Renal Cortical Transit time as a predictor for pyeloplasty in paediatric patients with unilateral hydronephrosis at the Red Cross War Memorial Children's Hospital

Background: Majority of patients with unilateral hydronephrosis (HN) detected on ultrasound (US) do not require pyeloplasty. Indications for pyeloplasty are in patients with symptomatic obstruction (recurrent flank pain), complications such as urinary tract infection, a drop in differential renal function (DRF) of more than 10% and a progressive increase in the anterior posterior diameter (APD) in subsequent studies. Schlotmann et al, Piepsz et al and Harper et al have demonstrated the measurement of the cortical transit time (CTT) to predict the need for patient who may require pyeloplasty. Objectives: To assess if the CTT would have predicted a drop in DRF in patients with unilateral HN on the affected side. In addition to assess whether the CTT would differ on the first renogram between those patients who had a pyeloplasty and those who did not have a pyeloplasty at the Red Cross War Memorial Children’s Hospital (RCWMCH). Methods: Sixty eight (68) patients with at least two renograms with unilateral HN with a normal contralateral kidney were observed retrospectively between December 2000 and May 2015. The CTT was recorded for the upper, middle and lower third of each kidney and the mean used as the CTT of the kidney. Each renogram was processed three times to measure the DRF using the Rutland Patlak and Integral methods. The mean of the three DRF measurements was used for analysis. Results: The mean CTT of the left and right hydronephrotic kidneys were 6.0minutes and 6.7minutes respectively. A significant relationship was demonstrated in the CTT and DRF as well as CTT and APD in the first renogram of those patients who did not have a pyeloplasty (p < 0.05). There was no difference between the DRF of the first and second renograms in those patients who did not have a pyeloplasty. In the 20 patients who had a pyeloplasty, there was a drop of more than 10% in the DRF of 3 patients. No difference was seen in the DRF or in the CTT between the first and second renogram. The CTT was shorter in the second renogram in 9 of the 20 patients who had a pyeloplasty. No significant difference was found in the CTT or DRF when comparing the group who had surgery against the group who did not have surgery. Conclusion: The current study was unable to demonstrate in our series of patients that CTT can predict those patients who would require pyeloplasty. This may be owing to the retrospective nature of the study and the reliance on the clinical notes for the US data and surgical notes. In future, a prospective study evaluating the relationship between CTT and a drop in the DRF should be undertaken in this unit

Differences in Tumour Aggressiveness Based on Molecular Subtype and Race Measured by [18F]FDG PET Metabolic Metrics in Patients with Invasive Carcinoma of the Breast

Breast cancer in women of African descent tends to be more aggressive with poorer prognosis. This is irrespective of the molecular subtype. [18F]FDG PET/CT metrics correlate with breast cancer aggressiveness based on molecular subtype. This study investigated the differences in [18F]FDG PET/CT metrics of locally advanced invasive ductal carcinoma (IDC) among different racial groups and molecular subtypes. Qualitative and semiquantitative readings of [18F]FDG PET/CT acquired in women with locally advanced IDC were performed. Biodata including self-identified racial grouping and histopathological data of the primary breast cancer were retrieved. Statistical analysis for differences in SUVmax, MTV and TLG of the primary tumour and the presence of regional and distant metastases was conducted based on molecular subtype and race. The primary tumour SUVmax, MTV, TLG and the prevalence of distant metastases were significantly higher in Black patients compared with other races (p &lt; 0.05). The primary tumour SUVmax and presence of distant metastases in the luminal subtype and the primary tumour SUVmax and TLG in the basal subtype were significantly higher in Black patients compared with other races (p &lt; 0.05). The significantly higher PET parameters in Black patients with IDC in general and in those with luminal and basal carcinoma subtypes suggest a more aggressive disease phenotype in this race

Tuberculosis : role of nuclear medicine and molecular imaging with potential impact of neutrophil-specific tracers

With Tuberculosis (TB) affecting millions of people worldwide, novel imaging modalities and tools, particularly nuclear medicine and molecular imaging, have grown with greater interest to assess the biology of the tuberculous granuloma and evolution thereof. Much early work has been performed at the pre-clinical level using gamma single photon emission computed tomography (SPECT) agents exploiting certain characteristics of Mycobacterium tuberculosis (MTb). Both antituberculous SPECT and positron emission tomography (PET) agents have been utilised to characteriseMTb. Other PET tracers have been utilised to help to characterise the biology of MTb (including Gallium-68-labelled radiopharmaceuticals). Of all the tracers, 2-[18F]FDG has been studied extensively over the last two decades in many aspects of the treatment paradigm of TB: at diagnosis, staging, response assessment, restaging, and in potentially predicting the outcome of patients with latent TB infection. Its lower specificity in being able to distinguish different inflammatory cell types in the granuloma has garnered interest in reviewing more specific agents that can portend prognostic implications in the management of MTb. With the neutrophil being a cell type that portends this poorer prognosis, imaging this cell type may be able to answer more accurately questions relating to the tuberculous granuloma transmissivity and may help in characterising patients who may be at risk of developing active TB. The formyl peptide receptor 1(FPR1) expressed by neutrophils is a key marker in this process and is a potential target to characterise these areas. The pre-clinical work regarding the role of radiolabelled N-cinnamoyl –F-(D) L – F – (D) –L F (cFLFLF) (which is an antagonist for FPR1) using Technetium 99m-labelled conjugates and more recently radiolabelled with Gallium-68 and Copper 64 is discussed. It is the hope that further work with this tracer may accelerate its potential to be utilised in responding to many of the current diagnostic dilemmas and challenges in TB management, thereby making the tracer a translatable option in routine clinical care.The Wellcome Trust, Bill and Melinda Gates Foundation and SA Medical Research Council (SAMRC) with funding from the SA Department of Health.https://www.frontiersin.org/journals/medicine#am2022Nuclear Medicin

