CMR T2* Technique for Segmental and Global Quantification of Myocardial Iron: Multicentre Transferability and Healthcare Impact Evaluation

The multislice multiecho T2* technique is transferable among scanners with good reproducibility. The network seems to be a robust and scalable system in which T2* CMR based cardiac iron overload assessment is available, accessible and reachable for a significant and increasing number of thalassemia patients, reducing the mean distance from the patients\u27 locations to the CMR sites

Exploring the Prognostic Role of Microsatellite Instability in Patients With Stage II Colorectal Cancer: A Systematic Review and Meta-Analysis

Many studies have disclosed the prognostic effect of microsatellite instability (MSI) and/or loss of mismatch repair proteins in colorectal cancer. Nevertheless, little evidence supports their role in decision-making of adjuvant therapy for the stage II. This systematic review evaluated the prognostic and/or predictive role of MSI status in patients with stage II colorectal cancer. Only 2 articles fulfilled the eligibility criteria, suggesting a prognostic role of MSI on disease-free survival but not supporting the hypothesis of a predictive effect

Qualiquantitatve study of biogas produced by substrates in batch biodigestors

Aiming to study the biogas produced by 5 substrates from both quality and quantity point of view, this research was conducted at the Rural Engineering Department of FCAV/UNESP - Brazil, State of São Paulo. The substractes that were used in the anaerobic digestion were characterized as: 1 - Slaughter fowls' manure with napier grass bed (MFNG); 2 - Slaughter fowls' manure with triturate napier grass bed (MFNGT); 3 - Suine manure (SM); 4 - Bovine manure (BM) and 5 - Bovine manure mixed with 50% of sugarcane bagasse (BM50S). From the data collected it was concluded that: the substract (MFNG) and the substract containing SM produced higher and lower volumes of biogas respectively, when compared to the others; the mixture of sugarcane bagasse in the substract containing Bovine manure damages the accumulated biogas production and its quality; 57 days after filling the biodigestors, all substrates produced biogas with a methane level higher than 48% except for the substrates containing Suine manure; the triturate substrates (MFNGT) did not present such distinct characteristics from the non-triturate substrates (MFNG); the quality of biogas at the maximum production stage was similar, for all the studied substrates; the biogas which presented higher quantity of methane in its composition was the one produced with BM, overcoming the value up to 17.7% over the MFNGT production

Feasibility, reproducibility, and reliability for the T^*₂ iron evaluation at 3 T in comparison with 1.5 T

This study aimed to determine the feasibility, reproducibility, and reliability of the multiecho T*2 Magnetic resonance imaging technique at 3 T for myocardial and liver iron burden quantification and the relationship between T*2 values at 3 and 1.5 T. Thirty-eight transfusion-dependent patients and 20 healthy subjects were studied. Cardiac segmental and global T*2 values were calculated after developing a correction map to compensate the artifactual T*2 variations. The hepatic T*2 value was determined over a region of interest. The intraoperator and interoperator reproducibility for T*2 measurements at 3 T was good. A linear relationship was found between patients' R (1000/T*2) values at 3 and 1.5 T. Segmental correction factors were significantly higher at 3 T. A conversion formula returning T*2 values at 1.5 T from values at 3 T was proposed. A good diagnostic reliability for T*2 assessment at 3 T was demonstrated. Lower limits of normal for 3 T T*2 values were 23.3 ms, 21.1 ms, and 11.7 ms, for the global heart, mid-ventricular septum, and liver, respectively. In conclusion, T*2 quantification of iron burden in the mid-ventricular septum, global heart, and no heavy–moderate livers resulted to be feasible, reproducible, and reliable at 3 T. Segmental heart T*2 analysis at 3 T may be challenging due to significantly higher susceptibility artifacts. Magn Reson Med, 2012

Dual therapy with peg-interferon and ribavirin in thalassemia major patients with chronic HCV infection: Is there still an indication?

Background: Iron overload and hepatitis C virus (HCV) infection together can lead to chronic liver damage in thalassemia major (TM) patients. Aims: We investigated viral, genetic, and disease factors influencing sustained virological response (SVR) after peg-interferon and ribavirin therapy in TM patients with HCV infection. Methods: We analyzed 230 TM patients with HCV infection (mean age 36.0 ± 6.3 years; 59.1% genotype 1; 32.2% genotype 2; 3.4% genotype 3; and 5.3% genotype 4; 28.7% carried CC allele of rs12979860 in IL28B locus; 79.6% had chronic hepatitis and 20.4% cirrhosis; 63.5% naive and 36.5% previously treated with interferon alone) treated in 14 Italian centers. Results: By multivariate regression analysis SVR was independently associated with CC allele of IL28B SNP (OR 2.98; CI 95% 1.29-6.86; p = 0.010) and rapid virologic response (OR 11.82; CI 95% 3.83-36.54; p < 0.001) in 136 genotype 1 patients. Combining favorable variables the probability of SVR ranged from 31% to 93%. In genotype 2 patients, only RVR (OR 8.61; CI 95% 2.85-26.01; p < 0.001) was associated with SVR higher than 80%. In 3 patients with cirrhosis a decompensation of liver or heart disease were observed. Over 50% of patients increased blood transfusions. Conclusion: Dual therapy in TM patients with chronic HCV infection is efficacious in patients with the best virological, genetic and clinical predictors. Patients with cirrhosis have an increased risk of worsening liver or heart disease

Tauroursodeoxycholic acid in patients with amyotrophic lateral sclerosis: The TUDCA-ALS trial protocol

Background: Amyotrophic lateral sclerosis (ALS) is a chronic neurodegenerative rare disease that affects motor neurons in the brain, brainstem, and spinal cord, resulting in progressive weakness and atrophy of voluntary skeletal muscles. Although much has been achieved in understanding the disease pathogenesis, treatment options are limited, and in Europe, riluzole is the only approved drug. Recently, some other drugs showed minor effects. Methods: The TUDCA-ALS trial is a phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The study aims to enroll 320 patients in 25 centers across seven countries in Europe. Enrolled patients are randomized to one of two treatment arms: TUDCA or identical placebo by oral route. The study measures disease progression during the treatment period and compares it to natural progression during a no-treatment run-in phase. Clinical data and specific biomarkers are measured during the trial. The study is coordinated by a consortium composed of leading European ALS centers. Conclusion: This trial is aimed to determine whether TUDCA has a disease-modifying activity in ALS. Demonstration of TUDCA efficacy, combined with the validation of new biomarkers, could advance ALS patient care