Early and late survival in Hodgkin disease among whites and blacks living in the United States

Background. The independent effect of race on response to treatment and prognosis in Hodgkin disease is unclear. Methods. The study included 9482 patients with histologically confirmed Hodgkin disease reported by 1084 different hospitals and institutions in the United States. The independent effect of race on response to treatment and recurrence was estimated using the logistic model. Cox proportional hazard model was applied to determine the independent effect of race and other covariables on risk of death. Results. Complete remission occurred in more white patients (67.3%) than black patients (58.2%). Recurrences were reported more often in black patients than in white patients (40.3% and 30.9% respectively). Controlling for confounding variables, race has a significant independent effect on remission and recurrence (P < 0.05). In the first 5 years after diagnosis of Hodgkin disease, the patient age at diagnosis, clinical stage, and histologic type were significant predictors for the risk of death. At 5–10 years after a diagnosis of Hodgkin disease, age, clinical stage, and race of the patient were found to be significant risk factors (whites versus blacks: RR = 0.56; P < 0.05). Conclusions. Race is a significant predictor for remission, recurrence and survival in Hodgkin disease. Black patients have a more unfavorable prognosis than do white patients.     

Mucormycosis in COVID-19 patients

Mucormycosis, commonly known as ‘Black Fungus’ which was then a rare fungal infection, has suddenly come to light post the COVID-19- pandemic, more so during the second wave in India. It thus becomes important not only for the medical fraternity but also the general population to build awareness about the same. The present review will focus on the pathophysiology, etiology, outcomes of some case studies, and current treatment methods of mucormycosis infection. Major focus of the current article is on rhino-orbital-cerebral mucormycosis. All the studies included in the present review article was extracted from the PubMed database.     

Persulfate-activated charcoal mixture: an efficient oxidant for the synthesis of sulfonated benzo[d][1,3]oxazines from N-(2-vinylphenyl)amides and thiols in aqueous solution

A series of 2,4-aryl-4-((arylsulfonyl)methyl)-4H-benzo[d][1,3]oxazines in good to excellent yields have directly been obtained from N-(2-vinylphenyl)amides and thiols by employing a mixture of K₂S₂O₈-activated charcoal in aqueous acetonitrile solution at 50 °C. A plausible mechanism for the reaction is reported. It reveals that the reaction follows a radical pathway and the persulfate has been the oxygen source for formation of the sulfone group in the products. It is worth mentioning that this protocol utilizes an easily accessible K₂S₂O₈-activated charcoal mixture and thiols, respectively, as an oxidant and sulfonylating precursors for the first time.

A simple method for the synthesis of 2,4-aryl-4-((arylsulfonyl)methyl)-4H-benzo[d][1,3]oxazines using an easily accessible K₂S₂O₈-activated charcoal mixture and thiols, respectively, as an oxidant and sulfonylating precursors has been described.     

Biocidal activity of Ba2+-doped CeO2 NPs against Streptococcus mutans and Staphylococcus aureus bacterial strains

Mishandling of antibiotics often leads to the development of multiple drug resistance (MDR) among microbes, resulting in the failure of infection treatments and putting human health at great risk. As a response, unique nanomaterials with superior bioactivity must be developed to combat bacterial infections. Herein, CeO₂-based nanomaterials (NMs) were synthesized by employing cerium(iii) nitrate and selective alkaline ions. Moreover, the influence of alkaline ions on CeO₂ was investigated, and their characteristics, viz.: biochemical, structural, and optical properties, were altered. The size of nano Ba-doped CeO₂ (BCO) was ∼2.3 nm, relatively smaller than other NMs and the antibacterial potential of CeO₂, Mg-doped CeO₂ (MCO), Ca-doped CeO₂ (CCO), Sr-doped CeO₂ (SCO), and Ba-doped CeO₂ (BCO) NMs against Streptococcus mutans (S. mutans) and Staphylococcus aureus (S. aureus) strains was assessed. BCO outperformed all NMs in terms of antibacterial efficacy. In addition, achieving the enhanced bioactivity of BCO due to reduced particle size facilitated the easy penetration into the bacterial membrane and the presence of a sizeable interfacial surface. In this study, the minimum quantity of BCO required to achieve the complete inhibition of bacteria was determined to be 1000 μg mL⁻¹ and 1500 μg mL⁻¹ for S. mutans and S. aureus, respectively. The cytotoxicity test with L929 fibroblast cells demonstrated that BCO was less toxic to healthy cells. Furthermore, BCO did not show any toxicity and cell morphological changes in the L929 fibroblast cells, which is similar to the control cell morphology. Overall, the results suggest that nano BCO can be used in biomedical applications, which can potentially help improve human health conditions.

The highest antibacterial activity was achieved for Ba-doped CeO₂ (BCO) NMs and is suitable for healthcare applications.     

Influence of Coronary Anatomy and SYNTAX Score on the Variations in Revascularization Strategies for Patients With Multivessel Disease

Background

The Variation in Revascularization Practice in Ontario (VRPO) project helped describe variations in revascularization across Ontario. Coronary anatomy was the most important predictor of revascularization strategy. We conducted a novel angiographic substudy of the VRPO cohort to: (1) validate “real-world” coronary angiographic reporting in the province of Ontario; and (2) understand the relationship between variability in revascularization and coronary anatomy complexity.

Methods

Seventeen hundred eighty-seven angiograms from 17 cardiac centres were randomly sampled from the VRPO cohort. The core lab assessment involved blinded interpretation of each angiographic film. A comparison of agreement in coronary anatomy and treatment strategy between abstracted chart data from the VRPO study and blinded film review was undertaken. Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) scores were calculated for all patients with multivessel disease.

Results

The weighted κ statistic for coronary anatomy was 0.75 (95% confidence interval, 0.72-0.77), suggesting substantial agreement between abstracted chart data and blinded film review. The weighted κ for revascularization strategy was 0.51 (95% confidence interval, 0.47-0.54) suggesting only moderate agreement. There were no significant differences in the mean/median SYNTAX scores across all 4 percutaneous coronary intervention: coronary artery bypass graft (CABG) groups.

Conclusions

Abstracted chart data in the VRPO project provides a valid assessment of coronary anatomy and furthermore serves as validation of “real-world” coronary angiographic reporting in the province of Ontario. The uniform distribution of coronary complexity across centres in Ontario, with respect to the SYNTAX score, suggests the variation of percutaneous coronary intervention: CABG ratio is not related to a difference in coronary anatomy complexity across sites, but rather a difference in management strategies for the same anatomy.     

ProKinO: A Unified Resource for Mining the Cancer Kinome

Protein kinases represent a large and diverse family of evolutionarily related proteins that are abnormally regulated in human cancers. Although genome sequencing studies have revealed thousands of variants in protein kinases, translating “big” genomic data into biological knowledge remains a challenge. Here, we describe an ontological framework for integrating and conceptualizing diverse forms of information related to kinase activation and regulatory mechanisms in a machine readable, human understandable form. We demonstrate the utility of this framework in analyzing the cancer kinome, and in generating testable hypotheses for experimental studies. Through the iterative process of aggregate ontology querying, hypothesis generation and experimental validation, we identify a novel mutational hotspot in the αC‐β4 loop of the kinase domain and demonstrate the functional impact of the identified variants in epidermal growth factor receptor (EGFR) constitutive activity and inhibitor sensitivity. We provide a unified resource for the kinase and cancer community, ProKinO, housed at http://vulcan.cs.uga.edu/prokino .     

Liquid filled nanoparticles as a drug delivery tool for protein therapeutics

In the present study, an attempt was made to study the feasibility of nanoparticulate adsorbents in the presence of an absorption enhancer, as a drug delivery tool for the administration of erythropoietin (EPO) to the small intestine. Liquid filled nano- and micro-particles (LFNPS/LFMPS) were prepared using solid adsorbents such as porous silicon dioxide (Sylysia 550), carbon nanotubes (CNTs), carbon nanohorns, fullerene, charcoal and bamboo charcoal. Surfactants such as a saturated polyglycolysed C8-C18 glyceride (Gelucire 44/14), PEG-8 capryl/caprylic acid glycerides (Labrasol) and polyoxyethylene hydrogenated castor oil derivative (HCO-60) were used as an absorption enhancer at 50mg/kg along with casein/lactoferrin as enzyme inhibitors. The absorption of EPO was studied by measuring serum EPO levels by an ELISA method after small intestinal administration of EPO-LFNPS preparation to rats at the EPO dose level of 100 IU/kg. Among the adsorbents studied, CNTs showed the highest serum EPO level of 62.7 +/- 11.6 mIU/ml. In addition, with the use of casein, EPO absorption was improved, C(max) 143.1 +/- 15.2 mIU/ml. Labrasol showed the highest absorption enhancing effect after intra-jejunum administration than Gelucire 44/14 and HCO-60, 25.6 +/- 3.2 and 22.2 +/- 3.6 mIU/ml, respectively. Jejunum was found to be the best absorption site for the absorption of EPO from LFNPS. The use of CNTs as LFNPS, improved the bioavailability of EPO to 11.5% following intra-small intestinal administration.     

A Randomised Prospective Study to Evaluate Preperitoneal Mesh Repair Versus Onlay Mesh Repair and Laparoscopic IPOM in Incisional Hernia Surgery

Incisional hernia remains a very common postoperative complication. These are encountered with an incidence of up to 20 % following laparotomy. These hernias enlarge over time, making the repair difficult, and serious complications like bowel obstruction, strangulation and enterocutaneous fistula can occur. Hence, elective repair is indicated to avoid these complications. Implantation of a prosthetic mesh is nowadays considered as the standard treatment due to low hernia recurrence. The most common mesh repair techniques used are the onlay repair, sublay repair and laparoscopic intraperitoneal onlay mesh (IPOM). However, it is still not clear which technique among the three is superior. A study consisting of 30 patients who underwent incisional hernia repair by onlay, laparoscopic and preperitoneal mesh repair with abdominoplasty was conducted in the Coimbatore Medical College and Hospital. Of the three groups, the preperitoneal repair with abdominoplasty was found to have better patient compliance and satisfaction with regard to occurrence of complications and appearance of the abdominal wall without laxity in a single sitting.     

电视腹腔镜外科手术在胃肠道肿瘤的临床应用

目的探讨腹腔镜外科技术在胃肠道肿瘤手术中的应用。方法经电视腹腔镜行胃肠道肿瘤手术１８例,其中右半结肠切除术４例,横结肠癌根治术３例,乙状结肠癌根治术５例,乙状结肠癌姑息切除术并肝转移癌电凝固化１例,胃癌术后复发转移行探查活检１例,胃巨大恶性淋巴瘤行探查活检１例,晚期回肠癌行小肠侧侧吻合术１例,乙状结肠腺瘤切除术２例。结果均获成功,无中转开腹,手术时间平均１６５．０分钟。术后平均３１．２小时胃肠功能恢复,无并发症发生,术后平均住院８．２天。１３例切除肿瘤的结肠癌术后随访２月～３０月,仅１例横结肠癌术后２３月出现肺转移。结论腹腔镜胃肠肿瘤手术损伤小、恢复快、胃肠干扰小、术后疼痛轻,值得进一步探索开展。