Retrospective characterisation and outcome of surgical treatment for cervical lymph node abscessation in 15 dogs.

CASE HISTORIES: Medical records of a private referral hospital (Veterinary Emergency Clinic, Toronto, Canada) and a university teaching hospital (Louisiana State University, Baton Rouge, LA, USA) were reviewed, using the search terms lymphadenectomy, lymph node extirpation, cervical lymphadenitis, and lymph node abscessation. Dogs (n = 15) with a diagnosis of cervical lymph node abscessations confirmed through histopathology that underwent surgery for treatment from January 2015-May 2022 were included in the study. Long-term follow-up data was obtained by an in-person visit or telephone interview with each owner. Dogs that met the inclusion criteria were of various breeds with a median age of 6 (min 0.5, max 12) years. All cases presented with cervical swelling and lethargy, with inappetence and fever in 5/15 dogs. The range of duration of clinical signs prior to treatment was 1-3 weeks. Seven dogs were treated with a short course of antibiotics, with or without prednisone, without successful resolution, before referral. CLINICAL FINDINGS: Diagnostic imaging using CT or cervical ultrasound revealed enlargement of unilateral mandibular and retropharyngeal lymph nodes with regional cellulitis and oedema in four dogs, enlargement of unilateral retropharyngeal lymph nodes with regional cellulitis in eight dogs, and a right ventral cervical abscess infiltrating the right medial retropharyngeal lymph nodes with oedema in one dog. Unilateral or bilateral cervical lymph node abscessation was diagnosed by lymphadenectomy and histopathology of affected lymph nodes. Bacterial cultures from samples of excised lymph nodes were positive in six cases. TREATMENT AND OUTCOME: Cervical exploration and lymphadenectomy were performed in all cases. Thirteen dogs received antibiotics along with surgical treatment. Resolution was defined as absence of cervical swelling or enlarged lymph node(s) at the time of long-term follow-up (median 300 (min 240, max 1,072) days). Most patients had resolution of clinical signs following surgical excision of affected lymph nodes. Two dogs had complications including recurrence of clinical signs and development of open wounds following surgery. Their clinical signs resolved following additional administration of antibiotics. CONCLUSIONS AND CLINICAL RELEVANCE: All dogs in this series had lymphadenectomy of abscessed lymph nodes and showed resolution of clinical signs with a favourable outcome. As 13/15 dogs also received antibiotics in conjunction with surgical treatment, appropriate use of antimicrobials may also play a role in treatment of this disease process.

Randomised clinical trial: Tong-Xie-Yao-Fang granules versus placebo for patients with diarrhoea-predominant irritable bowel syndrome.

BACKGROUND: Tong-Xie-Yao-Fang (TXYF) is a Chinese herbal formula for treating chronic diarrhoea accompanied by abdominal pain. The results were inconsistent in previous trials examining its effect. AIM: To study the efficacy of TXYF granules for treating diarrhoea-predominant irritable bowel syndrome (IBS-D). METHODS: We performed a double-blind, placebo-controlled randomised trial and enrolled 160 participants with IBS-D. The participants had VAS scores ≥3 cm in IBS-D global symptoms and ≥2 days in a week with abdominal pain and loose stools (Bristol score 5, 6 or 7). They were randomly assigned to received TXYF or placebo during a treatment period of 4 weeks, and they were followed up for 8 weeks after treatment. The primary outcome was adequate relief of IBS-D global symptoms for at least 2 of 4 weeks during weeks 1-4. Secondary outcomes included mean weekly VAS scores of IBS-D major symptoms, mean weekly stool frequency, mean weekly Bristol score, and adverse events. RESULTS: 155 of 160 patients completed the trial. We found a significantly higher rate of adequate relief of global symptoms in TXFY group during weeks 1 to 4 (57.5% vs 37.5%, χ2 = 5.6391, P = 0.017); logistic regression analysis showed a similar result (OR 2.2, 95% CI 1.2-4.4, P = 0.016). Most of the secondary outcomes showed superiority of TXYF over placebo in weekly assessment from week 3 to week 7. The adverse event rate was low in both groups (3.8% vs 3.8%, P = 1.000). CONCLUSION: During a 4 week trial, TXFY granules were superior to placebo in controlling symptoms of IBS-D.

Preventing occupational injury among police officers: does motivation matter?