Percepción de la gestión administrativa y el nivel de satisfacción de los estudiantes respecto al uso del aula de innovación pedagógica en la institución educativa “Javier Heraud”, San Juan de Miraflores – 2013

El presente trabajo de investigación titulado “Percepción de la Gestión administrativa y el nivel de satisfacción de los estudiantes respecto al uso del aula de innovación pedagógica en la institución educativa “Javier Heraud”, San Juan de Miraflores – 2013” tiene por objetivo determinar el nivel de satisfacción de los estudiantes de la institución educativa Javier Heraud respecto del servicio que reciben en el Aula de Innovación Pedagógica y su relación con la percepción de la gestión administrativa. Se desarrolló una investigación de enfoque cuantitativa cuyo tipo de estudio corresponde al tipo Descriptivo correlaciona de corte transversal, Se trabajó con dos variables “Percepción de la Gestión administrativa” y “Nivel de satisfacción de los estudiantes”, ambas variables fueron medidas mediante encuestas a los estudiantes de la Institución educativa Javier Heraud en el año 2013. Su población escolar es de 1940 estudiantes, pero se trabajó con una muestra de 240 estudiantes. Los resultados obtenidos reflejan claramente el nivel de insatisfacción de la gran mayoría de estudiantes encuestados con respecto al servicio que reciben en el aula de Innovación pedagógica. De lo anterior se deduce que la Gestión administrativa del personal encargado del aula de innovación y de las autoridades no es acorde a lo que se requiere en el aula de Innovación Pedagógica. Por lo que se sugiere que se brinde mayor apoyo y control hacia el aula de innovación pedagógica por parte de todos los estamentos de la comunidad educativa

Gallium-68 fibroblast activation protein inhibitor positron emission tomography in cardiovascular disease

Gallium-68 fibroblast activation protein inhibitor [(68Ga)Ga-FAPI] is a new radiopharmaceutical positioning itself as the preferred agent in patients with malignant tumours, competing with 2-Deoxy-2-[18F]fluoro-d-glucose [2-(18F)FDG] using positron emission tomography (PET). While imaging oncology patients with [68Ga]Ga-FAPI PET, incidental uptake of [68Ga]Ga-FAPI has been detected in the myocardium. This review summarises original research studies associating the visualisation of FAPI-based tracers in the myocardium with underlying active cardiovascular disease

Endoplasmic Reticulum Stress signalling - from basic mechanisms to clinical applications

The endoplasmic reticulum (ER) is a membranous intracellular organelle and the first compartment of the secretory pathway. As such, the ER contributes to the production and folding of approximately one-third of cellular proteins, and is thus inextricably linked to the maintenance of cellular homeostasis and the fine balance between health and disease. Specific ER stress signalling pathways, collectively known as the unfolded protein response (UPR), are required for maintaining ER homeostasis. The UPR is triggered when ER protein folding capacity is overwhelmed by cellular demand and the UPR initially aims to restore ER homeostasis and normal cellular functions. However, if this fails, then the UPR triggers cell death. In this review, we provide a UPR signalling-centric view of ER functions, from the ER's discovery to the latest advancements in the understanding of ER and UPR biology. Our review provides a synthesis of intracellular ER signalling revolving around proteostasis and the UPR, its impact on other organelles and cellular behaviour, its multifaceted and dynamic response to stress and its role in physiology, before finally exploring the potential exploitation of this knowledge to tackle unresolved biological questions and address unmet biomedical needs. Thus, we provide an integrated and global view of existing literature on ER signalling pathways and their use for therapeutic purposes

Present and Future CP Measurements

We review theoretical and experimental results on CP violation summarizing the discussions in the working group on CP violation at the UK phenomenology workshop 2000 in Durham.Comment: 104 pages, Latex, to appear in Journal of Physics

Student politics, teaching politics, black politics: an interview with Ansel Wong

Ansel Wong is the quiet man of British black politics, rarely in the limelight and never seeking political office. And yet his ‘career’ here – from Black Power firebrand to managing a multimillion budget as head of the Greater London Council’s Ethnic Minority Unit in the 1980s – spells out some of the most important developments in black educational and cultural projects. In this interview, he discusses his identification with Pan-Africanism, his involvement in student politics, his role in the establishment of youth projects and supplementary schools in the late 1960s and 1970s, and his involvement in black radical politics in London in the same period, all of which took place against the background of revolutionary ferment in the Third World and the world of ideas, and were not without their own internal class and ethnic conflicts

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)