Low cold tolerance of the invasive lizard Eutropis multifasciata constrains its potential elevation distribution in Taiwan

1. The invasive many-lined sun skink, Eutropis multifasciata, is established in much of southern Taiwan and is spreading northward. We investigated whether winter temperatures constrain further dispersion of this skink by comparing its cold tolerance to the spatial distribution of winter temperatures in Taiwan. 2. We measured the 28-day survival rate of this species at 4 constant temperatures (10-16 °C in 2 °C increments) and its critical thermal minimum (CTmin), i.e., the body temperature at which the righting reflex is lost during the cooling process. For comparison with the spatial distribution of temperatures over Taiwan, we used the biophysical model Niche Mapper™ in order to simulate the soil temperatures, where lizards are inactive in the winter, during the coldest month of the year, January, under three climatic scenarios (average temperature, average-3 °C, average+3 °C). 3. Our results indicate that this species has low tolerance to cold. Combining cold tolerance data with soil temperature data suggests that its upper elevation limit could range from 1000 m to 1500 m, above which the weather is lethal and precludes overwintering. The locations of sightings of E. multifasciata are consistent with this prediction, with no known locations above 500 m elevation. 4. This study highlights that the winter climate is a major factor in determining population establishment and hence in limiting this species' range. Future studies would benefit from accounting for low winter temperatures and their potential influence on range limits of invasive species.

Rehabilitation of atrophic jaw using iliac onlay bone graft combined with dental implants

Background

Rehabilitating severely atrophic alveolar crests remains challenging for implantologists and maxillofacial surgeons. Recently, a combination of augmentation and dental implantation has been used to treat cases with severe bone atrophy in the maxilla and mandible. Among autogenous bone grafts, iliac bone grafting (IBG) is considered safe for collecting large amounts of bone and obtaining high-density multipotent cells. However, vertical bone resorption may occur during the initial healing stage after IBG. The purpose of the present study is to evaluate bone graft success and implant survival rate, along with bone height in the augmented site and marginal bone level around dental implants placed in iliac onlay bone grafts. We also introduce technique and treatment considerations for successful IBG procedures, as well as optimal implant installation strategy and soft tissue manipulation.

Methods

We examined seven patients who were treated with IBG combined with implant systems over a period of 10 years. The long-term success rate of bone grafts and implant survival rate were recorded. Bone height change and marginal bone loss (MBL) were analyzed by assessing the radiograms acquired after augmentation, at implant installation, prosthetic loading, and after installation 1 year, 2 years, 3 years, and 5 years.

Results

In a mean observation period of 50 months (range 12–62 months), the success rate of IBG was 100%. A total of 29 implants were installed and the implant success rate was 100%. The mean bone height reductions compared to post-augmentation bone heights were 1.33 ± 0.81 mm after 3 months, 2.00 ± 1.88 mm at implant installation, 2.55 ± 1.68 mm at prosthetic loading, and 3.05 ± 1.63 mm after implant installation 1 year. The cumulative bone height change after implant installation 5 years was 4.05 ± 1.83 mm which corresponds to a mean resorption rate of 42.5%. The mean MBL after installation 3 months, at prosthetic loading, and after installation 1 year, 2 years, 3 years, and 5 years follow-ups were significantly higher than at implant installation. However, MBL at 2 years, 3 years, and 5 years post-installation did not differ significantly (p < 0.05).

Conclusion

In patients with atrophic jaws, a combination of the iliac onlay bone graft and dental implants can result in satisfactory reconstruction and reliable long-term prognosis. Despite early stage vertical bone resorption, we observed high success rates and comparable MBL over long-term follow-up. To reduce bone resorption, case evaluation and surgical planning must be meticulous. Further large-scale studies with longer-term follow-up are needed.

Comparison of Characteristics and Survival between Prospective and Retrospective Korea Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Cohort Studies

By comparing the data of prospectively and retrospectively enrolled cohorts, we evaluated whether the prospective cohort represented all patients in the retrospective cohort. The prospectively enrolled subjects were older and had lower CD4+ T cell counts, higher viral load. In addition, the initial antiretroviral treatment regimen of the prospective cohort consisted of less integrase strand transfer inhibitor-containing regimens. The 20-year survival rate was 51.8% in the prospective cohort and 84.6% in the retrospective cohort, respectively (P = 0.844). This study suggests the prospective cohort study may not represent all patients.

