Relative Versus Absolute Carbohydrate-Deficient Transferrin as a Marker of Alcohol Consumption in Patients With Acute Alcoholic Hepatitis

BACKGROUND: Carbohydrate-deficient transferrin has been described as a sensitive and specific marker for alcohol consumption. This study investigated the usefulness of carbohydrate-deficient transferrin as a marker of alcohol consumption in acute alcoholic hepatitis. METHODS: Absolute concentrations (U/I) and relative values (%) of carbohydrate-deficient transferrin determined in serum with commercial assays, as well as conventional markers for alcohol consumption, were compared with the alcohol consumption (as estimated by a questionnaire) in patients with acute alcoholic hepatitis (n = 19), alcoholic liver cirrhosis (n = 37), and nonalcoholic liver diseases (n = 16). RESULTS: The concentration of carbohydrate-deficient transferrin was increased (p < 0.001) in nonabstaining patients (median intake 80 g alcohol/day) with alcoholic liver cirrhosis (45.7 +/- 30 U/l), but not in patients with acute alcoholic hepatitis (20.0 +/- 7.8 U/l) despite higher alcohol consumption (median 130 g/d), nor in abstainers with alcoholic liver cirrhosis (19.4 +/- 6.0 U/l) or nonalcoholic liver disease (18.5 +/- 6.7 U/l). However, the relative values of carbohydrate-deficient transferrin were increased both in acute alcoholic hepatitis (7.9 +/- 2.1%) and nonabstainers with alcoholic liver cirrhosis (7.4 +/- 2.8%), but not in abstainers with alcoholic liver cirrhosis (4.6 +/- 3.5%) or nonalcoholic liver disease (3.8 +/- 0.9%) (p < 0.001). In acute alcoholic hepatitis, the sensitivity and specificity were only 32% and 87% for absolute concentrations, respectively, but 79% and 97% for relative values of carbohydrate-deficient transferrin. The concentrations of carbohydrate-deficient and total transferrin in serum were strongly correlated (r = 0.60; p = 0.008). CONCLUSIONS: The relative value (% of total), but not the absolute concentration, of carbohydrate-deficient transferrin in serum is a useful marker of alcohol consumption in acute alcoholic hepatitis.     

Primary amyloidosis of the mesentery and the retroperitoneum presenting with lymphedema

We report the case of a 57-yr-old woman presenting with moderate weight loss, abdominal distension, and lymphedema of the legs and vulva. Computed tomography of the abdomen revealed massive thickening of the rectal wall, mesentery, and retroperitoneum. Primary amyloidosis was diagnosed by immunohistochemistry from the rectum and duodenum. To our knowledge, lymphedema due to primary amyloidosis has not yet been reported. The diagnosis should be presumed in the case of retroperitoneal thickening and lymphedema and can be established by immunohistochemistry.     

Repeatability of clinical measurements of the amplitude of accommodation

In order to determine whether a significant change has occurred in a clinical parameter, it is essential to assess the repeatability of the measurement procedure. Accordingly, the present study has examined the repeatability of three techniques for evaluating the subjective amplitude of accommodation. Clinical amplitudes were determined using the push-up, push-down and minus lens procedures in 13 young individuals (mean age: 24.3 years) on five separate occasions. The standard deviation (SD) of the five examinations was calculated for each individual and the mean values for the population sample determined. The mean SDs for the push-up, push-down and minus lens techniques were equivalent, with 95% confidence limits of approximately 1.4 D being observed for all three procedures. Furthermore, the mean amplitude recorded using the push-up technique was significantly higher than that observed for the other two procedures. It is concluded that a change of at least ± 1.50 D should be adopted as the minimum significant shift in amplitude of accommodation for this age group.     

State of the art biological therapies in pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies with a five-year survival rate of approximately 5%. Several target agents have been tested in PDAC, but almost all have failed to demonstrate efficacy in late phase clinical trials, despite the better understanding of PDAC molecular biology generated by large cancer sequencing initiatives in the past decade. Eroltinib (a small-molecule tyrosine-kinase inhibitor of epidermal growth factor receptor) plus gemcitabine is the only schedule with a biological agent approved for advanced pancreatic cancer, but it has resulted in a very modest survival benefit in unselected patients. In our work, we report a summary of the main clinical trials (closed and ongoing) that refer to biological therapy evaluation in pancreatic cancer treatment.     

Non-acquired immunodeficiency syndrome definings malignancies among human immunodeficiency virus-positive subjects: Epidemiology and outcome after two decades of HAART era

Highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection has been widely available in industrialized countries since 1996; its widespread use determined a dramatic decline in acquired immunodeficiency syndrome (AIDS)-related mortality, and consequently, a significant decrease of AIDS-defining cancers. However the increased mean age of HIV-infected patients, prolonged exposure to environmental and lifestyle cancer risk factors, and coinfection with oncogenic viruses contributed to the emergence of other malignancies that are considered non-AIDS-defining cancers (NADCs) as a relevant fraction of morbidity and mortality among HIV-infected people twenty years after HAART introduction. The role of immunosuppression in the pathogenesis of NADCs is not well defined, and future researches should investigate the etiology of NADCs. In the last years there is a growing evidence that intensive chemotherapy regimens and radiotherapy could be safely administrated to HIV-positive patients while continuing HAART. This requires a multidisciplinary approach and a close co-operation of oncologists and HIV-physicians in order to best manage compliance of patients to treatment and to face drug-related side effects. Here we review the main epidemiological features, risk factors and clinical behavior of the more common NADCs, such as lung cancer, hepatocellular carcinoma, colorectal cancer and anal cancer, Hodgkin’s lymphoma and some cutaneous malignancies, focusing also on the current therapeutic approaches and preventive screening strategies.     

Assessment of Heat Flux Prediction Capabilities of Residual Distribution Method: Application to Atmospheric Entry Problems

In the present contribution we evaluate the heat flux prediction capabilities of second-order accurate Residual Distribution (RD ) methods in the context of atmospheric (re-)entry problems around blunt bodies. Our departing point is the computation of subsonic air flows (with air modeled either as an inert ideal gas or as chemically reacting and possibly out of thermal equilibrium gas mixture) around probe-like geometries, as those typically employed into high enthalpy wind tunnels. We confirm the agreement between the solutions obtained with the RD method and the solutions computed with other Finite Volume (FV ) based codes.However, a straightforward application of the same numerical technique to hypersonic cases involving strong shocks exhibits severe deficiencies even on a geometry as simple as a 2D cylinder. In an attempt to mitigate this problem, we derive new variants of RD schemes. A comparison of these alternative strategies against established ones allows us to derive a diagnose for the shortcomings observed in the traditional RD schemes.     

The Diffused Vortex Hydrodynamics Method

A new Particle Vortex Method, called Diffused Vortex Hydrodynamics (DVH), is presented in this paper. The DVH is a meshless method characterized by the use of a regular distribution of points close to a solid surface to perform the vorticity diffusion process in the boundary layer regions. This redistribution avoids excessive clustering or rarefaction of the vortex particles providing robustness and high accuracy to the method. The generation of the regular distribution of points is performed through a packing algorithm which is embedded in the solver. The packing algorithm collocates points regularly around body of arbitrary shape allowing an exact enforcement on the solid surfaces of the no-slip boundary condition. The present method is tested and validated on different problems of increasing complexities up to flows with Reynolds number equal to 100,000 (without using any subgrid-scale turbulence model).