Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study

OBJECTIVE

To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure.

DESIGN

Prospective cohort study.

SETTING

Barcelona, Spain.

POPULATION

A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP).

METHODS

After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins.

MAIN OUTCOME MEASURE

Treatment failure.

RESULTS

Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%.

CONCLUSION

Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients.

TWEETABLE ABSTRACT

IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.

Search for neutron dark decay: n → χ + e+e−

In January, 2018, Fornal and Grinstein proposed that a previously unobserved neutron decay branch to a dark matter particle (χ) could account for the discrepancy in the neutron lifetime observed in two different types of experiments. One of the possible final states discussed includes a single χ along with an e+e− pair. We use data from the UCNA (Ultracold Neutron Asymmetry) experiment to set limits on this decay channel. Coincident electron-like events are detected with ∼ 4π acceptance using a pair of detectors that observe a volume of stored Ultracold Neutrons (UCNs). We use the timing information of coincidence events to select candidate dark sector particle decays by applying a timing calibration and selecting events within a physically-forbidden timing region for conventional n → p + e- + ν̅e decays. The summed kinetic energy (Ee+e−) from such events is reconstructed and used to set limits, as a function of the χ mass, on the branching fraction for this decay channel.

Evolution of blood serum mineral composition during antler growth and rut as consequence of Cu supplementation in captive red deer and its effects in mature antler composition

In the present study we assessed the effects of Cu supplementation and antler growth stage on mineral composition of serum and hard antler in red deer fed a balanced diet. Correlations between minerals were analysed for serum, for antlers, and between serum versus mature antler. Blood samples were drawn at Days –36, 54, 132 and 197 of the start of antler growth (SAG). Hard antlers were cut at Day 165 from SAG. The Cu supplemented group (n = 9) was injected with 0.83 mg Cu/kg of bodyweight, whereas the control group (n = 9) was injected with a physiological saline solution, both every 42 days between Days –36 (Cu supplied after blood sampling) and 132 from SAG. Supplementation with Cu increased (P < 0.05) the contents of P and Cu in serum but did not affect the antler mineral profile. Serum contents of Mg, Na, S, B and Cu increased during the antler growth, whereas contents of K, Al and Fe decreased in the same period (P < 0.001). At Day 54 from SAG in Cu group, serum P content correlated negatively with antler Ca content whereas Zn of serum and antler correlated positively (P < 0.05). The maximum number of correlations between the mineral profile of serum and hard antler was achieved at Day 132 from SAG (3.3, 4.7 and 12.9% for Days –36, 54 and 132, respectively). In conclusion, the analysis of specific minerals in serum could be used to detect in advance some mineral deficiencies in the antler.

Succinyl-β-cyclodextrin: Influence of the substitution degree on albendazole inclusion complexes probed by NMR

Succinyl-β-CD derivatives were obtained by green synthesis with degrees of substitution (DS) 1.3 and 2.9. The spray-drying technique was used to obtain albendazole (ABZ):succinyl-β-CD inclusion complexes. Phase solubility diagrams indicated that both succinyl-β-CD derivatives formed 1:1 molar ratio ABZ complexes, but the complex with DS 2.9 has a lower formation constant. The presence of stable inclusion complexes in aqueous solution was confirmed by NMR. For both complexes the aromatic moiety is encapsulated into the host cavity. In the solid-state, ¹³C and ¹⁵N NMR spectral differences between ABZ and ABZ included in spray-dried systems showed that strong structural changes occurred in the systems. At least two different ABZ amorphous species were identified based on DS. ABZ species were stable over more than six months based on spectral data. Finally, the influence of DS in the number and type of the inclusion complexes was elucidated.

