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Measurement of energy and directional distribution of neutron ambient dose equivalent for the 7Li(p,n) 7Be reaction. Appl Radiat Isot 2024; 204:111140. [PMID: 38070360 DOI: 10.1016/j.apradiso.2023.111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023]
Abstract
Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.
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Novel molecular hybrid geometric-harmonic-Zagreb degree based descriptors and their efficacy in QSPR studies of polycyclic aromatic hydrocarbons. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2023; 34:569-589. [PMID: 37538006 DOI: 10.1080/1062936x.2023.2239149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
The physicochemical characteristics of polycyclic aromatic compounds critical to environmental modelling such as octanol partition coefficients, solubility, lipophilicity, polarity and several equilibrium constants are functions of their underlying molecular structures, prompting the development of mathematical models to predict such characteristics for which experimental results are difficult to obtain. We propose twelve novel descriptors derived from geometric, harmonic and Zagreb degree-based descriptors and then test the effectiveness of these descriptors on a data set consisting of 55 benzenoid hydrocarbons of environmental importance. Our computations show that the proposed descriptors have a good linear correlation and predictive power when compared to the degree and distance type descriptors. We have also derived the QSPR expressions for four properties of a large series of polycyclic aromatics arising from circumscribing coronenes and show that a scaling factor can be deduced to derive physicochemical properties of such series up to 2D graphene sheets.
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P2.08-02 Burning the Candle at Both Ends-Sleep Quality Before and After Chemotherapy in Lung Cancer Patients - A Systematic Review and Meta-Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chest HRCT Severity Scores among Hospitalized Patients with COVID-19. Mymensingh Med J 2022; 31:819-825. [PMID: 35780369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Corona Virus Disease 2019 (COVID-19) was declared a pandemic in March 2020. This global health crisis caused thousands of pneumonia related death all over the world since December 2019. RT-PCR is the primary test for diagnosis of COVID-19, though its sensitivity and specificity is variable. Several studies revealed that chest HRCT complements RT-PCR in highly suspected cases or in false negative RT-PCR and helps to gauge disease severity. This study was carried out with an aim to find out the severity scores of chest HRCT in hospitalized patients with COVID-19. This cross sectional descriptive type of observational study was carried out at COVID-19 unit of Sylhet Women's Medical College Hospital, Bangladesh from April 2021 to September 2021. Data were collected from purposively selected 204 patients with COVID-19 by face to face interview, chest HRCT and necessary laboratory investigations. Informed written consent was taken from the participants of the study at the beginning of the interview. Data were analyzed by using SPSS version 21.0. The results of the study showed that mean age of the patients with COVID-19 was 57.9 years with a standard deviation of ±15.8 years. Majority of them (121, 59.3%) were female and the remaining (83, 40.7%) were male. Regarding co-morbidities it was found that each 115 (56.4%) patients were hypertensive and diabetic. Thirty five (16.2%) had ischemic heart disease; 3(1.5%) had congestive cardiac failure and 2(1.0%) had asthma. One (0.5%) patient has atrial fibrillation. In case of 160(78.4%) RT-PCR confirmed patients with COVID-19, chest HRCT was found positive and in 44(21.6%) it was found negative. Among the positive cases mild (7 or less) chest HRCT score was found in 26(12.7%) patients; moderate (8-17) score was found in highest number of patients (128, 62.7%) and severe (18 or more) chest HRCT score was found in 6(2.9%) patients with COVID-19. Chi-square test was carried out to assess the relation of chest HRCT scores with age group, sex, troponin-I, D-Dimer and clinical outcomes within CCU but statistically significant relation was not found (p>0.05). The negative scans were highest (20, 9.8%) in the age group of 41-60 years. Mild, moderate and severe chest HRCT scores was found highest in the age group of 61-80 years (13, 6.4%; 51, 25.0% and 5, 2.5% respectively) (p=0.508). Chest HRCT scans were negative in 18(8.8%) male and 26(12.7%) female. Mild scores were equally distributed between each sex i.e. male 13(6.4%) and female 13(6.4%). Both moderate and severe scores were found more in female (77, 37.7% and 5, 2.5% respectively) than male (51, 25.0% and 1, 0.5% respectively) (p=0.492). Negative chest HRCT scans, mild, moderate and severe scores-all were found more in patients with elevated D-Dimer (p=0.194). Among 204 patients one (0.5%) died in the CCU who had mild score of chest HRCT (p=0.076) but highly elevated Troponin-I (21.70ng/mL). Chest HRCT was found positive among 78.4% of patients with COVID-19 confirmed by RT-PCR. Chest HRCT can help physicians to detect suspected cases and to assess the severity and outcome of the disease. However, further research is recommended to clarify the role of chest HRCT in assessing severity of COVID-19 and prediction of prognosis.
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Abstract
Background Atopic dermatitis (AD) affects up to 25% of children and 10% of adults in Western countries. When severe or recurrent infections and exceedingly elevated serum IgE levels occur in AD patients, an inborn error of immunity (IEI) may be suspected. The International Union of Immunological Societies classification lists variants in different genes responsible for so-called Hyper-IgE syndromes. Diagnosing an underlying IEI may influence treatment strategies. Methods Clinical and diagnostic workup of family members are presented including a detailed immunological description and histology of the carcinoma. Functional testing of the novel variant in CARD11 underlying ‘CARD11-associated atopy with dominant interference of NF-kB signaling’ (CADINS) was performed. Results We report on an 18-year-old patient with a long-standing history of infections, accompanied by hypogammaglobulinemia, intermittent agranulocytosis, atopy, eosinophilia and colitis. The working diagnosis of common variable immunodeficiency was revised when a novel heterozygous CARD11 variant [c.223C>T; p.(Arg75Trp)] was identified. Functional studies confirmed this variant to have a dominant negative (DN) effect, as previously described in patients with CADINS. Five other family members were affected by severe atopy associated with the above variant, but not hypogammaglobulinemia. Malignancies occurred in two generations: an HPV-positive squamous cell carcinoma and a cutaneous T-cell lymphoma. So far, one patient is under treatment with dupilumab, which has shown marked benefit in controlling severe eczema. Conclusion The phenotypic spectrum associated with heterozygous CARD11 DN mutations is broad. Partial T-cell deficiency, diminished IFN-γ cytokine and increased IL-4 production, were identified as disease-causing mechanisms. Malignant disease associated with germline CARD11 DN variants has only been reported sporadically. HPV vaccination in teenage years, and cytology screening analogous with routine cervical swabs may be recommended. Treatment with dupilumab, a monoclonal antibody blocking interleukin-4- and interleukin-13 signaling, may be of benefit in controlling severe and extended AD for some patients as reported for STAT3 loss-of-function.
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OP0095 SINGLE-CELL RNA SEQUENCING REVEALS POTENT ANTI-INFLAMMATORY AND ANTIFIBROTIC ACTIVITIES OF DIMETHYL-ALPHA-KETOGLUTARATE ON EXPLANTED SKIN FROM PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundActivated fibroblasts are the main drivers of skin fibrosis in SSc. We have recently identified dimethyl alpha-ketoglutarate (dm-aKG) as a potential repressor of myofibroblast differentiation and profibrotic activity in cultured skin fibroblasts.ObjectivesTo further analyse the clinical translation of our findings by investigating the antifibrotic capacity of dm-aKG on explanted skin biopsies from SSc patients.MethodsWe cultured forearm punch skin biopsies from SSc patients (n=10) for 24h ex vivo in the presence/absence of 6 mM dm-aKG. Thereafter, skin biopsies (n=4) were dissociated into single cells using a combined mechanical-enzymatic dissociation protocol, followed by single cell (sc)RNA-seq library preparation (10x Genomics) and sequencing (Illumina, NovaSeq6000, 50,000 reads/cell). We mapped the scRNA-seq reads to the reference genome GRCh38.p13 and analysed the data with R/Bioconductor tools. We deconvoluted cell types in bulk skin transcriptomes from SSc cohorts (GSE: 45485, 59785, 9285, 32413) using human skin scRNA-seq data1. The secretion of IL-6, procollagen-1, PRO-C1 (N-terminal type I collagen pro-peptide), C1M (MMP-degradation fragment of type I collagen), and fibronectin (FBN-C) from cultured skin (n=10) was measured in supernatants by ELISA. We analysed gene and protein expression in TGFβ-activated healthy and SSc dermal fibroblasts (DF, n=10) treated or not with dm-aKG using qPCR, Western blot and ELISA. Contractile properties of DF were assessed by gel contraction assay. Traction forces generated by DF were determined by reference-free traction force microscopy.ResultsDissociated cultured SSc skin exhibited comparable cell yield and viability in the presence (20,203; 89%) and absence (25,280; 93%) of dm-aKG, respectively. scRNA-seq skin analysis included 20,869 high quality single cell profiles segregating into 10 distinct skin cell populations (Figure 1A). This analysis demonstrated decreased proportion of fibroblasts and increased proportion of keratinocytes in dm-aKG treated skin (p<0.05; Figure 1B). Among skin cell types, skin fibroblasts exhibited the largest amount of differentially expressed genes upon dm-aKG treatment (44%, n=779, x-fold>0.5, FDR<0.05), suggesting that these cells are key targets of dm-aKG therapy in SSc skin. We identified inflammatory/cytokine signalling (hub genes IL6, STAT1) and extracellular matrix (ECM) organization (hub genes MMP1, ITGB3) as top downregulated biological processes in