Increasing Age Is a Predictor of Short-Term Outcomes in Esophagectomy: A Propensity Score Adjusted Analysis

Background

Esophagectomy is a high-risk surgical procedure. As the population ages, more elderly candidates are being evaluated for esophagectomy. The effects of patient age on outcomes after esophagectomy need to be evaluated.

Study Design

We identified all nonemergent esophagectomies in patients at least 18 years of age within the University HealthSystems Consortium Clinical Database/Resource Manager from 2009 to 2012. Using univariate and multivariate methods, the impact of increasing age on outcomes was analyzed. Additionally, propensity scoring was used to match patients to further investigate the effect of age on the stated outcomes.

Results

Increasing age is associated with increased mortality (p?<?0.001), length of stay (p?<?0.001), discharge to rehabilitative care (p?<?0.001), and cost (p?<?0.001). The effects of age on mortality (8.0 vs 4.2 %, p?=?0.03) and discharge to rehabilitative care (44.1 vs 23.4 %, p?<?0.01) were confirmed using propensity scoring, comparing patients above 80 with those age 70–79.

Conclusions

Increasing age has a significant impact on outcomes following esophagectomy, particularly mortality and discharge disposition. Compared to patients under age 80, patients at least 80 years of age considering esophagectomy should be recognized as a high-risk cohort, and these patients must be carefully risk-stratified, counseled, and selected for surgical intervention to prevent unnecessary hospitalization and mortality.     

Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III

Phase I of the International Study of Asthma and Allergies in Childhood has provided valuable information regarding international prevalence patterns and potential risk factors in the development of asthma, allergic rhinoconjunctivitis and eczema. However, in Phase I, only six African countries were involved (Algeria, Tunisia, Morocco, Kenya, South Africa and Ethiopia). Phase III, conducted 5-6 years later, enrolled 22 centres in 16 countries including the majority of the centres involved in Phase I and new centres in Morocco, Tunisia, Democratic Republic of Congo, Togo, Sudan, Cameroon, Gabon, Reunion Island and South Africa. There were considerable variations between the various centres of Africa in the prevalence of the main symptoms of the three conditions: wheeze (4.0-21.5%), allergic rhinoconjunctivitis (7.2-27.3%) and eczema (4.7-23.0%). There was a large variation both between countries and between centres in the same country. Several centres, including Cape Town (20.3%), Polokwane (18.0%), Reunion Island (21.5%), Brazzaville (19.9%), Nairobi (18.0%), Urban Ivory Coast (19.3%) and Conakry (18.6%) showed relatively high asthma symptom prevalences, similar to those in western Europe. There were also a number of centres showing high symptom prevalences for allergic rhinoconjunctivitis (Cape Town, Reunion Island, Brazzaville, Eldoret, Urban Ivory Coast, Conakry, Casablanca, Wilays of Algiers, Sousse and Eldoret) and eczema (Brazzaville, Eldoret, Addis Ababa, Urban Ivory Coast, Conakry, Marrakech and Casablanca).     

Exhaled breath analysis for early cancer detection: principle and progress in direct mass spectrometry techniques

Abstract Volatile biomarker analysis in exhaled breath is becoming one of the desirable strategies for cancer detection because it may offer a relatively inexpensive, rapid, and non-invasive screening method for early diagnosis. Breath analysis has attracted a considerable amount of scientific and clinical interest over the past decade. However, breath is not yet used for routine medical diagnostic purposes. Challenges faced in the development of breath analysis for cancer diagnosis include developing techniques that can measure biomarkers in exhaled breath at ultratrace levels, providing definitive evidence for their presence and for the relationship between the proposed biomarker and the underlying condition. Various analytical methods are used for the detection of breath biomarkers. Gas chromatography-based methods which involve sample collection, analyte preconcentration, desorption, and separation steps are the most popular. However, direct-sampling mass spectrometry techniques have been proven more reliable for air analysis without prior sample pretreatment or chromatographic separation. This review focuses on the most commonly used direct mass spectrometry methods for the direct online analysis of endogenous cancer biomarkers in exhaled breath, with particular attention to principle of detection, method performance, advantages, shortcomings, recent advances, and applications within health-related studies for cancer biomarkers research. The principle behind the science of breath analysis for cancer diagnosis is also discussed.     

Study of tooth shade in Black Africans]

The 243 sample prospective study shows specifities about black African teeth shade particularly the colour. The results after the use of a study mixed shader composed from three standard shaders are; first: the sequence from the clearest tooth to the less is: central incisor, lateral incisor. Second: the maxillary teeth shade is clearer than the mandibulars. Third, 16% teeth shade not be conducted to determine the objective parameters for black African dentogenics. Therefore: esthetic restorative treatment will be more efficient.     

Geographic distribution of anti-<Emphasis Type="Italic">Leptospira</Emphasis> antibodies in humans in Côte d’Ivoire,West Africa

Leptospirosis is a zoonotic bacterial disease with a worldwide importance, mostly frequent in tropical and subtropical countries. In Côte d’Ivoire, little is known about leptospirosis and human data are sparse. This disease is usually misdiagnosed with other febrile illnesses, and determining high-risk areas could allow better management of this disease, leading to policies. This study aims to map leptospirosis exposure areas by determining geographic distribution of anti-Leptospira antibodies in humans in Côte d’Ivoire. A total of 384 serum samples were randomly selected in the national surveillance system for communicable diseases in 2014. All the 82 health districts were include in the study. Serums were screened by ELISA at Institut Pasteur de Côte d’Ivoire and confirmed by MAT in the National Reference Centre for leptospirosis in Institut Pasteur in Paris. In these samples, ELISA screened 90 specimens showing anti-Leptospira antibodies and 36 specimens were confirmed by MAT (9.4%). Observed cases were mostly located in health districts of the western and the southern parts of the country. People with anti-Leptospira antibodies had a mean age of 34.5 years old and a sex ratio of 2. This pattern corresponds to active low-income farmers working into agricultural fields. This study reveals circulation of leptospirosis in human population in Côte d’Ivoire. The disease seems to be more frequent in the western and the southern parts of the country. Active low-income farmers working into agricultural fields without personal protective gear could be one of the most at-risk populations.     

