Chronic leukaemia

Chronic leukaemia manifests itself into two different types being Chronic Lymphocytic Leukaemia (CLL) and Chronic Myelogenous Leukaemia (AML) depending on the type of leukocyte being affected. CLL is the most common type of leukaemia in adults in contrast to CML which is the rarest type of leukaemia. This study shows the epidemiology and the etiology, such as chromosomal aberrations and gene mutations which include upregulation of Bcl2, mutation of p53, 13q deletion, 11q22-23 deletion, 12q trisomy and 17p deletion for CLL and the fusion of the BCR and ABL genes in CML. It also includes the clinical presentations consisting of both signs and symptoms as well as how these types of leukaemia are diagnosed and their pathophysiology which comprises a detailed description of the alterations in various cellular mechanisms. The treatment involving both chemotherapy and stem cell therapy, amongst others, has also been discussed.peer-reviewe

Electrogenic transport and K(+) ion channel expression by the human endolymphatic sac epithelium.

The endolymphatic sac (ES) is a cystic organ that is a part of the inner ear and is connected to the cochlea and vestibule. The ES is thought to be involved in inner ear ion homeostasis and fluid volume regulation for the maintenance of hearing and balance function. Many ion channels, transporters, and exchangers have been identified in the ES luminal epithelium, mainly in animal studies, but there has been no functional study investigating ion transport using human ES tissue. We designed the first functional experiments on electrogenic transport in human ES and investigated the contribution of K(+) channels in the electrogenic transport, which has been rarely identified, even in animal studies, using electrophysiological/pharmacological and molecular biological methods. As a result, we identified functional and molecular evidence for the essential participation of K(+) channels in the electrogenic transport of human ES epithelium. The identified K(+) channels involved in the electrogenic transport were KCNN2, KCNJ14, KCNK2, and KCNK6, and the K(+) transports via those channels are thought to play an important role in the maintenance of the unique ionic milieu of the inner ear fluid

J Womens Health (Larchmt)

Substance use during pregnancy increases risk for a wide range of adverse maternal and neonatal health outcomes. Polysubstance use is common among people who use substances during pregnancy; however, the risks of combined substance exposures during pregnancy are poorly understood. In this report, we provide an overview of the activities of the Centers for Disease Control and Prevention (CDC) and partners and identified gaps related to (1) surveillance, (2) routine screening, and (3) prevention of polysubstance use during pregnancy. Efforts by CDC and other partners to reduce polysubstance use during pregnancy can improve the health of pregnant people and their infants and children.CC999999/ImCDC/Intramural CDC HHSUnited States

Testing of pear trees on their own roots in comparison with important used rootstocks under organic farming conditions with special regard to fire blight (E. amylovora)

Pear trees on their own roots are tested in comparison to grafted trees in growth and yield characteristics and with special regard to the tolerance to diseases, above all fire blight (Erwinia amylovora). In spring 2004 15 randomized trees of the cultivar 'Williams' from three variants (self rooted in vitro, self rooted long cuttings, grafted on Quince A) were planted in a pear orchard, which was heavily infected with fire blight (Erwinia amylovora) the previous years. The trees were left untreated. Growth and yield characteristics, plant diseases and tree losses were observed. After four years the in vitro self rooted trees were significantly more vigorous in growth than those grafted on quince A. The self rooted long cuttings were comparable in growth with grafts on quince, but showed high tree losses probably due to frost damages in the first winter one year after planting. However no infections with Erwinia amylovora could be observed so far. In a field trial with more cultivars and rootstock variants planted in 2006 at two organically managed sites more significant effects are expected in the next years

Sensitivity, specificity, and diagnostic accuracy of WHO 2013 criteria for diagnosis of gestational diabetes mellitus in low risk early pregnancies: international, prospective, multicentre cohort study

Objective: To evaluate the predictability of gestational diabetes mellitus wth a 75 g oral glucose tolerance test (OGTT) in early pregnancy, based on the 2013 criteria of the World Health Organization, and to test newly proposed cut-off values. Design: International, prospective, multicentre cohort study.SettingSix university or cantonal departments in Austria, Germany, and Switzerland, from 1 May 2016 to 31 January 2019.ParticipantsLow risk cohort of 829 participants aged 18-45 years with singleton pregnancies attending first trimester screening and consenting to have an early 75 g OGTT at 12-15 weeks of gestation. Participants and healthcare providers were blinded to the results. Main outcome measures: Fasting, one hour, and two hour plasma glucose concentrations after an early 75 g OGTT (12-15 weeks of gestation) and a late 75 g OGTT (24-28 weeks of gestation). Results: Of 636 participants, 74 (12%) developed gestational diabetes mellitus, according to World Health Organization 2013 criteria, at 24-28 weeks of gestation. Applying WHO 2013 criteria to the early OGTT with at least one abnormal value gave a low sensitivity of 0.35 (95% confidence interval 0.24 to 0.47), high specificity of 0.96 (0.95 to 0.98), positive predictive value of 0.57 (0.41 to 0.71), negative predictive value of 0.92 (0.89 to 0.94), positive likelihood ratio of 10.46 (6.21 to 17.63), negative likelihood ratio of 0.65 (0.55 to 0.78), and diagnostic odds ratio of 15.98 (8.38 to 30.47). Lowering the postload glucose values (75 g OGTT cut-off values of 5.1, 8.9, and 7.8 mmol/L) improved the detection rate (53%, 95% confidence interval 41% to 64%) and negative predictive value (0.94, 0.91 to 0.95), but decreased the specificity (0.91, 0.88 to 0.93) and positive predictive value (0.42, 0.32 to 0.53) at a false positive rate of 9% (positive likelihood ratio 5.59, 4.0 to 7.81; negative likelihood ratio 0.64, 0.52 to 0.77; and diagnostic odds ratio 10.07, 6.26 to 18.31). Conclusions: The results of this prospective low risk cohort study indicated that the 75 g OGTT as a screening tool in early pregnancy is not sensitive enough when applying WHO 2013 criteria. Postload glucose values were higher in early pregnancy complicated by diabetes in pregnancy. Lowering the postload cut-off values identified a high risk group for later development of gestational diabetes mellitus or those who might benefit from earlier treatment. Results from randomised controlled trials showing a beneficial effect of early intervention are unclear. Trial registrationClinicalTrials.govNCT02035059

High-density mapping reveals short-term reversibility of atrial ablation lesions

Cardiac arrhythmias such as atrial fibrillation occur frequently in industrialized countries. Radiofrequency ablation (RFA) is a standard treatment if drug therapy fails. This minimally invasive surgery aims at stabilizing the heart rhythm on a permanent basis. However, the procedure commonly needs to be repeated because of the high recurrence rate of arrhythmias. Non-transmural lesions as well as gaps within linear lesions are among the main problems during the RFA. The assessment of lesion formation is not adequate in state of the art procedures. Therefore, the aim of this study is to investigate the short-term reversibility of lesions using human electrograms recorded by a high-density mapping system during an electrophysiological study (EPS). A predefined measurement protocol was executed during the EPS in order to create three ablation points in the left atrium. Subsequently, after preprocessing the recorded signals, electrogram (EGM) paths were formed along the endocardial surface of the atrium. By analyzing changes of peak to peak amplitudes of unipolar EGMs before and after ablation, it was possible to distinguish lesion area and healthy myocardium. The peak to peak amplitudes of the EGMs decreased by 40-61% after 30 seconds of ablation. Furthermore, we analyzed the morphological changes of EGMs surrounding the lesion. High-density mapping data showed that not only the tissue, which had direct contact with the catheter tip during the RFA, but also the surrounding tissue was affected. This was demonstrated by low peak to peak amplitudes in large areas with a width of 14 mm around the center of the ablation lesion. After right pulmonary vein isolation, high-density mapping was repeated on the previous lesions. The outer region of RFA-treated tissue appears to recover as opposed to the central core of the ablation point. This observation suggests that the meaningfulness of an immediate remap after ablation during an EPS may lead the physician to false conclusions

Wertschöpfung durch Unternehmenskommunikation - Evaluation der Erfolgswirkung durch Kommunikations-Controlling

Die Unternehmenskommunikation stellt längst keine reine Marketingfunktion mehr dar, sondern hat sich als strategischer Erfolgsfaktor im unternehmerischen Wertschöpfungsprozess bestätigt und folglich als Kernaufgabe der Unternehmensführung etabliert. Die vorliegende Ausarbeitung beleuchtet die zunehmende Bedeutung der Unternehmenskommunikation in der Unternehmenspraxis sowie ihren Beitrag zum Unternehmenserfolg und zeichnet nach, welchen hohen Stellenwert die interne und externe Unternehmenskommunikation inzwischen europaweit gewonnen hat. Angesichts der zunehmenden strategischen Bedeutung von Unternehmenskommunikation ist eine adäquate Evaluation ihrer Maßnahmen unerlässlich, um eine effiziente und effektive Planung, Steuerung und Kontrolle sämtlicher kommunikativer Anstrengungen im Unternehmen gewährleisten zu können. Diese Unterstützungs- und Steuerungsfunktion kommt der noch jungen Disziplin des Kommunikations-Controllings zu, das in seinen Grundzügen in der vorliegenden Publikation dargestellt wird. Um den Erfolg der Kommunikationsmaßnahmen diagnostizieren zu können und zu verstehen, wie die Unternehmenskommunikation wirkt, wird hierbei das sogenannte Wirkungsstufenmodell angewandt, das im engen fachlichen Austausch zwischen Wissenschaftsvertretern und Praxisexperten entwickelt wurde.Corporate Communication represents no longer a random function but is a strategic factor of success in a company. It is a valuable resource and becomes increasingly significant regarding the business success of a company. This discussion paper deals with the importance of corporate communication and its contribution to the corporate success to clarify the relevance of the internal and external communication of a company. Furthermore, the communication evaluation and measurement is a support and allocative function for corporate communication and able to diagnose and to understand the success of communication measures, thereby the effect level model is used