Predictive value of admission red cell distribution width-platelet ratio for no-reflow phenomenon in acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background: The red cell distribution width–platelet ratio (RPR), a novel inflammatory marker is currently used to predict inflammation in chronic diseases. It may be associated with adverse outcomes among artery disease but its prognostic value in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) has not been fully investigated. There is no data regarding the association between RPR and in-hospital major adverse cardiovascular events (MACEs). This study evaluated the relations between pre-procedural RPR and the in-hospital and long-term outcomes in STEMI patients undergoing primary PCI. Methods: This study included 580 STEMI patients (77% men, mean age: 59 ± 12 years). The patients were divided into two groups according to thrombolysis in myocardial infarction (TIMI) flow grades after primary PCI. No-reflow was defined as a post-PCI TIMI flow grade of 0, 1 or 2 (group 1). Angiographic success was defined as TIMI flow grade 3 (group 2). Results: Whole blood cell count, neutrophil and lymphocyte percentages, red cell distribution width, platecrit, neutrophil–lymphocyte ratio (NLR) and RPR values were higher among patients with no-reflow. On multivariate analysis, pain to balloon time, multivessel disease, TIMI thrombus grade, tirofiban, aspirin, previous coronary artery disease, NLR, platecrit and RPR remained independent predictors of no-reflow after primary PCI. Patients in no-reflow group tended to be higher percent in-hospital MACE, including nonfatal myocardial infarction and cardiovascular mortality compared to the reflow patients. Conclusions: Admission NLR, platecrit and RPR are independent correlates of no-reflow and in-hospital MACEs among patients with STEMI undergoing primary PCI.

Human Papilloma Virus Prevalence in Hyperplastic Tonsils and Adenoids in Children and Young Adults

Objective: Our aim was to determine HPV prevalence and genotypes in nontumoral tonsillar and/or adenoid tissue in young adults to open a discussion about the rationale of HPV detection in tonsil and adenoid tissues because of the cancer development risk. Material and Methods: Archived resection materials of 258 patients treated between 2003 and 2007 were retrieved for HPV detection and typing. Sections of formalin-fixed, paraffin-blocked tissue samples of each resected material were used as the DNA source. Six patients were excluded because of the inadequate quality of the extracted DNA. The age range of the remaining 252 patients was between 5 and 21 years (11.94 +/- 4.20). After PCR screening, four different sets of primers covering 18 HPV types were used for HPV genotyping by multiplex polymerase chain reaction (MPCR). Results: Sixteen of the 252 surgical samples, namely nine of 114 tonsillectomies (7.9%), four of 87 adenoidectomies (4.6%), and 3 of 51 adenotonsillectomy tissues (5.9%) were found to contain the HPV genome (6.3%). Genotypes revealed that HPV-16 was the dominant genotype, found in 11 cases, followed by HPV-6/11 in four cases, and HPV-31 in one case. Conclusion: The prevalence of HPV in children and young adults that suffered from upper airway obstruction due to nontumoral tonsil and/or adenoid overgrowth was found to be 6.3% in our study. This study reveals the need for further molecular assists for HPV under the light of 6.3% of detected HPV prevalence and the high risk HPV type 16 predominance. Since the oncogenic risk, we strongly suggest evaluation of HPV in tonsillectomy and adenoidectomy material similar to oropharyngeal squamous etithelium

Human Papilloma Virus Prevalence in Hyperplastic Tonsils and Adenoids in Children and Young Adults

Objective: Our aim was to determine HPV prevalence and genotypes in nontumoral tonsillar and/or adenoid tissue in young adults to open a discussion about the rationale of HPV detection in tonsil and adenoid tissues because of the cancer development risk. Material and Methods: Archived resection materials of 258 patients treated between 2003 and 2007 were retrieved for HPV detection and typing. Sections of formalin-fixed, paraffin-blocked tissue samples of each resected material were used as the DNA source. Six patients were excluded because of the inadequate quality of the extracted DNA. The age range of the remaining 252 patients was between 5 and 21 years (11.94 +/- 4.20). After PCR screening, four different sets of primers covering 18 HPV types were used for HPV genotyping by multiplex polymerase chain reaction (MPCR). Results: Sixteen of the 252 surgical samples, namely nine of 114 tonsillectomies (7.9%), four of 87 adenoidectomies (4.6%), and 3 of 51 adenotonsillectomy tissues (5.9%) were found to contain the HPV genome (6.3%). Genotypes revealed that HPV-16 was the dominant genotype, found in 11 cases, followed by HPV-6/11 in four cases, and HPV-31 in one case. Conclusion: The prevalence of HPV in children and young adults that suffered from upper airway obstruction due to nontumoral tonsil and/or adenoid overgrowth was found to be 6.3% in our study. This study reveals the need for further molecular assists for HPV under the light of 6.3% of detected HPV prevalence and the high risk HPV type 16 predominance. Since the oncogenic risk, we strongly suggest evaluation of HPV in tonsillectomy and adenoidectomy material similar to oropharyngeal squamous etithelium

Towards the completion of Europe. Analysis and perspectives of the new European Union enlargement.

This volume aims to contribute to the analysis of the EU in general and the background and consequences of its 2004 enlargement in particular. This enlargement is by far one of the greatest tests for the European Union and its institutions because the process of Europeanization is taking place in a variety of countries with diverse political cultures and dissimilar perceptions about the meaning and commitment to European integration. Given their differences in political and economic power, incumbent and new members are inevitably altering the functioning and character of the EU, a unique polity in the international system. Derived from this theoretical challenge, the chapters of this book suggest some explanations on six areas related to the 2004 enlargement: analytical approaches, citizens and identities, debates and regional transformations, external impacts, and the potential Turkey’s membership. The articles included in this publication are the result of the academic initiative of the Miami European Union Center, partnership formed by the University of Miami and Florida International University since 2000, which was also selected by the European Commission as one of the ten European Union Centers of Excellence in the United States for the period 2005|2008