High-resolution genomic profiling of adult and pediatric core-binding factor acute myeloid leukemia reveals new recurrent genomic alterations

To identify cooperating lesions in core-binding factor acute myeloid leukemia, we performed single-nucleotide polymorphism-array analysis on 300 diagnostic and 41 relapse adult and pediatric leukemia samples. We identified a mean of 1.28 copy number alterations per case at diagnosis in both patient populations. Recurrent minimally deleted regions (MDRs) were identified at 7q36.1 (7.7%), 9q21.32 (5%), 11p13 (2.3%), and 17q11.2 (2%). Approximately one-half of the 7q deletions were detectable only by single-nucleotide polymorphism-array analysis because of their limited size. Sequence analysis of MLL3, contained within the 7q36.1 MDR, in 46 diagnostic samples revealed one truncating mutation in a leukemia lacking a 7q deletion. Recurrent focal gains were identified at 8q24.21 (4.7%) and 11q25 (1.7%), both containing a single noncoding RNA. Recurrent regions of copy-neutral loss-of-heterozygosity were identified at 1p (1%), 4q (0.7%), and 19p (0.7%), with known mutated cancer genes present in the minimally altered region of 1p (NRAS) and 4q (TET2). Analysis of relapse samples identified recurrent MDRs at 3q13.31 (12.2%), 5q (4.9%), and 17p (4.9%), with the 3q13.31 region containing only LSAMP, a putative tumor suppressor. Determining the role of these lesions in leukemogenesis and drug resistance should provide important insights into core-binding factor acute myeloid leukemia.     

Thrombolytic therapy for central venous catheter occlusion

Background

Long-term central venous catheters have improved the quality of care for patients with chronic illnesses, but are complicated by obstructions which can result in delay of treatment or catheter removal.

Design and Methods

This paper reviews thrombolytic treatment for catheter obstruction. Literature from Medline searches using the terms “central venous catheter”, “central venous access device” OR “central venous line” associated with the terms “obstruction”, “occlusion” OR “thrombolytic” was reviewed. Efficacy of thrombolytic therapy, central venous catheter clearance rates and time to clearance were assessed.

Results

Alteplase, one of the current therapies, clears 52% of obstructed catheters within 30 min with 86% overall clearance (after 2 doses, when necessary). However, newer medications may have higher efficacy or shorter time to clearance. Reteplase cleared 67–74% within 30–40 min and 95% of catheters overall. Occlusions were resolved in 70 and 83% of patients with one and 2 doses of tenecteplase, respectively. Recombinant urokinase cleared 60% of catheters at 30 min and 73% overall. Alfimeprase demonstrated rapid catheter clearance with resolution in 40% of subjects within 5 min, 60% within 30 min, and 80% within 2 h. Additionally, urokinase prophylaxis decreased the incidence of catheter occlusions from 16–68% in the control group to 4–23% in the treatment group; in some studies, rates of catheter infections were also decreased in the urokinase group.

Conclusions

Thrombolytic agents successfully clear central venous catheter occlusions in most cases. Newer agents may act more rapidly and effectively than currently utilized therapies, but randomized studies with direct comparisons of these agents are needed to determine optimal management for catheter obstruction.     

Demographically Adjusted Normative Standards for New Indices of Performance on the Paced Auditory Serial Addition Task (PASAT)

Logical grammatical structures comprehension is the ability to understand the relations between objects, actions, and qualities in spoken and written sentences. The Logical Grammatical Structures Test (LGST) was especially devised to assess these abilities in children and adolescents. In the present study the LGST was administered to 405 healthy Dutch children and adolescents. The aims of the present study were (i) to evaluate the psychometric properties of the LGST (using an Item Response Theory framework), and (ii) to establish demographically corrected normative data. The results showed that there was a strong curvilinear relationship between age and LGST performance, i.e., the relative improvement in ability level was much more pronounced for younger children (aged below 14 years) than for older children (aged above 14 years). Level of parental education was positively associated with the LGST performance. Normative data that took the relevant demographic variables into account were established, and it was shown that the LGST had sound psychometric properties.     

