Accuracy of Preoperative Endometrial Sampling for the Detection of Endometrial Pathology: a Retrospective Study

Objective: To investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathology and the need of intraoperative frozen section. Methods: One hundred forty women who underwent endometrial sampling followed by hysterectomy between 2011 and 2014 were included in this study. Data were retrieved from patient files and pathology archives in Department of Obstetrics and Gynecology, Jose R. Reyes Memorial Medical Center, Manila, Philippines. Results: There were 25 patients with malignancy but endometrial sampling detected only 22 of them. The endometrial sampling sensitivity and specificity for detecting cancer were 88% and 100%, respectively with negative and positive predictive values of 97.5% and 100%, respectively. In 3 patients, the endometrial sampling failed to detect malignancy; 1 patient had a preoperative diagnosis of complex hyperplasia with atypia, 1 patient had complex hyperplasia without atypia and 1 patient had adenofibroma. A total of eighty patients had benign findings. There were fifty-three cases with finding of proliferative endometrium and twenty-seven were secretory. Twenty-three (55.0%) and 11 (39.0%) cases were confirmed by the hysterectomy specimen, respectively. The sensitivity of endometrial sampling in detecting benign samples was 76.0% and the specificity reached up to 83.0%. The histopathology result of the other fourteen cases were reported of having atrophy, twelve cases were reported of having endometrial hyperplasia, four with basal endometrium, four with endometrial polyp and one with adenomyosis. Conclusion: Outpatient endometrial biopsy has a high overall accuracy in diagnosing endometrial cancer when the specimen obtained is sufficient. A positive test result is more accurate for ruling in disease than a negative test result is for ruling it out. However, the diagnosis should be confirmed by frozen section in patients with complex hyperplasia and adenofibroma. [Indones J Obstet Gynecol 2017; 5-1: 23-29] Keywords: abnormal uterine bleeding, endometrial hyperplasia, endometrial sampling, frozen section, pipell

Lung regions differently modulate bronchial branching development and extracellular matrix plays a role in regulating the development of chick embryo whole lung.

Normal branching development is dependent on the correlation between cells and extracellular matrix. In this interaction glycosaminoglycans, cytokines and growth factors play a fundamental role. In order to verify the distribution and influence of extracellular matrix and related enzymes on chick embryo lung development, 6 day-old whole lungs were maintained in vitro with testicular hyaluronidase, beta-N-acetyl-D-glucosaminidase and chondrotinase ABC or in linkage with apical, medial and caudal lung regions of 6-day development before and after enzyme treatment. In a separate lung region beta-N-acetyl-D-glucosaminidase and hyaluronidase were determined. Our data show that the whole lung cultures increase bronchial branching development when the medial region is admixed separately, while the separate apical or caudal regions or apical combined with caudal region do not affect bronchial branching development. The enzyme treatment of medial region prevents the branching development in associated whole lung. The bronchial branching development of whole lung cultured in medium containing the enzymes related to glycosaminoglycans turnover is significantly altered. In conclusion, these data show that the different influence of separate apical, medial, caudal lung regions on bronchial branching development is related to the extracellular matrix composition

Functionalization of commercial electrospun veils with zinc oxide nanostructures

The present research is focused on the synthesis of hexagonal ZnO wurtzite nanorods for the decoration of commercially available electrospun nylon nanofibers. The growth of ZnO was performed by a hydrothermal technique and for the first time on commercial electrospun veils. The growth step was optimized by adopting a procedure with the refresh of growing solution each hour of treatment (Method 1) and with the maintenance of a specific growth solution volume for the entire duration of the treatment (Method 2). The overall treatment time and volume of solution were also optimized by analyzing the morphology of ZnO nanostructures, the coverage degree, the thermal and mechanical stability of the obtained decorated electrospun nanofibers. In the optimal synthesis conditions (Method 2), hexagonal ZnO nanorods with a diameter and length of 53.5 nm ± 5.7 nm and 375.4 nm ± 37.8 nm, respectively, were obtained with a homogeneous and complete coverage of the veils. This easily scalable procedure did not damage the veils that could be potentially used as toughening elements in composites to prevent delamination onset and propagation. The presence of photoreactive species makes these materials ideal also as environmentally friendly photocatalysts for wastewater treatment. In this regard, photocatalytic tests were performed using methylene blue (MB) as model compound. Under UV light irradiation, the degradation of MB followed a first kinetic order data fitting and after 3 h of treatment a MB degradation of 91.0% ± 5.1% was achieved. The reusability of decorated veils was evaluated and a decrease in photocatalysis efficiency was detected after the third cycle of use