fibroblasts in dm-aKG treated SSc skin (Figure 1C), coinciding with a decreased abundance of proinflammatory skin fibroblast subpopulation. Specifically, these cells were identified as the main source of IL6 (Figure 1D) and were enriched in SSc skin as revealed by deconvolution analysis of skin transcriptomes. Furthermore, dm-aKG reduced the secretion of IL-6, procollagen-1 and C1M, but not pro-C1 and FBN-C, from cultured skin explants. In cultured DF, dm-aKG blocked the inflammatory (IL-6, pSTAT3), profibrotic (aSMA, Fibronectin, Procollagen-1, Pro-C1) and contractile activities, and significantly diminished traction forces exerted by DF on the matrix substrate.Figure 1.scRNA-seq – comparison of untreated and dm-aKG treated paired skin biopsies. (A) UMAP plot with annotated skin cells, (B) differential abundance of main skin cell types, (C) volcano plot of DE genes with top downregulated gene ontology (GO) pathways in dm-aKG treated skin fibroblasts, (D) IL6 expression in untreated (blue) and treated (pink) skin fibroblasts.ConclusionDm-aKG broadly interferes with inflammatory and ECM organizational activities of skin fibroblasts in culture and in explanted skin from SSc patients. These results confirm that dm-aKG might represent a potential new therapeutic approach for efficient targeting of skin inflammation and fibrosis in SSc.References[1]He H et al. J Allergy Clin Immunol 2020AcknowledgementsThis work was supported by a research grant from FOREUM Foundation for Research in Rheumatology and University Medical Centre Ljubljana.Disclosure of InterestsBlaž Burja: None declared, Dominique Paul: None declared, Reto Gerber: None declared, Sam G. Edalat: None declared, Muriel Elhai Speakers bureau: BMS, Elena Pachera: None declared, Rahel S. Zingg: None declared, Francesca Michela Pramotton: None declared, Sofie Falkenløve Madsen: None declared, Kristina Buerki: None declared, Giampietro Costanza: None declared, Michael Whitfield: None declared, Anne-Christine Bay-Jensen: None declared, Snežna Sodin-Šemrl: None declared, Matija Tomsic: None declared, Gabriela Kania: None declared, Hubert Rehrauer: None declared, Oliver Distler Speakers bureau: Bayer, Boehringer Ingelheim, Janssen, Medscape, Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, 4P Science, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Grant/research support from: Kymera, Mitsubishi Tanabe, Boehringer Ingelheim, Ziga Rotar: None declared, Mark Robinson: None declared, Katja Lakota: None declared, Mojca Frank Bertoncelj: None declared.
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Cholecystitis: association between ultrasound findings and surgical outcomes. Clin Radiol 2022; 77:360-367. [DOI: 10.1016/j.crad.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/01/2022] [Indexed: 12/07/2022]
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Multicentric comparative study of dose indexes using an “in vivo” optical fiber detection system. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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83TiP Clinical implications of clonal hematopoiesis mutations in patients with solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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34P Validation of a new scoring system for molecular subtyping of gastric cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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84TiP Predictive value of exosomes for therapy response in resectable/borderline resectable pancreatic cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Comparative Analysis of Municipal Solid Waste Management in Kochi and Indore. NATURE ENVIRONMENT AND POLLUTION TECHNOLOGY 2021. [DOI: 10.46488/nept.2021.v20i03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Conventionally, the general understanding of Municipal Solid Waste (MSW) management is collecting solid waste and its disposal through its developed channels or outside contracts. However, depending upon the situation and context, the definition of MSW varies between countries across the globe. For instance, in countries like Singapore and Japan, Municipal Solid Waste is defined as general waste. However, while categorizing the general waste, the industrial waste component is considered for Singapore and not for Japan. Similarly, different countries associate different definitions for MSW and it becomes a difficult challenge to suggest a single unified definition applicable for all countries. This paper aims to do a comparative analysis of Waste management in Tier-II cities of India, Kochi and Indore. Kochi is ranked 372nd and the latter 1st according to the latest Swachh Survekshan undertaken as part of the Swachh Bharat Abhiyan (Urban) by the Ministry of Housing and Urban Affairs. This paper highlights what the key elements missing out in the management of waste in Kochi from the reference perspective of Indore and identifying the measures Kochi needs to undertake to improve its ranking among the cleanest city in India are.
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One Gene, Many Facets: Multiple Immune Pathway Dysregulation in SOCS1 Haploinsufficiency. Front Immunol 2021; 12:680334. [PMID: 34421895 PMCID: PMC8375263 DOI: 10.3389/fimmu.2021.680334] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/13/2021] [Indexed: 01/25/2023] Open
Abstract
Background Inborn errors of immunity (IEI) present with a large phenotypic spectrum of disease, which can pose diagnostic and therapeutic challenges. Suppressor of cytokine signaling 1 (SOCS1) is a key negative regulator of cytokine signaling, and has recently been associated with a novel IEI. Of patients described to date, it is apparent that SOCS1 haploinsufficiency has a pleiotropic effect in humans. Objective We sought to investigate whether dysregulation of immune pathways, in addition to STAT1, play a role in the broad clinical manifestations of SOCS1 haploinsufficiency. Methods We assessed impacts of reduced SOCS1 expression across multiple immune cell pathways utilizing patient cells and CRISPR/Cas9 edited primary human T cells. Results SOCS1 haploinsufficiency phenotypes straddled across the International Union of Immunological Societies classifications of IEI. We found that reduced SOCS1 expression led to dysregulation of multiple intracellular pathways in immune cells. STAT1 phosphorylation is enhanced, comparably with STAT1 gain-of-function mutations, and STAT3 phosphorylation is similarly reduced with concurrent reduction of Th17 cells. Furthermore, reduced SOCS1 E3 ligase function was associated with increased FAK1 in immune cells, and increased AKT and p70 ribosomal protein S6 kinase phosphorylation. We also found Toll-like receptor responses are increased in SOCS1 haploinsufficiency patients. Conclusions SOCS1 haploinsufficiency is a pleiotropic monogenic IEI. Dysregulation of multiple immune cell pathways may explain the variable clinical phenotype associated with this new condition. Knowledge of these additional dysregulated immune pathways is important when considering the optimum management for SOCS1 haploinsufficient patients.
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Animal genetic resources in Goa: an overview. JOURNAL OF LIVESTOCK SCIENCE 2021. [DOI: 10.33259/jlivestsci.2021.37-41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Expansion and persistence of blaCTXM gene within clinical-environmental interface: A study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Distribution and breeding habitats of Aedes: Implications for risk of potential arboviral outbreaks in urban Tripura, India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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cupA1/cupA5 gene overexpressed at subinhibitory concentration of carbapenem in biofilm forming Pseudomonas aeruginosa: Transcriptomic study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled trial. Contemp Clin Trials 2020; 94:106024. [PMID: 32389808 DOI: 10.1016/j.cct.2020.106024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Maternal obesity increases neonatal risk for obesity and metabolic syndrome later in life. Prior attempts to break this intergenerational obesity cycle by limiting excessive gestational weight gain have failed to reduce neonatal adiposity. Alternatively, pre-conception lifestyle interventions may improve the in utero metabolic milieu during early pregnancy leading to improved fetal outcomes. This randomized controlled trial (RCT) is evaluating whether a lifestyle intervention to reduce weight and improve maternal metabolism in preparation for pregnancy (LIPP) attenuates neonatal adiposity, compared to standard medical advice. MATERIAL AND METHODS Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. PRIMARY OUTCOMES Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. SECONDARY OUTCOMES Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation. DISCUSSION This RCT will determine the efficacy of maternal weight loss prior to pregnancy on reducing neonatal adiposity. Findings may change standard obstetrical care by providing Level 1 evidence on lifestyle interventions improving neonatal outcomes for women planning for pregnancy. CLINICAL TRIAL REGISTRATION NCT03146156.
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Real time PCR based detection of broadhost range plasmids and their potential use as biomarker in detection of multidrug resistant gram negative bacteria. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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DURABLE RESPONSE IN A CASE OF METASTATIC ANAPLASTIC THYROID CANCER USING A COMBINATION OF TYROSINE KINASE INHIBITORS AND A CHECK POINT INHIBITOR. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:236-241. [PMID: 33029242 DOI: 10.4183/aeb.2020.236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Anaplastic thyroid cancer (ATC) is a highly uncommon (less than 2% of thyroid malignancies) and aggressive type of cancer, with aggressive behavior and, therefore, exhibiting poor prognosis. ATC tumors are automatically labeled as stage IV disease regardless of standard criteria such as tumor burden or metastasis. ATC tumors require a diversified treatment approach that includes surgical resection, followed by a complete an aggressive combination of radiation and chemotherapy and/or palliative care. Despite best efforts, 1-year overall survival of patients is 20% to 40% with nearly universal mortality rate. Consequently, novel approaches (targeted therapy, immunotherapy) have been studied, alone or in combination, to improve the dire prognosis of these patients. BRAF V600E mutation is the most common genetic mutation found in ATC. We report the case of a 57-year-old man diagnosed with stage IVc (undifferentiated) ATC with hepatic and osseous metastases. The molecular analysis of the tumor revealed a V600E BRAF-mutation. The patient was treated with Dabrafenib and Trametinib, and achieved remission 5 weeks after starting the treatment. Subsequently, he had a thyroidectomy, and pembrolizumab was added to the two tyrosine kinase inhibitors. 9 months later he is still in remission. This case illustrates the importance of obtaining molecular information in anaplastic thyroid cancer and the urgent need of studies investigating the combination of tyrosine kinase inhibitors and check-point inhibitors in patients with V600E BRAF- mutations.
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Study of Lipid Abnormalities in Non Diabetic Chronic Kidney Disease Patients with Special Reference to Hemodialysis. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2020; 68:77. [PMID: 31979753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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The effect of cognitive and behavioural therapy for insomnia on changes in sleep architecture and AHI in patients with co-occurring insomnia and sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Changes in initial, middle and late insomnia subtypes during CBT-i and cpap therapy in co-morbid insomnia and sleep apnea (COMISA). Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Impact of Stereotactic Body Radiation Therapy on Assessment and Management for Older Adults with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Stereotactic Body Radiotherapy as Primary Treatment for Medically Unfit Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Prevention and reversal of Type 2 diabetes: highlights from a symposium at the 2019 Diabetes UK Annual Professional Conference. Diabet Med 2019; 36:359-365. [PMID: 30597609 DOI: 10.1111/dme.13892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/26/2022]
Abstract
AIM This symposium covers the gamut of Type 2 diabetes prevention, reversing established Type 2 diabetes, population-level delivery of weight loss programmes and personal insights into achieving and retaining substantial weight loss. RESULTS The NHS Diabetes Prevention Programme was launched in 2016 and rates of referral and attendance have both exceeded expectations. By March 2018, mean weight loss for completers (those attending more than 60% of sessions) was 3.2 kg reflecting considerable health benefits. Established Type 2 diabetes is now known to be a reversible condition in the early years, and the underlying mechanism is the removal of the excess fat from within liver and pancreas in these susceptible individuals. The Diabetes Remission Clinical Trial has shown that around half of a primary care population of people with Type 2 diabetes of less than 6 years' duration can be returned to non-diabetic blood glucose control which lasts at least 12 months. This raises the question of population-level intervention to achieve weight loss. The success of some mass weight loss programmes requires to be recognized. Reframing mass provision of weight loss support should be a vital part of our clinical strategy to prevent and treat Type 2 diabetes. However, the current obesogenic environment is a reality in which individuals must live. A personal account of achieving substantial and maintaining substantial weight loss provides an invaluable insight into practical problems encountered. All health professionals dealing with weight control should assimilate and reflect upon this understanding. CONCLUSIONS Effective prevention and long term reversal of Type 2 diabetes is feasible. The impact upon the individual must be considered during delivery of advice and support.
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PREVALENCE OF GESTATIONAL DIABETES MELLITUS IN AN URBAN INDIAN COHORT USING DIABETES IN PREGNANCY STUDY GROUP IN INDIA (DIPSI) CRITERIA – VALIDATING ONE-STEP APPROACH. INTERNATIONAL JOURNAL OF MEDICINE AND MEDICAL RESEARCH 2019. [DOI: 10.11603/ijmmr.2413-6077.2018.2.9317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. India is the “World’s Diabetes capital”, with half the diabetic population being women. Early detection of glucose intolerance during pregnancy offers a timely opportunity for screening, management and prevention of gestational diabetes mellitus (GDM) and prevents fetal complications.
Objective. The study assessed the prevalence of GDM in an Indian cohort using the Diabetes in Pregnancy Study group of India (DIPSI) criteria.
Methods. 200 pregnant women underwent two-phase testing with non-fasting 75-gram glucose challenge under Diabetes in Pregnancy Study group of India (DIPSI) criteria at <20 weeks and between 24-28 weeks period of gestation. A 3-hour 100-gm oral glucose tolerance test (OGTT) was used for confirmation. Repeat testing was done for women negative during the first-phase.
Results. Mean age was 24.26±3.75 years with 52.5% multigravidas. Mean Body Mass Index (BMI) was 20.7±3.07 kg/m2. The prevalence of GDM in study cohort was found to be 15.5% using the DIPSI criteria while the prevalence of GDM after 100 g OGTT was 13.0%. GDM was mostly seen to occur in women of 26-30-year age group. Statistically significant associations for age and GDM, and BMI and GDM were evidenced.
Conclusions. Maternal age of ≥25 years should be adopted as a risk factor for the development of GDM. The DIPSI criteria offer a cost-effective and an evidence-based protocol for a single-step definitive glucose test for both screening and diagnosis of pregnant patients belonging to any socio-economic strata; furthering its implementation for public health obstetrics.
