Quantitatively Excessive Normal Tissue Toxicity and Poor Target Coverage in Postoperative Lung Cancer Radiotherapy Meta-analysis

Background

A previous meta-analysis (MA) found postoperative radiotherapy (PORT) in lung cancer patients to be detrimental in N0/N1 patients and equivocal in the N2 setting. We hypothesized that treatment plans generated using MA protocols had worse dosimetric outcomes compared to modern plans.

Detection and genotyping of TT virus in healthy and subjects with HBV or HCV in different populations in the United Arab Emirates

TT virus (TTV) and TTV-like viruses (TTVLs) have been reported to be associated with non-A-E hepatitis. To determine the rate of infection and genotypic characteristics of TTV in the United Arab Emirates (UAE), a total of 449 serum samples representing different populations in the UAE and comprising healthy as well as patients positive for HBsAg and HCV were screened. National subjects (n = 200) and non-nationals residing in the UAE (n = 249) were tested by PCR. The results obtained showed that the rate of TTV infection in healthy nationals, and those with HBsAg or antibody to HCV were 34.9, 97.9, and 95.7, respectively, compared to 89.1% (115/129), 89.2% (66/74), and 84.8% (39/46), respectively, in non-nationals. Sequence analysis of the untranslated region (UTR) using 71 clones generated from the PCR products of eight serum samples from healthy individuals (four nationals and four non-nationals) showed that 83.1% of the TTV clones were classified into groups 1-4, whereas 16.9% into possibly new genotype(s). The analysis also revealed that healthy national subjects carried multiple viruses. Phylogenetic analysis of representative sequences revealed clustering of clones into at least five major groups. Also, when compared to reference genotypes (from GenBank), two of our clones belonged to two previously identified genotypes. Non-significant gender differences were seen in all ethnic groups studied (P > 0.05). In conclusion, the rate of TTV infection in the UAE nationals is significantly lower (P < 0.05) than that of the non-nationals and several genotypes were isolated with common multi-infections.     

Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes

Objectives

Monopolar transurethral resection of the prostate (TURP) is the gold standard surgical treatment for bothersome moderate to severe lower urinary tract symptoms (LUTS) secondary to benign prostate obstruction. The aim of the study is to compare monopolar versus bipolar TURP focusing on operative and functional outcomes, and evaluating complications with a long-term follow-up.

Methods

From January 2007 to July 2014, a total of 497 patients were randomized and prospectively scheduled to undergo bipolar (251) or monopolar (246) TURP. International prostate symptom score (IPSS), IPSS-Quality of life (QoL), post-void residual and maximum flow rate were assessed preoperatively and postoperatively at 3, 12, 24 and 36 months. Operative time, length of catheterization and hospitalization were all recorded. Complications were classified and reported.

Results

All patients completed the 36-month follow-up visit. Perioperative results showed no statistical significance between the two groups in terms of catheterization days, post-void residual, IPSS, IPSS-QoL score. The hospitalization length was found statistically significant in favor of the bipolar group. The 3-, 12-, 24- and 36-month follow-up showed significant and equal improvements in LUTS related to BPO in the two treatment groups. Regarding TURP complications, significant differences were observed in relation to urethral strictures, blood transfusion and TUR syndrome in favor of the bipolar group.

Conclusions

Monopolar and bipolar TURP are safe and effective techniques for BPH management. Bipolar TURP in our prospective study reported the same efficacy of monopolar prostate resection, with a significant reduction of related complications.

     

Isolated tuberculosis liver abscess in an immunocompetent patient

Isolated TLA is an extremely rare condition, but should always be considered in a patient presented with liver abscess, especially from an endemic area. Diagnosis depends on histological identification, with treatment being quadruple therapy.     

Multivariate Analysis of Electrophysiological Signals Reveals the Time Course of Precision Grasps Programs: Evidence for Nonhierarchical Evolution of Grasp Control

Current understanding of the neural processes underlying human grasping suggests that grasp computations involve gradients of higher to lower level representations and, relatedly, visual to motor processes. However, it is unclear whether these processes evolve in a strictly canonical manner from higher to intermediate and to lower levels given that this knowledge importantly relies on functional imaging, which lacks temporal resolution. To examine grasping in fine temporal detail here we used multivariate EEG analysis. We asked participants to grasp objects while controlling the time at which crucial elements of grasp programs were specified. We first specified the orientation with which participants should grasp objects, and only after a delay we instructed participants about which effector to use to grasp, either the right or the left hand. We also asked participants to grasp with both hands because bimanual and left-hand grasping share intermediate-level grasp representations. We observed that grasp programs evolved in a canonical manner from visual representations, which were independent of effectors to motor representations that distinguished between effectors. However, we found that intermediate representations of effectors that partially distinguished between effectors arose after representations that distinguished among all effector types. Our results show that grasp computations do not proceed in a strictly hierarchically canonical fashion, highlighting the importance of the fine temporal resolution of EEG for a comprehensive understanding of human grasp control.SIGNIFICANCE STATEMENT A long-standing assumption of the grasp computations is that grasp representations progress from higher to lower level control in a regular, or canonical, fashion. Here, we combined EEG and multivariate pattern analysis to characterize the temporal dynamics of grasp representations while participants viewed objects and were subsequently cued to execute an unimanual or bimanual grasp. Interrogation of the temporal dynamics revealed that lower level effector representations emerged before intermediate levels of grasp representations, thereby suggesting a partially noncanonical progression from higher to lower and then to intermediate level grasp control.     

Tuberous sclerosis presenting as neonatal cyanosis because of rhabdomyoma causing tricuspid valve obstruction needing a Blalock-Taussig shunt

We report a newborn female baby who presented at 6 hours of age with cyanosis without any signs of respiratory distress. Cardiovascular and systemic examination was unremarkable apart from cyanosis (saturation 75%). An echocardiogram showed multiple echogenic and homogeneous masses in the interventricular septum, one of which was big and protruding through the tricuspid valve causing right ventricular inflow obstruction. There was a small atrial septal defect (ASD) shunting right to left and patent ductus arteriosus (PDA) shunting left to right. The provisional diagnosis was rhabdomyoma. Blalock-Taussig shunt was done to preserve the tricuspid valve, because these masses tend to regress spontaneously, which was the case after few months. Subsequently, the patient was diagnosed with tuberous sclerosis.