A retrospective epidemiological analysis of shared risk factors for bovine trichomoniasis and bovine genital campylobacteriosis in La Pampa province (Argentina)

The venereal diseases bovine trichomoniasis (BT) and bovine genital campylobacteriosis (BGC) cause economic losses in endemic areas like La Pampa province in Argentina, where beef cattle are usually managed extensively. The eradication of both diseases is a priority in Argentine. The aim of this case-control study was to identify shared and specific risk factors of both diseases from the data obtained from the Provincial Program for the Control and Eradication of BT and BGC in La Pampa (PCE). The study population included 5777 breeding beef herds tested for BT and BGC in 2013. The study comprised 3481 herds that were surveyed in situ by official PCE veterinarians, distributed as follows: 3159 negative herds (with no BT or BGC positive bulls), 121 BT case herds (with at least a BT positive bull), 170 BGC case herds (with at least a BGC positive bull) and 31 BT and BGC co-infected case herds (with at least a positive bull for each disease). Three multivariable analyses were performed in order to identify the risk factors using a logistic regression model. Results showed that the risk factors shared by both diseases were the number of bulls (OR for BT = 1.03, 95% CI: 1.02-1.04, p <  0.001; OR for BGC = 1.02, 95% CI: 1.01-1.03, p <  0.001; OR for BT and BGC co-infection = 1.02, 95% CI: 1.01-1.04, p =  0.003) and the presence in the previous year of each disease (OR for BT = 18.69, 95% CI: 11.82-29.57, p <  0.001; OR for BGC = 4.65, 95% CI: 3.18-6.81, p <  0.001; OR for BT and BGC co-infection = 39.18, 95% CI: 16.72-91.80, p <  0.001). Disease-specific risk factors were continuous breeding season for BT (OR = 1.59, 95% CI: 1.04-2.47, p =  0.034), and inadequate condition of the fences for BGC (OR = 1.51, 95% CI: 1.06-2.15, p =  0.022). An integrated approach to venereal disease management needs to consider the risk characteristics identified in this study. This could lead to reduce both diseases and improve the efficiency of BT and BGC control activities in La Pampa.

Effects of Mn supplementation in late-gestating and lactating red deer (Cervus elaphus hispanicus) on milk production, milk composition, and calf growth

This study describes the effects of Mn supplementation of 20 late-gestating and lactating Iberian red deer (Cervus elaphus hispanicus) females (hinds) fed a balanced diet on milk production and milk composition over the lactation period. Body weight of their calves at birth and at weaning was also evaluated. In addition, the effect of lactation stage was studied. For these purposes, 2 groups of hinds, one composed by 12 individuals (experimental) and the other by 8 individuals (control) were compared. Experimental hinds were s.c. injected weekly with Mn (2 mg Mn/kg BW) from day 140 of gestation until the end of lactation (week 18; forced weaning by physical separation). Control hinds were injected with a physiological saline solution with the same volume and at the same frequency as the experimental group. Serum Mn content of hinds was assessed just before the first Mn injection and at week 10 of lactation to assess whether the injected Mn increased Mn concentrations in blood. No differences were observed for BW of calves at birth but calves whose mothers were injected with Mn tended (P = 0.07) to have greater gain of BW from birth to weaning in proportion of BW at birth compared to calves from control hinds. In addition, supplementation with Mn increased (P ≤ 0.05) daily milk production by 10.2%, milk fat content by 11.2%, and total fat yield by 17.8%. Also, milk from hinds supplemented with Mn had more Ca (P < 0.001) and P (P < 0.05) than milk from control hinds. Manganese supplementation did not influence Mn serum content when blood was analyzed at week 10 of lactation, but increased the Mn content of milk by 18.3% (P < 0.001). Lactation stage affected (P < 0.001) fat, protein, lactose, and DM. Their contents increased as lactation proceeded, and protein was substituted by fat. Therefore, results suggest that Mn supplementation of hinds is recommended, even when they are fed a balanced diet, to increase milk production and the content of fat, Ca, P, and Mn of milk.

