Preoperative predictors for residual tumor after surgery in patients with ovarian carcinoma

Objectives: Suboptimal debulking (>1 cm residual tumor) results in poor survival rates for patients with an advanced stage of ovarian cancer. The purpose of this study was to develop a prediction model, based on simple preoperative parameters, for patients with an advanced stage of ovarian cancer who are at risk of suboptimal cytoreduction despite maximal surgical effort. Methods: Retrospective analysis of 187 consecutive patients with a suspected clinical diagnosis of advanced-stage ovarian cancer undergoing upfront debulking between January 1998 and December 2003. Preoperative parameters were Karnofsky performance status, ascites and serum concentrations of CA 125, hemoglobin, albumin, LDH and blood platelets. The main outcome parameter was residual tumor >1 cm. Univariate and multivariate logistic regression was employed for testing possible prediction models. A clinically applicable graphic model (nomogram) for this prediction was to be developed. Results: Serum concentrations of CA 125 and blood platelets in the group with residual tumor >1 cm were higher in comparison to the optimally cytoreduced group (p 1 cm based on serum levels of CA 125 and albumin was established. Conclusion: Postoperative residual tumor despite maximal surgical effort can be predicted by preoperative CA 125 and serum albumin levels. With a nomogram based on these two parameters, probability of postoperative residual tumor in each individual patient can be predicted. This proposed nomogram may be valuable in daily routine practice for counseling and to select treatment modality. Copyrigh

Structural basis of ABCF-mediated resistance to pleuromutilin, lincosamide, and streptogramin A antibiotics in Gram-positive pathogens

he antibiotic target. One class of such proteins are the antibiotic resistance (ARE) ATP-binding cassette (ABC) proteins of the F-subtype (ARE-ABCFs), which are widely distributed throughout Gram-positive bacteria and bind the ribosome to alleviate translational inhibition from antibiotics that target the large ribosomal subunit. Here, we present single-particle cryo-EM structures of ARE-ABCF-ribosome complexes from three Gram-positive pathogens: Enterococcus faecalis LsaA, Staphylococcus haemolyticus VgaALC and Listeria monocytogenes VgaL. Supported by extensive mutagenesis analysis, these structures enable a general model for antibiotic resistance mediated by these ARE-ABCFs to be proposed. In this model, ABCF binding to the antibiotic-stalled ribosome mediates antibiotic release via mechanistically diverse long-range conformational relays that converge on a few conserved ribosomal RNA nucleotides located at the peptidyltransferase center. These insights are important for the future development of antibiotics that overcome such target protection resistance mechanisms

Non-food rewards and highly processed food intake in everyday life

Reducing intake of highly processed, energy-dense food may prevent chronic disease. One proposed intervention strategy for reducing intake of these foods is to increase non-food reward experiences (e.g., music, socializing, art) in their place. However, research supporting this strategy has yet to establish temporal order between non-food reward experiences and highly processed food intake, and has yet to test mediators. The current study sought to build upon this literature with an ambulatory electronic diary study wherein the time-specific associations between non-food reward experiences and highly processed food intake were observed. A sample of 84 young adults reported on multiple types of non-food reward experiences and highly processed food intake hourly for two weekdays and two weekend days through an application on their personal electronic devices. Time-lagged analysis was employed to predict the odds of highly processed food intake in the following hour from non-food rewards experienced in the current hour. Secondary (e.g., receiving positive social feedback) and hedonic (e.g., viewing pleasant images) non-food reward experiences in the current hour predicted greater instead of lower odds of highly processed food intake in the following hour. These associations were mediated by increased subjective pleasure. Purely eudaimonic (e.g., affirming values), social (e.g., cooperating with others), and primary (e.g., having sex) reward experiences generally did not predict odds of highly processed food intake in the following hour. These results suggest that-at least for young adults-many non-food reward experiences may fail to reduce highly processed food intake, and some may even backfire. A different intervention strategy targeting reward processes implicated in highly processed food intake (e.g., interfering with conditioned learned associations) may prove a more promising avenue for improving physical health

Measurement of radiographic changes occurring in rheumatoid arthritis by image analysis techniques.

We have applied image analysis techniques to serial measurements of bone contour in standard radiographs of single small joints of the hands in subjects with rheumatoid arthritis (RA) and controls. Adequate reproducibility was shown in 20 controls radiographed twice over a six month period. The technique showed significant changes in a proximal interphalangeal joint of 13 of 15 patients with RA studied over periods of three to 10 months. In further serial studies in selected small joints of RA hands significant changes could be shown as early as four months. These results justify further development of these techniques to allow their full scale evaluation in multiple joints in patients with RA receiving long term drug therapy