Improvement of survival rates in the last decade in Thai childhood-onset systemic lupus erythematosus

BACKGROUND

Morbidity and mortality in childhood onset systemic lupus erythematosus (SLE) is more severe than adult onset SLE. Long-term follow up is needed to determine the prognosis. The objectives of this study are to describe the mortality of childhood SLE in a single tertiary care centre over three decades, compare trends in survival over time, and determine predictors for survival.

METHODS

We retrospectively reviewed the medical records of children aged < 18 years who were diagnosed with SLE at the Department of Pediatrics, Songklanagarind Hospital, Thailand, from 1985 to 2016.

RESULTS

There were 331 children (272 girls, 59 boys) with a mean age at presentation of 11.5 ± 2.6 years. The mean follow-up duration was 7.0 ± 5.0 (range 1-28) years, 77 children (23.3%) died, 28.6% within the first year after diagnosis. The overall mortality rate was 3.3 per 100 person-years. Survival rates at 1, 5 and 10 years were 93.4%, 83.1% and 72.6%, respectively. Ten-year survival rates for the children diagnosed in the decades 1985-1996, 1997-2006 and 2007-2016 were 67.4%, 63.4% and 82.8%, respectively (p < 0.001). Boys had worse survival than girls (hazard ratio = 2.3, 95% CI: 1.4-3.7) even after adjusting for decade of diagnosis. Lupus nephritis (LN) class IV had similar survival compared to LN classes II/III/V combined (hazard ratio = 1.0, 95% CI: 0.6-1.7).

CONCLUSION

In our setting, the survival rate of childhood onset SLE has improved during the past 10 years, but mortality is still high compared to developed countries, particularly in boys.

Long-Term Functioning and Participation Across the Life Course for Preterm Neonatal Intensive Care Unit Graduates

To understand the trajectories of risk and resilience in the vulnerable preterm and neonatal brain, clinicians must go beyond survival and critically examine on a population basis the functional outcomes of children, adolescents, and adults across their life course. Evaluations must go well beyond Bayley assessments and counts of neonatal morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, sonographic brain injury, sepsis, and necrotizing enterocolitis. Proactively providing support to families and developmental and educational supports to children can optimize academic functioning and participation in adult learning, physical and behavioral health activities, community living, relationships, and employment.

Recovery of Immunoglobulin VJ Recombinations from Pancreatic Cancer Exome Files Strongly Correlates with Reduced Survival

We assessed pancreatic cancer, lymphocyte infiltrates with a computational genomics approach. We took advantage of tumor-specimen exome files available from the cancer genome atlas to mine T- and B-cell immune receptor recombinations, using highly efficient, scripted algorithms established in several previous reports. Surprisingly, the results indicated that pancreatic cancer exomes represent one of the highest level yields for immune receptor recombinations, significantly higher than two comparison cancers used in this study, head and neck and bladder cancer. In particular, pancreatic cancer exomes have very large numbers of immunoglobulin light chain recombinations, both with regard to number of samples characterized by recovery of such recombinations and with regard to numbers of recombination reads per sample. These results were consistent with B-cell biomarkers, which emphasized the Th2 nature of the pancreatic lymphocyte infiltrate. The tumor specimen exomes with B-cell immune receptor recombination reads represented a dramatically poor outcome, a result not detected with either the head and neck or bladder cancer datasets. The results presented here support the potential value of immunotherapies designed to engineer a Th2 to Th1 shift in treating certain forms of pancreatic cancer.

Milk yield and kit development of four breeds of rabbit in Ibadan, Nigeria

Background

Rabbit breeding with high performance imported ones would be of benefit for genetic diversity and improvement of performance in domestic rabbit breeds. The rearing of more productive rabbit breeds could be pathway to improve the productivity and reduce the production cost. Maternal nutritional status exert a great influence on reproductive functions of does, which may expand from conception, through gestation and parturition and development of kits to puberty.

Methods

Four breeds of rabbit were evaluated for their parturition, weaning and pubertal differences among the rabbit population in Ibadan, Nigeria. The breed consist of Fauve De Bourgogne (FDB), Chinchilla (CHA), British Spot (BS) and New Zealand White (NZW) rabbits. A total of 60 bucks and 360 does consisting of 15 bucks and 90 does per breed were mated in 6 mating cycles, three each of natural mating and artificial insemination. All does were synchronized for estrus with 20 IU pregnant mare serum gonadotropin 48 h prior to mating. The does after parturition were assessed for milk yield (g) and kit survival rate (%) till weaning, weight changes of kits from birth to puberty. At puberty, the pubertal age (days) and weight (g) of the offspring were assessed.

Result

Results obtained reveals that British Spot doe had highest milk yield among the breeds which significantly increased growth of kit and weight at weaning in British Spot rabbits. Survival rates of Chinchilla kits were significantly (p < 0.05) higher than Fauve de Bourgogne, British Spot and New Zealand White kits. Puberty attainment of the rabbits indicates that British spot does and Fauve de Bourgogne bucks are early maturing.

Conclusion

Chinchilla shows high kit survivability and British spot has highest milk yield among the four breeds of rabbit.

Survival Rates in Closed and Open Vitrification for Human Mature Oocyte Cryopreservation: A Meta-Analysis

BACKGROUND/AIMS

Survival of warmed oocytes is the first part and is one of the most important aspects of in vitro fertilization following oocyte cryopreservation. There is no definite conclusion about the difference in survival rates between closed and open vitrification for oocyte cryopreservation. This study aimed to investigate whether there is a difference in survival rates between closed and open vitrification for cryopreservation of human mature oocytes.

METHODS

A literature search was performed using the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases. A total of 4 studies were included in the meta-analysis.

RESULTS

In the frequentist meta-analysis, the random effects model showed no statistically significant difference in survival rates between closed and open vitrification (risk ratio [RR] 0.8873, 95% confidence interval [CI] 0.7658-1.0280). However, an effect size deviation of the RR from 1.0 and a borderline trend of the 95% CI were noted. In the Bayesian meta-analysis, the posterior probability that closed vitrification would decrease the survival rate when compared to that with open vitrification was 83.04% for the random effects model.

CONCLUSION

It is not yet possible to conclude that closed vitrification is an aseptic alternative to open vitrification in human mature oocyte cryopreservation.

Improved outcome of childhood acute myeloid leukemia in an Eastern European country: Lithuanian experience

The reported treatment outcomes of children treated for cancer in Eastern European countries are inferior to those in Northern/Western Europe. We hypothesized that recent survival rates could be comparable to the current standards and performed a population-based analysis of treatment outcome of childhood acute myeloid leukemia (AML) in Lithuania, a small Eastern European country. Children < 18 years old who were treated for AML from 2000 to 2013 were included (n = 54). Estimates of 5-year event-free (EFS_5y) and overall survival (OS_5y) rates were analyzed. Comparing periods 2000-2006 (n = 32) and 2007-2013 (n = 22), the EFS_5y improved from 31 to 63% (p = 0.04), and the OS_5y improved from 31 to 72% (p = 0.02) because of reductions in toxicity-related mortality (42 vs. 15%, p = 0.08) and relapse (43 vs. 25%, p = 0.08). The most significant improvement was demonstrated in high-risk patients (OS_5y improved from 26 to 75%, p = 0.02) who benefited from hematopoietic stem cell transplantation: the post-transplant EFS_5y increased from 13 to 86% (p = 0.01).

CONCLUSIONS

The current survival rate of Lithuanian children treated for AML was comparable to the expected rate in other parts of Europe. What is Known: • In the last three decades, significant improvement has been achieved in treating childhood cancer, with an overall survival (OS) rate of > 80% in high-income countries. The difference in survival rates between Northern/Western and Eastern European countries as well as between high- and middle-/low-income countries is as much as 20%. Recently, the 5-year event-free survival rate of acute myeloid leukemia (AML) has reached > 60% in high-income countries. The survival rates for myeloproliferative diseases were the lowest in Eastern European countries. • The reported inferior survival rates were calculated based on outcome data of patients treated until 2007. The recent survival rates in Eastern European countries are unknown. What is New: • Being a small Eastern European country, Lithuania has experienced good economic growth during the last decade. We hypothesized that economic growth and gain of experience could result in better survival rates of children treated for cancer in our country in recent years. • A population-based analysis of treatment outcome of childhood AML treated in Lithuania in the recent years was performed for the first time. The survival rates of childhood AML in Lithuania are comparable to those of other high-income countries. Current survival rates of children treated for cancer in Eastern European countries could be comparable to the best current standards contributing to better European survival rates of childhood cancer in general.

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

BACKGROUND

Reports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America.

METHOD

A retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan-Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes.

MAIN RESULTS

One hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value=0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value=0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value=0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value=0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries.

CONCLUSION

Patients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.

Why does total elbow arthroplasty fail today? A systematic review of recent literature

BACKGROUND

Total elbow arthroplasty is a relatively uncommon type of arthroplasty, which has undergone several design changes in the past four decades. However, research on improvement requires knowledge of failure mechanisms that can be addressed. Therefore, we conducted a systematic review on modes of failure of total elbow arthroplasty.

METHODS

We conducted searches on PubMed/Medline, Embase and Cochrane databases to identify studies describing modes of failure of primary total elbow arthroplasties. The results were coupled per type of total elbow arthroplasty and individual arthroplasty models.

RESULTS

A total of 70 articles were included in this systematic review. 9308 individual total elbow arthroplasties were identified with 1253 revisions (13.5%). Aseptic loosening was the most prevalent reason for revision (38%), followed by deep infection (19%) and periprosthetic fractures (12%).

CONCLUSION

Revision rates have been found similar to a systematic review published in 2003. The revision percentage of total elbow arthroplasty for rheumatoid arthritis is significantly higher than for trauma and post-traumatic osteoarthritis. Aseptic loosening was seen less in linked implants. Infections and periprosthetic fractures did not differ between linkage design groups. Aseptic loosening remains the most frequent cause for revision of primary total elbow arthroplasty. Therefore, more research on the occurrence, progression and risk factors of aseptic loosening should be performed and lead to higher implant survival.

Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital

Background

Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients.

Methods

This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients’ vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival.

Results

Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814 patients with data on their Duke’s staging, independent predictors of poor colorectal cancer (5-year) survival were male sex (Hazard Ratio [HR]: 1.41; 95% CI: 1.12, 1.76), Chinese ethnicity (HR: 1.41; 95% CI: 1.07,1.85), elevated (≥ 5.1 ng/ml) pre-operative carcino-embryonic antigen (CEA) level (HR: 2.13; 95% CI: 1.60, 2.83), Duke’s stage C (HR: 1.68; 95% CI: 1.28, 2.21), Duke’s stage D (HR: 4.61; 95% CI: 3.39, 6.28) and emergency surgery (HR: 1.52; 95% CI: 1.07, 2.15).

Conclusions

The survival rates of colorectal cancer among our patients were comparable with those of some Asian countries but lower than those found in more developed countries. Males and patients from the Chinese ethnic group had lower survival rates compared to their counterparts. More advanced staging and late presentation were important predictors of colorectal cancer survival. Health education programs targeting high risk groups and emphasizing the importance of screening and early diagnosis, as well as the recognition of symptoms and risk factors should be implemented. A nationwide colorectal cancer screening program should be designed and implemented to increase early detection and improve survival outcomes.

Quantifying climate change impacts emphasises the importance of managing regional threats in the endangered Yellow-eyed penguin

Climate change is a global issue with effects that are difficult to manage at a regional scale. Yet more often than not climate factors are just some of multiple stressors affecting species on a population level. Non-climatic factors—especially those of anthropogenic origins—may play equally important roles with regard to impacts on species and are often more feasible to address. Here we assess the influence of climate change on population trends of the endangered Yellow-eyed penguin (Megadyptes antipodes) over the last 30 years, using a Bayesian model. Sea surface temperature (SST) proved to be the dominating factor influencing survival of both adult birds and fledglings. Increasing SST since the mid-1990s was accompanied by a reduction in survival rates and population decline. The population model showed that 33% of the variation in population numbers could be explained by SST alone, significantly increasing pressure on the penguin population. Consequently, the population becomes less resilient to non-climate related impacts, such as fisheries interactions, habitat degradation and human disturbance. However, the extent of the contribution of these factors to declining population trends is extremely difficult to assess principally due to the absence of quantifiable data, creating a discussion bias towards climate variables, and effectively distracting from non-climate factors that can be managed on a regional scale to ensure the viability of the population.

Helical tomotherapy of spinal chordomas: French Multicentric, retrospective study of a cohort of 30 cases

PURPOSE

To evaluate the efficacy and toxicity of helical tomotherapy (HT) in the management of spine chordomas when proton therapy is unavailable or non-feasible.

METHODS AND MATERIALS

Between 2007 and 2013, 30 patients with biopsy-proven chordomas were treated by HT in five French institutions. Information regarding local control (LC), overall survival (OS), progression-free survival (PFS) and metastasis-free survival (MFS) was collected. Clinical efficacy, toxicity and treatment quality were evaluated.

RESULTS

Two-year actuarial LC, OS, PFS and MFS were 69.9%, 96.7%, 61.2% and 76.4%, respectively. HT treatments were well tolerated and no Grade 4-5 toxicities were observed. HT permitted the delivery of a mean dose of 68 Gy while respecting organ at risk (OAR) dose constraints, in particular in the spinal cord and cauda equina.

CONCLUSIONS

This multicentric, retrospective study demonstrated the feasibility of HT in the treatment of spine chordomas, in the absence of hadron therapy.

Prognostic Factors for Renal Cell Carcinoma Subtypes Diagnosed According to the 2016 WHO Renal Tumor Classification: a Study Involving 928 Patients

The morphotype and grade of renal cell carcinoma (RCC) in 928 nephrectomies were reclassified according to the 2016 WHO classification in order to analyze the distribution and outcomes of RCC subtypes in Hungary, to assess whether microscopic tumor necrosis is an independent prognostic factor in clear cell RCC, and to study whether a two-tiered grading (low/high) for clear cell and papillary RCC provides similar prognostic information to that of the four-tiered ISUP grading system. 83.4% of the cohort were clear cell, 6.9% papillary, 4.5% chromophobe, 2.3% unclassified, 1.1% Xp11 translocation, 1.1% clear cell papillary, 0.3% collecting duct and 0.1% mucinous tubular and spindle cell RCCs. RCC occurred in 16 patients with end-stage kidney disease and none of them displayed features of acquired cystic kidney disease-associated RCC. The 5-year survival rates were as follows: chromophobe 100%, clear cell papillary 100%, clear cell low-grade 96%, papillary type 1 92%, clear cell high-grade 63%, papillary type 2 65%, unclassified 46%, Xp11 translocation 20%, and collecting duct 0%. The 5-year survival rates in low-grade and high-grade papillary RCC were 95% and 59%, respectively. In clear cell RCC, only the grade, the stage and the positive surgical margin proved to be independent prognostic factors statistically. Overall, papillary RCC occurred relatively infrequently; microscopic tumor necrosis in clear cell RCC did not predict the outcome independently of the tumor grading; and the assignment of clear cell and papillary RCCs into low-grade or high-grade tumors was in terms of survival no worse than the ISUP grading.

Differences in fall injury hospitalization and related survival rates among older adults across age, sex, and areas of residence in Canada

Background

Falls are the leading cause of injury-related hospital admissions in Canadian older adults, accounting for 85 % of injury hospitalizations among older adults aged over 65 years. While many of these injuries can lead to death, the survival rates of fall-related injuries are rarely examined. This surveillance study examined the fall injury hospitalization and survival rates among older adults in the context of place.

Methods

Saskatchewan’s health administrative data on injury hospitalizations among individuals aged 65 years and over (n = 39,867) was utilized for this study. Variables of interest included age group, sex, and the geographical area of residence at the time of hospitalization (rural, urban, north). Logistic regression analysis was applied to determine the association of variables of interest (age group, sex, and area of residence at the time of hospitalization as the covariate) with frequency of fall injury hospitalizations. Probable time to death due to fall-related injury hospitalization was determined by survival analysis.

Results

Three key findings that emerged from the present study are the following: (1) fall injury hospitalizations accounted for 77 % of all injury hospitalizations; (2) fall injury hospitalization rates varied by age group, sex, and area of residence, with advancing age, women, and certain geographical areas showing higher rates; and (3) survival rates also varied by sex and area of residence. Women had longer survival estimates after a fall injury hospitalization compared to men, and those living in the north have the shortest survival estimates.

Conclusions

The findings from the study highlighted the high rate of fall-related injury hospitalization among older adults varying with their age group, sex, and area of residence. These factors need to be considered in injury surveillance and fall prevention research as well as programs and policies that support the reduction of falls.

A new ten-gene risk fraction model serving as prognostic indicator for clinical outcome of multiple myeloma

Multiple myeloma (MM) is a kind of aggressive tumor prevalent with high heterogeneity. Abnormal expression of certain genes may lead to the occurrence and development of MM. Nowadays, it is not commonly seen in clinical research to predict the prognostic circumstances of patients with MM by multiple gene expression profiling method. Identification of potential genes in prognostic process could be beneficial for clinical management of MM. Therefore, we aimed to build a risk fraction model to screen out the prognostic indicator for clinical outcome of MM. Microarray data were downloaded from the Genome Expression Omnibus (GEO) datasets with accession numbers GSE24080 and GSE57317. A total of 279 samples were selected out randomly. Besides, a risk formula was constructed and verified in the dataset. Time-dependent receiver operating characteristic (ROC) curve was applied in evaluating the accurate prognostic conditions of patients. Finally, a ten genes model in the training dataset was found to be closely related to the survival condition of MM patients. Patients with MM were divided into two groups, high-risk and low-risk, by the expression of these ten genes, and significant statistical difference was found between the two groups. Furthermore, the result of multivariate cox regression and stratified analysis indicated that this model was independent of other clinical phenotypes. ROC curves also showed its feasibility to predict the survival status of MM patients. Our results demonstrated that the fraction risk model constructed by the selected ten genes could be used to predict survival status of multiple myeloma patients, which could also help in improvement of prognostic and therapeutic tool of MM.

Clinical evaluation of two formulations of slow-freezing solutions for cleavage stage embryos

PURPOSE

The aim was to investigate if improved survival rates could be achieved using a new formulation of solutions for slow freezing of human cleavage stage embryos.

METHODS

The evaluation was divided into two parts. The first part was a retrospective analysis of results obtained after freezing and thawing of day 3 embryos from 400 women using an old formulation of cryopreservation solutions compared to results from 108 women for which cryopreservation had been performed using new compositions of solutions. The second part was prospective, adding cycles until similar numbers of patients had been included in both groups. In total, 2274 embryos from 897 patients were thawed using the old formulation of solutions while 1273 embryos from 542 patients were frozen and thawed using the new solutions. The primary endpoint was survival rate.

RESULTS

With the new solutions, the survival rate increased from 82.1 to 94.4 % and the complete embryo survival rate increased from 54.9 to 81.3 %. The implantation rate, clinical pregnancy rate per embryo transfer, and per cycle were 28.2, 45.2, and 43.7 %, respectively, using the old formulations of cryosolutions. With the new solutions, the results reached 33.7, 54.1, and 54.1 %, respectively. All differences in results were statistically significant. The number of cancelled embryo transfers due to no survived embryos was 18 with the old solutions and 0 using the new solutions.

CONCLUSION

With the new composition of solutions for slow freezing and thawing of embryos, significantly improved results were obtained. Additionally, the number of cancelled embryo transfers was reduced.

Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital

PURPOSE

The aim of this study is to present the survival rates in patients treated for oral cancer with primary surgery in a large district general hospital. We discuss the influence of the most significant prognostic factors on survival and compare our results with larger centres specializing in the management of oral cancer.

METHODS

All patients diagnosed with oral cancer from 1995 to 2006 and were treated in the Department had their details entered prospectively onto a computerized database. Demographic details of patients, type of treatment, pathological stage of tumor (TNM), local and regional recurrence rate, overall survival, disease specific survival and incidence of involved margins were recorded and calculated.

RESULTS

Of the 178 patients, 96 (54 %) were alive and free of oral cancer 5 years after surgery. Forty-four patients died of oral cancer (24.7 %) but 38 (21.3 %) died of other causes. The overall survival rate after primary surgery in relation to stage was: I 84 %, II 71 %, III 36 % and IV 28 %.

DISCUSSION

As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

Persistent Disparities in Hispanics with Cervical Cancer in a Major City

OBJECTIVES

Despite an overall improvement in cervical cancer screening, incidence, and mortality rates for minorities in the USA, regional differences in screening and stage at presentation have been observed. This study evaluated cervical cancer disparities in a predominately Hispanic population treated in a major treatment center in San Antonio, Texas.

METHODS AND MATERIALS

Data on 446 patients with cervical cancer treated between 2000 and 2011 at the Cancer Therapy and Research Center in San Antonio, Texas, were reviewed. Sufficient information was obtained on 319 patients and was compared with the Surveillance, Epidemiology, and End Results (SEER) data.

RESULTS

Of 319 patients treated for cervical cancer between 2000 and 2011, 209 were Hispanics and 110 were Whites (82), Blacks (20), Asians (7), and others (1). The median and mean ages at diagnosis were 47 and 49, respectively. Only 36 % were known to have screening Pap tests prior to diagnosis, of which only 24 had yearly Pap tests. Forty-two patients (20 %) of those with no known screening Pap tests presented with stage IV disease at diagnosis (vs. 3 % of those with known Pap tests). Among the Hispanics, 68 % presented with regional disease (vs. 37 % SEER) and 46 % were stage III or higher disease, with stage IIIB accounting for 30 % of total. Although the overall age-adjusted death rates were higher in Hispanics due to a higher percentage of more advanced disease, survival rates appear similar, stage for stage, to the SEER data.

CONCLUSION

Even in a major city, Hispanics often present with more advanced cervical cancer than the general population. In order to minimize the cervical cancer disparities, efforts and strategies are needed to study the cultural and locale effects and to implement preventive measures and adaptive health education.

Liver transplantation for alcoholic liver disease: Lessons learned and unresolved issues

The use of liver transplantation (LT) as a treatment for alcoholic liver disease (ALD) has been highly controversial since the beginning. The ever increasing shortage of organs has accentuated the low priority given to patients suffering from ALD, which is considered a “self-inflicted” condition. However, by improving the long-term survival rates, making them similar to those from other indications, and recognizing that alcoholism is a primary disease, ALD has become one of the most common indications for LT in Europe and North America, a situation thought unfathomable thirty years ago. Unfortunately, there are still many issues with the use of this procedure for ALD. There are significant relapse rates, and the consequences of excessive drinking after LT range from asymptomatic biochemical and histological abnormalities to graft failure and death. A minimum three-month period of sobriety is required for an improvement in liver function, thus making LT unnecessary, and to demonstrate the patient’s commitment to the project, even though a longer abstinence period does not guarantee lower relapse rates after LT. Recent data have shown that LT is also effective for severe alcoholic hepatitis when the patient is unresponsive to corticosteroids therapy, with low relapse rates in highly selected patients, although these results must be confirmed before LT becomes a standard procedure in this setting. Finally, LT for ALD is accompanied by an increased risk of de novo solid organ cancer, skin cancer, and lymphoproliferative disorders, which has a large impact on the survival rates.

Long-term outcome of transcatheter arterial chemoembolization after radiofrequency ablation as a combined therapy for Chinese patients with hepatocellular carcinoma

OBJECTIVE

This study was undertaken to assess the long-term outcome of transcatheter arterial chemoembolization (TACE) after radiofrequency ablation (RFA) combined with a combined therapy for Chinese patients with intermediate (stage B) hepatocellular carcinoma (HCC) of single block type, and evaluate the survival rate for 1, 3, 5, and 7 years.

RESEARCH DESIGN AND METHODS

This prospective, single-center study consisted of patients with solitary massive intermediate (stage B) HCC treated by RFA combined with TACE from October 1999 to December 2013.

MAIN OUTCOME MEASURES

The survival rate of the patients for 1, 3, 5, and 7 years, and safety of the RFA treatment in the interim, total RFA for each case, and number of TACE cycles were evaluated.

