Cancer patients’ experiences of living with venous thromboembolism: A systematic review and qualitative thematic synthesis

Background: Cancer-Associated thrombosis is common. Recommended treatment is daily injected low-molecular-weight heparin for 6months. Most studies focus on prophylaxis and treatment; few have explored patients’ experience. Aims To identify and synthesise the available literature concerning patients’ experience of cancer associated thrombosis. Design Systematic literature review and qualitative thematic synthesis. MethodsMEDLINE, Embase, CINAHL, PsychINFO (until 10/2016; limited to English) were searched. Eligible papers were qualitative studies of adult patients’ experience of cancer-associated thrombosis. Two researchers screened titles/abstracts/papers against inclusion criteria with recourse to a third for disagreements. Critical Appraisal Skills Programme qualitative checklist tool was used for quality appraisal. Results1397 articles were identified. Five qualitative studies (total n=92; age range 32 to 84 years) met the inclusion criteria. Participants had various cancer types. Most had advanced disease and were receiving palliative care. Four major themes emerged from the data: knowledge deficit (patients and clinicians); effects of cancer associated thrombosis (physical and psychological); effects of anticoagulation; coping strategies. ConclusionThe cancer journey is difficult in itself, but thrombosis was an additional, frightening and unexpected burden. Although the association between cancer and thromboembolism is well known, cancer patients are not educated routinely about the risk or warning symptoms/signs of thromboembolism which may otherwise be misattributed to the cancer by patient and clinician alike. This systematic review highlights the impact of cancer-associated thrombosis on the lives of cancer patients, and calls for education for patients and clinicians to be part of routine care, and further work to address this patient priority

Global Properties of Neutral Hydrogen in Compact Groups

Compact groups of galaxies provide a unique environment to study the evolution of galaxies amid frequent gravitational encounters. These nearby groups have conditions similar to those in the earlier universe when galaxies were assembled and give us the opportunity to witness hierarchical formation in progress. To understand how the compact group environment affects galaxy evolution, we examine the gas and dust in these groups. We present new single-dish GBT neutral hydrogen (HI) observations of 30 compact groups and define a new way to quantify the group HI content as the HI-to-stellar mass ratio of the group as a whole. We compare the HI content with mid-IR indicators of star formation and optical [g-r] color to search for correlations between group gas content and star formation activity of individual group members. Quiescent galaxies tend to live in HI-poor groups, and galaxies with active star formation are more commonly found in HI-rich groups. Intriguingly, we also find "rogue" galaxies whose star formation does not correlate with group HI content. In particular, we identify three galaxies (NGC 2968 in RSCG 34, KUG 1131+202A in RSCG 42, and NGC 4613 in RSCG 64) whose mid-IR activity is discrepant with the HI. We speculate that this mismatch between mid-IR activity and HI content is a consequence of strong interactions in this environment that can strip HI from galaxies and abruptly affect star-formation. Ultimately, characterizing how and on what timescales the gas is processed in compact groups will help us understand the interstellar medium in complex, dense environments similar to the earlier Universe.Comment: Accepted to A

Some Like It Hot: Linking Diffuse X-ray Luminosity, Baryonic Mass, and Star Formation Rate in Compact Groups of Galaxies

We present an analysis of the diffuse X-ray emission in 19 compact groups of galaxies (CGs) observed with Chandra. The hottest, most X-ray luminous CGs agree well with the galaxy cluster X-ray scaling relations in $L_X-T$ and $L_X-\sigma$, even in CGs where the hot gas is associated with only the brightest galaxy. Using Spitzer photometry, we compute stellar masses and classify HCGs 19, 22, 40, and 42 and RSCGs 32, 44, and 86 as fossil groups using a new definition for fossil systems that includes a broader range of masses. We find that CGs with total stellar and HI masses $\gtrsim10^{11.3}$ M$_\odot$ are often X-ray luminous, while lower-mass CGs only sometimes exhibit faint, localized X-ray emission. Additionally, we compare the diffuse X-ray luminosity against both the total UV and 24 $\mu$m star formation rates of each CG and optical colors of the most massive galaxy in each of the CGs. The most X-ray luminous CGs have the lowest star formation rates, likely because there is no cold gas available for star formation, either because the majority of the baryons in these CGs are in stars or the X-ray halo, or due to gas stripping from the galaxies in CGs with hot halos. Finally, the optical colors that trace recent star formation histories of the most massive group galaxies do not correlate with the X-ray luminosities of the CGs, indicating that perhaps the current state of the X-ray halos is independent of the recent history of stellar mass assembly in the most massive galaxies.Comment: 20 pages, 7 figures, accepted for publication in Ap