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Long Term Follow-Up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Levulinate-intercalated LDH: A potential heterogeneous organocatalyst for the green epoxidation of α,β-unsaturated esters. Catal Today 2018. [DOI: 10.1016/j.cattod.2016.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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New organic-inorganic LDH composites: Synthesis, characterization and catalytic behavior in the green epoxidation of α, β-unsaturated esters. Inorganica Chim Acta 2018. [DOI: 10.1016/j.ica.2017.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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EP-1071: Organ-sparing SBRT in reirradiation of head and neck cancer: efficacy, toxicity, and quality of life. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Deep sequencing analysis of bacterial community structure of Soldhar hot spring, India. Microbiology (Reading) 2017. [DOI: 10.1134/s0026261717010118] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract P4-16-01: Evaluation of miracle mouthwash (MMW) plus hydrocortisone or prednisolone mouth rinses as prophylaxis for everolimus-associated stomatitis: Results of a randomized phase II study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-16-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Oral stomatitis is a frequent adverse event (AE) associated with mTOR-inhibitor therapy, and can impact adherence. In BOLERO-2, patients (pts) with hormone receptor-positive (HR+) metastatic breast cancer (MBC) treated with exemestane plus everolimus (EVE), the incidence of all-grade (G) stomatitis or related AEs was 67%, with 24%/8% of pts developing G2/G3 stomatitis or related AEs, respectively (Perez et al ASCO 2013 Abs 7029). In BOLERO-2, 24% of pts required EVE dose reduction for stomatitis (Rugo et al Ann Oncol 2014;25:808). This study evaluated 2 steroid-based mouth rinses for the prevention or amelioration of oral stomatitis in pts with MBC treated with EVE. Methods: This prospective randomized phase II study enrolled postmenopausal pts (planned accrual=100) with HR+ MBC within the US Oncology Network who were initiating therapy with an aromatase inhibitor plus EVE (10 mg/day)(AIE). Pts were randomized 1:1 to prophylactic therapy with 1 of 2 oral rinses (ARM 1: MMW 480 ml recipe: 320 mL oral Benadryl, 2 g Tetracycline, 80 mg Hydrocortisone, 40 mL Nystatin suspension, water; or ARM 2: Prednisolone (P) 15mg/5mL oral solution, 1.8% alcohol). Pts were instructed to swish/expectorate 10 ml of the assigned rinse 4x daily starting with D1 of EVE treatment, for a total of 12 wks. The primary objective was to determine the incidence of G≥2 stomatitis or related oral AEs during the first 12 wks of treatment. Based on a historical estimate that ≥37% of pts receiving AIE develop G≥2 stomatitis, 50 pts for each arm were required to detect a reduction of the incidence of G≥2 stomatitis from 37% to <20%, with alpha = 0.05, 80% power, and a 1-sided test. Secondary objectives included assessment of AEs (all grades), determination of the percentage of pts requiring dose interruption/reduction of EVE or discontinuation of therapy due to toxicity, and evaluation of the impact of the oral rinses on the duration and severity of stomatitis. Results: As of 5/30/2016, a total of 104 pts have been randomized and 100 pts have received treatment (49 MMW; 51 P). Median age was 61 yrs (range 31-82 yrs). The incidence of stomatitis and related oral AEs (any grade) during the first 12 wks was 29% (n=14/49) and 27.5% (14/51) in the MMW and P arms respectively. The incidence of G2 oral AEs was 12% (6/49) and 8% (4/51) with MMW and P respectively. There was only 1 G3 oral AE (MMW arm), and no G4 events. There was 1 EVE dose reduction (MMW) and 4 EVE dose delays (3 MMW, 1 P) during the first 12 wks of treatment. No pts stopped the steroid mouth rinse therapy due to mouth rinse-related toxicity. Conclusion: These prospective data provide evidence of a reduced incidence of mTOR-associated oral AEs with prophylactic use of a steroid mouth rinse. The 29%/27.5% incidence of all-grade and 12%/8% incidence of G2 oral AEs, with only 1 G3 event, compare favorably with the 67% and 24%/8% incidence of all-grade and G2/3 stomatitis, respectively, in BOLERO-2. These data also show the safety and tolerability of these 2 steroid mouth rinses. Prophylactic use of steroid mouth rinses substantially decreases the incidence of G2/3 stomatitis and the need for EVE dose modifications.
Citation Format: Jones VE, McIntyre KJ, Paul D, Wilks ST, Ondreyco SM, Sedlacek SM, Melnyk Jr. AM, Oommen SP, Wang Y, O'Shaughnessy JA. Evaluation of miracle mouthwash (MMW) plus hydrocortisone or prednisolone mouth rinses as prophylaxis for everolimus-associated stomatitis: Results of a randomized phase II study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-16-01.
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Background gamma radiation mapping in forest ecosystem of Bangladesh: A study on the radioactivity distribution in the national reserve forest of Gazipur. RADIATION PROTECTION AND ENVIRONMENT 2017. [DOI: 10.4103/rpe.rpe_17_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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A Phase I Dose Escalation Study of Targeted Radionuclide Therapy of Malignant Tumors Using 18F Fluorodeoxyglucose (18F-FDG): Initial Experience and Early Results. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Bismaleimide (BMI) resins are a new breed of thermosetting resins used mainly for high-temperature applications and have major usage in aerospace. Fourier transform infrared (FTIR) studies have shown signatures of imide, C–N–C stretching, maleimide, and N–H stretching. These BMI polymer coatings were deposited on aluminum (Al) and mild steel substrates by sprinkling powers followed by baking. Thermogravimetric analysis and differential scanning calorimetric studies showed the degradation temperature of these polymers around 370°C. Al coatings were deposited on BMI that is previously deposited on Al and mild steel to make a metal–BMI–metal trilayer. These trilayers can solve the problem charging of the aircraft bodies at high altitudes. Atomic force microscopy was done to determine the morphology of the surface. Roughness and thickness measurements of the BMI coatings were carried out by a surface profilometer. Vickers microhardness tests showed an increase in the hardness of the metal–BMI–metal trilayer. FTIR spectrum showed signatures of imides, C–N–C stretching, maleimide, and N–H stretching in BMI. Peak broadening indicates the release of the stress during thermal treatment of the coating. The coating is subject to variable Atmospheric Pressure Plasma Jet (APPJ) conditions, which improves the properties at high temperature. X-ray diffraction studies showed a hint of crystallinity on APPJ treatment.
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Distribution of Class II integrons and their contribution to antibiotic resistance within Enterobacteriaceae family in India. Indian J Med Microbiol 2016; 34:303-7. [DOI: 10.4103/0255-0857.188319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Concentration dependent carbapenem exposure alters the plasmid copy number within nosocomial isolates of Escherichia coli harboring blaNDM-1: A study from Northeast India. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Transcriptional response of arnA and pmrB in relation to polymyxin resistance in Pseudomonas aeruginosa associated with surgical wound infection: A study from North- East India. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Alanine Aminotransferase and Total Bilirubin Concentration in Preeclampsia and Eclampsia. Mymensingh Med J 2016; 25:85-90. [PMID: 26931255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Eclampsia is an important cause of maternal mortality in developing countries. This cross-sectional comparative study was conducted in the Departments of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), and Obstetrics and Gynecology, BSMMU, and Dhaka Medical College Hospital, Dhaka, Bangladesh, from March 2012 to February 2013 and was designed to evaluate liver markers to predict preeclampsia. One hundred fifty (150) women with pregnancy of ≥28 weeks, 50 for each normal, preeclampsia and eclampsia group, were enrolled purposively. The protocol was approved by IRB of BSMMU. Consent was taken from each patient. Serum total Bilirubin and ALT were assessed. Data was collected in a questionnaire and analyzed by SPSS-16. Quantitative data were compared by ANOVA or 't' test and qualitative data by chi-square test. P value <0.05 was considered significant. The patients of all groups were similar in age and gravida. The mean±SD serum total bilirubin and ALT were significantly higher in preeclampsia and eclampsia groups than normal pregnancy. However they were similar in preeclampsia and eclampsia group.
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IXCHEL: The Mayan Goddess of Midwifery. MIDWIFERY TODAY WITH INTERNATIONAL MIDWIFE 2016:56. [PMID: 27464410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Quality of Life and Locoregional Disease Control Following Stereotactic Body Radiation Therapy in Previously Irradiated Recurrent Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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[Patients' rights - medical duties (II). An analysis of the patients' rights law by physicians for physicians]. VERSICHERUNGSMEDIZIN 2015; 67:123-125. [PMID: 26548004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
The use of high-throughput data to study the changing behavior of biological pathways has focused mainly on examining the changes in the means of pathway genes. In this paper, we propose instead to test for changes in the co-regulated and unregulated variability of pathway genes. We assume that the eigenvalues of previously defined pathways capture biologically relevant quantities, and we develop a test for biologically meaningful changes in the eigenvalues between classes. This test reflects important and often ignored aspects of pathway behavior and provides a useful complement to traditional pathway analyses.
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When a patient's ethnicity is declared, medical students' decision-making processes are affected. Intern Med J 2015; 45:805-12. [DOI: 10.1111/imj.12800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
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Correlation of Connective Tissue Growth Factor (CTGF/CCN2) with Hepatic Fibrosis in Chronic Hepatitis B. Mymensingh Med J 2015; 24:558-563. [PMID: 26329955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
CTGF/CCN2 plays an important role in the formation and development of hepatic fibrosis. This study determined the correlation between serum CTGF/CCN2 and stages of hepatic fibrosis and explored the clinical value of serum CTGF/CCN2 in the assessment of hepatic fibrosis in chronic hepatitis B. This cross sectional study was done in department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2012 to February 2013. Serum CTGF was measured by using of a sandwich immunoassay technique. Forty (40) chronic hepatitis B patients were included in this study. The sensitivity of CTGF/CCN2 was 71.6%, specificity 67.5%. Spearman's rank correlation coefficient was 0.652 between serum CTGF/CCN2 and stages of hepatic fibrosis (p<0.001). The area under receiver-operating curve (ROC) was 0.750 for identification of hepatic fibrosis. This present data revealed that serum CTGF/CCN2 in chronic hepatitis B were strongly associated with stages of hepatic fibrosis. CTGF/CCN2 may useful diagnostic tool for assessing the hepatic fibrosis in chronic hepatitis B.
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[Patients' rights--doctors' duties]. VERSICHERUNGSMEDIZIN 2015; 67:70-74. [PMID: 26281286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
On 26 February 2013 the new "Law on Patients' Rights" (hereinafter also the "Law") became effective. This Law strengthens patients' rights vis-à-vis the insurdnce company and also regulates patients' rights regarding their relation to the doctor. This has consequences for the laws on medical liability all doctors must consider. The doctor's performance is and remains a service and such service does not hold any guarantee of success. Nevertheless, this Law primarily reads as a "law on the duties of physicians". To duly take into account these duties and to avoid mistakes and misinterpretation of the Law, the Ethics Committee of the Consortium of Osteosynthesis Trauma Germany (AOTRAUMA-D) has drafted comments on the Law. Brief summaries of its effects are to be found at the end of the respective comment under the heading "Consequences for Practice". The text of the law was influenced particularly by case law, as continuously developed by the German Federal Court of Justice ("BGH"). The implementation of the Law on Patients' Rights was effected by the newly inserted sections 630a to 630h of the German Civil Code (the "BGB"), which are analysed below. The following comments are addressed to physicians only and do not deal with the specific requirements and particularities of the other medical professions such as physiotherapy, midwifery and others so on. Special attention should be paid to the comments on the newly inserted Duty to inform, which has to be fullfilled prior to any diagnostic or therapeutic procedure (sec. 630c para 2 sentence 1 BGB). Under certain conditions the doctor also has to inform the patient about the circumstances that lead to the presumed occurance of a therapeutic or diagnostic malpractice (sec. 630c para. 2 sentence 2 BGB), based on the manifestation of an undesired event or an undesired outcome. As before, the patient's valid consent to any procedure (sec. 630d BGB) is directly linked to the comprehensive and timely provision of information (sec. 630e BGB). Comprehensive documentation obligations regarding all procedures are stipulated in sec. 630f BGB. As before, the burden of proof still rests with the patient, unless a severe malpractice has been established (sec. 630h BGB). The definition of "severe malpractice" remains unchanged and is based on the case law of the Federal Court of Justice (BGH). The patient's obligations to preserve his or her health and to actively support the process of recovery and securing a positive outcome of the treatment are not explicitly mentioned in the Law. Nevertheless, the patient and the physician need to work closely together to achieve a successful result of the treatment. In case the patient does not give his or her cooperation, the physician should consider terminating the treatment relationship.
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Dietary exposure to benzoates (E210-E213), parabens (E214-E219), nitrites (E249-E250), nitrates (E251-E252), BHA (E320), BHT (E321) and aspartame (E951) in children less than 3 years old in France. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32:293-306. [PMID: 25686474 DOI: 10.1080/19440049.2015.1007535] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study aimed to estimate the exposure to seven additives (benzoates, parabens, nitrites, nitrates, BHA, BHT and aspartame) in children aged less than 3 years old in France. A conservative approach, combining individual consumption data with maximum permitted levels, was carried out for all the additives. More refined estimates using occurrence data obtained from products' labels (collected by the French Observatory of Food Quality) were conducted for those additives that exceeded the acceptable daily intake (ADI). Information on additives' occurrence was obtained from the food labels. When the ADI was still exceeded, the exposure estimate was further refined using measured concentration data, if available. When using the maximum permitted level (MPL), the ADI was exceeded for benzoates (1.94 mg kg(-1) bw day(-1)), nitrites (0.09 mg kg(-1) bw day(-1)) and BHA (0.39 mg kg(-1) bw day(-1)) in 25%, 54% and 20% of the entire study population respectively. The main food contributors identified with this approach were current foods as these additives are not authorised in specific infant food: vegetable soups and broths for both benzoates and BHA, delicatessen and meat for nitrites. The exposure estimate was significantly reduced when using occurrence data, but in the upper-bound scenario the ADI was still exceeded significantly by the age group 13-36 months for benzoates (2%) and BHA (1%), and by the age group 7-12 months (16%) and 13-36 months (58%) for nitrites. Measured concentration data were available exclusively for nitrites and the results obtained using these data showed that the nitrites' intake was below the ADI for all the population considered in this study. These results suggest that refinement of exposure, based on the assessment of food levels, is needed to estimate the exposure of children to BHA and benzoates for which the risk of exceeding the ADI cannot be excluded when using occurrence data.
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Carriage of quinolone resistance in faecal coliforms among healthy individuals: A study from northeast India. Indian J Med Microbiol 2015; 33:190-1. [DOI: 10.4103/0255-0857.148441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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