RESULTS

Ninety-three patients (aged 54.4 ± 8.0 years) underwent RFA combined with TACE as a combined therapy, and they were analyzed and followed up until December 2013. The mean time for the initial ablation was 1.5-3 h, and, on average, each patient received 1.39 RFA and 1.43 TACE therapies. Overall, complete ablation was achieved in nine patients, and the majority of ablation was seen in 84 patients. The longest survival time was 102 months and, among the survivors the 1, 3, 5, and 7 year survival rate was 94.4%, 52.3%, 26.1%, and 14.1%, respectively. The median survival time was 36 months (95% confidence interval = 32.7-39.3). Serum alpha-fetoprotein (AFP) levels showed significant correlation with tumor size in patients with HCC (r = 0.323, p = 0.0001). There were no major complications related to this therapy.

CONCLUSION

This was the first study that performed RFA combined with TACE in Chinese patients with intermediate (stage B) HCC. RFA combined with TACE, as a combined therapy for intermediate (stage B) HCC, seems to be a promising regimen that showed a satisfactory clinical effect, which may become a new therapy mode for HCC. However, a larger cohort and control group(s) reflecting usual standards of care are needed to assess the external validity of these results in a wider population.

Rickia wasmannii increases the need for water in Myrmica scabrinodis (Ascomycota: Laboulbeniales; Hymenoptera: Formicidae)

The order Laboulbeniales (Fungi, Ascomycota) is a little-studied group of microscopic ectoparasites of invertebrates, mostly insects. The effects of Laboulbeniales species on their hosts are mostly unknown. Rickia wasmannii Cavara, 1899 is a common Laboulbeniales fungus occurring in Europe and is currently known to be a parasite of at least eight Myrmica ant species. R.wasmannii serves as a good model organism for Laboulbeniales-host interactions, as this species covers the host in a very high density, and infected host individuals can be easily collected in high numbers. The effect of R. wasmannii on the survival rate of its most common host species, Myrmica scabrinodis Nylander 1846, was therefore investigated in a laboratory experiment on an individual level. To enhance the results, environmental stresses were simulated by depriving infected and uninfected workers of water and food. The survival of individuals was recorded hourly until the death of the last individual. Infected specimens were significantly more sensitive to the withdrawal of food and water than uninfected specimens. When we tested for water consumption, we found that infected ants spent more time consuming water than uninfected ants. Therefore, it is possible that infected ants must replace the loss of water. Based on these results, R. wasmannii substantially decreases the chances and time of survival of infected individuals, at least in resource-limited environments, which suggest that R. wasmannii has a negative effect on its host.

Reconstruction plates used in the surgery for mandibular discontinuity defect

OBJECTIVES

The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects.

MATERIALS AND METHODS

We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT).

RESULTS

Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages (9.25±5.10 months), plate fracture was the most common complication, but in the later stages (35.75±17.00 months), screw loosening was the most common complication.

CONCLUSION

It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

Prostate cancer trends in Latvia during 1990-2012: incidence, prevalence, mortality, and survival rates

BACKGROUND AND OBJECTIVE

Prostate cancer (PCa) is one of the most common form of cancer in males worldwide. One of the highest PCa-related mortality rates in the world is observed in Latvia.

MATERIALS AND METHODS

Our study included male patients diagnosed with PCa between 1990 and 2012. We analyzed incidence, prevalence and mortality trends using joinpoint analysis. Kaplan-Meier analysis was performed for 5-, 10-, 15- and 20-year overall survival and cancer-specific survival rates.

RESULTS

A total of 14,083PCa patients with a mean age of initial PCa diagnosis being 70.1 (SD 8.6) was registered. The standardized incidence rates (per 100,000) increased from 18.9 in 1990 to 74.7 in 2012, while the standardized prevalence rates (per 100,000) increased from 69.9 in 1990 to 437.6 in 2012. Standardized PCa mortality rates (per 100,000) also rose from 13.2 in 1990 to 27.2 in 2006 followed by statistically insignificant decrease continuing up to 2012. The mean 5-year cancer-specific survival rates increased from 43.6% in 1990 to 70.7% in 2007, and the mean 10-year cancer-specific survival rates from 32.9% in 1990 to 40.5% in 2001.

CONCLUSIONS

This study revealed that the incidence, prevalence and mortality rates increased between 1990 and 2012, and although the 5- and 10-year overall and cancer-specific survival rates improved over the reviewed period they still needed to get better.