BACKGROUND: Injury prevention is an important issue for police officers, but the effectiveness of prevention initiatives is dependent on officers' motivation toward, and adherence to, recommended health and safety guidelines. AIMS: To understand effects of police officers' motivation to prevent occupational injury on beliefs about safety and adherence to injury prevention behaviours. METHODS: Full-time police officers completed a survey comprising validated psychometric scales to assess autonomous, controlled and amotivated forms of motivation (Treatment Self-Regulation Questionnaire), behavioural adherence (Self-reported Treatment Adherence Scale) and beliefs (Safety Attitude Questionnaire) with respect to injury prevention behaviours. RESULTS: There were 207 participants; response rate was 87%. Hierarchical multiple regression analyses demonstrated that autonomous motivation was positively related to behavioural adherence, commitment to safety and prioritizing injury prevention. Controlled motivation was a positive predictor of safety communication barriers. Amotivation was positively associated with fatalism regarding injury prevention, safety violation and worry. CONCLUSIONS: These findings are consistent with the tenets of self-determination theory in that autonomous motivation was a positive predictor of adaptive safety beliefs and adherence to injury prevention behaviours.

Personal beliefs, learned resourcefulness, and adaptive functioning in depressed adults.

Learned resourcefulness and personal beliefs are significant predictors of adaptive functioning. The mediating effect of personal beliefs on the relationship between learned resourcefulness and adaptive functioning was validated in adults with depression. The findings from this study may provide the basis for developing a useful nursing intervention constituting resourcefulness skills with positive personal beliefs to help patients with depression improve their ability to function well in their daily activities. ABSTRACT: Research has shown that patients with depression have difficulty with performing daily tasks and meeting their own personal care needs. According to Beck's cognitive theory of depression, such deficits in adaptive functioning are affected by disturbances in specific personal beliefs that reflect the process of regulating cognitions. Rosenbaum's learned resourcefulness theory proposed that adaptive functioning is influenced by learned resourcefulness, while learned resourcefulness is associated with the process regulating cognitions. This study aims to test the mediating effect of personal beliefs on the relationship between resourcefulness and adaptive functioning. The study involved a cross-sectional design. Participants consisted of 187 adults with depression in southern Taiwan. The data were collected through four instruments: Cognitive Triad Inventory, Self-Control Schedule, modified Community Living Skills Scale, and a demographic questionnaire. Both resourcefulness and personal beliefs were significant predictors of adaptive functioning, and personal beliefs mediated the effect of learned resourcefulness on the adaptive functioning of the adults with depression. The results validate the role played by personal beliefs in effecting learned resourcefulness and adaptive functioning among adults with depression and provide direction for designing nursing interventions that consider personal beliefs when teaching resourcefulness skills to adults with depression.

Collision in the colon: concurrent adenocarcinoma and diffuse large B-cell lymphoma in the same tumour.

Double malignancies in the gastrointestinal tract are unusual. Concurrent lymphoma and adenocarcinoma is a rare clinical condition. We herein report a collision tumour which first presented with a diffuse large B-cell lymphoma in the skull base and ileocecal junction area. After rituximab and chemotherapy the skull base tumour disappeared, but the ileocecal lesion remained. A biopsy revealed the presence of adenocarcinoma in the same lesion. The tumour was surgically removed. Further microscopic examination of the tumour showed it was an adenocarcinoma but residual lymphoma cell infiltration could still be observed. Serum Epstein-Barr virus (EBV) was detected at diagnosis of lymphoma and the concentration further elevated at diagnosis of adenocarcinoma. Therefore, both lymphoma and carcinoma may be EBV related. Our experience illustrated that such collision tumours are rare and difficult in diagnosis. Clinicians and pathologists should be aware of such an association in order to make a correct diagnosis and initiate proper treatment.

AML patients with CEBPalpha mutations mostly retain identical mutant patterns but frequently change in allelic distribution at relapse: a comparative analysis on paired diagnosis and relapse samples.

The roles of CEBPalpha mutations and its cooperating mutations in the relapse of acute myeloid leukemia (AML) are not clear. CEBPalpha mutations were analyzed on 149 patients with de novo AML at both diagnosis and relapse. Twenty-two patients (14.8%) had the mutations at diagnosis, two patients had N-terminal nonsense mutations alone, one had homozygous inframe duplication at the bZIP domain, and 19 patients had both N-terminal and bZIP mutations. Twenty patients relapsed with identical mutant patterns, two lost CEBPalpha mutations and none acquired the mutations at relapse. Cloning analysis showed that the N-terminal and C-terminal mutations occurred on separate cloned alleles and also on the same alleles in most of the diagnosis and relapse samples. Losing one of the two or more mutations on the same allele or acquiring the other mutation on the allele original carrying single mutation were observed not infrequently in the paired samples analyzed. Seven patients with CEBPalpha mutations had cooperating mutations with FLT3/ITD, FLT3/TKD or N-ras but not K-ras mutations. Our study showed that 91% of de novo AML harboring CEBPalpha mutations at diagnosis retained the identical mutant patterns but frequently changed in the allelic distribution at relapse.

Characterization of fusion partner genes in 114 patients with de novo acute myeloid leukemia and MLL rearrangement.

The fusion transcripts of MLL rearrangement [MLL(+)] in acute myeloid leukemia (AML) and their clinicohematologic correlation have not be well characterized in the previous studies. We used Southern blot analysis to screen MLL(+) in de novo AML. Reverse transcriptase-polymerase chain reaction was used to detect the common MLL fusion transcripts. cDNA panhandle PCR was used to identify infrequent or unknown MLL partner genes. MLL(+) was identified in 114 (98 adults) of 988 AML patients. MLL fusion transcripts comprised of 63 partial tandem duplication of MLL (MLL-PTD), 14 MLL-AF9, 9 MLL-AF10, 9 MLL-ELL, 8 MLL-AF6, 4 MLL-ENL and one each of MLL-AF1, MLL-AF4, MLL-MSF, MLL-LCX, MLL-LARG, MLL-SEPT6 and MLL-CBL. The frequency of MLL-PTD was 7.1% in adults and 0.9% in children (P<0.001). 11q23 abnormalities were detected in 64% of MLL/t11q23 and in none of MLL-PTD by conventional cytogenetics. There were no differences in remission rate, event-free survival and overall survival between adult MLL-PTD and MLL/t11q23 groups. Adult patients had a significantly poorer outcome than children. The present study showed that cDNA panhandle PCR can identify all rare or novel MLL partner genes. MLL-PTD was rare in childhood AML. MLL(+) adults had a poor outcome with no difference in survival between MLL-PTD and MLL/t11q23 groups.

Isolation of a novel candidate oncogene within a frequently amplified region at 3q26 in ovarian cancer.

Amplification of 3q25-q26 was one of the most frequent chromosomal alterations in human ovarian carcinoma. A chromosome microdissection-hybrid selection method was applied to isolate transcribed sequences from a primary ovarian cancer containing high-copy-number amplification of 3q26 using 3q26 band-specific DNAs generated by chromosome microdissection. Using this method, we have isolated a novel candidate oncogene eIF-5A2 (eukaryotic initiation factor 5A2). eIF-5A2 shares 82% identity of amino acid sequence with eIF-5A including the minimum domain needed for eIF-5A maturation by hypusine modification at lysine-50 residue. Amplification and overexpression of eIF-5A2 was frequently detected in primary ovarian cancers and ovarian cancer cell lines. The proliferation-related function of eIF-5A supports that eIF-5A2 is a candidate oncogene related to the development of ovarian cancer.

Community study of depression in old age in Taiwan: prevalence, life events and socio-demographic correlates.

BACKGROUND: Published studies of prevalence of depression in old age in Taiwan have yielded equivocal results. AIMS: To study the prevalence of depressive disorders among community-dwelling elderly; further, to assess socio-demographic correlates and life events in relation to depression. METHOD: A randomised sample of 1500 subjects aged 65 and over was selected from three communities. Research psychiatrists conducted all assessments using the Geriatric Mental State Schedule. The diagnosis of depression was made with the GMS-AGECAT (Automated Geriatric Examination for Computerised Assisted Taxonomy); data on life events were collected with the Taiwanese version of the Life Events and Difficulties Schedule. RESULTS: One-month prevalence of psychiatric disorders was 37.7%, with 15.3% depressive neurosis and 5.9% major depression. A high risk of depressive disorders was found among widows with a low educational level living in the urban community, and among those with physical illnesses. CONCLUSIONS: Contrary to most previous reports, we found that the prevalence of depressive disorders among the elderly in the community in Taiwan is high and comparable to rates reported in some studies of UK samples.

Validation of the Chinese Health Questionnaire (CHQ-12) in community elders.

There has been no validated screening instrument for use in non-psychotic illness of the elderly in Taiwan. This study aims to test the validity of the 12-item Chinese Health Questionnaire (CHQ-12) among the elderly in a community study. The CHQ-12 was administrated via reading-out to 222 subjects aged 65 and over from three communities. Psychiatrists using the Geriatric Mental Status Schedule (GMS) assessed psychiatric condition while the diagnosis was made according to the computerized program, AGECAT. Validity indices of the CHQ-12 were calculated, using the Relative Operating Characteristic (ROC) analysis for its optimal cut-off point. Variables hypothesized to affect its performance were assessed. Validity of the CHQ-12 at optimal cut-off point 2/3 were estimated with a sensitivity of 79.7%, a specificity of 83.6%, a positive predictive value of 68.9%, a negative predictive value of 90.0% and an overall misclassification rate of 17.6%, and an estimate of the area under the ROC curve of 0.81. The performance of the CHQ-12 was better in males, in those who were literate, and in those without any physical illness. This study demonstrated that the use of CHQ-12 in the elderly community is as valid as in the general population survey. However, it should be read out by the investigator rather than self-administered due to the high proportion of illiteracy among the Taiwanese elderly.