Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

PurposeTo investigate the feasibility, safety, and absorbed-dose distribution of prostatic artery radioembolization (RE) in a canine model.Materials and MethodsFourteen male castrated beagles received dihydroandrosterone/estradiol to induce prostatic hyperplasia for the duration of the study. Each dog underwent fluoroscopic prostatic artery catheterization. Yttrium-90 (⁹⁰Y) microspheres (TheraSphere; Boston Scientific, Marlborough, Massachusetts) were delivered to 1 prostatic hemigland (dose escalation from 60 to 200 Gy), with the contralateral side serving as a control. Assessments for adverse events were performed throughout the follow-up (Common Terminology Criteria for Adverse Events v5.0). Positron emission tomography/magnetic resonance (MR) imaging provided a confirmation after the delivery of absorbed-dose distribution. MR imaging was performed before and 3, 20, and 40 days after RE. Tissue harvest of the prostate, rectum, bladder, urethra, penis, and neurovascular bundles was performed 60 days after RE.ResultsAll the animals successfully underwent RE. Positron emission tomography/MR imaging demonstrated localization to and good coverage of only the treated hemigland. No adverse events occurred. The MR imaging showed a significant dose-dependent decrease in the treated hemigland size at 40 days (25%–60%, P < .001). No extraprostatic radiographic changes were observed. Necropsy demonstrated no gross rectal, urethral, penile, or bladder changes. Histology revealed RE-induced changes in the treated prostatic tissues of the highest dose group, with gland atrophy and focal necrosis. No extraprostatic RE-related histologic findings were observed.ConclusionsProstate ⁹⁰Y RE is safe and feasible in a canine model and leads to focal dose-dependent changes in the gland without inducing unwanted extraprostatic effects. These results suggest that an investigation of nonoperative prostate cancer is warranted.     

Effects of COVID-19 in South African health system and society: An explanatory study

Background and aimsThe underestimation of the severity of COVID-19 by the South African government resulted in delayed action against the pandemic. Ever since WHO declared COVID-19 a pandemic preventive action was comprehensively upgraded worldwide. This prompted South African authorities to implement physical distancing, self-isolation, closure of non-essential services, schools, travelling restrictions and recursive national lockdowns to mitigate the impact of COVID-19. This explanatory study sought to review the effects of COVID-19 in the South African health system and society.MethodsThe study applied literature research of COVID-19 reports, policies from the National Department of Health, WHO, Africa CDC, and articles from Google Scholar, Science Direct, Web of Science, Scopus and PubMed.ResultsThe South African health system is affected by the lack of PPEs, increased mortality rates, mental health problems, substance abuse, resurgent of NCDs. The closure of international borders, global demand meltdown, supply disruptions, dramatic scaling down of human and industrial activities during lockdown cause socio-economic problems. The prolonged effects of lockdown on psychosocial support services resulted in the outbursts of uncertainties, acute panic, fear, depression, obsessive behaviours, social unrests, stigmatization, anxiety, increased gender-based violence cases and discrimination in the distribution of relief food aid.ConclusionTo slow down the spread of COVID-19, massive testing must be adopted, contact tracing, isolation, and home quarantine guidelines for asymptomatic cases which promote behavioural change and reviewing of policy on food relief.     

Identification and characterization of a novel protective antigen,Sec_205 of Streptococcus equi ssp. Zooepidemicus

Streptococcus equi ssp. zooepidemicus (SEZ) is an important pathogen of swine streptococcal diseases and can infect a wide range of animals as well as human beings. The absence of effective vaccine confounds the control of SEZ infection. Sec_205, a novel protein identified in the previous study, was inducibly over-expressed in Escherichia coli in the present study. The purified recombinant protein could elicit a significant humoral antibody response and provide efficient protection against lethal challenge of SEZ C55138 in mouse model. The protection against SEZ infection was mediated by specific antibodies to Sec_205 to some extent and was identified by the passive protection assay. The Sec_205 was an in vivo-induced antigen confirmed by the real-time PCR and could adhere to the Hep-2 cells by the inhibition assay. These suggest that Sec_205 may play a vital role in pathogenicity and serve as a new vaccine candidate against SEZ infection.     

Vitamin D supplementation and lipid profile: What does the best available evidence show?

Vitamin D supplements have increasingly been used for the treatment and prevention of osteoporosis. Historically, effects of the vitamin on the cardiovascular (CV) system have been proposed and demonstrated in the literature, including benefits on serum lipids. Although observational studies support an association between increased serum vitamin D levels and a favorable lipid profile, interventional studies have shown no effects.     

1例192Ir源致外照射轻度骨髓型急性放射病的临床观察与随访

目的 对2005年哈尔滨"7.13"¹⁹²Ir源放射事故受照者1例进行临床观察与12年的医学随访，探讨外照射轻度骨髓型急性放射病的临床治疗及远后效应。方法 详细采集患者病史，收集临床资料，从血液系统改变、心理健康等方面进行总结，评价治疗效果，观察远后效应。结果 早期治疗后，患者造血系统改变、心理创伤、无力综合征、神经衰弱综合征均有所改善，受照后第10年患者开始出现粒系、红系、巨核细胞系同时减少，受照后第13年被诊断患有分离转换障碍，病程中还伴有心力衰竭、肝功异常、免疫力低下、神经衰弱等疾病。治疗后可缓解症状，但易反复。结论 本例轻度骨髓型急性放射病在临床表现与远后效应上有其独特的疾病特点，并发症较多，为今后此类疾病的临床救治提供了参考。     

鲍曼不动杆菌的临床分布、耐药表型分析及防治对策

目的 探讨鲍曼不动杆菌(Acinetobacter baumannii,Ab)的临床分布及耐药表型,为治疗Ab及防范Ab医院感染提供实验依据.方法 回顾性分析2012年7月～2013年3月佛山市第二人民医院分离得到的326株鲍曼不动杆菌的标本来源、病区分布及耐药表型.结果 326株鲍曼不动杆菌中,标本类型为痰及咽拭子的占80.98％,其次是血培养及分泌物标本.院内感染鲍曼不动杆菌者来自重症医学病区(intensive care unit,ICU),占42.64％;而呼吸内科、神经外科分别占17.48％、7.98％,居第2、3位.药敏结果显示,鲍曼不动杆菌对第一、第二代头孢菌素类药物均处于高度耐药,多粘菌素则处于敏感状态,其他抗生素耐药水平则在30％ ～60％之间,但2012年7月～2013年3月每个季度的耐药性变迁不明显.结论 鲍曼不动杆菌的耐药问题日趋严重.医护人员应综合考虑本地区药敏结果及病人情况,采取适宜的治疗操作,合理使用抗菌药物,以预防及控制鲍曼不动杆菌的流行及多重耐药菌株的产生.     

手术室的职业危害自我防护及自我保健

目的研究手术室护士的自我保健的重要性以及手术室带来的职业危害。方法组织研究小组,采用查阅资料的方法包括书籍和计算机网络中查找,同时采取回顾性分析的方法,通过对手术室带来的危害分析的基础上,提出几点建设性意见,进而得出手术室护士自我保健的重要性。结果术室护士主要有生物因素,化学因素,物理因素及心理因素,针对四大因素提出有效的防治和预防措施。结论手术室护士的自我保健意识非常重要,树立正确的观念,有利于自身的身心健康,同时,使工作效率提高,给患者带来更快捷的服务。     

大学生自立人格与焦虑的关系

目的探索大学生的自立人格与焦虑的关系。方法共选取280名大学生为调查对象,用青少年学生自立人格量表和焦虑自评量表对其进行问卷调查。结果人际独立(r=-0.15)、人际责任(r=-0.30)、人际灵活(r=-0.15)、人际开放(r=-0.27)、个人独立(r=-0.23)、个人主动(r=-0.13)、个人责任(r=-0.26)均与焦虑呈负相关(P<0.05或P<0.01)。人际责任、人际开放、个人责任、个人独立4种自立人格特质进入焦虑对自立人格的多元线性回归方程(P<0.05或P<0.01)。结论自立人格对焦虑有预测作用,自立人格是焦虑的保护性人格因素的假设获得了支持。     

Myocardial Fibrosis and Inflammation by CMR Predict Cardiovascular Outcome in People Living With HIV

ObjectivesThe goal of this study was to examine prognostic relationships between cardiac imaging measures and cardiovascular outcome in people living with human immunodeficiency virus (HIV) (PLWH) on highly active antiretroviral therapy (HAART).BackgroundPLWH have a higher prevalence of cardiovascular disease and heart failure (HF) compared with the noninfected population. The pathophysiological drivers of myocardial dysfunction and worse cardiovascular outcome in HIV remain poorly understood.MethodsThis prospective observational longitudinal study included consecutive PLWH on long-term HAART undergoing cardiac magnetic resonance (CMR) examination for assessment of myocardial volumes and function, T1 and T2 mapping, perfusion, and scar. Time-to-event analysis was performed from the index CMR examination to the first single event per patient. The primary endpoint was an adjudicated adverse cardiovascular event (cardiovascular mortality, nonfatal acute coronary syndrome, an appropriate device discharge, or a documented HF hospitalization).ResultsA total of 156 participants (62% male; age [median, interquartile range]: 50 years [42 to 57 years]) were included. During a median follow-up of 13 months (9 to 19 months), 24 events were observed (4 HF deaths, 1 sudden cardiac death, 2 nonfatal acute myocardial infarction, 1 appropriate device discharge, and 16 HF hospitalizations). Patients with events had higher native T1 (median [interquartile range]: 1,149 ms [1,115 to 1,163 ms] vs. 1,110 ms [1,075 to 1,138 ms]); native T2 (40 ms [38 to 41 ms] vs. 37 ms [36 to 39 ms]); left ventricular (LV) mass index (65 g/m² [49 to 77 g/m²] vs. 57 g/m² [49 to 64 g/m²]), and N-terminal pro–B-type natriuretic peptide (109 pg/l [25 to 337 pg/l] vs. 48 pg/l [23 to 82 pg/l]) (all p < 0.05). In multivariable analyses, native T1 was independently predictive of adverse events (chi-square test, 15.9; p < 0.001; native T1 [10 ms] hazard ratio [95% confidence interval]: 1.20 [1.08 to 1.33]; p = 0.001), followed by a model that also included LV mass (chi-square test, 17.1; p < 0.001). Traditional cardiovascular risk scores were not predictive of the adverse events.ConclusionsOur findings reveal important prognostic associations of diffuse myocardial fibrosis and LV remodeling in PLWH. These results may support development of personalized approaches to screening and early intervention to reduce the burden of HF in PLWH (International T1 Multicenter Outcome Study; NCT03749343).