HPLC Analysis and Cytotoxicity of n-Butanol Extract from Glyphaea brevis Roots Against C6 Glioma Cells

The n-butanol extract of the roots of Glyphaea brevis was analysed. HPLC analysis suggested the presence of phenolic compounds like protocatechuic acid (PCA). The extract showed moderate cytotoxic activity against C6 glioma cells (EC₅₀ > 1 mg/ml).     

BRCA1, BRCA2, AR and IGF-I expression in prostate cancer: correlation between RT-qPCR and immunohistochemical detection

Identification and characterization of biomarkers in prostate cancer are important for improving the diagnosis. The aim of this study was to determine differences in the expression of 4 genes according to the stage of malignancy in prostate cancer. We analyzed BRCA1, BRCA2, androgen receptor (AR) and IGF-I gene expression in a cohort of 98 prostate biopsies. We used TaqMan RT-qPCR for mRNA detection, and correlation with proteins was performed using immunohistochemistry. Among the 98 studied prostate biopsies, high heterogeneity in the expression of the 4 genes was detected among the different histological types. However, down-regulation of BRCA1 and BRCA2 mRNA was detected, particularly in the normal tissues. The expression of AR was dependent on the stage of the tumor. The IGF-I gene was specifically expressed in the tumor tissues. Upon comparison between protein and mRNA expression for BRCA1, BRCA2 and AR, we obtained a trend; however, this did not achieve statistical significance. Regarding IGF-I, a correlation between mRNA expression and staining intensity of the protein was found to be significant (p<0.012). The AR biomarker was found to be slightly correlated with the prostate cancer diagnosis (p=0.013). AR was found to be decreased in the tumors with a 43% sensitivity and 90% specificity. The relative risk of 2.05 (1.13-3.69) indicated a 2?fold higher chance of cancer occurrence when AR was ≤0.206.     

Seasonal Accumulations of Some Heavy Metal in Water,Sediment and Tissues of Black-Chinned Tilapia <Emphasis Type="Italic">Sarotherodon melanotheron</Emphasis> from Biétri Bay in Ebrié Lagoon,Ivory Coast

The seasonal accumulation of cadmium, copper, lead, mercury and zinc was determined in sediments, water, and black-chinned tilapia (Sarotherodon melanotheron; muscle, brain, kidney and liver tissues) collected monthly from Biétri Bay. The mean water concentration of metals (in mg L⁻¹) ranged from 0.01 to 0.30 (mercury), 0.02–0.26 (cadmium), 2.40–4.80 (lead), 9.05–9.68 (copper), and 12.05–19.87 (zinc). The seasonal variations showed a significant difference in the levels of mercury, cadmium and lead among season. The highest mercury (0.30 ± 0.02 μg L⁻¹), cadmium (0.26 ± 0.02 mg L⁻¹) and lead (4.80 ± 1.03 mg L⁻¹) levels were observed during dry season, while the lowest levels (0.21 ± 0.01, 0.02 ± 0.01 and 2.40 ± 0.02 mg L⁻¹, respectively mercury, cadmium and lead) were measured during rainy season. The average cadmium (0.58 ± 0.36 mg L⁻¹), copper (42.15 ± 19.40 mg L⁻¹), lead (58.47 ± 38.10 mg kg⁻¹), mercury (0.79 ± 0.47 μg kg⁻¹) and zinc (187.58 ± 76.99 mg kg⁻¹) concentrations determined in Biétri Bay sediments showed a similar trend as in water. The seasonal variations of mercury, cadmium and lead in tissues revealed that these metals were higher concentrated during dry and swelling seasons. The levels of zinc and copper followed by lead were higher in the tissues. The order of tissues metals concentrations was: kidney > liver > brain > muscle.     

Diabetes mellitus in children in Lomé (Togo)

AIM: Describe clinical aspects and outcome of children with diabetes mellitus in Lomé (Togo). METHODS: This work concern eighteen children consecutively admitted between 1997 and 2004 for diabetes mellitus. Diagnosis of type 2 diabetes mellitus (T2DM) were done on the presentation of at least one of T2DM risk factors: obesity, familial history of T2DM, acanthosis nigricans, polycystic ovary syndrome, dislipidemia, high blood pressure. RESULTS: Twelve children presented type 1 diabetes mellitus (T1DM), 5 T2DM and one, corticosteroids induced diabetes. At least one of the first degree parent suffered from diabetes in 4 of the 5 children with T2DM and 4 of the 12 patients with T1DM. Most patients (with T1DM or T2DM) presented polyuria, polydypsia and ketonuria at admission. All patients with T2DM were obese and had lifestyles characterised by high fat intake, sedentary attitudes, and physical inactivity. The corticosteroid induced diabetes cessed when corticosteroid stopped. The other patients were successfully treated with insulin (T1DM) or insulin then exercises and diets (T2DM). CONCLUSION: Clinical presentation of diabetes mellitus is now characterised in Togo by the emergence of T2DM which principal risks factors are obesity and familial history of T2DM.