Management and supportive treatment of frail patients with metastatic pancreatic cancer

Data regarding management of frail patients with pancreatic ductal adenocarcinoma practice is currently very scarce. Randomized clinical trials usually exclude these subgroup of patients and the majority of the publications only consider chronological age and ECOG performance status for their classification. Therefore, the current available data do not reflect daily clinical practice. Only data from a phase two study (FRAGANCE study), designed to select a tolerable dose-schedule of nab-placitaxel + gemcitabine (Phase one) and to evaluate the efficacy of the selected regimen (Phase two) in patients with ECOG-2 and previously untreated advanced PDAC, are currently available. Management of these particular patients is exceedingly complex and requires collaboration of multidisciplinary teams and intensive support treatment. This article reviews the literature available regarding the management of the so-called frail patients and provide guidance for chemotherapy as well as supportive care treatments.

Oxygen uptake rate in alginate producer (algU+) and nonproducer (algU-) strains of Azotobacter vinelandii under nitrogen-fixation conditions

AIMS

The sigma E (AlgU) in Azotobacter vinelandii has been shown to control the expression of cydR gene, a repressor of genes of the alternative respiratory chain, and alginate has been considered a barrier for oxygen diffusion. Therefore, the aim of the present study was to compare the respiratory activity of an alginate nonproducing strain, lacking the sigma factor E (algU-), and polymer-producing strains (algU+) of A. vinelandii under diazotrophic conditions at different aeration conditions.

METHODS AND RESULTS

Our results reveal that under diazotrophic and high aeration conditions, A. vinelandii strain OP (algU-) had a specific oxygen consumption rate higher (30 and 54%) than those observed in the OP algU+-complemented strain, named OPAlgU+, and the ATCC 9046 respectively. However, the specific growth rate and biomass yields (based on oxygen and sucrose) were lower for OP cultivations as compared to the algU+ strains. These differences were partially explained by an increase in 1·5-fold of cydA relative expression in the OP strain, as compared to that obtained in the isogenic OPAlgU+ strain.

CONCLUSIONS

Overall, our results confirm the important role of algU gene on the regulation of respiratory metabolism under diazotrophic growth when A. vinelandii is exposed to high aeration.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study highlights the role of AlgU to control respiration of A. vinelandii when exposed to diazotrophy.

Lactobacillus fermentum UCO-979C strongly inhibited Helicobacter pylori SS1 in Meriones unguiculatus

Searching for bacterial probiotics active upon Helicobacter pylori continue to be an important clinical challenge because of the increased prevalence of this highly priority pathogen in humans. In this work, we assess the in vivo anti-H. pylori SS1 (cagA+/vacAs2m2+) properties of a previously isolated human gastric probiotic strain Lactobacillus fermentum UCO-979C by using a Meriones unguiculatus (Mongolian gerbil) model. Animals were administered with a saline suspension of L. fermentum UCO-979C or H. pylori SS1 as negative and positive control for H. pylori colonisation controls, prior to assayed the challenge group that was administered with these two species per animal for detecting protective activity of the probiotic strain against colonisation. The results showed that L. fermentum UCO-979C strongly inhibited the colonisation of H. pylori decreasing up to 87% of the colonisation in the antrum by the pathogen, suggesting that this probiotic strain has a strong probiotic activity against H. pylori in the most valuable animal model for in vivo assays nowadays.

Abdominal Drainage After Laparoscopic Appendectomy in Children: An Endless Controversy?

BACKGROUND

Routine prophylactic abdominal drains after laparoscopic appendectomy for perforated appendicitis in children are still controversial. Throughout the history of surgery, potential benefits of the abdominal drains have been described. However, in recent studies, no benefits were observed and serious complications have been reported.

METHODS

From January 2000 to December 2013, all charts of the pediatric patients who underwent laparoscopic appendectomy in our tertiary center were revised. The data from 1736 appendectomies were analyzed. We only included those patients with perforated appendicitis treated with early appendectomy (n = 192). Prophylactic drains were established according to the surgeon's preference. The sample was divided into two groups, those with drain (n = 117) and those without drain (n = 75). Demographics, operative findings, and postoperative outcomes were analyzed in both groups.

RESULTS

Of all patients, 121 were male and 71 were female with a mean age of 7.77 ± 3.4 years. There were not statistically significant differences between the groups in gender (p = 0.82) and mean age (p = 0.31). There were no statistically significant differences between the two groups in the rate of intra-abdominal abscess, wound infection, and bowel obstruction. However, the drainage group has been statistically associated with an increased requirement of antibiotic and analgesic medication, fasting time, operative time, and length of hospital stay.

CONCLUSION

The prophylactic use of abdominal drainage after laparoscopic appendectomy for perforated appendicitis in children does not prevent postoperative complications and may be associated with negative outcomes. Prospective randomized studies will be necessary to verify this question.

Correlation of the Renal Cortex Volume With the Glomerular Filtration Rate in Live Donors for Renal Transplantation

INTRODUCTION

As a pretransplantation evaluation, renal function is determined by the glomerular filtration rate (GFR) with the use of renal scintigraphy (RS) and the estimated glomerular filtration rate (eGFR). To date, there are few studies that correlate renal cortex volume with eGFR determined with renal gammagram (GR) and eGFR by equations (Cockroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equation) in Latin American living donors.

AIM

This study sought to determine whether there is correlation of the volume of the renal cortex by Herts equation with the GFR determined with renal gammagram (GFR-GR).

PATIENTS AND METHODS

This was an analytical, observational, and cross-sectional study. A review of the donor charts from January 1, 2014, to December 1, 2014, with a complete clinical file, kidney measurements, predonation tomography volume, and eGFR by different formulas and by renal scintigraphy.

RESULTS

Thirty-three donors were included, 51.5% male and 48.5% female. The mean age was 38.58 ± 10 years, with an average volume of 127.83 ± 28.30 mL, with diethylenetriamine-pentaacetate (DTPA) of 54.80 ± 7.13 mL/min/1.73 m² in the donated kidney. Spearman correlation showed the best association with the Herts equation (r = 0.346) reaching significance (P = .049) when comparing the different equations against the GFR with DTPA. Using the Bland-Altman method, the lowest variability and best significance was verified with the same equation compared to the other formulas (P = .0002).

CONCLUSIONS

There is no consensus regarding which is the best formula for calculating the GFR of both kidneys. Of the different formulas, the one that best correlated with the GFR was the Herts method, which uses the volume of the kidney.

Uso de cascarilla de arroz durante el periodo de pre-montanera para dietas de bienestar. Resultados preliminares

En los sistemas de producción extensivos del cerdo Ibérico, la alimentación de los animales está restringida durante la premontanera. Con el propósito de incrementar el bienestar durante este periodo, tres dietas diferentes con niveles crecientes de fibra (5,0 %; 8,5 %; 12,0 %) procedentes de cascarilla de arroz, que es un subproducto infrautilizado, fueron evaluados en cerdo Ibérico durante la premontanera (desde los 9 a los 13 meses de edad). El bienestar animal fue evaluado mediante el test Welfare Quality©. Ninguno de los grupos de tratamientos tuvo problemas de diarrea, a pesar del contenido relativamente elevado en fibra de las dietas enriquecidas. El peso corporal al final de la premontanera no varió significativamente entre tratamientos. Sin embargo, la ganancia de peso desde el segundo mes del experimento hasta su conclusión fue significativamente superior en el grupo con el nivel de fibra más alto que en los otros 2 grupos. Por tanto, los resultados preliminares muestran que el uso de altos niveles de fibra (12 %) en dietas de cerdo Ibérico durante la premontanera podría ser usado para mejorar el bienestar animal en este periodo, lo que adicionalmente supondría un uso alternativo para este importante subproducto agrícola.

Foreign body impaction in the esophagus: are there underlying motor disorders?

RESULTS

Compared with the control group, the impacted subjects presented marked reduction in amplitude and duration of esophageal contraction in the proximal esophagus.

CONCLUSIONS

These motor disorders could be responsible for the foreign body impaction in the esophagus. However, we believe this patient group should be further studied by 24-hour esophageal manometry to reach a more accurate diagnosis by studying each patient's entire circadian cycle.

J. Risk models for patients with localised renal cell carcinoma

INTRODUCTION

We conducted a retrospective analysis of our series to assess the factors that influenced disease-free survival (DFS) and cancer-specific survival (CSS) for patients with localised renal cell carcinoma (RCC). We also created our own risk groups.

