Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

High quality copy number and genotype data from FFPE samples using Molecular Inversion Probe (MIP) microarrays

BACKGROUND:A major challenge facing DNA copy number (CN) studies of tumors is that most banked samples with extensive clinical follow-up information are Formalin-Fixed Paraffin Embedded (FFPE). DNA from FFPE samples generally underperforms or suffers high failure rates compared to fresh frozen samples because of DNA degradation and cross-linking during FFPE fixation and processing. As FFPE protocols may vary widely between labs and samples may be stored for decades at room temperature, an ideal FFPE CN technology should work on diverse sample sets. Molecular Inversion Probe (MIP) technology has been applied successfully to obtain high quality CN and genotype data from cell line and frozen tumor DNA. Since the MIP probes require only a small (~40 bp) target binding site, we reasoned they may be well suited to assess degraded FFPE DNA. We assessed CN with a MIP panel of 50,000 markers in 93 FFPE tumor samples from 7 diverse collections. For 38 FFPE samples from three collections we were also able to asses CN in matched fresh frozen tumor tissue.RESULTS:Using an input of 37 ng genomic DNA, we generated high quality CN data with MIP technology in 88% of FFPE samples from seven diverse collections. When matched fresh frozen tissue was available, the performance of FFPE DNA was comparable to that of DNA obtained from matched frozen tumor (genotype concordance averaged 99.9%), with only a modest loss in performance in FFPE.CONCLUSION:MIP technology can be used to generate high quality CN and genotype data in FFPE as well as fresh frozen samples.This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at [email protected]

Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p &lt; 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

Readings in Management

PREFACE One reality any academic book on management faces is that events in the real world are constantly changing, and rapidly at that. What is different about this book is its commitment to capture the fundamentals of management. In publishing Readings in Management, the editors recognize the enormous role played by the internet, academic and non-academic journals, and other academic publications in providing up-to-date educational information regarding a broad spectrum of management. What is special about this book is the fact that it ensures the material presented is relevant to readers. This book examines current topics in management and its applications in an intercultural context. It includes subjects that are crucial for management practitioners and students in the field of management. Topics covered in this book include: Benchmarking, decision making, stress and coping with stress, organizational learning, diversity management, crisis management, conflict management, time management, outsourcing, groups and teams in organizations, and paradoxical leadership behaviors. Each chapter of the book begins with a case study that focuses on the necessity for that specific topic. Subsequently, students and practitioners will be introduced to the concept that addresses the why, what, and how regarding the specific managerial topic. Finally, a summary of the specific topic will be provided and followed by a relevant case study, helpful internet sites, and important definitions of terms. Chapter One focuses on benchmarking with the aim to bridge a performance gap and achieve leadership position. As the author states, successful benchmarking leads to improvements as well as positive results in quality and efficiency while encouraging a learning culture, which is the key to constant long-term quality improvement and competitiveness . Chapter Two explores the topic of decision making and its significance to management and organizations. The author stresses the fact that there is a strong relation between the continuity of the business and decisions made by employees at the position of manager. The most important task of the managers is decision making . The author of Chapter Three introduces us to an important managerial challenge facing managers, employees, and organizations in stress and coping with stress. To perform stress management effectively, initially, the causes of stress should be known. Additionally, this chapter introduces stress factors, consequences of stress, and stress management methods. Chapter Four explains the subject of organizational learning and its importance to create a learning organization. The author suggests that to survive, organizations should be able to respond directly to changes and developments in their environment. For this reason, the information to be acquired because of the combination of all resources should be processed and used where necessary . Chapter Five explores a fundamental topic facing management and organization in diversity. It focuses on the emphasis on tolerance, mutual understanding, effective communication, and respect for all. Chapter Six introduces the topic of crisis management and its relevance to today\u27s organizations, emphasizing the fact that they should develop and implement strategies to counteract the crises. Chapter seven discusses the subject of conflict with its negative and positive aspects. Additionally, it provides various conflict resolutions that managers and organizations can utilize. The focus of Chapter Eight is time management. The author sums it beautifully by stating that good time management is the most effective way of organizing, planning, setting priorities, effective transfer, and reducing stressful situations . Chapter Nine\u27s emphasis is on outsourcing. Today\u27s organizations are focusing on efficiency in connection to speed, flexibility, and adapting to environmental conditions . According to the author, these three factors transform organizations into high-mobility units, and they establish functional structure on the market. Outsourcing is a managerial strategy that helps organizations gain a professional human resources potential and to build relationships with the environment on the basis of mutual productivity . Groups and teams are the focus of Chapter Ten. The emphasis of this chapter is on the understanding of group dynamics and their influence on individual and organizational functioning. It also explores teams and special kinds of groups as well as their purpose and importance in today\u27s organizations. Chapter Eleven covers the introduction and theoretical discussion of paradoxical leadership behaviors. The author noted that, when the concept of paradox is defined in the literature, it is seen that researchers commonly use the concepts of opposite , independent and simultaneous . The author defines paradoxical leadership as one that involves the simultaneous management of contrasting demands encountered within the organizational area . Finally, the book is concluded with Chapter Twelve that emphasize Intellectual Capital. Intellectual capital is a critical concept in contemporary business regardless of the industry. After the industrial revolution, business styles are constantly changing, and the result is the supremacy of intelligence over brute force. Then, currently, robotics and artificial intelligence are changing the scene. Intellectual capital has become a key competitive tool for firms in today\u27s business environment. Editors Issam A. Ghazzawi, Ph.D., Professor of Management, University of La Verne, California, USA Muharrem Tuna, Ph.D., Professor of Tourism, Gazi University, Ankara, Turkey Aysegul Acar, Ph.D., Doctor of Tourism Management, Karabuk University, Karabuk, Turkey ISBN: 978-1-7321275-6-

miR-125b Targets ARID3B in Breast Cancer Cells

Mounting evidence suggests involvement of deregulated microRNA (miRNA) expression during the complex events of tumorigenesis. Among such deregulated miRNAs in cancer, miR-125b expression is reported to be consistently low in breast cancers. In this study, we screened a panel of breast cancer cell lines (BCCLs) for miR-125b expression and detected decreased expression in 14 of 19 BCCLs. Due to the heterogeneity of breast cancers, MCF7 cells were chosen as a model system for ERBB2 independent breast cancers to restore miR-125b expression (MCF7-125b) to investigate the phenotypical and related functional changes. Earlier, miR-125b was shown to regulate cell motility by targeting ERBB2 in ERBB2 overexpressing breast cancer cells. Here we showed decreased motility and migration in miR-125b expressing MCF7 cells, independent of ERBB2. MCF7-125b cells demonstrated profoundly decreased cytoplasmic protrusions detected by phalloidin staining of filamentous actin along with decreased motility and migration behaviors detected by in vitro wound closure and transwell migration assays compared to empty vector transfected cells (MCF7-EV). Among possible numerous targets of miR-125b, we showed ARID3B (AT-rich interactive domain 3B) to be a novel target with roles in cell motility in breast cancer cells. When ARID3B was transiently silenced, the decreased cell migration was also observed. In light of these findings, miR-125b continues to emerge as an interesting regulator of cancer related phenotypes

Brief report of efficacy and side effect profile of crossing over to modified-release capsules of methylphenidate in ADHD patients receiving other treatments: case series

WOS: 000407497300009OBJECTIVES: Stimulants are recommended as the first-line pharmacotherapy in attention deficit/hyperactivity disorder (ADHD). Methylphenidate (MPH) is the most used stimulant. Medikinet Retard has modified-release capsules of MPH (MRC-MPH). In this study, we aimed to report observations on a sample of outpatients, who had been previously treated with other agents, but switched to MRC-MPH treatment. These observations focus on the treatment course, efficacy, side effects, and switching reasons. METHODS: We included 20 out of the 163 patients with ADHD, who were previously treated with other medications, and switched to MRC-MPH. Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening as diagnosing tool and Rating Scale, Barkley's Stimulants Side Effects Rating Scale for screening side effects and Clinical Global Impression Scale-Severity and -Improvement were administered. RESULTS: Patients' ages ranged between 9 and 17 years. Mean Clinical Global Impression ScaleSeverity (CGI-S) score before the MRC-MPH treatment was 3.2, whereas after treatment it was 3.15. CGI-S scores were not significantly different (p =.593). Loss of appetite (n = 4, 20%) and drowsiness (n = 4, 20%) were the most common adverse events during the MRC-MPH treatment. CONCLUSIONS: We did not observe significant difference between other treatment options and MRC-MPH with respect to efficacy. In terms of side effect profile, Osmotic Release Oral System-MPH was observed to be more problematic than immediate-release MPH and MRCMPH formulations, while these two regimens did not differ significantly

Investigation of Regulatory T Cells and Secreted Immunomodulatory Cytokine IL-10 Levels in Patients with Hepatitis B

Hepatitis B infection is still among the most important public health problems worldwide, even great improvements have been made in the treatment strategies. Hepatitis B virus (HBV) replicates itself by entering the liver cells and simultaneously with the antigen release, many antagonistic immune responses are induced by the regulatory cells including T cell (Treg), T helper 17 (Th-17), T helper 1 (Th-1) and T helper 2 (Th-2) cells. The main function of Treg cells is to develop an appropriate immune response against infection and to suppress the immune response if it is not required. Tregs suppress the effector T cells via secreting immune system supressor cytokines such as Transforming Growth Factor-Beta and interleukin (IL)-10 or contact dependent way. Tregs protect cells from immunopathologic damage of HBV specific T cell immune response and also cause viral persistence, cirrhosis, hepatocellular carsinoma (HCC) and autoimmunity but the mechanisms are not clear, yet. In this study, we aimed to determine whether evaluation of Treg cells and cytokine IL-10 levels together in hepatitis B patients is useful that may indicate the disease survey and response to the treatment. The peripheral blood samples of ninety-one volunteers, including 61 HBV infected patients and 30 healthy controls selected from applicants of Infectious Diseases Outpatient/Clinic Service, were taken. Their CD4(+)CD25(high)FOXP3(+)CD152(+)CD127(low) Treg cell distribution were measured by flow cytometry method, using the recently defined markers. The level of IL-10 cytokine released by immunomodulatory cells was determined by quantitative ELISA method. Treg cell percentages of the patients with acute hepatitis B were below the normal range (2-4%) (median=1.50%, 0.6-3.5) and the difference was statistically significant (p=0.005). Treg cell percentages of the patients with chronic hepatitis B were higher than the control group (p<0.05), and it was found to be related to the parameters used in the diagnosis, staging and follow-up of the disease. IL-10 levels were significantly higher in all hepatitis B clinical stages compared to the healthy controls (median=11.7, 17.3-44.9) (p<0.05). Also, in parallel with Treg cells, IL-10 levels were correlated with HBV DNA load and HBsAg levels (r=0.48, p<0.02). Treg cells and the related cytokine IL-10 are thought to play an important role in the immunology of HBV infection and therefore, promising to follow up the disease and to develop new therapeutic strategies targeting the Treg cell

Interreader agreement in evaluation of Ga-68-PSMA PET/CT at the time of initial staging: comparison of the three evaluation criteria in the pretreatment risk groups

Objective The aim of this study was to assess the interreader agreement in evaluation 68Ga-prostate-specific membrane antigen (PSMA) PET/CT according to three current criteria European association of nuclear medicine, PROMISE with miTNM, and PSMA-RADS in newly diagnosed prostate cancer (PC) patients. Methods The images of 101 patients who had been diagnosed with PC and underwent Ga-68-PSMA PET/CT at the time of initial staging were evaluated according to the three interpretation criteria by two nuclear medicine specialists. Local tumor, pelvic lymph node metastasis and distant metastasis were evaluated separately. Abdominal lymph nodes, bone and visceral organ metastases were additionally evaluated as subregions of distant metastatic sites. Patients were evaluated in subgroups Gleason score >= 8 or prostate-specific antigen >= 20 ng/mL as the high-risk group (HR) and prostate-specific antigen <= 20 ng/mL and Gleason score <8 as the low-risk group (LR). To measure interreader agreement for each judgment site Cohen's Kappa statistic coefficient (kappa) was calculated. Results All three criteria European association of nuclear medicine, PROMISE with miTNM and PSMA-RADS exhibit substantial and almost perfect agreement between the readers in all sites except for PSMA-RADS in bone and visceral metastasis (kappa = 0.495, kappa = 0.506, respectively). According to the risk groups, a remarkable difference in interreader agreement for bone metastasis for all three criteria (especially in PSMA-RADS) between the HR and LR patients was detected. Conclusions In low-risk patients especially PSMA-RADS criteria leads to increased interreader reporting differences. While evaluating Ga-68-PSMA PET/CT images it should be considered that pretreatment risk levels of PC patients could affect the interreader agreement

Evaluation of Ga-68-PSMA PET/CT with volumetric parameters for staging of prostate cancer patients

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