Spatiotemporal Dynamics of the Processing of Spoken Inflected and Derived Words: A Combined EEG and MEG Study

The spatiotemporal dynamics of the neural processing of spoken morphologically complex words are still an open issue. In the current study, we investigated the time course and neural sources of spoken inflected and derived words using simultaneously recorded electroencephalography (EEG) and magnetoencephalography (MEG) responses. Ten participants (native speakers) listened to inflected, derived, and monomorphemic Finnish words and judged their acceptability. EEG and MEG responses were time-locked to both the stimulus onset and the critical point (suffix onset for complex words, uniqueness point for monomorphemic words). The ERP results showed that inflected words elicited a larger left-lateralized negativity than derived and monomorphemic words approximately 200 ms after the critical point. Source modeling of MEG responses showed one bilateral source in the superior temporal area ∼100 ms after the critical point, with derived words eliciting stronger source amplitudes than inflected and monomorphemic words in the right hemisphere. Source modeling also showed two sources in the temporal cortex approximately 200 ms after the critical point. There, inflected words showed a more systematic pattern in source locations and elicited temporally distinct source activity in comparison to the derived word condition. The current results provide electrophysiological evidence for at least partially distinct cortical processing of spoken inflected and derived words. In general, the results support models of morphological processing stating that during the recognition of inflected words, the constituent morphemes are accessed separately. With regard to derived words, stem and suffix morphemes might be at least initially activated along with the whole word representation

Enrichment of cancer-predisposing germline variants in adult and pediatric patients with acute lymphoblastic leukemia

Despite recent progress in acute lymphoblastic leukemia (ALL) therapies, a significant subset of adult and pediatric ALL patients has a dismal prognosis. Better understanding of leukemogenesis and recognition of germline genetic changes may provide new tools for treating patients. Given that hematopoietic stem cell transplantation, often from a family member, is a major form of treatment in ALL, acknowledging the possibility of hereditary predisposition is of special importance. Reports of comprehensive germline analyses performed in adult ALL patients are scarce. Aiming at fulfilling this gap of knowledge, we investigated variants in 93 genes predisposing to hematologic malignancies and 70 other cancer-predisposing genes from exome data obtained from 61 adult and 87 pediatric ALL patients. Our results show that pathogenic (P) or likely pathogenic (LP) germline variants in genes associated with predisposition to ALL or other cancers are prevalent in ALL patients: 8% of adults and 11% of children. Comparison of P/LP germline variants in patients to population-matched controls (gnomAD Finns) revealed a 2.6-fold enrichment in ALL cases (CI 95% 1.5-4.2, p = 0.00071). Acknowledging inherited factors is crucial, especially when considering hematopoietic stem cell transplantation and planning post-therapy follow-up. Harmful germline variants may also predispose patients to excessive toxicity potentially compromising the outcome. We propose integrating germline genetics into precise ALL patient care and providing families genetic counseling.Peer reviewe

River and lake nutrient targets that support ecological status: European scale gap analysis and strategies for the implementation of the Water Framework Directive