Bio-nanoparticle assembly: a potent on-site biolarvicidal agent against mosquito vectors

Background: Vector-borne diseases such as malaria, dengue, yellow fever, encephalitis and filariasis are considered serious human health concerns in the field of medical entomology. Controlling the population of mosquito vectors is one of the best strategies for combating such vector-borne diseases. However, the use of synthetic insecticides for longer periods of time increases mosquito resistance to the insecticides. Recently, the search for new environmentally friendly and efficient insecticides has attracted major attention globally. With the evolution of material sciences, researchers have reported the effective control of such diseases using various sustainable resources. The present investigation demonstrates a potent on-site biolarvicidal agent against different mosquito vectors such as Aedes albopictus, Anopheles stephensi and Culex quinquefasciatus. Methods: Stable and photo-induced colloidal silver nanoparticles were generated via the surface functionalization of the root extract of Cyprus rotundas. Characterizations of the nanoparticles were performed using assorted techniques, such as UV-visible spectroscopy, FTIR spectroscopy, DLS and HRTEM. The bioefficacy of the synthesized nanoparticles was investigated against different species of mosquito larvae through the evaluation of their life history trait studies, fecundity and hatchability rate of the treated larvae. Histopathological and polymerase chain reaction-random amplified polymorphic DNA (RAPD) analyses of the treated larvae were also examined to establish the cellular damage. Results: The synthesized nanoparticles showed remarkable larvicidal activity against mosquito larvae in a very low concentration range (0.001–1.00) mg L⁻¹. The histopathological study confirmed that the present nanoparticles could easily enter the cuticle membrane of mosquito larvae and subsequently obliterate their complete intestinal system. Furthermore, RAPD analysis of the treated larvae could assess the damage of the DNA banding pattern. Conclusion: The present work demonstrates a potent biolarvicidal agent using sustainable bioresources of the aqueous Cyprus rotundas root extract. The results showed that the synthesized nanoparticles were stable under different physiological conditions such as temperature and photo-induced oxidation. The effectiveness of these materials against mosquito larvae was quantified at very low dose concentrations. The present biolarvicidal agent can be considered as an environmentally benign material to control the mosquito vectors with an immense potential for on-site field applications.

The present work demonstrates a potent and stable biolarvicidal agent using sustainable bioresources. The synthesized nanomaterials can control the mosquito vectors at a very low concentration range (0.01–1.00 mg L⁻¹) for on-site field applications.     

The paradigm shift to prevention and its relationship to dental education

The past seventy-five years have witnessed an extraordinary growth of scientific knowledge related to oral health and the development of evidence-based dentistry. The centrality of prevention to the control of oral diseases and the maintenance of good oral health has become increasingly recognized by the scientific community, dental educators, dental practitioners, and the public at large. Yet, despite significant improvements in the overall oral health of Americans, important disparities exist, and large segments of the population are disproportionately burdened by oral diseases. Despite the proven effectiveness of various preventive modalities, such as fluoridation and dental sealants, these have not been universally disseminated and implemented. This review will highlight the challenges remaining in completing the decades-long paradigm shift to prevention and the important role to be played by the dental education community in this process.     

Psychotropic drug use in non-psychiatric departments of three European university hospitals

The use of psychotropic drugs in the university hospitals in Tartu, Estonia; Huddinge, Sweden; and Badajoz, Spain, were studied, using the defined daily doses per 100 bed-days (DDD/100 bed-days) method. The total amount of drugs used in the surgical and medical departments was 50 DDD/100 bed-days in Huddinge, versus 33 and 14 DDD/100 bed-days in Tartu and Badajoz, respectively. Barbiturates accounted for 35% of all psychotropics in Tartu but were practically not used in Huddinge. In contrast, antidepressants were practically not used in Tartu. The use of psychotropic drugs in the intensive care units was highest in Huddinge (320 DDD/100 bed-days), compared with Tartu and Badajoz (177 and 96 DDD/100 bed-days, respectively). The frequency of psychotropic drug use were strikingly different in the three hospitals studied.     

Ageing and dementia in low and middle income countries–Using research to engage with public and policy makers

While two thirds of the 24 million people with dementia worldwide live in low and middle income countries, very little research has been conducted to support policy making in these regions. Among the non-communicable diseases, dementia (in common with other chronic NCDs linked more to long-term disability than to mortality) has been relatively under-prioritized. International agreements, plans and policy guidelines have called for an end to ageist discrimination and a focus upon reducing disadvantage arising from poverty and the consequences of ill health. Social protection, access to good quality age-appropriate healthcare and addressing the problem of disability are all key issues. However, as yet, little progress has been made in addressing these concerns. In this review we outline the current international policy agenda for older individuals, and its specific relevance to those with dementia and other disabling non-communicable diseases. We consider the potential for epidemiological research to raise awareness, refine the policy agenda, and promote action, using the example of the dissemination strategy developed by the 10/66 Dementia Research Group.