Ovarian vein thrombosis in a polytrauma patient

A young mother presented to a Major Trauma Centre (MTC) following a road traffic collision. Her admission computed tomography (CT) traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised c-reactive protein (CRP). CT abdomen one week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries. A multi-disciplinary, consultant-led plan was made to slowly increase enoxaparin to a therapeutic dose under close surveillance and to then switch to warfarin following an outpatient consultation with a consultant haematologist. A magnetic resonance venogram was performed after 3 months of anticoagulation and this demonstrated complete resolution of the OVT and normal appearances of the ovary

Quality of Life is Similar between Long-term Survivors of Indolent and Aggressive Non-Hodgkin Lymphoma

Differences in quality of life (QOL) of long-term survivors of aggressive or indolent subtypes of non-Hodgkin lymphoma (NHL) have not been frequently evaluated. We assessed these differences by analyzing results of a large QOL survey of long-term NHL survivors. We hypothesized that the incurable nature of indolent NHL would relate to worse QOL in long-term survivors while the potentially cured long-term survivors of aggressive lymphoma would have better QOL. We found that QOL was similar between the two groups. Results suggest that patients with indolent NHL are coping well with their disease, yet experience some overall feelings of life threat

Antigen and Thapsigargin Promote Influx of Ca2+ in Rat Basophilic RBL-2H3 Cells by Ostensibly Similar Mechanisms That Allow Filling of Inositol 1,4,5-Trisphosphate-Sensitive and Mitochondrial Ca2+ Stores

In single, Fura 2-loaded RBL-2H3 cells, antigen and thapsigargin depleted the same intracellular pool of Ca2+ in the absence of external Ca2+; provision of external Ca2+ induced immediate increases in levels of free Ca2+ ([Ca2+](i)). These increases were dependent on the presence of external Ca2+ and, presumably, on influx of Ca2+ across the cell membrane. Both stimulants enhanced intracellular accumulation of 45Ca2+ through ostensibly similar mechanisms because accumulation was blocked to similar extents by various multivalent cations or by depolarization with K+. Because thapsigargin blocked reuptake of Ca2+ into inositol 1,4,5-trisphosphate sensitive stores, uptake occurred independently of the refilling of these stores. Uptake was dependent instead on sequestration of 45Ca2+ in a pool of high capacity that was insensitive to thapsigargin, caffeine, GTP and inositol 1,4,5-trisphosphate but sensitive to ionomycin and mitochondrial inhibitors. The existence of an inositol 1,4,5-trisphosphate-insensitive pool was also apparent in permeabilized cells; at 0.1 μM [Ca2+](i), uptake of 45Ca2+ was largely confined (\u3e 80%) to the inositol 1,4,5-trisphosphate-sensitive pool, but at 2 μM [Ca2+](i) uptake was largely (\u3e 60%) into the inositol 1,4,5-trisphosphate-insensitive pool. Provision of mitochondrial inhibitors along with thapsigargin to block uptake into both pools, did not impair the thapsigargin-induced increase in [Ca2+](i) or influx of Ca2+, as indicated by changes in Fura 2 fluorescence, but did block the intracellular accumulation of 45Ca2+. The studies illustrate the utility of simultaneous measurements of [Ca2+](i) and 45Ca2+ uptake for a full accounting of Ca2+ homoeostasis as exemplified by the ability to distinguish between influx and mitochondrial uptake of Ca2+

Radar backscatter measurements from Arctic sea ice during the fall freeze-up

Radar backscatter measurements from sea ice during the fall freeze-up were performed by the United States Coast Guard Icebreaker Polar Star as a part of the International Arctic Ocean Expedition (IAOE'91) from Aug. to Sep. 1991. The U.S. portion of the experiment took place on board the Polar Star and was referred to as TRAPOLEX '91 (Transpolar expedition) by some investigators. Before prematurely aborting its mission because of mechanical failure of her port shaft, the Polar Star reached 84 deg 57 min N latitude at 35 deg E longitude. The ship was in the ice (greater than 50 percent coverage) from 14 Aug. until 3 Sep. and was operational for all but 6 days due to two instances of mechanical problems with the port shaft. The second was fatal to the ship's participation in the expedition. During the expedition, radar backscatter was measured at C-band under a variety of conditions. These included measurements from young ice types as well as from multiyear and first-/second-year sea ice during the fall freeze-up. The sea ice types were determined by measurement of the ice properties at several of the stations and by visual inspection on others. Radar backscatter measurements were performed over a large portion of the ship's transit into the Arctic ice pack. These were accompanied by in situ sea ice property characterization by the U.S. Army Cold Regions Research and Engineering Laboratory (CRREL) at several stations and, when snow was present, its properties were documented by The Microwave Group, Ottawa River (MWG)

Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

Purpose: We evaluated the extent of changes in training practices, recovery, mental health, and sleep patterns of athletes during the early COVID-19 lockdown in a single country-cohort. Methods: A total of 686 athletes (59% male, 41% female; 9% World Class, 28% International, 29% National, 26% State, 8% Recreational) from 50 sports (45% individual, 55% team) in Malaysia completed an online, survey-based questionnaire study. The questions were related to training practices (including recovery and injury), mental health, and sleep patterns. Results: Relative to pre-lockdown, training intensity (−34%), frequency (−20%, except World-Class), and duration (−24%–59%, especially International/World-Class) were compromised, by the mandated lockdown. During the lockdown, more space/access (69%) and equipment (69%) were available for cardiorespiratory training, than technical and strength; and these resources favoured World-Class athletes. Most athletes trained for general strength/health (88%) and muscular endurance (71%); and some used innovative/digital training tools (World-Class 48% vs. lower classification-levels ≤34%). More World-Class, International, and National athletes performed strength training, plyometrics, and sport-specific technical skills with proper equipment, than State/Recreational athletes. More females (42%) sourced training materials from social media than males (29%). Some athletes (38%) performed injury prevention exercises; 18% had mild injuries (knees 29%, ankles 26%), and 18% received a medical diagnosis (International 31%). Lower-level athletes (e.g., State 44%) disclosed that they were mentally more vulnerable; and felt more anxious (36% vs. higher-levels 14%–21%). Sleep quality and quantity were “normal” (49% for both), “improved” (35% and 27%), and only 16% and 14% (respectively) stated “worsened” sleep. Conclusion: Lockdown compromised training-related practices, especially in lower-level athletes. Athletes are in need of assistance with training, and tools to cope with anxiety that should be tailored to individual country requirements during lockdown situations. In particular, goal-driven (even if it is at home) fitness training, psychological, financial, and lifestyle support can be provided to reduce the difficulties associated with lockdowns. Policies and guidelines that facilitate athletes (of all levels) to train regularly during the lockdown should be developed

Sleep and performance during a preseason in elite rugby union athletes

BACKGROUND: Preseason training optimises adaptations in the physical qualities required in rugby union athletes. Sleep can be compromised during periods of intensified training. Therefore, we investigated the relationship between sleep quantity and changes in physical performance over a preseason phase in professional rugby union athletes. METHODS: Twenty-nine professional rugby union athletes (Mean ± SD, age: 23 ± 3 years) had their sleep duration monitored for 3 weeks using wrist actigraphy. Strength and speed were assessed at baseline and at week 3. Aerobic capacity and body composition were assessed at baseline, at week 3 and at week 5. Participants were stratified into 2 groups for analysis: 7 h 30 min sleep per night (HIGH, n = 14). RESULTS: A significant group x time interaction was determined for aerobic capacity (p = 0.02, d = 1.25) at week 3 and for skinfolds at week 3 (p < 0.01, d = 0.58) and at week 5 (p = 0.02, d = 0.92), in favour of the HIGH sleep group. No differences were evident between groups for strength or speed measures (p ≥ 0.05). CONCLUSION: This study highlights that longer sleep duration during the preseason may assist in enhancing physical qualities including aerobic capacity and body composition in elite rugby union athletes

The primary structure of a monoclonal λ-type immunoglobulin L-chain of subgroup II (Bence-Jones protein NEI): Evolutionary origin of antibody variability

ObjectiveThe objective of this study is to assess the gestational age at detection and prevalence of anencephaly in the North of The Netherlands over a 5-year period. MethodsA case list of all cases of anencephaly from two fetal medicine units was compiled. Cases were included if the estimated due date was between 1 August 2008 and 31 July 2013. ResultsOverall prevalence of anencephaly was 5.4 per 10.000 pregnancies (n=110). The majority of cases (69%) was detected before 18 weeks' gestation. Factors determining successful early diagnosis were competence level of the sonographers, with a significantly higher detection rate when scans were performed by a sonographer licensed by the Fetal Medicine Foundation (FMF) for nuchal translucency measurement (p=0.001), and gestational age at or beyond 11weeks of gestation (p=0.024). ConclusionImproving detection of anencephaly in the first trimester requires ultrasound screening at or after 11weeks of gestation, performed by experienced sonographers trained in recognizing fetal anomalies. Sonographers should be instructed that the goal of the first trimester scan is not only to measure nuchal translucency thickness but also to exclude major anomalies. (c) 2015 John Wiley & Sons, Ltd

Long-term remission in multiply relapsed enteropathy-associated T-cell lymphoma following CD30 CAR T-cell therapy

Enteropathy-associated T-cell lymphoma (EATL) is a rare lymphoma arising in the setting of celiac disease. Multiagent anthracycline-based chemotherapy alone is associated with poor long-term outcomes with a median overall survival of only 7 months. In patients who achieve a response to firstline therapy and are eligible for autologous stem cell transplantation (SCT), 5-year median overall survival can be improved to 50% to 60%. Because ~50% of patients with EATL express the CD30 antigen, targeted therapy with brentuximab vedotin has been explored with promising outcomes. We have recently completed a phase 1/2 study showing safety and efficacy of chimeric antigen receptor (CAR)–modified T cells targeting the CD30 molecule (CD30 CAR T cells) in CD301 Hodgkin lymphoma. Here we describe a patient with multiply relapsed EATL after previous allogeneic SCT (allo-SCT) who achieved a durable remission with CD30 CAR T cells

Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training

The purpose of this study was to investigate associations between acute exercise-induced hormone responses and adaptations to high intensity resistance training in a large cohort (n = 56) of young men. Acute post-exercise serum growth hormone (GH), free testosterone (fT), insulin-like growth factor (IGF-1) and cortisol responses were determined following an acute intense leg resistance exercise routine at the midpoint of a 12-week resistance exercise training study. Acute hormonal responses were correlated with gains in lean body mass (LBM), muscle fibre cross-sectional area (CSA) and leg press strength. There were no significant correlations between the exercise-induced elevations (area under the curve—AUC) of GH, fT and IGF-1 and gains in LBM or leg press strength. Significant correlations were found for cortisol, usually assumed to be a hormone indicative of catabolic drive, AUC with change in LBM (r = 0.29, P < 0.05) and type II fibre CSA (r = 0.35, P < 0.01) as well as GH AUC and gain in fibre area (type I: r = 0.36, P = 0.006; type II: r = 0.28, P = 0.04, but not lean mass). No correlations with strength were observed. We report that the acute exercise-induced systemic hormonal responses of cortisol and GH are weakly correlated with resistance training-induced changes in fibre CSA and LBM (cortisol only), but not with changes in strength