Symptomatic and asymptomatic candidiasis in a pediatric intensive care unit

<p>Abstract</p> <p>Introduction</p> <p>This study aimed to examine the incidence, epidemiology, and clinical characteristics of symptomatic and asymptomatic candidiasis in a pediatric intensive care unit (PICU), and to determine the risk factors associated with symptomatic candidiasis.</p> <p>Methods</p> <p>This retrospective study included 67 patients from a 7-bed PICU in a tertiary care hospital that had Candida-positive cultures between April 2007 and July 2009. Demographic and clinical characteristics of the patients, Candida isolates, antimicrobial and antifungal treatments, and previously identified risk factors for symptomatic candidiasis were recorded, and symptomatic and asymptomatic patients were compared.</p> <p>Results</p> <p>In all, 36 (53.7%) of the patients with Candida-positive cultures had asymptomatic candidiasis and 31 (46.3%) had symptomatic candidiasis. Candida albicans was the most common Candida sp. in the asymptomatic patients (n = 20, 55.6%), versus Candida parapsilosis in the symptomatic patients (n = 15, 48.4%). The incidence of central venous catheter indwelling, blood transfusion, parenteral nutrition, and surgery was higher in the symptomatic patient group than in the asymptomatic patient group (P < 0.5). Surgery was the only independent predictor of symptomatic candidiasis according to forward stepwise multivariate logistic regression analysis (OR: 6.1; 95% CI: 1.798-20.692).</p> <p>Conclusion</p> <p>Surgery was the only risk factor significantly associated with symptomatic candidiasis and non-albicans Candida species were more common among the patients with symptomatic candidiasis. While treating symptomatic candidiasis in any PICU an increase in the incidence of non-albicans candidiasis should be considered.</p

Effects of Different Estrous Synchronization Methods on the Composition of Simmental Cow’s Milk

Background: Estrous synchronization is one of the primary applications performed to improve the fertility and to consolidate the parturition times in dairy cattle farms. Since the primary objective is to increase fertility regardless of the method of synchronization used, the effect of this process on the udder health and the quality of milk is generally ignored. Therefore, in the present study, the aim was to investigate the effect of different estrous synchronization methods t on the milk quality in a dairy cattle farm.Materials, Methods &amp; Results: In this study, a total of 100 Simmental cows the same farm under good management practices were used. The animals were randomly divided into 4 groups of 25 cows each. The animals in the 1st group were used as a control group without any treatment. Progesterone-releasing intravaginal device (PRID) was inserted to the animals in the 2nd group, double dose of prostaglandin F2 alpha (PGF2-alpha) with 11 days apart was applied to the animals in the 3rd group, and the Ovsynch protocol was applied to the animals in the 4th group. Starting from the first day of the applications, milk samples from each milk tank belonging to the groups were taken, kept frozen for 3 months and analyzed for the levels of fat, nonfat solids, density, protein, lactose and minerals over the course of one month. According to the results, the minimum milk fat content was found in the PRID group as 2.47 ± 0.354%, and the highest value was in the PGF2-alpha group as 3.58 ± 0.207%. The difference in milk fat ratio between the groups was found to be significant (P &lt; .05). However, the differences between the groups for other parameters were not significant (P &gt; .05).Discussion: Among the reasons for the low values of the milk fat rates obtained in the present study than the mean values of all lactation milk fat rates of the Simmental breed, the effect of the lactation period in which the milk samples were collected comes to mind. Because, as we know, the first 45-60 day period following the start of lactation after parturition in cattle is accepted as the period in which daily milk yield reaches to the maximum level of the lactation period. This period lasts for a certain period of time, and then starts to decrease gradually. Among the non-hereditary factors, the most important factor causing changes in the composition of the milk and its amount is the lactation period. In this study, the significant difference in the milk fat rates between the control and the application groups is quite remarkable compared to the low level of milk fat rates in the milk in all groups. According to the multiple comparison test results to determine which groups these differences arise from, the difference was found to be particularly between the PGF2-alpha group and PRID group. In this study, no significant effects of different synchronization methods on all components of the milk except the milk fat and the density values were determined. But results indicate that Ovsynch group was the synchronization group that caused the minimum change in milk fat compared to the other groups

Novel Dynamic Partial Reconfiguration Implementation of K-Means Clustering on FPGAs: Comparative Results with GPPs and GPUs

K-means clustering has been widely used in processing large datasets in many fields of studies. Advancement in many data collection techniques has been generating enormous amounts of data, leaving scientists with the challenging task of processing them. Using General Purpose Processors (GPPs) to process large datasets may take a long time; therefore many acceleration methods have been proposed in the literature to speed up the processing of such large datasets. In this work, a parameterized implementation of the K-means clustering algorithm in Field Programmable Gate Array (FPGA) is presented and compared with previous FPGA implementation as well as recent implementations on Graphics Processing Units (GPUs) and GPPs. The proposed FPGA has higher performance in terms of speedup over previous GPP and GPU implementations (two orders and one order of magnitude, resp.). In addition, the FPGA implementation is more energy efficient than GPP and GPU (615x and 31x, resp.). Furthermore, three novel implementations of the K-means clustering based on dynamic partial reconfiguration (DPR) are presented offering high degree of flexibility to dynamically reconfigure the FPGA. The DPR implementations achieved speedups in reconfiguration time between 4x to 15x

Recurrent Intestinal Intussuseption in Adult: A Case Report

Intussusseption is an usually incident that may present in pediatric patients but we encounter rarely in adults. It leads to obstruction of the gastrointestinal tract. In pediatric patients, etiological factors are due to benign incidents usually, but in adults, often depends on tumors. Etiological factors should be investigated after obtaining the reduction of intussusception and intraluminal pathologies should be excluded. It will cause to intussusseption recurrence after years if reduction perform without treating etiological factors

