Tumor Epigenetic Signature and Survival in Resected Gastric Cancer Patients

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Screening for subclinical subclavian artery stenosis before coronary artery bypass grafting: Should we do it?

Atherosclerotic subclavian artery disease is detected in about 5% of patients referred for coronary artery bypass (CABG) surgery. The internal mammary artery, a branch of the subclavian artery, is the most frequently utilized graft to restore coronary circulation because of its longevity. Stenosis or occlusion of the subclavian artery can cause retrograde blood flow in the ipsilateral internal mammary artery, known as “steal,” compromising coronary circulation supplied by the graft. Steal may be asymptomatic or may result in symptoms of myocardial ischemia. Symptomatic subclavian artery stenosis post bypass is referred to as coronary subclavian steal syndrome post‐CABG. The incidence is not well defined, and the benefits of screening patients referred for CABG are not known. Despite the various modalities available to detect subclavian artery stenosis, current guidelines fail to provide guidance about screening high‐risk patients for this entity. Detection of subclavian artery disease prior to CABG can reduce complications posed by post‐mammary artery graft cardiac ischemia. This review discusses the utility of preoperative subclavian artery screening prior to CABG.     

Sustainable fragrance cum antimicrobial finishing on cotton: Indigenous essential oil

Fragrance finishing of textile has been enormously increased and used in domestic and industrial application. Fragrance can be synthesis chemically but available in natural and inorganic. The investigation of this research is to study the combined effect of fragrance and antimicrobial finishing on cotton fabric by lavender essential oil with the use of β-Cyclodextrin, Chitosan citrate and β-Cyclodextrin/Grafted Chitosan through pad-dry method. Fourier Transform Infrared spectroscopy (FTIR) was used to study the formation of ester bonds between β-cyclodextrin/grafted chitosan and cotton celluloses. For all the finished fabric samples fragrance release rate performance and antimicrobial properties were measure by standard test methods. The results revealed that β-CD was highly soluble in 0.6 gpl NaOH solution and 80 gpl β-CD and 6% essential lavender oil solutions were found to be a most suitable combination for fragrance and antimicrobial finishing. FTIR studies reveal about the formation of a carboxylic ester between cotton and β-Cyclodextrin/Grafted Chitosan at 1730 cm^?1 ester peak.     

Contiguous multiple cervicothoracic spinous process fractures in an adult: A case report

Fracture of isolated spinous processes at multiple levels is a rare injury. Herein, we present a 45-year-old male with cervical pain and swelling following a road traffic accident. Computerized tomography and magnetic resonance imaging revealed fractures of spinous process from C7 to D6 vertebra. The patient was managed with rest, analgesics and immobilization. At the 1-year follow-up, the patient is doing well without any neurological problem.     

Double‐Chambered Right Ventricle with Pulmonary Valve Endocarditis

We describe a rare case of pulmonary valve endocarditis associated with a double‐chambered right ventricle in an adolescent male highlighting the two‐dimensional and three‐dimensional transthoracic echocardiographic findings. He was managed with aggressive antibiotic therapy followed by surgery. The echocardiographic findings were confirmed during surgery.     

A Concise Panel of Biomarkers Identifies Neurocognitive Functioning Changes in HIV-Infected Individuals

Neurocognitive (NC) impairment (NCI) occurs commonly in people living with HIV. Despite substantial effort, no biomarkers have been sufficiently validated for diagnosis and prognosis of NCI in the clinic. The goal of this project was to identify diagnostic or prognostic biomarkers for NCI in a comprehensively characterized HIV cohort. Multidisciplinary case review selected 98 HIV-infected individuals and categorized them into four NC groups using normative data: stably normal (SN), stably impaired (SI), worsening (Wo), or improving (Im). All subjects underwent comprehensive NC testing, phlebotomy, and lumbar puncture at two timepoints separated by a median of 6.2 months. Eight biomarkers were measured in CSF and blood by immunoassay. Results were analyzed using mixed model linear regression and staged recursive partitioning. At the first visit, subjects were mostly middle-aged (median 45) white (58 %) men (84 %) who had AIDS (70 %). Of the 73 % who took antiretroviral therapy (ART), 54 % had HIV RNA levels below 50 c/mL in plasma. Mixed model linear regression identified that only MCP-1 in CSF was associated with neurocognitive change group. Recursive partitioning models aimed at diagnosis (i.e., correctly classifying neurocognitive status at the first visit) were complex and required most biomarkers to achieve misclassification limits. In contrast, prognostic models were more efficient. A combination of three biomarkers (sCD14, MCP-1, SDF-1α) correctly classified 82 % of Wo and SN subjects, including 88 % of SN subjects. A combination of two biomarkers (MCP-1, TNF-α) correctly classified 81 % of Im and SI subjects, including 100 % of SI subjects. This analysis of well-characterized individuals identified concise panels of biomarkers associated with NC change. Across all analyses, the two most frequently identified biomarkers were sCD14 and MCP-1, indicators of monocyte/macrophage activation. While the panels differed depending on the outcome and on the degree of misclassification, nearly all stable patients were correctly classified.     

ApoE and Quality of Life in Nonagenarians

ObjectivesApoE ε4 is associated with adverse health conditions that negatively impact the quality of life (QOL). The relationship between ApoE ε4 and QOL has not been explored in the oldest old. Our study aimed to examine ApoE in the oldest old and explore its association with QOL.DesignCross-sectional cohort study.SettingA medium sized community in Olmsted County, Minnesota.ParticipantsIndividuals aged 90 to 99 years, living independently or in long term care environments.MeasurementsWe collected demographic information and measured cognitive function (Short Test of Mental Status, Mini-Mental State Examination, Mattis Dementia Rating Scale), QOL (Linear Analogue Self Assessment), and ApoE distribution. Subjects were classified as cognitively normal, mild cognitive impairment, dementia, or dementia with stroke and/or parkinsonism (DEMSP). Regression model was used to assess the predictors of QOL.ResultsA total of 121 subjects (45 cognitively normal, 13 with mild cognitive impairment, 34 with dementia, 29 DEMSP) aged 90–99 years, 106 (87.6 %) females, were included. Frequency of ApoE ε3 allele was highest (194 [80.2%]: ε2/3 18, ε3/3 77, ε3/4 22) followed by ApoE ε4 (25 [10.3%]: ε2/4 3, ε3/4 22) and ApoE ε2 (23 [9.5%; ε2/2 1, ε2/3 18, ε2/4 3). None of the subjects carried ApoE ε4/4 genotype. QOL was similar between ApoE ε4 carrier and noncarriers. Physical well-being, emotional well-being, intellectual well-being, social connectedness, and coping ability were positively associated with QOL, whereas male sex, DEMSP, pain frequency, and pain severity were negatively associated.ConclusionsThe most common ApoE in the oldest old was ε3/3 genotype and ε3 allele. No association was found between ApoE ε4 and QOL. However, those with high physical, emotional and intellectual well being, social connectedness, and coping ability had the highest overall QOL.