ENHANCED RECOVERY (FAST-TRACK) PROGRAM IN ELECTIVE ARTHROPLASTY OF WEIGHT-BEARING JOINTS

Objective: To evaluate the effect of feeding with a whey protein plus carbohydrate drink on metabolic parameters, general state of the patient and recovery time after knee and hip arthroplasty. Methods: The results of the perioperative period of 60 patients with osteoarthritis (OA) of the hip and knee were evaluated between March and July 2021. All patients underwent hip or knee arthroplasty under spinal anaesthesia. In addition, patients of the study group received the ProvideXtra® Drink 2 hours before surgery. Otherwise, the management of patients in the perioperative period was the standard. Mobilisation and verticalisation of patients were carried out after achieving physical fitness, resolution of the spinal block and haemodynamic stability on the day of surgery or the next day. Results: In all patients after 4 hours, increased glucose levels were recorded in both groups, statistically significant in the control group – 7.15±0.94 versus 7.88±1.18 mmol/l (p=0.02). The decrease in haemoglobin level had no difference in the study groups and before discharge was 100±16 g/l versus 101±18 g/l (p=0.86). The difference in total protein level before discharge was in favour of the study group, 63.1±6.1 versus 59.2±5.9 g/l (p=0.17). Verticalisation timing in the study group was as follows: 10 patients were verticalised on the day of surgery, and the remaining 20 patients – were on the next day. In the control group – 8 patients were verticalised on the day of surgery and 22 – on the next day. In the control group, 2 cases of postoperative nausea requiring correction were observed. Conclusion: The modern surgical approaches include the maximal preservation of natural feeding, based on the Enhanced Recovery after Surgery (ERAS®) concept. However, guidelines for choosing a particular diet on the day of surgery remain to be finally established. Using ready-made carbohydrate-protein mixtures is a convenient solution that delivers the required amount of energy and protein. Therefore, the effect of the mixture on protein metabolism in the postoperative period remains to be elucidated through further studies

A novel COLD-PCR/FMCA assay enhances the detection of low-abundance IDH1 mutations in gliomas

10.1097/PDM.0b013e31826c7ff8Diagnostic Molecular Pathology22128-34DMPA

Regulation of p27Kip1 protein levels contributes to mitogenic effects of the RET/PTC kinase in thyroid carcinoma cells.

We show that treatment of a panel of thyroid carcinoma cell lines naturally harboring the RET/PTC1 oncogene, with the RET kinase inhibitors PP1 and ZD6474, results in reversible G(1) arrest. This is accompanied by interruption of Shc and mitogen-activated protein kinase (MAPK) phosphorylation, reduced levels of G(1) cyclins, and increased levels of the cyclin-dependent kinase inhibitor p27Kip1 because of a reduced protein turnover. MAP/extracellular signal-regulated kinase 1/2 inhibition by U0126 caused G(1) cyclins down-regulation and p27Kip1 up-regulation as well. Forced expression of RET/PTC in normal thyroid follicular cells caused a MAPK- and proteasome-dependent down-regulation of p27Kip1. Reduction of p27Kip1 protein levels by antisense oligonucleotides abrogated the G(1) arrest induced by RET/PTC blockade. Therefore, in thyroid cancer, RET/PTC-mediated MAPK activation contributes to p27Kip1 deregulation. This pathway is implicated in cell cycle progression and in response to small molecule kinase inhibitors

Consistency and reproducibility of next-generation sequencing and other multigene mutational assays: A worldwide ring trial study on quantitative cytological molecular reference specimens.

Molecular testing of cytological lung cancer specimens includes, beyond epidermal growth factor receptor (EGFR), emerging predictive/prognostic genomic biomarkers such as Kirsten rat sarcoma viral oncogene homolog (KRAS), neuroblastoma RAS viral [v-ras] oncogene homolog (NRAS), B-Raf proto-oncogene, serine/threonine kinase (BRAF), and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α (PIK3CA). Next-generation sequencing (NGS) and other multigene mutational assays are suitable for cytological specimens, including smears. However, the current literature reflects single-institution studies rather than multicenter experiences. Quantitative cytological molecular reference slides were produced with cell lines designed to harbor concurrent mutations in the EGFR, KRAS, NRAS, BRAF, and PIK3CA genes at various allelic ratios, including low allele frequencies (AFs; 1%). This interlaboratory ring trial study included 14 institutions across the world that performed multigene mutational assays, from tissue extraction to data analysis, on these reference slides, with each laboratory using its own mutation analysis platform and methodology. All laboratories using NGS (n = 11) successfully detected the study's set of mutations with minimal variations in the means and standard errors of variant fractions at dilution points of 10% (P = .171) and 5% (P = .063) despite the use of different sequencing platforms (Illumina, Ion Torrent/Proton, and Roche). However, when mutations at a low AF of 1% were analyzed, the concordance of the NGS results was low, and this reflected the use of different thresholds for variant calling among the institutions. In contrast, laboratories using matrix-assisted laser desorption/ionization-time of flight (n = 2) showed lower concordance in terms of mutation detection and mutant AF quantification. Quantitative molecular reference slides are a useful tool for monitoring the performance of different multigene mutational assays, and this could lead to better standardization of molecular cytopathology procedures. Cancer Cytopathol 2017;125:615-26. © 2017 American Cancer Society