Prognostic factors of radiosynovectomy in haemophilia patients with inhibitors: Survival analysis in a 19-year period

Introduction People with haemophilia (PwH) with inhibitors have an increased risk of bleeding and early development of progressive arthropathy. Radiosynovectomy (RS) has been effective in dramatically reducing the frequency of haemarthroses. In the present study, the mid- and long-term results of the efficacy of RS in PwHs with inhibitors and prognostic factors that influence success and failure of RS were presented. Material and Method Radiosynovectomy was performed in 51 joints of 22 PwHs with inhibitors diagnosed with chronic haemophilic synovitis between January 2000 and December 2018. Two patients were lost to follow-up and four joints were excluded. Number of bleeding episodes within the pre- and post-treatment 6 months were documented. Treatment failure was defined as need for repeat RS injection. Results Results of 47 RS were analysed. The mean bleeding frequency of the joints was 11.2 +/- 6.2 (median 9) within the last 6 months in the pre-treatment evaluation. After the treatment, the mean bleeding frequency of the joints decreased to 1.2 +/- 2.8 (median 0) for first 6 months (P < .0001). The cumulative survival rate at 12 months was 87% and 78% at 36 months. The receiver operating characteristic (ROC) curve analysis revealed that cut-off points of 12 bleeding episodes within the last 6 months (sensitivity, 71.4; specificity, 81.8P = .0022) and an inhibitor titre of 63.4 BU (sensitivity, 57.1; specificity, 75.8;P = .31) were threshold levels for a predisposition for failure. Conclusion Radiosynovectomy is an effective and safe intervention in PwHs with inhibitors. Bleeding frequency is a prognostic marker for the success of RS treatment. Patients who have more than 12 bleeding episodes within the last 6 months before the RS treatment have a higher rate of failure

Phosphorus and humic acid application alleviate salinity stress of pepper seedling

WOS: 000281680400011Humic acid is a commercial product that contains many elements which improve the soil fertility and increase the availability of nutrient elements. It consequently affects plant growth and yield and ameliorates the deleterious effects of salt stress. The objective of the study was to determine the effect of humic acids and phosphorus on growth and nutrient content of pepper seedlings (cv. Demre) grown under moderate salt stress in growth chamber conditions. Applications of different levels of phosphorus [0 (P(0)), 50 (P(1)), 100 (P(2)) and 150 (P(3)) mg kg(-1)] and humic acid [0 (HA(0)), 750 (HA(1)) and 1500 (HA(2)) mg kg(-1)] to growing media containing moderate salt dose (8 mM NaCl treatment) were studied. The study was replicated four times with 20 plants in each replicate. Humic acid (HA) and phosphorus applications increased the growth and growth parameter of plants. In company, effects of HA and P application was more effective on growth and growth parameter than each separate effect. The optimum total yield was obtained from 69 mg kg(-1) P application with HA2 doses according to regression analysis. Humic acid application significantly increased N, P, K, Ca, Mg, S, Mn and Cu contents of shoot of pepper seedling. Also, N, P, K, Ca, S, Fe, Mn, Zn and Cu contents of root were increased with humic acid application. Na contents of both shoot and root of pepper decreased with increased humic acid doses. It can be concluded that high humic acid doses has positive effects on salt tolerance based on the plant growth parameters and nutrient contents. The present study suggests that HA treatments can ameliorate the deleterious effects of salt stress on pepper plants and HA could offer an economical and simple application to reduce problems of pepper production in moderately saline soil

Association of amoxicillin use and molar incisor hypomineralization in piglets: Visual and mineral density evaluation

WOS: 000325236600019PubMed ID: 23870729Aim: The aim of the present study was to determine the prevalence of MIH both visually and quantitatively, and describes the range of mineral densities of enamel specimens from three groups of piglets where two groups were given different doses of amoxicillin in infancy. Methods: In this blind randomized clinical study, 20 piglets were randomly divided into three groups. Group A received a standard dose (50 mg/kg/day) and Group B received a high dose (90 mg/kg/day) of amoxicillin in selected days of the month (20 working days) they were born. Group K did not receive any medication and served as control. Thirteen right mandibular permanent first molars (PFMs) were randomly collected from 3 groups of piglets at age 10 months for evaluation under X-ray micro-tomography. Tomographic data were obtained using a Skyscan 1174 compact micro-CT in the Department of Anatomy. Results: Prevalence of MIH was 0% in all groups. MD values were quantified after enamel grey level (0-255) measurements on horizontal cross-sectional slices. After MD measurements, the effects of amoxicillin use on MIH are presented. Conclusions: While MIH is a multifactorial disturbance, the present study attempted to highlight the clinical findings of a possible relationship between amoxicillin use and MIH with the aid of X-ray micro-tomography. (C) 2013 Elsevier Ltd. All rights reserved

Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-beta) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC