Resistance index determination in the pre and post kidney transplantation time points in graft dysfunction diagnosis

BACKGROUND

Donor shortage necessitates the development of tools capable of objectively assessing kidney graft quality from expanded criteria donors and kidneys donated after cardiac death. The deteriorating donor profile is leading to a shift from cold storage toward machine perfusion preservation. Several authors found that renal resistance (RR) at the end of machine perfusion was an independent risk factor for the development of delayed graft function (DGF). In contrast, Doppler ultrasonography in the posttransplant period reveals renal hemodynamics and is useful in diagnosing renal allograft dysfunction. We sought to determine concordance between RR and the resistance index (RI) and their diagnostic value in the assessment of graft viability.

METHODS

RR was determined at the end of perfusion during hypothermic machine preservation and RI was measured by Doppler ultrasonography in the early posttransplant period. Agreement between these 2 measures was established by means of the intraclass correlation coefficient (ICC). Diagnostic validity for RR and RI was determined by sensitivity, specificity and positive and negative predictive values.

RESULTS

The ICC was 0.135, which indicates a slight agreement. RR and RI had limited value in the prediction of DGF for a specific kidney as reflected by a c-statistic of 0.58 and 0.66, respectively.

CONCLUSIONS

There is no agreement between the RR and RI, which may be owing to the different conditions under which measurements are made. The poor predictive power of RR for DGF indicates that kidneys should not be discarded based on RR criteria alone.

Training and capacity building evaluation: Maximizing resources and results with Success Case Method

This article describes the use of Success Case Method (Brinkerhoff, 2003) to evaluate health promotion and public health training programs. The goal of the Office Community Research and Engagement (OCRE) of the Puerto Rico Clinical and Translational Research Consortium (PRCTRC) is to establish a stable and sustainable translational research capacity. Early efforts toward achieving this goal included sponsoring two independent research training programs. A description of the implementation of the five step Success Case Method is presented. Results reveal that SCM would deem both trainings as highly successful, based upon the overall impact of a low number of success cases. However, a traditional summative evaluation would consider this disappointing. Strengths of SCM are discussed. It was concluded that the Success Case Method is a useful and valuable evaluative method for measuring the success of health promotion and public health training initiatives and provides sufficient information for decision-making processes.

Efficacy of mesalazine or beclomethasone dipropionate enema or their combination in patients with distal active ulcerative colitis

OBJECTIVE

Mesalazine or Beclomethasone dipropionate (BDP) enema have been shown effective in treatment of distal active ulcerative colitis (UC). This study was aimed to determine whether the combination of topical mesalazine and BDP is superior to topical mesalazine or BDP used alone in patients with distal active UC. PATIENTS AND METHODS: One-hundred and twenty patients with clinical, endoscopic and histological diagnosis of distal active UC were randomly assigned to a regimen with mesalazine tablets 2.4 g/day associated to either mesalazine enema 4 g/day (group A, n=40), BDP 3 mg/60 ml every day (group B, n=40) or the combination treatment with the two compounds in a single administration (group C, n=40) for eight weeks. After four weeks of treatment all patients underwent clinical controls but only 109 patients returned back for clinical, endoscopic and histological controls at the end of the treatment period.

RESULTS

After eight weeks, complete remission rates were of 52%, 47% and 65% respectively, in group A, B and C. From baseline to 4 and 8 weeks the CAI score decreased significantly in all the three groups (p < 0.0001).

CONCLUSIONS

All the three combinations achieved equivalent results in terms of symptoms in inducing symptoms relief and mucosa healing in distally active UC.

Familiality and SNP heritability of age at onset and episodicity in major depressive disorder

BACKGROUND

Strategies to dissect phenotypic and genetic heterogeneity of major depressive disorder (MDD) have mainly relied on subphenotypes, such as age at onset (AAO) and recurrence/episodicity. Yet, evidence on whether these subphenotypes are familial or heritable is scarce. The aims of this study are to investigate the familiality of AAO and episode frequency in MDD and to assess the proportion of their variance explained by common single nucleotide polymorphisms (SNP heritability).

