147 research outputs found
Giant cystosarcoma phyllodes tumor of prostate: Case report of a rare entity
Although glandular and stromal proliferations of prostate are very
common in adult men, neoplastic proliferations of prostatic stroma are
distinctly uncommon. These tumors are now grouped as Prostatic Stromal
Proliferations of Uncertain Malignant Potential (PSPUMP). Phyllodes
tumor of the prostate is a rare neoplasm in this group with cellular,
sarcomatoid stroma and benign hyperplastic glands. It is a locally
expansile tumor with clinical course varying from benign to aggressive.
We report a case of a 45-year-old man presented with retention of urine
and abdominal lump. On laparotomy it was a huge tumor of 4 kg and was
histologicaly characterized by cellular pleomorphic stroma and
hyperplastic epithelium. Immunohistochemistry demonstrated prostate
specific antigen in the glands. It was diagnosed as cystosarcoma
phyllodes tumor of prostate. This is extremely uncommon tumor similar
in histology to that of breast and it\u2032s clinical course varies
with the grade. The patient was without recurrence one year after
surgery
Hybrid plasma-catalytic steam reforming of toluene as a biomass tar model compound over Ni/AlâOâ catalysts
In this study, plasma-catalytic steam reforming of toluene as a biomass tar model compound was carried out in a coaxial dielectric barrier discharge (DBD) plasma reactor. The effect of Ni/Al2O3 catalysts with different nickel loadings (5â20 wt%) on the plasma-catalytic gas cleaning process was evaluated in terms of toluene conversion, gas yield, by-products formation and energy efficiency of the plasma-catalytic process. Compared to the plasma reaction without a catalyst, the combination of DBD with the Ni/Al2O3 catalysts significantly enhanced the toluene conversion, hydrogen yield and energy efficiency of the hybrid plasma process, while significantly reduced the production of organic by-products. Increasing Ni loading of the catalyst improved the performance of the plasma-catalytic processing of toluene, with the highest toluene conversion of 52% and energy efficiency of 2.6 g/kWh when placing the 20 wt% Ni/Al2O3 catalyst in the plasma. The possible reaction pathways in the hybrid plasma-catalytic process were proposed through the combined analysis of both gas and liquid products
Molecular Epidemiology of HIV-1 Subtypes in India: Origin and Evolutionary History of the Predominant Subtype C
This thesis describes the translational genomics of HIV-1subtype C in India from its origin to therapeutic response with the aim to improve our knowledge for better therapeutic and preventive strategies to combat HIV/AIDS. In a systemic approach, we identified the molecular phylogeny of HIV-1 subtypes circulating in India and the time to most recent common ancestors (tMRCA) of predominant HIV-1 subtype C strains. Additionally, this thesis also studied drug resistance mutations in children, adolescents and adults, the role of host factors in evolution of drug resistance, and population dynamics of viremia and viral co-receptor tropism in perinatal transmission. Finally, the long term therapeutic responses on Indian national first-line antiretroviral therapy were also studied.
In Paper I, we reported an increase in the HIV-1 recombinant forms in the HIV-1 epidemiology using a robust subtyping methodology. While the study confirmed HIV- 1 subtype C as a dominant subtype, its origin was dated back to the early 1970s from a single or few genetically related strains from South Africa, whereafter, it has evolved independently. In Paper II, the lethal hypermutations due to the activity of human apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3G (hA3G) was significantly associated with antiretroviral therapy (ART) failure in Indian HIV-1 subtype C patients. The presence of M184I and M230I mutations were observed due to the editing of hA3G in the proviral compartment but stop codons were also found in the open reading frames and the same drug resistance mutations were absent in plasma virus. Therefore, it is unlikely that the viral variants which exhibit hypermutated sequences and M184I and/or M230I will mature and expand in vivo and hence are unlikely to have any clinical significance. The high concordance of drug resistance genotyping in the plasma and proviral compartments in therapy-naĂŻve patients, gives weight to the idea of using whole blood for surveillance of drug resistance mutations which precludes logistic challenges of cold chain transport.
In Papers III and IV, we identified a substantial proportion of HIV-1 subtype C perinatally-infected older children who had a high burden of plasma viremia but also had high CD4+ T-cell counts. In addition, older children with HIV-1 subtype C infection presented a high prevalence of predicted X4 and R5/X4 tropic strains which indicates that HIV-1 subtype C strains required longer duration of infection and greater disease progression to co-receptor transition from R5- to X4-tropic strains (IV). Our studies also indicate that transmitted drug resistance is low among Indian HIV-1 infected children, adolescents (III) and adults (II).
In Paper V, in a longitudinal cohort study, a good long-term response to the Indian national first-line therapy for a median of nearly four years with 2.8% viral failure, indicating the overall success of the Indian ART program. Our study also showed that three immunologically well patients with virological rebound and major viral drug resistance mutations (M184V, K103N and Y181C) during one study visit had undetectable viral load at their next visit. These findings suggest that use of multiple parameters like patientsâ immunological (CD4+ T-cell count), virological (viral load) and drug resistance data should all be used to optimize the treatment switch to second line therapy.
In conclusion, this translational genomics study enhances our knowledge about the HIV-1 subtype C strains circulating in India which are genetically distinct from prototype African subtype C strains. Considerably more research using appropriate models need to be performed to understand the phenotypic and biological characteristics of these strains to guide efficient disease intervention and management strategies
The Elizabeth Casson Memorial lecture 2014: Changing ways; changing times.
