Individualized immunosuppression in transplant patients: potential role of pharmacogenetics.

The immunosuppressive drugs used to prevent the rejection of transplanted organs have a narrow therapeutic index. Under treatment results in episodes of rejection leading to either damage or loss of the organ. Over immunosuppression increases the risk of infection and malignancy as well as drug specific complications including diabetes mellitus and nephrotoxicity. There is wide variation in the drug dose required to achieve target blood concentrations and there is often dissociation between pharmacokinetics and pharmacodynamics. Currently, immunosuppressive drug treatment is individualized based on a clinical assessment of the risk of rejection or toxicity. Therapeutic drug monitoring is routinely employed for several immunosuppressive drugs. Pharmacogenetics has the potential to complement therapeutic drug monitoring but clinical benefit has yet to be demonstrated. Novel biomarker-based approaches to risk stratification and pharmacodynamic monitoring are under development and are ready for clinical trials

Management of erectile dysfunction post-radical prostatectomy

© 2015 Saleh et al.Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients

Combined effects of gamma irradiation and blanching process on acrylamide content in fried potato strips

Potato tubers were irradiated in 60Co gamma station at different doses in order to investigate the effect of gamma irradiation on acrylamide formation in fried potato strips. Acrylamide content due to the irradiation treatment was reduced by 20–54% compared to a control after frying the irradiated tubers. While apply a blanching process, using warm tap water, to potato strips before frying has decreased acrylamide by 61%. A combination of gamma irradiation and a blanching process, which was applied in this work, showed a maximum decrease in acrylamide formation to reach 78% in fried potatoes

Cell cyclins: triggering elements of cancer or not?

Cyclins are indispensable elements of the cell cycle and derangement of their function can lead to cancer formation. Recent studies have also revealed more mechanisms through which cyclins can express their oncogenic potential. This review focuses on the aberrant expression of G1/S cyclins and especially cyclin D and cyclin E; the pathways through which they lead to tumour formation and their involvement in different types of cancer. These elements indicate the mechanisms that could act as targets for cancer therapy

Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic. Results from the MIMIC Study (A Multi-centre cohort study evaluating the role of Inflammatory Markers in patients presenting with acute ureteric Colic)

Objectives There is conflicting data on the role of white blood cell count (WBC) and other inflammatory markers in spontaneous stone passage in patients with acute ureteric colic. The aim of the study was to assess the relationship of WBC and other routinely collected inflammatory and clinical markers including stone size, stone position and Medically Expulsive Therapy use (MET) with spontaneous stone passage (SSP) in a large contemporary cohort of patients with acute ureteric colic. Subjects and Methods Multi‐centre retrospective cohort study coordinated by the British Urology Researchers in Surgical Training (BURST) Research Collaborative at 71 secondary care hospitals across 4 countries (United Kingdom, Republic of Ireland, Australia and New Zealand). 4170 patients presented with acute ureteric colic and a computer tomography confirmed single ureteric stone. Our primary outcome measure was SSP as defined by the absence of need for intervention to assist stone passage. Multivariable mixed effects logistic regression was used to explore the relationship between key patient factors and SSP. Results 2518 patients were discharged with conservative management and had further follow up with a SSP rate of 74% (n = 1874/2518). Sepsis after discharge with conservative management was reported in 0.6% (n = 16/2518). On multivariable analysis neither WBC, Neutrophils or CRP were seen to predict SSP, with an adjusted OR of 0.97 [95% CI 0.91 to 1.04, p = 0.38], 1.06 [95% CI 0.99 to 1.13, p = 0.1] and 1.00 [95% CI 0.99 to 1.00, p = 0.17], respectively. Medical expulsive therapy (MET) also did not predict SSP [adjusted OR 1.11 [95% CI 0.76 to 1.61]). However, stone size and stone position were significant predictors. SSP for stones 7mm. For stones in the upper ureter the SSP rate was 52% [95% CI 48 to 56], middle ureter was 70% [95% CI 64 to 76], and lower ureter was 83% [95% CI 81 to 85]. Conclusion In contrast to the previously published literature, we found that in patients with acute ureteric colic who are discharged with initial conservative management, neither WBC, Neutrophil count or CRP help determine the likelihood of spontaneous stone passage. We also found no overall benefit from the use of MET. Stone size and position are important predictors and our findings represent the most comprehensive stone passage rates for each mm increase in stone size from a large contemporary cohort adjusting for key potential confounders. We anticipate that these data will aid clinicians managing patients with acute ureteric colic and help guide management decisions and the need for intervention

Випробування твердості за Віккерсом сталевих труб, зварених високочастотною індукцією

Швидкий розвиток технології проектування та висока ринкова конкуренція спонукали нас розглянути сферу виробництва сталевих труб із процесом, який повністю відповідає промисловим вимогам, а саме високочастотним (HF) індукційним зварюванням, який є найпоширенішим процесом зварювання у виробництві сталевих труб. На даний момент цей процес більш відомий для виробництва труб різного діаметру на установці Tube Gaz в Тебесі (Алжир). Серед різних відомих руйнівних випробувань для контролю труб використовується тест на твердість за Віккерсом. Цей тест дозволяє визначити еволюцію твердості в поздовжньому та поперечному напрямках зварного з'єднання. Метою нашого дослідження є характеристика процесів, які керують механічною поведінкою сталевих труб (тип S235) товщиною 2,2 мм і зовнішнім діаметром 70,70 мм, зварених HF індукцією. Аналіз показує наявність дуже різноманітних мікроструктур у досліджуваному зварному з'єднанні.The rapid development of design technology and strong market competition have prompted us to look into the field of production of steel pipes with a process that perfectly meets industrial requirements, which is high frequency (HF) induction welding, which is the most common welding process to produce steel pipes. This process is currently better known for the manufacture of pipes of different diameters at the Tube Gaz unit in Tebessa (Algeria). Among the various known destructive tests, the Vickers hardness test is used to control the pipe. This test will allow us to determine the evolution of hardness in the longitudinal and transverse directions of the welded joint. The objective of our study is based on the characterization of the processes controlling the mechanical behavior of steel pipes (type S235) with a thickness of 2.2 mm and an outside diameter of 70.70 mm, welded by HF induction. The analysis shows the existence of very diverse microstructures in the studied welded joint