Relationship of sociodemographic variables with outcomes after cataract surgery

PURPOSE

The objective of this study is to analyse the relationship between sociodemographic characteristics of patients undergoing cataract extraction and their outcomes.

METHODS

The method comprised a prospective cohort study of patients recruited from 17 hospitals of different areas of Spain. Data gathered before surgery included sociodemographic variables, visual acuity, and visual function (using the Visual Function Index-14). After surgery, we assessed visual acuity and visual function at 6 weeks and at 3 months, respectively. Multivariate multilevel analysis was performed to assess the relationship of sociodemographic variables with changes in visual acuity and function, analysing whether improvements surpassed the minimal clinically important differences (MCIDs).

RESULTS

Multivariate analysis showed that for visual acuity, (i) older men had a lower odds ratio (OR) of surpassing the MCID (OR: 65-75 years, 0.64; >75 years, 0.51); (ii) those with primary (1.65) or secondary (1.41) education had higher ORs than those with no formal education; and (iii) those living in a residential home had a lower OR than men living alone (0.36). In women, we found that the higher the educational level, the greater the improvement in visual acuity (primary, 1.41; secondary, 1.76), whereas socially dependent women (0.70) were less likely to exceed the MCID. With regards to predictors related to achievement of an MCID in visual function, only dependency was associated with more improvement in men (OR: 1.39), whereas in women the educational level was the only predictor (primary: 0.72; secondary: 0.61).

CONCLUSIONS

This study found that patients with certain sociodemographic characteristics were less likely to experience an MCID in visual acuity or visual function after cataract surgery.

Swarm of terminal 35S in Cheirolophus (Asteraceae, Centaureinae)

Island radiation constitutes a playground for species diversification, which has long fascinated researchers and still does today. Because only a small subset of taxa within the pool of island colonizers is concerned by this process, the question is raised on whether some factors could make a taxon prone to radiate. Cheirolophus is the only genus of Centaureinae subtribe to have experienced a radiation in the Canary Islands. Cytogenetic characterization through FISH of 5S and 35S ribosomal RNA genes in eight Cheirolophus species from continent and Canary Islands revealed an unusually high number of 35S predominantly at terminal position, together with a single interstitial 5S rDNA locus in all the studied taxa. Such an abundance of 35S rDNA signals is unique among Centaureinae and predates Cheirolophus arrival in Canary Islands. The possible link of the rDNA profile with radiation process is discussed through a comparison with two other case studies, the closely related Rhaponticum group and the genus Centaurea.

Dysbindin-1 modulates prefrontal cortical activity and schizophrenia-like behaviors via dopamine/D2 pathways

Dysbindin-1 regulates D2-receptor trafficking and is implicated in schizophrenia and related cognitive abnormalities, but whether this molecular effect mediates the clinical manifestations of the disorder is unknown. We explored in dysbindin-1-deficient mice (dys-/-) (1) schizophrenia-related behaviors, (2) molecular and electrophysiological changes in medial prefrontal cortex (mPFC) and (3) the dependence of these on D2-receptor stimulation. Dysbindin-1 disruption altered dopamine-related behaviors and impaired working memory under challenging/stressful conditions. Dys-/- pyramidal neurons in mPFC layers II/III were hyperexcitable at baseline but hypoexcitable following D2 stimulation. Dys-/- were also respectively more and less sensitive to D2 agonist- and antagonist-induced behavioral effects. Dys-/- had reduced expression of Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) and CaMKKβ in mPFC. Chronic D2 agonist treatment reproduced these changes in protein expression, and some of the dys-/- behavioral effects. These results elucidate dysbindin's modulation of D2-related behavior, cortical activity and mPFC CaMK components, implicating cellular and molecular mechanisms of the association of dysbindin with psychosis.

Bioabsorbable staple-line reinforcement for pancreatectomy in a porcine model: a preliminary study

BACKGROUND

We conducted an exploratory study to assess the use of FOREseal® bioabsorbable reinforcement sleeves in stapling of the pancreatic parenchyma.

METHODS

A left pancreatectomy was carried out with linear stapler on 12 pigs: in the FOREseal group (n = 6), the stapling was reinforced with FOREseal, while in the control group (n = 6), simple stapling was applied.

RESULTS

The mean operating time was not different between the two groups. No additional haemostasis of the stapling transection was necessary with FOREseal, while in the control group, four pigs required additional haemostasis (p = 0.03). The mean postoperative drainage volume and the mean duration of drainage were, respectively, in the FOREseal group versus the control group: 82 versus 204 ml (p = 0.2) and 3.2 versus 4.7 days (p = 0.3). No adverse event occurred in the FOREseal group. There was no anatomopathological difference between the two groups.

CONCLUSION

A good tolerance of FOREseal was observed when used on the pancreatic stump. In this study, it was demonstrated a better haemostatic control of the pancreatic stump with FOREseal which also tends to reduce the volume of postoperative drainage liquid.

P4-09-12: Clinical Validation of Immunohistochemical Signature Predictive of Patients' 8 Year Outcome in Node Negative Breast Carcinomas

Background

Immunohistochemical (IHC) signatures predictive of prognosis can be a cost effective alternative to genomic signature suitable in clinical practice for patients’ management in early stages of breast carcinoma (BrCa) in clinical. IHC procedures are very easy to handle in pathology laboratories, since require very few amount of formalin fixed tissue samples since assessed on consecutive 4 μm thick sections of paraffin embedded tumors fragments validated by pathologists’ expertise. We recently reported (C Charpin et al Int J Cancer 2009) that standardized IHC assays using high throughput densitometry on digitized microscopic images allow to predict an adverse outcome of patients with BrCa, provided that identified the IHC predictive signatures can be validated in other patients’ cohorts. In this regard we have repeated our previously reported IHC procedures on 418 series of BrCa (Marseille University) on a second series including 303 BrCa diagnosed at Yale University.

Material and Methods: TMA(s) of two cohorts of patients with BrCa (418/Marseille University and 303 Yale University) were respectively investigated for immunohistochemical expression of 15 markers, including (i) those of the best signature predictive of patients outcome in N- patients in our previous studies and (ii) new markers reported in the literature as EMT cells and Stem cells. Monoclonal antibodies against HIFa, PI3, pAKT, pmTOR, moesin, P21, 4EBP-1, P27, Ker 5.6, pMAPKAPK-2, SHARP2, Claudin, ALDH, AF6, CD24, IHC was screened using standardized (Ventana Benchmark XT) on consecutive 4 μm thick sections of TMAs from both series, Quantitative measurements of immunoprecipitates were automatically assessed with TRIBVN device, and correlated to 8 year patients’ outcome. Logistic regression determined the best combination of markers to predict patients’ prognosis and results of the two cohorts were compared.

Results: In node negative BrCa the best predictive combination of markers signature was HIF-1a, PI3K, Claudin, AF6, pAKT independently of ER PR and HER-2 status. When results of logistic regression with these markers was compared very similar results were obtained with 92.34 % (333/418) of well classified patients in the first set (Marseille University series) and 89.8 % (158/176) in the second set from Yale University.

Discussion: The results suggest that the new optimal IHC signature predictive of prognosis identified in BrCa including HIF-1a, PI3K, Claudin, AF6 and pAKT is validated by this study with very similar results in two different cohorts of patients.

This validation also suggests (1) that IHC signatures investigated in individual patients can be considered as suitable in clinical practice offering a cost effective convenient mean to predict patients’ outcome at diagnostic time (2) and to select those patients with poor prognosis, particularly in N- BrCa subset, requiring more aggressive adjuvant therapies, and to avoid useless expensive therapies and their side effects in N- patients with favourable prognosis.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-12.

The impact of cash transfers to poor women in Colombia on BMI and obesity: prospective cohort study

Introduction

Prevalence of obesity is rising in Latin America, is increasingly affecting socially disadvantaged groups, particularly women. Conditional cash transfers are recently established welfare interventions in the region. One, Familias en Accion, transfers ~20% of average monthly income to women in Colombia’s poorest families. Previous work has found that families buy more food as a result.