This lecture reflects on:
how Rheumatology occupational therapy practice and research has developed in the last 30 years;
self-management in Rheumatology (a personâs ability to manage the symptoms, treatment, physical, and psychosocial consequences and lifestyle changes inherent in living with a chronic condition (Barlow et al 2002) and why or clients may or may not adopt health behaviours
And how therapists might need to change to implement evidence-based practic
Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Analysis of Linked Databases in Wales, Norway and Funen, Denmark
Background: Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP). Methods and Findings: Three population-based EUROCAT congenital anomaly registries- Norway (2004â2010), Wales (2000â2010) and Funen, Denmark (2000â2010)âwere linked to the electronic healthcare databases holding prospectively collected prescription information for all pregnancies in the timeframes available. We included 519,117 deliveries, including foetuses terminated for congenital anomalies, with data covering pregnancy and the preceding quarter, including 462,641 with data covering pregnancy and one year either side. For SSRI exposures 91 days either side of LMP, separately and together, odds ratios with 95% confidence intervals (ORs, 95%CI) for all major anomalies were estimated. We also explored: pausing or discontinuing SSRIs preconception, confounding, high dose regimens, and, in Wales, diagnosis of depression. Results were combined in meta-analyses. SSRI prescription 91 days either side of LMP was associated with increased prevalence of severe congenital heart defects (CHD) (as defined by EUROCAT guide 1.3, 2005) (34/12,962 [0.26%] vs. 865/506,155 [0.17%] OR 1.50, 1.06â2.11), and the composite adverse outcome of 'anomaly or stillbirth' (473/12962, 3.65% vs. 15829/506,155, 3.13%, OR 1.13, 1.03â1.24). The increased prevalence of all major anomalies combined did not reach statistical significance (3.09% [400/12,962] vs. 2.67% [13,536/506,155] OR 1.09, 0.99â1.21). Adjusting for socio-economic status left ORs largely unchanged. The prevalence of anomalies and severe CHD was reduced when SSRI prescriptions were stopped or paused preconception, and increased when >1 prescription was recorded, but differences were not statistically significant. The dose-response relationship between severe CHD and SSRI dose (meta-regression OR 1.49, 1.12â1.97) was consistent with SSRI-exposure related risk. Analyses in Wales suggested no associations between anomalies and diagnosed depression. Conclusion: The additional absolute risk of teratogenesis associated with SSRIs, if causal, is small. However, the high prevalence of SSRI use augments its public health importance, justifying modifications to preconception care
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Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF
M. Kaste on työryhmÀn ROCKET AF Steering Comm jÀsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe
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Measurements of Higgs boson production in the decay channel with a pair of leptons in proton-proton collisions at = 13 TeV
A preprint version of the article is available at arXiv:2204.12957v2 [hep-ex], https://arxiv.org/abs/2204.12957v2 . Comments: Replaced with the published version. Added the journal reference and the DOI. All the figures and tables, including additional supplementary figures and tables, can be found at https://cms-results.web.cern.ch/cms-results/public-results/publications/HIG-19-010 (CMS Public Pages). Report number: CMS-HIG-19-010, CERN-EP-2022-027.Measurements of Higgs boson production, where the Higgs boson decays into a pair of Ï leptons, are presented, using a sample of proton-proton collisions collected with the CMS experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 138 fb^{â1}. Three analyses are presented. Two are targeting Higgs boson production via gluon fusion and vector boson fusion: a neural network based analysis and an analysis based on an event categorization optimized on the ratio of signal over background events. These are complemented by an analysis targeting vector boson associated Higgs boson production. Results are presented in the form of signal strengths relative to the standard model predictions and products of cross sections and branching fraction to Ï leptons, in up to 16 different kinematic regions. For the simultaneous measurements of the neural network based analysis and the analysis targeting vector boson associated Higgs boson production signal strengths are found to be 0.82 ± 0.11 for inclusive Higgs boson production, 0.67 ± 0.19 (0.81 ± 0.17) for the production mainly via gluon fusion (vector boson fusion), and 1.79 ± 0.45 for vector boson associated Higgs boson production.SCOAP3
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Measurements of the Higgs boson production cross section and couplings in the W boson pair decay channel in proton-proton collisions at = 13 TeV
A preprint version of the article is available at arXiv:2206.09466v2 [hep-ex], https://arxiv.org/abs/2206.09466v2 . Comments: Replaced with the published version. Added the journal reference and the DOI. All the figures and tables can be found at httpS://cms-results.web.cern.ch/cms-results/public-results/publications/HIG-20-013 (CMS Public Pages). Report number: CMS-HIG-20-013, CERN-EP-2022-120.Production cross sections of the standard model Higgs boson decaying to a pair of W bosons are measured in proton-proton collisions at a center-of-mass energy of 13 TeV. The analysis targets Higgs bosons produced via gluon fusion, vector boson fusion, and in association with a W or Z boson. Candidate events are required to have at least two charged leptons and moderate missing transverse momentum, targeting events with at least one leptonically decaying W boson originating from the Higgs boson. Results are presented in the form of inclusive and differential cross sections in the simplified template cross section framework, as well as couplings of the Higgs boson to vector bosons and fermions. The data set collected by the CMS detector during 2016-2018 is used, corresponding to an integrated luminosity of 138 fb^â1. The signal strength modifier ÎŒ, defined as the ratio of the observed production rate in a given decay channel to the standard model expectation, is measured to be ÎŒ = 0.95 +0.10â0.09. All results are found to be compatible with the standard model within the uncertainties.SCOAP3
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