A perioperative multidisciplinary care bundle reduces surgical site infections in patients undergoing synchronous colorectal and liver resection

Background

Surgical site infections (SSIs) are a major cause of morbidity, mortality, and healthcare costs, and patients undergoing simultaneous colorectal/liver resections are at an especially high SSI risk.

MTHFR Gene Polymorphisms and the Risk of Acute Lymphoblastic Leukemia in Adults and Children: A Case Control Study in India

Genetic polymorphisms in the methylene tetrahydrofolate reductase (MTHFR) gene have been associated with the development of acute leukemias and various malignancies. The role of MTHFR polymorphism in the development of pediatric acute lymphoblastic leukemia (ALL) has been extensively studied among north Indians in various settings, yet its association with acute leukemias remains unresolved. To evaluate the relationship between functional MTHFR polymorphisms, C677T and A1298C and possible effect on risk of ALL in adults and children in North Indian population by comparing them with healthy controls. DNA was isolated from peripheral blood of 184 ALL patients (33 adults, 151 children) and 155 controls and analyzed by a PCR-restriction fragment length polymorphism assay. The frequency of MTHFR 677CT and 1298 AC genotypes were significantly lower among adult ALL cases when compared to the controls. We found a 1.74-fold reduced risk of ALL in individuals with 1298AC polymorphic variant and a 9.17-fold decreased risk of adult ALL. However, no statistically significant difference was evident between the above polymorphisms and susceptibility to ALL in children. Polymorphisms in the MTHFR gene possibly modulate risk of ALL in north Indian adults but not in children, although larger studies are needed.     

One-pot pyro synthesis of a nanosized-LiMn2O4/C cathode with enhanced lithium storage properties

A simple one-pot polyol-assisted pyro-technique has been adopted to synthesize highly crystalline, carbon-coated LiMn₂O₄ (LMO/C) nanoparticles for use as a cathode material in rechargeable Li-ion battery (LIB) applications. The phase purity, structure and stoichiometry of the prepared cathode was confirmed using X-ray techniques that included high-resolution powder X-ray diffraction and X-ray absorption fine structure spectroscopy. Electron microscopy studies established that the synthetic technique facilitated the production of nano-sized LMO particles with uniform carbon coating. The prepared LMO/C cathode demonstrates excellent electrochemical properties (cycling stabilities of 86% and 77.5% and high rate capabilities of 79% and 36% within the potential windows of 3.3–4.3 V and 2.5–4.3 V, respectively). The high electrochemical performance of the LMO/C cathode is attributed to the nano-size of the LiMn₂O₄ particles enabling high surface area and hence greater lithium insertion and also the uniform amorphous carbon coating facilitating effective reduction in manganese dissolution and volume expansion during the lithium de-intercalation/intercalation reactions. In addition, cyclic voltametry and impedance characterization confirm the reversible Li-intercalation and the role of the solid electrolyte interface layer (SEI) in the stable electrochemical reaction of the LMO/C electrode. Furthermore, this study shows the efficacy of a simple and low-cost pyro-synthetic method to realize high performance nano-sized particle electrodes with uniform carbon coating for useful energy storage applications.

A simple one-pot polyol-assisted pyro-synthesized LiMn₂O₄/C cathode demonstrated remarkable lithium cycling stabilities of 86% and 19% and high rate capabilities of 77.5% and 36% at 3.3–4.3 V and 2.5–4.3V, respectively.     

Venetoclax and hypomethylating agents in FLT3-mutated acute myeloid leukemia

FMS-like tyrosine kinase 3 (FLT3) mutations are prevalent in acute myeloid leukemia (AML), and their presence confers adverse risk. FLT3-mutated (FLT3m) AML is a challenging leukemia to manage, particularly in older and unfit patients as well as patients with relapsed/refractory (r/r) disease. We retrospectively analyzed the outcomes of 50 FLT3m AML patients (17 treatment-naïve, 33 r/r) treated with venetoclax (VEN) and hypomethylating agents (HMA). The overall CR/CRi rate with VEN-HMA was 60% (94% in treatment-naïve AML and 42% in r/r AML). Early (60-days) treatment related mortality was 2%. The r/r AML setting was an independent predictor of lower complete response (OR: 0.08; 95%CI: 0.00-0.60, P = .03). Cytogenetics-molecular risk, concurrent mutations, the type of FLT3 mutation (ITD vs TKD), the ITD allelic ratio, the type of HMA, age, prior exposure to HMA and receipt of prior allogeneic transplant did not independently impact response or leukemia-free survival (LFS). Concurrent IDH mutations were associated with lower CR/CRi (P = .01), while ASXL1 or TET2 mutations showed a non-significant association toward higher CR/CRi (P = .07, for both). However, none of the concurrent mutations were an independent predictor for response when adjusted to AML setting. In conclusion, VEN-HMA is associated with encouraging efficacy in FLT3m AML among both newly diagnosed unfit and r/r patients.     

International league of associations for rheumatology recommendations for the management of psoriatic arthritis in resource-poor settings

Clinical Rheumatology - Psoriatic arthritis (PsA) is a challenging heterogeneous disease. The European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and...     

Chemically induced Salmonella enteritidis ghosts as a novel vaccine candidate against virulent challenge in a rat model

Salmonella enteritidis ghosts (SEGs), non-living empty bacterial cell envelopes were generated by using the minimum inhibitory concentration (MIC) of sodium hydroxide (NaOH) and investigated as a vaccine candidate in rats. To determine the immunogenicity and protective efficacy of SEG vaccine, rats were divided into four groups: group A (non-vaccinated control), group B (orally vaccinated), group C (intramuscularly vaccinated) and group D (intramuscularly vaccinated with complete Freund's adjuvant). Vaccination of rats with SEGs induced significant immune responses before and after virulent challenge. Rats vaccinated with SEGs showed significant increases in serum IgG antibodies after challenging with virulent S. enteritidis on week 8 and week 10 (P < 0.01). During the vaccination period, groups B, C and D showed significantly higher serum bactericidal activity (SBA) compared to group A (P < 0.01). Most importantly, bacterial loads in vaccinated groups were significantly lower than in the non-vaccinated group (P < 0.01). In conclusion, these results show that the chemically induced SEGs as a vaccine candidate against virulent challenge.