Progression of autosomal-dominant polycystic kidney disease in children1

Progression of autosomal-dominant polycystic kidney disease in children.BackgroundAlthough many case reports describe manifestations of autosomal-dominant polycystic kidney disease (ADPKD) in children, no longitudinal studies have examined the natural progression or risk factors for more rapid progression in a large number of children from ADPKD families.MethodsSince 1985, we have studied 312 children from 131 families with a history, a physical examination, blood and urine chemistries, an abdominal ultrasonography, and gene linkage analysis. One hundred fifteen of 185 affected children were studied multiple times for up to 15 years. Renal volumes were determined by ultrasound imaging. Graphs of mean renal volumes according to age were compared between affected and unaffected children, ADPKD children with and without early severe disease, and children with and without high blood pressure.ResultsAffected children had faster renal growth than unaffected children. ADPKD children with severe renal enlargement at a young age continued to experience faster renal growth than those with mild enlargement or normal kidney size for their age, and affected children with high blood pressure had faster renal growth than those with lower blood pressure. Glomerular filtration rate did not decrease in any children except for two with unusually severe early onset disease.ConclusionsThe progression of ADPKD clearly occurs in childhood and manifests as an increase in cyst number and renal size. This study identifies children at risk for rapid renal enlargement who may benefit the most from future therapeutic interventions

Grasslands, Rangelands, Pastoralists – What Do We Mean?

The terms grasslands and rangelands are often confused, but the terms used to describe the people who live and manage these areas are even more confusing. The myriad of words used about these people includes: pastoralists, farmers, ranchers, herders, transhumants, indigenous peoples, nomads, graziers, gauchos. The terms used vary across the world, and meanings vary across time and space. One definition of pastoralists is “livestock-keepers who specialise in taking advantage of variability, managing grazing itineraries at a variety of scales so that livestock feed better than without a herder” (Krätli 2019). The United Nations Decade of Family Farming defines farmers as “people who own or operate an agricultural enterprise, either commercially or to sustain their families”. “Family farmers” include peasants, indigenous peoples, traditional communities, fisherfolk, mountain farmers, forest users and pastoralists (FAO & IFAD 2019). Excellent glossaries on rangelands and grasslands have been developed by the Society for Range Management (SRM), the International Grassland Congress (IGC) and the International Rangeland Congress (IRC). More recently, another group of scientists developed a complementary glossary of socio-institutional and political terms, the “people” terms. This glossary includes terms for the people who live and manage rangelands, including pastoralists, farmers, ranchers and many others. Also included are terms about the mobility of animals and people, e.g. transhumance, as well as land tenure, property and ownership, land rights, changes in rights to land, and land management and governance. This glossary has a Western focus, even though definitions take terms from various parts of the world into consideration. At this stage, terms are defined only in English, but it is hoped that they will be translated into other languages, and also that more terms will be added that are specific to certain regions of the world

The Infrared Properties of Hickson Compact Groups

Compact groups of galaxies provide a unique environment to study the mechanisms by which star formation occurs amid continuous gravitational encounters. We present 2MASS (JHK), Spitzer IRAC (3.5-8 micron) and MIPS (24 micron) observations of a sample of twelve Hickson Compact Groups (HCGs 2, 7, 16, 19, 22, 31, 42, 48, 59, 61, 62, and 90) that includes a total of 45 galaxies. The near-infrared colors of the sample galaxies are largely consistent with being dominated by slightly reddened normal stellar populations. Galaxies that have the most significant PAH and/or hot dust emission (as inferred from excess 8 micron flux) also tend to have larger amounts of extinction and/or K-band excess and stronger 24 micron emission, all of which suggest ongoing star formation activity. We separate the twelve HCGs in our sample into three types based on the ratio of the group HI mass to dynamical mass. We find evidence that galaxies in the most gas-rich groups tend to be the most actively star forming. Galaxies in the most gas-poor groups tend to be tightly clustered around a narrow range in colors consistent with the integrated light from a normal stellar population. We interpret these trends as indicating that galaxies in gas-rich groups experience star formation and/or nuclear actively until their neutral gas consumed, stripped, or ionized. The galaxies in this sample exhibit a ``gap'' between gas-rich and gas-poor groups in infrared color space that is sparsely populated and not seen in the Spitzer First Look Survey sample. This gap may suggest a rapid evolution of galaxy properties in response to dynamical effects. These results suggest that the global properties of the groups and the local properties of the galaxies are connected.Comment: 34 pages, 26 figures, accepted for publication in AJ, higher quality images available in publicatio

