Delta-like protein (DLK) is a novel immunohistochemical marker for human hepatoblastomas

Delta-like protein (DLK) is a membrane protein with mostly unknown function. It is expressed by several embryonic tissues among others by the hepatoblasts of rodent and human fetal livers. We have investigated in the present study if this protein is expressed in human hepatoblastomas. The presence of DLK has been studied by standard immunohistochemistry in 31 hepatoblastomas and in several differential diagnostically related tumours: hepatocellular carcinomas and in undifferentiated childhood neoplasms. All the hepatoblastomas were positive for DLK; the surrounding liver tissue remained negative. The reaction was present in the epithelial component of the tumours. The staining pattern was mostly membranous, occasionally cytoplasmic. The other studied tumours were negative for DLK, except one hepatocellular carcinoma and the differentiating cells of two ganglioneuroblastomas. Therefore, DLK seems to be a highly sensitive and specific marker for hepatoblastomas. K. D and J. H. contributed equally to this work.     

The feasibility of antibiotic dosing four times per day: a prospective observational study in primary health care

Objective

To investigate whether the increase in the number of doses of penicillin V from three times daily to four times daily for common infections, as recommended in the new Norwegian guidelines for antibiotic treatment in primary health care, would lead to reduced patient compliance.

Design

Prospective observational study.

Setting and subjects

Six general practitioners included all patients who were prescribed systemic antibiotic treatment regardless of indication during a 10-month period. A total of 270 patients provided data for the study.

Methods

Telephone interview focusing on omitted antibiotic doses.

Results

Some 17% of patients had poor compliance, defined as failing to take 5% or more of total antibiotic doses. Neither level of poor compliance nor number of omitted doses differed significantly when the number of daily doses increased from three to four. There were significantly fewer omitted doses in the group given two doses per day when compared with three doses (p = 0.04) and four doses per day (p = 0.01).

Conclusion

We found no difference in compliance or omitted doses between antibiotic regimens of three and four doses per day. The new Norwegian guidelines for antibiotic treatment in primary health care appear feasible with regard to patient compliance.Key Words: Antibiotics, guidelines, Norway, patient non-compliance, primary care, treatmentCompliance with antibiotic treatment has been shown to decrease with increasing dose frequency. New Norwegian guidelines for antibiotic treatment in primary health care recommend penicillin V dosing four times per day as compared with three times per day in earlier recommendations.

• An overall good compliance with treatment was found, even with regimens of four doses per day.
• There was no significant difference in compliance when comparing four antibiotic doses per day with three doses per day.
• The new Norwegian guidelines for antibiotic treatment in primary health care appear feasible in clinical practice.

     

IGF2R genetic variants, circulating IGF2 concentrations and colon cancer risk in African Americans and Whites

The Mannose 6 Phosphate/Insulin-like Growth Factor Receptor-2 (IGF2R) encodes a type-1 membrane protein that modulates availability of the potent mitogen, IGF2. We evaluated the associations between IGF2R non-synonymous genetic variants (c.5002G>A, Gly1619Arg(rs629849), and c.901C>G, Leu252Val(rs8191754)), circulating IGF2 levels, and colon cancer (CC) risk among African American and White participants enrolled in the North Carolina Colon Cancer Study (NCCCS). Generalized linear models were used to compare circulating levels of IGF2 among 298 African American and 518 White controls. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of IGF2R genetic variants and CC risk. Women homozygous for the IGF2R c.5002 G>A allele, had higher mean levels of circulating IGF2, 828 (SD=321) ng/ml compared to non-carriers, 595 (SD=217) ng/ml (p-value=0.01). This pattern was not apparent in individuals homozygous for the IGF2R c.901 C>G variant. Whites homozygous for the IGF2R c.901 C>G variant trended towards a higher risk of CC, OR=2.2 [95% CI(0.9-5.4)], whereas carrying the IGF2R c.5002 G>A variant was not associated with CC risk. Our findings support the hypothesis that being homozygous for the IGF2R c.5002 G>A modulates IGF2 circulating levels in a sex-specific manner, and while carrying the IGF2R c.901 C>G may increase cancer risk, the mechanism may not involve modulation of circulating IGF2.     

Sex differences in the treatment of patients with atrial fibrillation: population-based study in a local health district

Differences in the treatment of atrial fibrillation between men and women were investigated by using patients in a local health district as a reference population. The study included 688 patients (359 female) who presented with atrial fibrillation. Women were older, more frequently had heart failure, and were more often functionally dependent than men. With regards to the management of atrial fibrillation, women were prescribed digoxin more frequently than men, but underwent electrical cardioversion less often, were less frequently seen by a cardiologist, and understood less about their treatment. After stratifying the findings by age and adjusting for heart failure and the degree of functional dependence, it was observed that women aged over 85 years were prescribed digoxin more often than men, while women aged under 65 years underwent cardioversion less often than men. In conclusion, gender differences observed in the treatment of atrial fibrillation cannot be fully explained by differences in clinical characteristics between men and women in the population.Full English text available from: www.revespcardiol.org     

Biodistribution and radiation dosimetry of the 18?kDa translocator protein (TSPO) radioligand [18F]FEDAA1106: a human whole-body PET study

Purpose

[¹⁸F]FEDAA1106 is a recently developed positron emission tomography (PET) radioligand for in vivo quantification of the 18?kDa translocator protein [TSPO or, as earlier called, the peripheral benzodiazepine receptor (PBR)]. TSPO imaging is expected to be useful for the clinical evaluation of neuroinflammatory diseases. The aim of this study was to provide dosimetry estimates for [¹⁸F]FEDAA1106 based on human whole-body PET measurements.

Methods

PET scans were performed for a total of 6.6?h after the injection of 183.8?±?9.1?MBq of [¹⁸F]FEDAA1106 in six healthy subjects. Regions of interest were drawn on coronal images. Estimates of the absorbed doses of radiation were calculated using the OLINDA software.

Results

Peak uptake was largest in lungs, followed by liver, small intestine, kidney, spleen and other organs. Peak values of the percent injected dose (%ID) at a time after radioligand injection were calculated for the lungs (27.1%ID at 0.2?h), liver (21.1%ID at 0.6?h), small intestine (10.4%ID at 6.3?h), kidney (4.9%ID at 1.8?h) and spleen (4.6%ID at 0.6?h). The largest absorbed dose was found in the spleen (0.12?mSv/MBq), followed by kidneys (0.094?mSv/MBq). The calculated mean effective dose was 0.036?mSv/MBq.

Conclusion

Based on the distribution and dose estimates, the estimated radiation burden of [¹⁸F]FEDAA1106 is moderately higher than that of [¹⁸F]fluorodeoxyglucose (FDG). In clinical studies, the administered activity of this radioligand ought to be adjusted in line with regional regulations. This result would be helpful for further clinical TSPO imaging studies.     

Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population,focusing on gender,age and education?

Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change.