Eutrophication caused by an excessive presence of nutrients is affecting large portions of European waters with more than 60% of the surface water bodies failing to achieve the primary ambition of water management in Europe, that of good ecological status (GES) with diffuse emission from agriculture being the second most important pressure affecting surface waters. We developed EU wide and regional nutrient targets that define the boundary concentrations between good and moderate status for river and lake total P (TP) and total N (TN) and assessed the gap between actual nutrient concentrations and these targets and considered strategies of nutrient reductions necessary to achieve GES and deliver ecosystem services. The nutrient targets established for rivers ranged from 0.5–3.5 mg/L TN and 11–105 μg/L TP and for lakes 0.5–1.8 mg/L TN and 10–60 μg/L TP. Based on the EU wide targets, 59% of the TN and 57% of the TP river monitoring sites and 64% of the TN and 61% of the TP lake monitoring sites exceed these value and are thus at less than GES. The PCA and step-wise regression for EU basins clearly showed that the basin nutrient export is predominantly related to agricultural inputs. In addition, the step-wise regression models for TN and TP provided the ability to extrapolate the results and quantify the input reductions necessary for reaching the nutrient targets at the EU level. The results suggest that a dual water management strategy would be beneficial and should focus a) on those less polluted rivers and lakes that can easily attain the GES goal and b) on the more highly polluted systems that will improve the delivery of ecosystem services

Can we enhance the ability to return to work among workers with stress-related disorders?

<p>Abstract</p> <p>Background</p> <p>Stress-related disorders are widespread and responsible for high societal costs e.g. sick leave payment and reduced productivity. The aim of this study was to evaluate the effect of an intervention program on return to work or labour market.</p> <p>Methods</p> <p>In a controlled interventional study design we compared 72 emotionally distressed patients, who received support during 2006, with 89 control individuals who had also been sick listed for emotional distress. Intervention was provided by trained psychologists and social workers who were in continuous dialog with the patients, providing counselling e.g. on decisions concerning resumption of work, support to families, participation in meetings with the workplace. Basically, the controls and the intervention group share the same access to welfare benefits. The main outcome was time to return to labour market (TTR).</p> <p>Results</p> <p>The baseline characteristics were similar in the two groups. There were no differences in the rate of resuming work between the two groups. About 80% in both groups had returned to the labour market after one year.</p> <p>Conclusion</p> <p>An intervention program with psychological stress management and case management did not improve work capability compared to usual care. Work resumption as a single outcome probably is an insensitive parameter of intervention management quality, and should be supplemented by other data on different aspects of treatment.</p

Characterization of multifunctional β-NaEuF4/NaGdF4 core–shell nanoparticles with narrow size distribution

We characterized NaEuF4/NaGdF4 core–shell nanoparticles

Low energy radioactive ion beams at SPES for nuclear physics and medical applications

Over the past decades many accelerator facilities have been built in order to produce radioactive nuclei. Among the falcility under construction, SPES (Selective Production of Exotic Species) is the Italian ISOL (Isotope Separation On Line) facility in the installation phase in these years in the Laboratori Nazionali di Legnaro. The innovative aspect of this facility is that the radioactive beam produced by fission induced by the proton beam, produced by a high power cyclotron, interact with a multi-disks uranium carbide target. The formed RIB will be sent directly to the low energy experimental area and, afterwards, to the post-acceleration complex. Currently the installation program concerning the SPES RIB source provides the set-up of the apparatus around the production bunker. The main objective of SPES project is to provide, in the next years, the first low-energy radioactive beams for beta decay experiments using the b-DS (beta Decay Station) set-up and for radiopharmaceutical applications by means of the IRIS (ISOLPHARM Radioactive Implantation Station) apparatus. In this work, all the specific issues related to the SPES RIB and the Low Energy beam lines will be reported. The main RIB systems, such as ion source systems, target-handling devices and the installation of low energy transport line, will be presented in detail

Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study

The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs) ability to correctly appraise the origin of chest pain within the first minutes of an encounter. The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year. Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5%) of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3%) and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%). The predictive abilities of an early diagnostic guess were consistent among GPs. The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain