the hind leg was early maturing. Lumbar circumference length was later maturing than the carcass length and thigh length. Sex did not affect the relative growth of most of the components. Butterfield's model showed that males had an earlier development of full gastrointestinal tract and later growth of kidneys than females. No effect of selection on the relative growth of any of the components studied was found, leading to similar patterns of growth and similar carcass composition at a given degree of maturity after 11 generations of selection for growth rate.

Changes in collagen, texture and sensory properties of meat when selecting rabbits for growth rate.

The consequences of selection for growth rate and the associated decrease of maturity at slaughter in rabbits on collagen content, collagen solubility, meat texture (Warner-Bratzler shear device) and the sensory properties of the m. Longissimus were studied. Sixty rabbits from the 7th generation of a line selected for growth rate (group C) were compared to 60 rabbits from the 23rd generation of the same line (group S). Both groups were contemporarily reared and slaughtered at 2000g. No changes on collagen content were found, but group S had a higher (5%) collagen solubility. Shear force, shear firmness and area or total work needed to cut the sample were not different between groups, and hardness evaluated in the panel test was not relevantly changed. Most of the sensory properties studied did not differ relevantly between groups. Group S had 8% less aniseed odour and 10% more juiciness.