A Comparative Study of Multiparametric MRI Sequences in Measuring Prostate Cancer Index Lesion Volume

Objectives: To compare the effectiveness of individual multiparametric prostate MRI (mpMRI) sequences—T2W, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE)—in assessing prostate cancer (PCa) index lesion volume using whole-mount pathology as the ground-truth; to assess the impact of an endorectal coil (ERC) on the measurements. Materials and Methods: We retrospectively enrolled 72 PCa patients who underwent 3T mpMRI with (n = 39) or without (n = 33) an ERC. A pathologist drew the index lesion borders on whole-mount pathology using planimetry (whole-mountvol). A radiologist drew the borders of the index lesion on each mpMRI sequence—T2Wvol, DWIvol, ADCvol, and DCEvol. Additionally, we calculated the maximum index lesion volume for each patient (maxMRIvol). The correlation and differences between mpMRI and whole-mount pathology in measuring the index lesion volume and the impact of an ERC were investigated. Results: The median T2Wvol, DWIvol, ADCvol, DCEvol, and maxMRIvol were 0.68 cm3, 0.97 cm3, 0.98 cm3, 0.82 cm3, and 1.13 cm3. There were good positive correlations between whole-mountvol and mpMRI sequences. However, all mpMRI-derived volumes underestimated the median whole-mountvol volume of 1.97 cm3 (P ≤ 0.001), with T2Wvol having the largest volumetric underestimation while DWIvol and ADCvol having the smallest. The mean relative index lesion volume underestimations of maxMRIvol were 39.16% ± 32.58% and 7.65% ± 51.91% with and without an ERC (P = 0.002). Conclusion: T2Wvol, DWIvol, ADCvol, DCEvol, and maxMRIvol substantially underestimate PCa index lesion volume compared with whole-mount pathology, with T2Wvol having the largest volume underestimation. Additionally, using an ERC exacerbates the volume underestimation

Comparison of Fixed and Ramping Voltage Extracorporeal Shockwave Lithotripsy with Acute Kidney Injury Biomarkers: Prospective Randomized Clinical Study

Objective: To compare extracorporeal shock wave lithotripsy (ESWL) induced renal injury in patients undergoing different ESWL treatment protocols by measuring urinary tissue metalloproteinase-2 inhibitor (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) excretion. Materials and Methods: This prospective, randomized study was conducted between April 2016 and June 2016 in group 1 patients undergoing fixed voltage ESWL and group 2 patients undergoing ramping voltage ESWL. Urinary TIMP-2 and IGFBP7 levels were analyzed before ESWL and 2 hours after ESWL, and urinary beta- 2-microglobulin (β2-MG) and albumin were analyzed before ESWL and 1 week after ESWL to assess renal injury. The primary outcome was to compare the effect of ESWL on early renal injury with biochemical markers in the different treatment protocols, and the secondary outcome was to compare the two treatment protocols in terms of stone free rate and complications. Results: There was no statistically significant difference between groups in terms of demographic and stone characteristics. There were statistically significant differences in serum creatinine and e-GFR at baseline and one week after treatment (p0.05). Conclusion: In this prospective randomized study, we observed a significant increase in TIMP-2, IGFBP7 and combination levels after ESWL treatment in both groups, suggesting that these two biomarkers could be used to identify acute kidney injury due to ESWL. However, the comprehensive evaluation of clinical parameters and urinary markers did not differ in the rates of renal injury, success, and complications after ESWL in both protocols

Epigenetic-focused CRISPR/Cas9 screen identifies (absent, small, or homeotic)2-like protein (ASH2L) as a regulator of glioblastoma cell survival

Background: Glioblastoma is the most common and aggressive primary brain tumor with extremely poor prognosis, highlighting an urgent need for developing novel treatment options. Identifying epigenetic vulnerabilities of cancer cells can provide excellent therapeutic intervention points for various types of cancers. Method: In this study, we investigated epigenetic regulators of glioblastoma cell survival through CRISPR/Cas9 based genetic ablation screens using a customized sgRNA library EpiDoKOL, which targets critical functional domains of chromatin modifiers. Results: Screens conducted in multiple cell lines revealed ASH2L, a histone lysine methyltransferase complex subunit, as a major regulator of glioblastoma cell viability. ASH2L depletion led to cell cycle arrest and apoptosis. RNA sequencing and greenCUT&RUN together identified a set of cell cycle regulatory genes, such as TRA2B, BARD1, KIF20B, ARID4A and SMARCC1 that were downregulated upon ASH2L depletion. Mass spectrometry analysis revealed the interaction partners of ASH2L in glioblastoma cell lines as SET1/MLL family members including SETD1A, SETD1B, MLL1 and MLL2. We further showed that glioblastoma cells had a differential dependency on expression of SET1/MLL family members for survival. The growth of ASH2L-depleted glioblastoma cells was markedly slower than controls in orthotopic in vivo models. TCGA analysis showed high ASH2L expression in glioblastoma compared to low grade gliomas and immunohistochemical analysis revealed significant ASH2L expression in glioblastoma tissues, attesting to its clinical relevance. Therefore, high throughput, robust and affordable screens with focused libraries, such as EpiDoKOL, holds great promise to enable rapid discovery of novel epigenetic regulators of cancer cell survival, such as ASH2L. Conclusion: Together, we suggest that targeting ASH2L could serve as a new therapeutic opportunity for glioblastoma

Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study

Regorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analysed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male, and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ≥ 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1-2.3; P = 0.01), pretreatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1-2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1-2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0-1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2-0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival