Prostate cancer after heart transplantation: unicenter case-control study.

BACKGROUND: We have noted an unexpectedly high incidence of prostate cancer in our heart transplant recipients (HTR). METHODS: We conducted a retrospective review of patients after heart transplantation to investigate the prevalence, treatment, and outcome of prostate cancer diagnosed after systematic screening (study group). We compared them with case-matched HTR (control). RESULTS: Among 702 recipients, 15 patients had elevated prostate-specific antigen (PSA) levels. Fourteen cases of prostate cancer were diagnosed and treated. The median time between transplantation and prostate cancer diagnosis was 73 months. No patient was diagnosed in a locally advanced (>T2) or metastatic stage. Eleven patients (78.6%) received curative treatment. During follow-up (median, 44 months), 1 patient died from prostate cancer. The survival rate between the study and control groups did not differ. CONCLUSION: Routine PSA testing is recommended as a screening test for prostate cancer in patients after heart transplantation. We believe this could also result in detection of early stages of prostate cancer, thus allowing curative treatment, and achieving similar survival to other case-matched HTR with no prostate cancer.     

Measure of association between selenium status and sepsis in cattle

Odds ratio was used to evaluate relationship between sepsis in cattle less than 1 year old and mastitis in cows and erythrocyte glutathione peroxides (GSH-PX) activity as an indicator of selenium status. Data were from 178 blood samples collected from referred cases to Urmia University, Veterinary Teaching Hospital. Low activity of GSH-PX was significantly associated with higher odds of developing sepsis (P=0.005) in young cattle and mastitis (P=0.044) in adult cows. The odds ratios for the low activity of GSH-PX on incidence of sepsis and mastitis were 4.74 and 3.95, respectively. Selenium deficiency was associated with sepsis in young cattle and mastitis in cows, i.e., cattle with low activity of erythrocyte GSH-PX were at increased risk of sepsis and mastitis.     

Perioperative outcomes of goal-directed versus conventional fluid therapy in radical cystectomy with enhanced recovery protocol

International Urology and Nephrology - The aim of this study is to evaluate the intra/perioperative fluid management and early postoperative outcomes of patients who underwent radical cystectomy...     

Novel Derivatives of Tetrahydrobenzo (g) Imidazo[α-1,2] Quinoline Induce Apoptosis Via ROS Production in the Glioblastoma Multiforme Cells,U-87MG

Background:Despite newer therapeutic approaches against glioblastoma multiforme (GBM), the severely poor prognosis and treatment resistance are still disadvantages that slow down the patient’s recovery process. Consistent with the need to develop more effective and optimized therapies to control GBM cell growth, the effects of a new series of tetrahydrobenzo(g)imidazo[α-1,2]quinolone derivatives on GBM cell growth and the underlying mechanism is investigated in the current study. Methods:U-87MG cell line, glioblastoma multiforme and normal skin fibroblast cell line, AGO1522 were used to study the anticancer effects of 5 derivatives of tetrahydrobenzo(g)imidazo[α-1,2]quinolone and paclitaxel as a standard drug. The cytotoxic effect on cell growth was assessed using the MTT assay. Annexin V FITC staining and PI staining were applied to detect apoptosis and cell cycle distribution using flow cytometry. The extent of reactive oxygen species (ROS) formation was assessed using the fluorescent probe 7-dichlorofluorescin diacetate and caspase-3 activity using the colorimetric assay kit. Results:Among the 5 derivatives of tetrahydrobenzo(g)imidazo[α-1,2]quinolone, the 5c derivative (5-(6-bromo-2-chloroquinolin-3-yl)-9a-hydroxy-8,8-dimethyl-4-Nitro-2,3,5,5a,7,8,9,9a-octahydroimidazo[α-1,2]quinoline-6(1H)) showed the strongest cytotoxic effect on U-87MG cells in a time and Dose-dependent manner compared to the other derivatives and paclitaxel. The IC₅₀ (11.91 M) of the 5c derivative induced apoptosis accompanied by a significant increase in sub-G1 and super-G2 phases of U-87MG cells. The increased level of cellular ROS and caspase 3 activity after treatment of U-87MG cells with 5c derivative was significant compared to untreated cells. Conclusion:Our data provide insights into the potent anticancer effects of the 5c-derivative of tetrahydrobenzo(g)imidazo[α-1,2]quinolone on GBM cells via the caspase-dependent apoptotic pathway, which may merit further attention.Key Words: Glioblastoma multiforme, imidazoquinoline, apoptosis, ROS, reactive oxygen species     

Contemporary Use of Venoarterial Extracorporeal Membrane Oxygenation: Insights from the Multicenter RESCUE Registry

BackgroundVenoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used as a life-saving therapy for patients with cardiovascular collapse, but identifying patients unlikely to benefit remains a challenge.Methods and ResultsWe created the RESCUE registry, a retrospective, observational registry of adult patients treated with VA-ECMO between January 2007 and June 2017 at 3 high-volume centers (Columbia University, Duke University, and Washington University) to describe short-term patient outcomes. In 723 patients treated with VA-ECMO, the most common indications for deployment were postcardiotomy shock (31%), cardiomyopathy (including acute heart failure) (26%), and myocardial infarction (17%). Patients frequently suffered in-hospital complications, including acute renal dysfunction (45%), major bleeding (41%), and infection (33%). Only 40% of patients (n = 290) survived to discharge, with a minority receiving durable cardiac support (left ventricular assist device [n = 48] or heart transplantation [n = 7]). Multivariable regression analysis identified risk factors for mortality on ECMO as older age (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12–1.42) and female sex (OR, 1.44; 95% CI, 1.02–2.02) and risk factors for mortality after decannulation as higher body mass index (OR 1.17; 95% CI, 1.01-1.35) and major bleeding while on ECMO support (OR, 1.92; 95% CI, 1.23–2.99).ConclusionsDespite contemporary care at high-volume centers, patients treated with VA-ECMO continue to have significant in-hospital morbidity and mortality. The optimization of outcomes will require refinements in patient selection and improvement of care delivery.     

Larger hip circumference independently contributed to reduced metabolic risks in Tehranian adult women

BACKGROUND: It has been suggested that health professionals may discard measurement of hip circumference from public health screening efforts. Before discarding the hip circumference in epidemiological surveys, it is important to consider whether any important information is likely to be lost. OBJECTIVE: To evaluate the relationship between hip circumference and metabolic risk factors in an urban adult population of Tehranian women. DESIGN: In this population-based cross-sectional study, a representative sample of 5720 women aged 18-74 years, were included. Demographic data was collected; anthropometric indices and blood pressure were measured according to standard protocol. Hypertension was defined based on Joint National Committee VI (JNC VI). Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose (FPG) > or =126 mg/dl or 2-h plasma glucose (2hPG) > or =200 mg/dl. Lipid disorders and components of metabolic syndrome were considered based on Adult Treatment Panel III (ATP III). RESULTS: Mean age of women was 39.9+/-14.6 years. Mean body mass index, waist-to-hip ratio, waist and hip circumferences for subjects were 27.1+/-5.1 kg/m2, 0.83+/-0.08, 86.5+/-13.1 cm and 103.5+/-9.8 cm, respectively. Higher hip circumference was associated with lower levels of serum total- and LDL-cholesterol, serum triglyceride, fasting plasma glucose, 2-h plasma glucose, systolic and diastolic blood pressure. Subjects in the top quintile of hip circumference had higher values of serum HDL-cholesterol concentration compared to those in the lower category. After adjustment for potential confounding variables and anthropometric measures associated with higher hip circumference, a significant decreasing trend was observed for odds of having high LDL-cholesterol (odds ratios among quintiles: 1.00, 0.98, 0.97, 0.95, 0.84, respectively, P for trend=0.04), diabetes (1.00, 0.68, 0.58, 0.45, 0.42, P for trend=0.01), hypertension (1.00, 0.96, 0.82, 0.78, 0.70, P for trend 0.02), low serum HDL-cholesterol (1.00, 1.03, 0.86, 0.82, 0.56, P for trend=0.04), elevated blood pressure (1.00, 0.99, 0.82, 0.70, 0.61, P for trend=0.01) and abnormal glucose homeostasis (1.00, 0.69, 0.66, 0.54, 0.48, P for trend=0.01) among hip circumference quintile categories. Individuals in the upper category of hip circumference had lower odds of having hypercholestrolemia (0.86 vs. 1.00) and high serum triglyceride levels (0.74 vs. 1.00) compared to those in the lowest category. CONCLUSION: Hip circumference is independently and inversely associated with metabolic risk factors. This study underscores the importance of continuing to measure hip circumference in epidemiologic surveys in Tehranian adult women.     

Design and finite element analysis of a novel smart clamper for aortic cross-clamping in minimally invasive surgery

Aortic cross-clamping is a critical action during heart surgeries which may cause some injuries to the wall of the artery. These injuries may have both short-term and long-term adverse effects on the artery function. Appropriate clampers can properly occlude the artery and decrease the extent of injury. Thus, developing a model for evaluation of such clampers is inevitable. In this paper, a finite element model of the aorta is presented; then, different mechanisms of clamping are investigated. In this regard, a numerical model of aortic cross-clamping by three types of clampers has been implemented with consideration of nonlinear behavior of two-layer artery, residual stress in aorta, and calcification. These three clamper models are commercial Chitwood clamper and linear mechanism clamper with and without balloon. Using the obtained results, comparative analysis was performed between the proposed clamper design and the commercial one. Based upon the analysis, it was concluded that the designed clamper, linear mechanism clamper with balloon, helps to distribute the stress uniformly in different layers of the aorta, which results in better performance of the clamping procedure and causes less injury in the aorta, especially when there is calcification.