Efficacy of Colchicine in the Treatment of Mesenteric Panniculitis in a Young Patient

Mesenteric panniculitis (MP) is a rare inflammatory and fibrotic disease of the mesentery of unknown etiology. It has various clinical and radiological manifestations, posing a diagnostic challenge for clinicians. Its diagnosis is indicated via radiologic imaging and is usually confirmed via peritoneal biopsies. We describe a case of a patient with histopathologically proven MP, in which steroid dependence was successfully managed with colchicine.     

Apolipoprotein E and Paraoxonase 1 polymorphisms are associated with lower serum thyroid hormones in postmenopausal women

Objective  Autoimmune thyroiditis and overt or subclinical hypothyroidism have been associated with increased prevalence of cardiovascular disease (CVD).
Design  Cross-sectional investigation of the association between gene polymorphisms related to CVD with thyroid function and autoimmunity.
Patients  In total 84 healthy postmenopausal women aged 49–69 years.
Measurements  FT3, FT4, anti-TPO and anti-TG were assessed in the sera of participants. The following polymorphisms were assessed from peripheral lymphocyte DNA: Apolipoprotein E E2/E3/E4, paraoxonase 1 A/B, Glycoprotein IIIa leu33pro, MTHFR ala222val, ApoBarg3500gln, plasminogen activator inhibitor 1 4G/5G, cholesterol 7-α hydroxylase A204C and cholesterol ester transfer protein B1/B2.
Results  A statistically significant correlation was found between Apolipoprotein E and paraoxonase1 polymorphisms and serum thyroid hormones: carriers of the E2 or E4 allele of the ApoE gene had lower levels of FT4 ( P  = 0·0005) than women with the E3/E3 genotype. Carriers of the B allele of paraoxonase 1 gene had lower levels of FT3 compared to women with the wild-type genotype ( P =  0·047). A statistically significant positive association ( P =  0·049) was also observed between anti-TG antibodies and the presence of the E2 allele of the Apolipoprotein E gene.
Conclusions  Polymorphisms of apolipoprotein E and paraoxonase 1 are associated with different levels of thyroid hormone and anti-Tg antibody levels in the study population in this pilot study. The mechanism underlying this association remains to be elucidated.     

Adolescents’ Self-reported Running Away from Home and Suicide Attempts During a Period of Economic Recession in Greece

Background

Running away from home and suicide attempts during adolescence are high-risk behaviors for safety and health, and a “way out” from negative life experiences.

Objective

To examine the self-reported prevalence of running away and suicide attempts among adolescents in Greece in the midst of a severe economic recession which is exerting pressure on families, and to identify associated psychosocial factors.

Methods

Data were drawn from a nationally representative school survey (n = 23,279, 15–19 years old). Students answered in their classrooms an anonymous questionnaire under the supervision of trained researchers.

Results

Each behavior was reported by one in nine adolescents (11.3 % for lifetime suicide attempts and 11.6 % for lifetime running away). Among those who reported the one behavior, a quarter also reported the other. Logistic regression analyses indicated that these behaviors share several common psychosocial correlates: family related (quality of parental relationships, parental monitoring), school related (poor performance and dissatisfaction), substance use, and emotional, psychological and behavioral problems. Gender was a significant correlate but in opposite directions for running away (more common among boys) and suicide attempts (more common among girls). Socioeconomic status was not a significant correlate for either behavior, possibly because the impact of the economic crisis on parents had not yet filtered down to their children in 2011 (the survey year).

Conclusions

Findings suggest the need for timely interventions towards vulnerable youth and their families by identifying personal, familial and school factors associated with these two health- and life-compromising behaviors.     

Refining amyloid complete hematological response: Quantitative serum free light chains superior to ratio

Response assessment in light chain (AL) amyloidosis is based on serum and urine monoclonal protein studies. Newly diagnosed patients (n = 373) who achieved very good partial response or complete response (CR) to first line therapy were assessed for the survival impact of each of the monoclonal protein studies. At end of therapy (EOT), negative serum/urine immunofixation (IFE) was achieved in 61% of patients, 72% achieved normal serum free light chain ratio (sFLCR), and the median involved free light chain (iFLC) and difference between involved to uninvolved light chain (dFLC) were 17 mg/L and 5 mg/L, respectively. Overall, 46% of patients achieved a CR at EOT. At EOT, iFLC ≤20 mg/L and dFLC ≤10 mg/L were additive in survival discrimination to negative serum/urine IFE and were independent predictors of overall survival. In contrast, normalization of sFLCR did not add survival discrimination to serum/urine IFE and was not independent predictor of survival. We propose a new definition for hematological CR to include serum/urine IFE negativity plus iFLC ≤20 mg/L or dFLC ≤10 mg/L, instead of the current definition of serum/urine IFE negativity and normal sFLCR. Complete response using dFLC ≤10 mg/L had the best performance in those with significant renal dysfunction and by light chain isotype, making it the preferred partner to IFE. Validation of these results in a multicenter cohort is warranted.     

Stimulating effect of implant loading on surrounding bone. Comparison of three numerical models and validation by in vivo data

A number of algorithms have been proposed to model the adaptive behavior of bone under load. However, the predictions of several models have neither been compared nor have they been systematically related to in vivo data. To this end, the stress states of loaded implant-bone interfaces were analyzed before and after osseointegration using finite element (FE) techniques. In a preliminary step, an FE mesh of a cylindrical implant encased in a cancellous core surrounded by a cortical layer was constructed, and the stresses and strains that developed at the interface were determined. The implant was loaded with 100 N vertical and 30 N lateral loads. Using this structure, the peak compressive and tensile stresses were determined. Then bone remodeling predictions were assessed using three different models: von Mises equivalent strain, strain energy density and effective stress. Finally, a systematic search of the literature was conducted to relate the numerical predictions to existing in vivo data. The FE simulations led to the following conclusions: (1) calculated compressive stresses were lower than the ultimate compressive stresses of cortical and cancellous bone. (2) Calculated tensile stresses were generally superior to experimental data on the tensile strength of the bone-implant interface. (3) With one exception, the predictions of all models were homogeneously grouped on the stimulus scales. (4) The predictions of the models as to bone gain or loss were not consistent and at times contradictory. It is hypothesized that this effect is linked to a lazy zone that is too narrow. With respect to the application of the numerical models to in vivo data, peak strains and strain energy densities were consistent with in vivo data. No in vivo data were found that supported effective stress as a stimulus.     

Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding

AIM: To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications. METHODS: All patients referred for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) were randomly assigned to undergo ES either with a partially covered or an uncovered sphincterotome. Both patient and technical risk factors contributing to the development of post-ES bleeding were recorded and analyzed. The characteristics of blee...     

Vaccine adverse event text mining system for extracting features from vaccine safety reports

Objective

To develop and evaluate a text mining system for extracting key clinical features from vaccine adverse event reporting system (VAERS) narratives to aid in the automated review of adverse event reports.

Design

Based upon clinical significance to VAERS reviewing physicians, we defined the primary (diagnosis and cause of death) and secondary features (eg, symptoms) for extraction. We built a novel vaccine adverse event text mining (VaeTM) system based on a semantic text mining strategy. The performance of VaeTM was evaluated using a total of 300 VAERS reports in three sequential evaluations of 100 reports each. Moreover, we evaluated the VaeTM contribution to case classification; an information retrieval-based approach was used for the identification of anaphylaxis cases in a set of reports and was compared with two other methods: a dedicated text classifier and an online tool.

Measurements

The performance metrics of VaeTM were text mining metrics: recall, precision and F-measure. We also conducted a qualitative difference analysis and calculated sensitivity and specificity for classification of anaphylaxis cases based on the above three approaches.

Results

VaeTM performed best in extracting diagnosis, second level diagnosis, drug, vaccine, and lot number features (lenient F-measure in the third evaluation: 0.897, 0.817, 0.858, 0.874, and 0.914, respectively). In terms of case classification, high sensitivity was achieved (83.1%); this was equal and better compared to the text classifier (83.1%) and the online tool (40.7%), respectively.

Conclusion

Our VaeTM implementation of a semantic text mining strategy shows promise in providing accurate and efficient extraction of key features from VAERS narratives.