METHOD

For investigating familiality, we used 691 families with 2-5 full siblings with recurrent MDD from the DeNt study. We fitted (square root) AAO and episode count in a linear and a negative binomial mixed model, respectively, with family as random effect and adjusting for sex, age and center. The strength of familiality was assessed with intraclass correlation coefficients (ICC). For estimating SNP heritabilities, we used 3468 unrelated MDD cases from the RADIANT and GSK Munich studies. After similarly adjusting for covariates, derived residuals were used with the GREML method in GCTA (genome-wide complex trait analysis) software.

RESULTS

Significant familial clustering was found for both AAO (ICC = 0.28) and episodicity (ICC = 0.07). We calculated from respective ICC estimates the maximal additive heritability of AAO (0.56) and episodicity (0.15). SNP heritability of AAO was 0.17 (p = 0.04); analysis was underpowered for calculating SNP heritability of episodicity.

CONCLUSIONS

AAO and episodicity aggregate in families to a moderate and small degree, respectively. AAO is under stronger additive genetic control than episodicity. Larger samples are needed to calculate the SNP heritability of episodicity. The described statistical framework could be useful in future analyses.

Kuramoto transition in an ensemble of mercury beating heart systems

We have studied, experimentally, the collective behavior of the electrically coupled autonomous Mercury Beating Heart (MBH) systems exhibiting the breathing mode, by varying both the coupling strength and the population size (from N = 3 to N = 16). For a fixed N, the electrical and the mechanical activities of the MBH systems achieve complete synchronization at different coupling strengths. The electrical activity of each MBH system is measured by the corresponding electrode potential (Ei = Vi). Additionally, the mechanical activity of each MBH oscillator is visually observed (snapshots and video clips). Subsequently, this activity is quantified by calculating the temporal variation in the area (Ai) of the Hg drop. As a result, the synchronization of the electrical (Ei = Vi) and the mechanical (Ai) activities can be measured. The extent of synchronization was quantified by employing the order parameter (r). Our experimental results are found to be in agreement with the Kuramoto theory.

High prevalence of symptoms in a severely abused "non-patient" women population

OBJECTIVE

The objective of this article is to assess the prevalence of somatic symptoms and of gastrointestinal (GI) syndromes in abused "non-patient" women and the association with the time of perpetration, type, and severity of abuse.

METHODS

Sixty-seven women, 18-58 years, receiving shelter in anti-violence associations were invited to fill out an anonymous questionnaire with a medical and an abuse section. The severity of abuse was expressed as the 0-6 Abuse Severity Measure (ASM). The association between abuse characteristics and the number of symptoms, and GI syndromes was assessed by Poisson regression model.

RESULTS

Most women suffered from childhood and adulthood sexual and physical abuse. They reported a mean of 5.1 GI symptoms (range 0-13; median 5; IQR 6) and of 1.3 extra-GI symptoms (range 0-6; median 1; IQR 2); 30% of women matched the Rome II Criteria for one, 36% for two, and 4.4% for three or more syndromes, respectively. Women with an ASM of 5-6, having suffered from both sexual and physical abuse, reported significantly (p = 0.02) more GI symptoms, but not extra-GI ones (p = 0.07), and met criteria for more GI syndromes than women with an ASM ≤4 and those reporting only one type of abuse. No association was found between the time of perpetration of the abuse and the number of GI and extra-GI symptoms.

CONCLUSIONS

Symptoms in abused "non-patient" women mainly concern the abdomen and the GI tract. A history of severe, combined physical and sexual abuse is associated with a higher number of GI symptoms.

New perspectives for direct PDMS microfabrication using a CD-DVD laser

A simple and inexpensive alternative to high-power lasers for the direct fabrication of microchannels and rapid prototyping of poly-dimethylsiloxane (PDMS) is presented. By focusing the infrared laser beam of a commercial, low-power CD-DVD unit on absorbing carbon micro-cluster additives, highly localized PDMS combustion can be used to etch the polymer, which is otherwise transparent at such wavelengths. Thanks to a precise and automated control of laser conditions, laser-induced incandescence is originated at the material surface and produces high-resolution micropatterns that present properties normally induced with lasers of much greater energies in PDMS: formation of in situ nanodomains, local fluorescence and waveguide patterns. An extensive study of the phenomenon and its performance for PDMS microfabrication are presented.