Recombinant prolylcarboxypeptidase activates plasma prekallikrein

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106127/1/jth03969.pd

Mapping the interaction between uPAR and high molecular weight kininogen

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106070/1/jth03972.pd

Comparison of facilitated tucking and oral dextrose in reducing the pain of heel stick in preterm infants: A randomized clinical trial

Background: With the increase in hospitalization of premature infants in emergency departments and the painful procedure in these sectors, appropriate methods of pain relief are required. This study aimed to compare the effect of oral dextrose and facilitated tucking in the reduction of pain during heel sticks in premature infants and assess their effectiveness and feasibility for use in emergency settings. Methods: This study was a randomized controlled clinical trial with cross-over design. Sixty infants were recruited from a Neonatal Intensive Care Unit (NICU) at Valiasr hospital in Tehran, Iran from March 2015 to September 2016. They were randomly allocated into three groups (no pain relief method, oral dextrose and facilitated tucking). Six blood samples were collected by heel stick for each infant. Oral dextrose and facilitated tucking were compared with the routine method of blood sampling and pain was measured two times for each method. The pain scores was measured by the Premature Infant Pain Profile (PIPP). Repeated Measure ANOVA, ANOVA and Scheffe post-hoc test were used with SPSS 16. Results: The pain score's increase during heel stick was significantly lower after using oral dextrose (3.58 ± 0.34) and facilitated tucking (5.58 ± 0.53) in comparison to the routine method (8.91 ± 0.18) of blood sampling (P < 0.001, η2 = 0.971). Oral dextrose was more effective than facilitated tucking (P < 0.001, Cohen's d = 4.49). The emergency nurses rated oral dextrose as easier (t = 2.20, df = 118, p = 0.02, Cohen's d = 0.39) and more applicable method (t = 2.99, df = 118, p = 0.003, Cohen's d = 0.54) for the emergency department. Conclusions: Facilitated tucking is an effective method of pain reduction which can be used in the absence of oral dextrose, in a situation in which it is contraindicated or in combination with oral dextrose. Based on the increase of infant's admission in emergency department future studies are needed to identify the best method of pain reduction for procedures in this setting. Trial registration: Current Controlled Trials IRCT201408029568N9, 2014-09-08. © 2020 The Author(s)

Concomitant Carcinoma in situ in Cystectomy Specimens Is Not Associated with Clinical Outcomes after Surgery

Objective: The aim of this study was to externally validate the prognostic value of concomitant urothelial carcinoma in situ (CIS) in radical cystectomy (RC) specimens using a large international cohort of bladder cancer patients. Methods: The records of 3,973 patients treated with RC and bilateral lymphadenectomy for urothelial carcinoma of the bladder (UCB) at nine centers worldwide were reviewed. Surgical specimens were evaluated by a genitourinary pathologist at each center. Uni- and multivariable Cox regression models addressed time to recurrence and cancer-specific mortality after RC. Results: 1,741 (43.8%) patients had concomitant CIS in their RC specimens. Concomitant CIS was more common in organ-confined UCB and was associated with lymphovascular invasion (p < 0.001). Concomitant CIS was not associated with either disease recurrence or cancer-specific death regardless of pathologic stage. The presence of concomitant CIS did not improve the predictive accuracy of standard predictors for either disease recurrence or cancer-specific death in any of the subgroups. Conclusions: We could not confirm the prognostic value of concomitant CIS in RC specimens. This, together with the discrepancy between pathologists in determining the presence of concomitant CIS at the morphologic level, limits the clinical utility of concomitant CIS in RC specimens for clinical decision-making. Copyright (C) 2011 S. Karger AG, Base

Differences in the rate of lymph node invasion in men with clinically localized prostate cancer might be related to the continent of origin

OBJECTIVETo test whether the rate of lymph node invasion (LNI) differs between patients treated with radical prostatectomy (RP) at a European or a North American centre.PATIENTS AND METHODSIn all, 1385 men had RP with bilateral lymphadenectomy for clinically localized prostate cancer (587 from Dallas, Texas and 798 from Milan, Italy). Univariate and multivariate analyses focused on the association between the continent of origin and the rate of LNI, after controlling for prostate‐specific antigen (PSA) level, clinical stage, biopsy Gleason sum and the number of examined and removed lymph nodes.RESULTSEuropean men had higher PSA levels (9.1 vs 7.8 ng/mL), a higher proportion of palpable cancers (44.5 vs 32.8%), more nodes removed (mean 14.9 vs 7.8) and a higher rate of LNI (9.0% vs 1.2%; all differences P < 0.001). In multivariate analyses that controlled for PSA level and clinical variables, European men had an 8.9‐fold higher risk of LNI (P < 0.001) than their counterparts from the USA. Among preoperative variables, the continent of origin was the third most informative predictor of LNI (67.5%), after biopsy Gleason sum (74.3%) and the number of examined lymph nodes (71.0%), and improved the ability to predict LNI by 4.7%.CONCLUSIONMen treated at a European centre had a 7.3–8.9‐fold higher rate of LNI, despite adjusting for all clinical and pathological variables. It remains to be shown what predisposes European men to a higher rate of LNI

4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study.

PURPOSE: Advanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectively evaluated dynamic contrast-enhanced computed tomography (DCE-CT) for the detection of prostate cancer lesions in the peripheral zone (PZ) using qualitative and quantitative image analysis compared to multiparametric magnet resonance imaging (mpMRI) of the prostate. METHODS: With local ethics committee approval, 14 patients (mean age, 67 years; range, 57-78 years; PSA, mean 8.1 ng/ml; range, 3.5-26.0) underwent DCE-CT, as well as mpMRI of the prostate, including standard T2, diffusion-weighted imaging (DWI), and DCE-MRI sequences followed by transrectal in-bore MRI-guided prostate biopsy. Maximum intensity projections (MIP) and DCE-CT perfusion parameters (CTP) were compared between healthy and malignant tissue. Two radiologists independently rated image quality and the tumor lesion delineation quality of PCa using a five-point ordinal scale. MIP and CTP were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/area under the curve (AUC) analysis. RESULTS: The PCa detection rate ranged between 57 to 79% for the two readers for DCE-CT and was 92% for DCE-MRI. DCE-CT perfusion parameters in PCa tissue in the PZ were significantly different compared to regular prostate tissue and benign lesions. Image quality and lesion visibility were comparable between DCE-CT and DCE-MRI (VGC: AUC 0.612 and 0.651, p>0.05). CONCLUSION: Our preliminary results suggest that it is feasible to use DCE-CT for identification and visualization, and subsequent segmentation for focal radiotherapy approaches to PCa

Growth and development status in the first two years of uninfected children born from HIV positive mothers

Recently prevention of HIV transmission from mother to child by antiretroviral regimens has resulted in growing the numbers of HIV exposed but uninfected children (HIV-EU). The aim of present study was evaluation of growth and neurodevelopment status among less than 2-year-old HIV exposed uninfected children. A cohort study was carried out at Vali-e-Asr Hospital (Tehran-Iran). Thirty-nine HIV-EU neonates were recruited (2014 to 2016). Neonates and infants with concern to growth and neurodevelopment status were evaluated at 6, 12, 18, and 24 months by an expert physician. Neurodevelopment assessment was based on WHO Milestones Chart and Age and Stage Questionnaire. Of all children, 22 were male, and 17 were female. Regarding growth indices, although mean birth weight in half of the neonates was lower than normal population; no postnatal descending trend was observed in their growth chart. No significant differences were found between two groups' height and head circumference. Among the neurodevelopmental parameters measured, in 6th months of life, 2 cases had abnormality in the gross motor while at 12 months, 6 cases had delay in language, social problem, and motor disorders. At 18 and 24 months, 7 infants showed developmental problems of which 71.4 of their mothers were younger than others (age&lt;25 years, P=0.009). Prevalence of neurodevelopmental disorders including delay in language, motor, and social domains was common among HIV-EU children. As several environmental factors may involve the etiology of neurodevelopmental disorders, nearly-full postnatal control and prevention seem necessary. © 2018 Tehran University of Medical Sciences. All rights reserved

Growth and development status in the first two years of uninfected children born from HIV positive mothers

Recently prevention of HIV transmission from mother to child by antiretroviral regimens has resulted in growing the numbers of HIV exposed but uninfected children (HIV-EU). The aim of present study was evaluation of growth and neurodevelopment status among less than 2-year-old HIV exposed uninfected children. A cohort study was carried out at Vali-e-Asr Hospital (Tehran-Iran). Thirty-nine HIV-EU neonates were recruited (2014 to 2016). Neonates and infants with concern to growth and neurodevelopment status were evaluated at 6, 12, 18, and 24 months by an expert physician. Neurodevelopment assessment was based on WHO Milestones Chart and Age and Stage Questionnaire. Of all children, 22 were male, and 17 were female. Regarding growth indices, although mean birth weight in half of the neonates was lower than normal population; no postnatal descending trend was observed in their growth chart. No significant differences were found between two groups' height and head circumference. Among the neurodevelopmental parameters measured, in 6th months of life, 2 cases had abnormality in the gross motor while at 12 months, 6 cases had delay in language, social problem, and motor disorders. At 18 and 24 months, 7 infants showed developmental problems of which 71.4 of their mothers were younger than others (age&lt;25 years, P=0.009). Prevalence of neurodevelopmental disorders including delay in language, motor, and social domains was common among HIV-EU children. As several environmental factors may involve the etiology of neurodevelopmental disorders, nearly-full postnatal control and prevention seem necessary. © 2018 Tehran University of Medical Sciences. All rights reserved