Effects of different doses of erythropoietin in patients with myelodysplastic syndromes: A propensity score-matched analysis

Erythropoiesis-stimulating agents effectively improve the hemoglobin levels in a fraction of anemic patients with myelodysplastic syndromes (MDS). Higher doses (HD) of recombinant human erythropoietin (rhEPO) have been proposed to overcome suboptimal response rates observed in MDS patients treated with lower "standard doses" (SD) of rhEPO. However, a direct comparison between the different doses of rhEPO is lacking

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia

Sodium channel-inhibiting drugs and survival of breast, colon and prostate cancer: a population-based study

Metastasis is the leading cause of cancer-related deaths. Voltage-gated sodium channels (VGSCs) regulate invasion and metastasis. Several VGSC-inhibiting drugs reduce metastasis in murine cancer models. We aimed to test the hypothesis that patients taking VGSC-inhibiting drugs who developed cancer live longer than those not taking these drugs. A cohort study was performed on primary care data from the QResearch database, including patients with breast, bowel or prostate cancer. Cox proportional hazards regression was used to compare the survival from cancer diagnosis of patients taking VGSC-inhibiting drugs with those not exposed to these drugs. Median time to death was 9.7 years in the exposed group and 18.4 years in the unexposed group, and exposure to these medications significantly increased mortality. Thus, exposure to VGSC-inhibiting drugs associates with reduced survival in breast, bowel and prostate cancer patients. This finding is not consistent with the preclinical data. Despite the strengths of this study including the large sample size, the study is limited by missing information on potentially important confounders such as cancer stage, co-morbidities and cause of death. Further research, which is able to account for these confounding issues, is needed to investigate the relationship between VGSC-inhibiting drugs and cancer survival

Spatial and temporal uplift history of South America from calibrated drainage analysis

A multidisciplinary approach is used to analyze the Cenozoic uplift history of South America. Residual depth anomalies of oceanic crust abutting this continent help to determine the pattern of present-day dynamic topography. Admittance analysis and crustal thickness measurements indicate that the elastic thickness of the Borborema and Altiplano regions is ≤₁₀ km with evidence for sub-plate support at longer wavelengths. A drainage inventory of 1827 river profiles is assembled and used to investigate landscape development. Linear inverse modeling enables river profiles to be fitted as a function of the spatial and temporal history of regional uplift. Erosional parameters are calibrated using observations from the Borborema Plateau and tested against continent-wide stratigraphic and thermochronologic constraints. Our results predict that two phases of regional uplift of the Altiplano plateau occurred in Neogene times. Regional uplift of the southern Patagonian Andes also appears to have occurred in Early Miocene times. The consistency between observed and predicted histories for the Borborema, Altiplano, and Patagonian plateaux implies that drainage networks record coherent signals that are amenable to simple modeling strategies. Finally, the predicted pattern of incision across the Amazon catchment constrains solid sedimentary flux at the Foz do Amazonas. Observed and calculated flux estimates match, suggesting that erosion and deposition were triggered by regional Andean uplift during Miocene times

6Hydrothermal alteration and magnetic properties of rocks in the Carolina de Michilla stratabound copper district, northern Chile

In the Carolina de Michilla district, northern Chile, stratabound copper mineralization is hosted by Jurassic volcanic rocks along the trace of the Atacama fault system. In this study, we present the overall effects of hydrothermal alteration on the magnetic properties of rocks in this district. Two types of metasomatic alteration associations occur, one of regional extent and the other of local hydrothermal alteration associated with copper mineralization (e.g., Lince-Estefania-Susana). Regional alteration is interpreted as a low-grade "propylitic association" characterized by an epidote-chlorite-smectite-titanite-albite-quartz-calcite association. The local hydrothermal alteration is characterized broadly by a quartz-albite-epidote-chlorite-calcite mineral assemblage. The most pervasive alteration mineral is albite, followed by epidote and, locally, actinolite. These minerals contrast sharply against host rock minerals such as chlorite, calcite, zeolite, prehnite, and pumpellyite, but alteration is constrained to mineralized bodies as narrow and low contrast alteration halos that go outwards from actinolite-albite to epidote-albite, to epidote-chlorite, and finally to chlorite. Hydrothermal alteration minerals, compared to regional alteration minerals, show iron-rich epidotes, a lower chlorite content of the chlorite-smectite series, and a nearly total albite replacement of plagioclase in the mineralized zones. Opaque minerals associated with regional alteration are magnetite and maghemite, and those associated to hydrothermal alteration are magnetite, hematite, and copper sulphides. We present paleomagnetic results from nine sites in the Michilla district and from drill cores from two mines. Local effects of hydrothermal alteration on the original magnetic mineralogy indicate similar characteristics and mineralogy, except for an increase of hematite that is spatially associated with the Cu-sulphide breccias with low magnetic susceptibilities. Results indicate that it is impossible to magnetically differentiate mineralized bodies from unmineralized lavas, except for pyrite-rich hydrothermal breccias. In conclusion, for stratabound copper deposits of the Michilla type, the overall effect of hydrothermal alteration on the paleomagnetic properties of rocks is of low contrast, not clearly discernable even at a small scale. From an exploration point of view, magnetic exploration surveys should not discern mineralized bodies of Cu-sulphide breccias except in detailed ground surveys due to the small size of contrasting bodies. Unoriented drill cores with primary ore mineralization record a characteristic remanent magnetization of reverse polarity. Taking into account the azimuth and dip of the drill cores, we were able to compare the magnetization of the mineralized bodies with the characteristic directions from sites drilled in situ from Late Jurassic-Early Cretaceous intrusives mostly. The characteristic direction recorded by the Pluton Viera is similar to the magnetization of the ore bodies of the Estefania mine. If copper mineralization mostly postdates the tilt of the volcanic flows, the low paleomagnetic inclinations suggest an age for the mineralization near 145 Ma, the time of the lowest paleolatitude for the South American plate during the Mesozoic