We tested the hypothesis that participation in Familias would be associated with increasing body mass index (BMI) in participating women

Methods

Women from participating areas and control areas (matched on environmental and socioeconomic criteria) were surveyed in 2002 and 2006. Pregnant, breast-feeding or women aged<18 or with BMI<18.5kg/m² were excluded. The sample comprises 835 women from control and 1238 from treatment areas. Because some treatment areas started Familias shortly before baseline data collection, a dummy variable was created that identified exposure independent of time-point or area. Follow-up was 61.5%.

BMI was measured by trained personnel using standardized techniques. Overweight was defined as BMI>25kg/m² and obesity as >30kg/m². The effect of Familias was estimated using linear regression (or logistic regression for dichotomous outcomes) in a double-difference technique, controlling for several individual, household and area characteristics, including parity and baseline BMI, using robust standard-errors clustered at area-level in an intention-to-treat analysis.

Results

At baseline, women’s mean age was 33.3 years and mean BMI 25.3kg/m²; 12.3% women were obese. After adjustment, exposure to Familias was significantly associated with increased BMI (β=0.25, 95% CI 0.03, 0.47; p=0.03). Age (β=0.09; 95%CI 0.06, 0.13; p<0.001) and household wealth (β=0.78; 95%CI 0.41, 1.15; p<0.001) were also positively associated with BMI. Familias was also associated with increased odds of obesity (O.R.=1.27 95%CI 1.03, 1.57; p=0.03), as was age (O.R.=1.04; 95%CI 1.02, 1.06; p=0.001).

Conclusion

Conditional cash transfers to poor women in Colombia are independently associated with increasing BMI and obesity risk. Although conditional cash transfers are generally regarded as popular and successful schemes, parallel interventions at individual, household and community level are needed to avoid unanticipated adverse outcomes.

Epidemiology of multiple myeloma and the role of M-band detection on serum electrophoresis in a small developing country. A retrospective study

OBJECTIVE

The objective of the study was to determine the role of M-band component on serum protein electrophoresis and bone marrow biopsy in the diagnosis.

METHODS

Data was collected on 34 patients with MM diagnosed and/or treated.

RESULTS

There were equal numbers of men 17 (50%) and women 17 (50%). All patients were first screened for the presence of M-Band using serum protein electrophoresis (SPE) followed by bone marrow biopsy as the confirmatory test. Only two patients screened negative by SPE. On the other hand six patients who tested positive by SPE were negative on biopsy. Thus the sensitivity of the SPE was 96% and specificity 71%. This means that 29 patients had an established diagnosis of MM. There was a slight male predominance when compared to females.

CONCLUSION

The data showed that the SPE and bone biopsy are the important tools in the diagnosis of multiple myeloma in a small developing country.

Lactic acid bacteria in the inhibition of Fusarium graminearum and deoxynivalenol detoxification

AIMS

Considering the agronomic and industrial damage that is caused by the fungus Fusarium graminearum, as well as the serious health risks it poses to humans and animals exposed to F. graminearum-produced mycotoxin deoxynivalenol (DON), this study evaluated the ability of different lactic acid bacteria (LAB) strains to inhibit fungal development and remove DON in vitro.

METHODS AND RESULTS

The antagonistic effects of strains and commercial cultures of LAB were evaluated against F. graminearum IAPAR 2218 by the agar diffusion method. Additionally, the influence of the culture media, pH and the presence of lactic and acetic acid on these effects was tested. The capacity to remove DON by viable cells and heat-inactivated cells was analysed in liquid media and quantified by high performance liquid chromatography (HPLC). All isolated strains and commercial cultures inhibited the fungus and removed DON. The pH and culture media concentration did not influence these abilities, but heat inactivation had a strong effect on the ability of bacteria to remove mycotoxin.

CONCLUSIONS

The isolated bacteria are able to inhibit F. graminearum growth and remove DON in vitro.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study suggests potential application of the isolated LAB strains in the inhibition of F. graminearum IAPAR 2218 and DON removal in vitro.