The effect of radiotherapy and chemotherapy on osmotic fragility of red blood cells and plasma levels of malondialdehyde in patients with breast cancer

Background: Gamma radiation effects on the erythrocyte membrane from three different functional parts, lipid bilayer, cytoskeleton and protein components. When the red cell membrane is exposed to radiation, it loses its integrity and hemoglobin leaks out. In addition, irradiation leads to lipid peroxidation and the products of this process, leading to hemolysis. The aim of the present study was to measure osmotic fragility (OF) of red blood cells and malondialdehyde (MDA) levels as a marker of oxidative injury in breast cancer patients treated with radiation and chemotherapy. Materials and Methods: The OF test was performed using different concentrations of a salt solution. The measurement of MDA was done with chemical methods.11 The sampling was taken during three stages of treatment: first sample was taken before starting chemotherapy, the second sample was taken before radiation therapy and the third sample was taken after radiotherapy. Results: No statistically significant differences between levels of MDA in these three stages of treatment were observed. However, the comparison of mean levels of MDA showed an increase after radiotherapy. The OF rate did not show significant difference (P > 0.05) during the stages of treatment. Conclusion: In a standard treatment program of radiotherapy and chemotherapy lipid peroxidation level and OF do not significantly increase. © 2014 Greater Poland Cancer Centre

Mini-sternotomy for aortic valve replacement reduces the length of stay in the cardiac intensive care unit: meta-analysis of randomised controlled trials

Background Mini-sternotomy for isolated aortic valve replacement aims to reduce operative trauma hastening recovery and improving the cosmetic outcome of cardiac surgery. The short-term clinical benefits from the mini-sternotomy are presumed to arise because the incision is less extensive and the lower half of the chest cage remains intact. The basic conduct of virtually all other aspects of the aortic valve replacement procedure remains the same. Therefore, similar long-term outcomes are to be expected. Objectives To conduct a meta-analysis of the only available randomised controlled trials (RCT) in the published English literature. Data sources Electronic search for relevant publications in MEDLINE, EMBASE and CENTRAL databases were performed. Four studies met the criteria. Study eligibility criteria RCT comparing minimally invasive (inverted C or L (J)-shaped) hemi-sternotomy versus conventional sternotomy for adults undergoing isolated aortic valve replacement using standard cardiopulmonary bypass technique. Methods Outcome measures were the length of positive pressure ventilation, blood loss, intensive care unit (ICU) and hospital stay. Results The length of ICU stay was significantly shorter by 0.57 days in favour of the mini-sternotomy group (CI −0.95 to −0.2; p=0.003). There was no advantage in terms of duration of ventilation (CI −3.48 to 0.36; p=0.11). However, there was some evidence to suggest a reduction in blood loss and the length of stay in hospital in the mini-sternotomy group. This did not prove to be statistically significant (154.17 ml reduction (CI −324.51 to 16.17; p=0.08) and 2.03 days less (CI −4.12 to 0.05; p=0.06), respectively). Limitations This study includes a relatively small number of subjects (n=220) and outcome variables. The risk of bias was not assessed during this meta-analysis. Conclusion Mini-sternotomy for isolated aortic valve replacement significantly reduces the length of stay in the cardiac ICU. Other short-term benefits may include a reduction in blood loss or the length of hospital stay

Is there a renoprotective value to leukodepletion during heart valve surgery? A randomized controlled trial (ROLO)

Background: Acute Kidney Injury (AKI) adversely affects outcomes after cardiac surgery. A major mediator of AKI is the activation of leukocytes through exposure to the cardiopulmonary bypass circuit. We evaluate the use of leukodepletion filters throughout bypass to protect against post-operative AKI by removing activated leukocytes during cardiac surgery. Methods: This is a single-centre, double-blind, randomized controlled trial comparing the use of leukodepletion versus a standard arterial filter throughout bypass. Elective adult patients undergoing heart valve surgery with or without concomitant procedures were investigated. The primary clinical outcome measured was the development of AKI according to the KDIGO criteria. Secondary measures included biomarkers of renal tubular damage (urinary Retinol Binding Protein and Kidney Injury Molecule-1), glomerular kidney injury (urinary Micro Albumin and serum Cystatin C) and urinary Neutrophil Gelatinase Associated Lipocalin, as well as the length of hospital stay and quality of life measures through EQ-5D-5L questionnaires. Results: The ROLO trial randomized 64 participants with a rate of recruitment higher than anticipated (57% achieved, 40% anticipated). The incidence of AKI was greater in the leukodepletion filter group (44% versus 23%, risk difference 21, 95% CI − 2 to 44%). This clinical finding was supported by biomarker levels especially by a tendency toward glomerular insult at 48 h, demonstrated by a raised serum Cystatin C (mean difference 0.11, 95% CI 0.00 to 0.23, p = 0.068) in the leukodepleted group. There was however no clear association between the incidence or severity of AKI and length of hospital stay. On average, health related quality of life returned to pre-operative levels in both groups within 3 months of surgery. Conclusions: Leukocyte depletion during cardiopulmonary bypass does not significantly reduce the incidence of AKI after valvular heart surgery. Other methods to ameliorate renal dysfunction after cardiac surgery need to be investigated. Trial registration: The trial was registered by the International Standard Randomized Controlled Trial Number Registry ISRCTN42121335. Registered on the 18 February 2014. The trial was run by the Bristol Clinical Trials and Evaluation Unit. This trial was financially supported by the National Institute of Health Research (Research for Patient Benefit), award ID: PB-PG-0711-25,090

Modelling two stage duration process

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN032257 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Correlated quasiskyrmions as alpha-particles

By replacing quasiparticles by quasiskyrmions, we calculate the binding energy of the alpha-particle using the cluster expansion method

Assessment of cumulative radiation dose of neonate hospitalized in intensive care units

BACKGROUND AND OBJECTIVE: Newborns admitted to the neonatal intensive care unit (NICU), would be undergo a large number of X-ray imaging due to their involvement with various diseases The most important complication of receiving too much X-rays is an increased risk of various cancers. The aim of this study was to determine the average cumulative dose received by neonates admitted to the neonatal intensive care unit. METHODS: This cross-sectional study was performed on 20 neonates admitted to the intensive care unit of Taleghani Children's Hospital who were randomly selected. Infant information registrated including time of birth, arrival time, duration of hospitalization, age, sex, weight and number of radiographs performed on the infant and radiographic information including tube-to-patient distance, tube voltage (kVp) and milliamperes (mAs). The amount of skin absorption dose of each patient was evaluated using MTS700 thermoluminescence dosimeter and the number of imaging was examined. FINDINGS: The amount of entrance skin dose of the studied neonates with an average of 78 micrograys varied from 42 to 121 micrograys (78±19.6). The mean number of imaging and cumulative dose were 6 (6±7.71) and 521 micrograys (521±547.99), respectively. The highest cumulative dose (2106 μg) was related to a neonate who underwent 27 imaging. CONCLUSION: According to the results of this study, the need for multiple imaging of these infants can significantly increase their absorption dose, especially in infants with very low weight. © 2020, Babol University of Medical Sciences. All rights reserved