MATERIAL AND METHODS

Between January 1990 and December 2012, 596 patients underwent surgery for localised RCC (clear cell, papillary or chromophobe). Using Cox regression models, we analysed the clinical-pathological variables that influenced DFS and CSS and designed risk groups for DFS and CSS with the variables.

RESULTS

The median follow-up for the series was 5.96 years. By the end of the study, 112 patients (18.8%) had a recurrence of the disease, with DFS rates of 82%, 77% and 72% at 5, 10 and 15 years, respectively. The independent factors that influenced DFS in the multivariate study were the following: A Furhman grade of 3-4, haematuria, lymphocytic or vascular invasion, the presence of tumour necrosis and a disease stage pT3-pT4. Furthermore, by the end of the study, 57 patients (9.6%) died due to renal cancer, with CSS rates of 92%, 86% and 83% at 5, 10 and 15 years, respectively. The independent factors that influenced CSS in the multivariate study were the following: A Furhman grade of 3-4, perinephric fat invasion and the presence of tumour necrosis.

CONCLUSIONS

Factors in addition to the disease stage pT3-pT4 in patients with localised RCC are important, such as the presence of haematuria and lymphocytic or vascular invasion for DFS. A Furhman grade of 3-4 and the presence of tumour necrosis are especially relevant for DFS and CSS.

Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

BACKGROUND

Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored.

METHODS

We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers.

RESULTS

Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57).

CONCLUSIONS

During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.

Seroprevalence of Toxoplasma gondii in domestic pets from metropolitan regions of Panama

Toxoplasmosis is a worldwide zoonotic disease but information regarding domestic animals in Central America is scarce and fragmented. The aim of this study was to determine the seroprevalence of Toxoplasma gondii in domestic cats and dogs in different metropolitan regions of Panama. A total of 576 samples were collected; sera from 120 cats and 456 dogs were tested using a commercial indirect enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of IgG antibodies was 30.73%. There is high seroprevalence of T. gondii in cats and dogs in the metropolitan regions around the Panama Canal; however, differences between these species were not significant. Statistical analysis indicated that there are relevant variables, such as the age of animals, with a direct positive relationship with seroprevalence. None of the variables related to animal welfare (veterinary attention provided, type of dwelling, and access to green areas and drinking water) were associated with seropositivity.

A metabolomic approach shows sphingosine 1-phosphate and lysophospholipids as mediators of the therapeutic effect of liver growth factor in emphysema

Tobacco smoke exposure is the principal cause of lung tissue destruction, which in turn results in emphysema that leads into shortness of breath. Liver growth factor (LGF, a cell and tissue regenerating factor with therapeutic activity in several organs) has antifibrotic and antioxidant properties that could be useful to promote lung tissue regenerating capacity in damaged lungs. The current study has examined differences in metabolite profiles (fingerprints) of plasma from mice (strain C57BL/6J, susceptible to develop emphysema) exposed to tobacco smoke during six months. One group of mice received a treatment with Liver Growth Factor (LGF) after emphysema was established, whereas the other group did not receive the treatment. Age and sex-matched mice not exposed to smoke were also maintained with or without treatment as controls. Metabolic fingerprints (untargeted analysis) of plasma after protein precipitation were obtained by LC-QTOF-MS. The signals were processed and a large number of possible metabolites were found (23944). Multivariate data analysis provided models that highlighted the differences between control and smoke exposed mice in both conditions. Accurate masses of features (possible compounds) representing significant differences were searched using online public databases. Lipid mediators, related to intracellular signaling in inflammation, were found among the metabolites putatively identified as markers of the different conditions and among them, sphingosine, sphingosine 1-phosphate and lysophospholipids point at the relevance of such metabolites in the regulation of the processes related to tissue regeneration mediated by LGF. These results also suggest that metabolomic fingerprinting could potentially guide the characterization of relevant metabolites leading the regeneration of lungs in emphysema disease.