Peroxynitrite modified DNA may be an antigenic trigger for antibodies in various cancers of gynecologic origin

This study aimed towards probing the role of peroxynitrite damaged human DNA (ONOO^–-DNA) in the induction of circulating antibodies in certain cancers of gynecologic origin. We have compared the binding specificity of DNA isolated from the lymphocytes of cancer patients with that of the experimentally modified DNA. Also, the induced anti-ONOO⁻-DNA antibodies have been used to probe oxidative damage in the DNA isolated from cancer patients. Human placental DNA was modified with peroxynitrite (ONOO⁻) and analyzed by ultraviolet (UV) and fluorescence spectroscopy, gel electrophoresis, thermal denaturation profile, etc. Antibodies against modified DNA were induced in experimental animals. Specific binding of the antibodies was evaluated by ELISA and band shift assay. 91 cancer patients were selected and grouped according to the type of cancer. Specific binding characteristics of circulating autoantibodies (IgG) were determined by competitive-inhibition ELISA, using different inhibitors. Maximum inhibition of antibody activity by ONOO⁻-DNA reflected specific recognition of modified epitopes by cancer IgG. This shows generation of neo-epitopes on DNA, upon modification with ONOO⁻, that are recognized by cancer IgG. Our results indicate epitope sharing between the DNA isolated from cancer patients and the in-vitro modified ONOO⁻-DNA. The possible role of nitrosative stress in the gynecologic oncology has been discussed.     

Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials

Purpose

High fasting blood glucose (FBG) can lead to chronic diseases such as diabetes mellitus, cardiovascular and kidney diseases. Consuming probiotics or synbiotics may improve FBG. A systematic review and meta-analysis of controlled trials was conducted to clarify the effect of probiotic and synbiotic consumption on FBG levels.

Methods

PubMed, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched for relevant studies based on eligibility criteria. Randomized or non-randomized controlled trials which investigated the efficacy of probiotics or synbiotics on the FBG of adults were included. Studies were excluded if they were review articles and study protocols, or if the supplement dosage was not clearly mentioned.

Results

A total of fourteen studies (eighteen trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in FBG. Overall reduction in FBG observed from consumption of probiotics and synbiotics was borderline statistically significant (?0.18 mmol/L 95 % CI ?0.37, 0.00; p = 0.05). Neither probiotic nor synbiotic subgroup analysis revealed a significant reduction in FBG. The result of subgroup analysis for baseline FBG level ≥7 mmol/L showed a reduction in FBG of 0.68 mmol/L (?1.07, ?0.29; ρ < 0.01), while trials with multiple species of probiotics showed a more pronounced reduction of 0.31 mmol/L (?0.58, ?0.03; ρ = 0.03) compared to single species trials.

Conclusion

This meta-analysis suggests that probiotic and synbiotic supplementation may be beneficial in lowering FBG in adults with high baseline FBG (≥7 mmol/L) and that multispecies probiotics may have more impact on FBG than single species.

     

Effects of surgical and endoscopic electrocautery on modern-day permanent pacemaker and implantable cardioverter-defibrillator systems

Background: Current guidelines recommend that all implanted pacemakers (PPM) and defibrillators (ICD) be interrogated before and after every invasive procedure. The ability of newer devices to withstand system malfunction or failure during surgery/endoscopy remains unknown.
Objective: To determine the frequency of PPM or ICD malfunction from periprocedural electrocautery.
Methods: Ninety-two consecutive individuals referred for evaluation of a PPM or ICD system prior to noncardiac surgery/endoscopy were enrolled. Devices were preoperatively programmed to a "monitor only" zone to allow for detection of electromagnetic interferences (EMIs). Pacing parameters were maintained without disabling rate responsiveness. The devices were fully interrogated again after surgery. Correlations of inappropriate EMI sensing were made with reference to the distance from the site of electrocautery application to the device system.
Results: All devices withstood periprocedural EMI exposure without malfunction or changes in programming. Minor changes in lead parameters were noted. Three device systems demonstrated brief atrial mode switching episodes, one of which was likely secondary to inappropriate sensing of atrial noise . Two pacemaker devices demonstrated inappropriate sensing of ventricular noise, both of which occurred when the application of electrocautery was within close proximity to the pacemaker generator (<8 cm). No ventricular sensed events were noted in any ICD system.
Conclusions: EMIs during noncardiac surgical/endoscopic procedures pose little threat to current device systems. Rare occasions of inappropriate sensing by devices can be seen in situations where the application of unipolar electrocautery is in close proximity of the system. Routine postsurgical interrogation of PPM or ICDs may not be necessary.     

A cross-sectional survey of critical care services in Sri Lanka: A lower middle-income country

Purpose

To describe the extent and variation of critical care services in Sri Lanka as a first step towards the development of a nationwide critical care unit (CCU) registry.

Materials and Methods

A cross-sectional survey was conducted in all state CCUs by telephone or by visits to determine administration, infrastructure, equipment, staffing, and overall patient outcomes.

Results

There were 99 CCUs with 2.5 CCU beds per 100 000 population and 13 CCU beds per 1 000 hospital beds. The median number of beds per CCU was 5. The overall admissions were 194 per 100 000 population per year. The overall bed turnover was 76.5 per unit per year, with CCU mortality being 17%.Most CCUs were headed by an anesthetist. There were a total of 790 doctors (1.6 per bed), 1 989 nurses (3.9 per bed), and 626 health care assistants (1.2 per bed). Majority (87.9%) had 1:1 nurse-to-patient ratio, although few (11.4%) nurses had received formal intensive care unit training. All CCUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (such as electronic monitoring and infusion pumps).

Conclusion

Sri Lanka, a lower middle-income country has an extensive network of critical care facilities but with inequalities in its distribution and facilities.