Genotypic and phenotypic characterization of antimicrobial resistance in Neisseria gonorrhoeae: A cross-sectional study of isolates recovered from routine urine cultures in a high-incidence setting

ABSTRACT The objectives of this study were to perform genomic and phenotypic characterization of antimicrobial resistance in Neisseria gonorrhoeae isolates recovered from urine samples from patients in St. Louis, MO, USA. Sixty-four clinical isolates were banked over a 2-year period and subjected to antimicrobial susceptibility testing (AST) by Kirby-Bauer disk diffusion (penicillin, tetracycline, cefuroxime, and ciprofloxacin) and gradient diffusion (tetracycline, doxycycline, azithromycin, ceftriaxone, cefixime, ciprofloxacin, gemifloxacin, and delafloxacin). The medical records for the patients were evaluated to determine the demographics, location, and prescribed treatment regimen. Isolate draft genomes were assembled from Illumina shotgun sequencing data, and resistance determinants were identified by ResFinder and PointFinder. Of the 64 isolates, 97% were nonsusceptible to penicillin, with resistant isolates all containing the blaTEM-1b gene; 78 and 81% of isolates were nonsusceptible to tetracycline and doxycycline, respectively, with resistant isolates all containing the tet(M) gene. One isolate was classified as non-wild-type to azithromycin, and all isolates were susceptible to ceftriaxone; 89% of patients received this combination of drugs as first-line therapy. Six percent of isolates were resistant to ciprofloxacin, with most resistant isolates containing multiple gyrA and parC mutations. Correlation between disk and gradient diffusion AST devices was high for tetracycline and ciprofloxacin (R2 > 99% for both). The rates of N. gonorrhoeae antibiotic resistance in St. Louis are comparable to current rates reported nationally, except ciprofloxacin resistance was less common in our cohort. Strong associations between specific genetic markers and phenotypic susceptibility testing hold promise for the utility of genotype-based diagnostic assays to guide directed antibiotic therapy. IMPORTANCE Neisseria gonorrhoeae causes the sexually transmitted infection gonorrhea, which is most commonly diagnosed using a DNA-based detection method that does not require growth and isolation of N. gonorrhoeae in the laboratory. This is problematic because the rates of antibiotic resistance in N. gonorrhoeae are increasing, but without isolating the organism in the clinical laboratory, antibiotic susceptibility testing cannot be performed on strains recovered from clinical specimens. We observed an increase in the frequency of urine cultures growing N. gonorrhoeae after we implemented a total laboratory automation system for culture in our clinical laboratory. Here, we report on the rates of resistance to multiple historically used, first-line, and potential future-use antibiotics for 64 N. gonorrhoeae isolates. We found that the rates of antibiotic resistance in our isolates were comparable to national rates. Additionally, resistance to specific antibiotics correlated closely with the presence of genetic resistance genes, suggesting that DNA-based tests could also be designed to guide antibiotic therapy for treating gonorrhea

Renal structure and hypertension in autosomal dominant polycystic kidney disease

Renal structure and hypertension in autosomal dominant polycystic kidney disease. Hypertension has been reported to occur in 50 to 75 percent of subjects with autosomal dominant polycystic kidney disease (ADPKD) prior to the onset of marked renal insufficiency but concurrent with cystic deformation of the renal parenchyma. The present study was undertaken to examine whether the renal structural abnormalities are greater in hypertensive (HBP) versus normotensive (NBP) male and female patients with ADPKD who were matched within gender groups for age, body surface area, serum creatinine concentration (males HBP 1.2 ± 0.02 vs. NBP 1.1 ± 0.03 mg/dl, NS; females HBP 0.9 ± 0.03 vs. NBP 0.9 ± 0.02 mg/dl, NS) and creatinine clearance (males HBP 100 ± 3 vs. NBP 108 ± 3 ml/min/1.73 m2, NS; females HBP 97 ± 3 vs. NBP 96 ± 2 ml/min/1.73 m2, NS). Renal volume was significantly greater in the HBP compared to the NBP group (males HBP 624 ± 47 vs. NBP 390 ± 43 cm3, P < 0.0005; females HBP 466 ± 32 vs. NBP 338 ± 24 cm3, P < 0.002). Since increased renal volume is due to increased cysts, the results indicate that the early high incidence of hypertension in ADPKD correlates with the renal structural abnormalities in this disorder