Plasma lipid biomarker signatures in squamous carcinoma and adenocarcinoma lung cancer patients

There is a clinical need for reliable biomarkers for lung cancer that permit early diagnosis of the disease and provide prediction of histological phenotype. A prospective study design was used with a study population of patients with suspected lung cancer. Blood samples were collected from 17 patients with histologically confirmed squamous cell lung carcinoma, 17 individuals with adenocarcinoma, and 17 control individuals who did not subsequently have a diagnosis of lung cancer or any other cancer. Blood plasma samples were analysed for their lipid profiles using liquid chromatography coupled with high resolution mass spectrometry. Data were analysed using multivariate statistical methods. There was good separation between histological subtypes and control groups and also between individuals with a subsequent diagnosis of adenocarcinoma and squamous cell carcinoma (sensitivity 80 %, specificity 83 %, Q2 = 0.70). Alterations in the levels of different classes of lipids including triglycerides (TGs), phosphatidylinositols (PIs), phosphatidylcholines (PCs), phosphatidylethanolamines (PEs), free fatty acids, lysophospholipids and sphingolipids were observed in squamous carcinoma and adenocarcinoma lung cancer patients when compared with control patients. In conclusion, this study has identified candidate lipid biomarkers of non-small cell lung cancer patients which may be helpful to indicate the tumour subtype and to differentiate them from patients who do not have lung cancer. Measuring these biomarkers has the potential to improve diagnosis in patients with suspected lung cancer and risk stratification in screening

In situ guided tissue regeneration in musculoskeletal diseases and aging: Implementing pathology into tailored tissue engineering strategies

In situ guided tissue regeneration, also addressed as in situ tissue engineering or endogenous regeneration, has a great potential for population-wide “minimal invasive” applications. During the last two decades, tissue engineering has been developed with remarkable in vitro and preclinical success but still the number of applications in clinical routine is extremely small. Moreover, the vision of population-wide applications of ex vivo tissue engineered constructs based on cells, growth and differentiation factors and scaffolds, must probably be deemed unrealistic for economic and regulation-related issues. Hence, the progress made in this respect will be mostly applicable to a fraction of post-traumatic or post-surgery situations such as big tissue defects due to tumor manifestation. Minimally invasive procedures would probably qualify for a broader application and ideally would only require off the shelf standardized products without cells. Such products should mimic the microenvironment of regenerating tissues and make use of the endogenous tissue regeneration capacities. Functionally, the chemotaxis of regenerative cells, their amplification as a transient amplifying pool and their concerted differentiation and remodeling should be addressed. This is especially important because the main target populations for such applications are the elderly and diseased. The quality of regenerative cells is impaired in such organisms and high levels of inhibitors also interfere with regeneration and healing. In metabolic bone diseases like osteoporosis, it is already known that antagonists for inhibitors such as activin and sclerostin enhance bone formation. Implementing such strategies into applications for in situ guided tissue regeneration should greatly enhance the efficacy of tailored procedures in the future

Sacral area complete sonographic assessment to identify pressure ulcers: SACS study

Learning Objectives: Pressure ulcer (PU) development in hospitalized patients is a major problem with a significant impact on patients and the health care system. Duration to development of PU is unknown. Detecting changes in the Subcutaneous (SC) tissue before clinical skin changes, may help management and prevent progression. Methods: A prospective observational study conducted in a Surgical Intensive Care Unit (SICU), in a tertiary care teaching hospital. Patients studied to identify SC tissue changes in the sacral area while in a supine position for at least 24 hours. High Frequency Ultrasound (US) transducer of 14 MHz was used to evaluate the sacral area to detect any SC tissue changes. The US transducer was placed in a sagittal plane at the sacral area to examine the SC tissue. Abnormal signs in the SC tissue were identified as 1) Dermal-Epidermal interface changes. 2) Edema or hypoechoic area development 3) Disruption in the fascia layer. A sample t-test was used to examine the effect of being in supine position on the SC tissue compared to normal and to test the null hypothesis to determine if supine position for \u3e 24 hours can lead to developing abnormal SC tissue changes. Results: 12 patients in the SICU were randomly selected in this study. All patients had no visual evidence of skin breakdown at the sacral area at the time of the exam. No moisture or sacral edema was noted. All patients were in a supine position for at least 24 hours. Mean age was 52.7 years, 66% were females, 7 Caucasians and 5 African Americans. Five patients were admitted to the SICU from the operating room, 4 from home and 3 from an outside hospital. 33% (4), receiving vasopressor support and 50% (6) were on mechanical ventilation. The patients were in a supine position for a period of time, ranging from 24-144 hours with a mean of 59.9 hours. Average body mass index was 29.2 Kg/m. The Dermal-Epidermal interface changes were noted in 33%. The Edema or hypoechoic area development noted in 58%. Disruption in the fascia layer noted in 75% with t-value 2.3, 3.9 and 3.9 respectively and a p-value \u3c 0.005 in all three categories. Conclusions: Changes in the SC tissue in the sacral area can happen when patients are in supine position for a mean time of about 59 hours or more. Early detection maybe helpful to prevent further injury

Intravascular volume assessment by sonography (VAS) score

Learning Objectives: Intravascular volume Status assessment (IVSA) by bedside ultrasound (BU) usually focus on individual organs. Combining different organs and using a scoring system to compare to the standard methods (SM) and the clinical impression, may aid in the diagnosis and standardize BU applications. Methods: A Prospective, observational study, in the surgical intensive care unit (SICU), of a single academic tertiary center. Patients with IVSA were included. IVSA identified by the SM of heart rate, mean arterial pressure, central venous pressure, serum lactate, Oxygen Saturation of central venous blood (SCVO2), and cardiac index. BU studies included the heart, lungs, Inferior Vena Cava (IVC), and Internal Jugular Vein (IJV). VAS score developed to assess IVSA; A) Heart: Hyperkinetic=-1, Normal=0, hypokinetic=+ 1. B) Lungs: Absence of B-Lines=-1, 1-2 B-Lines=0, 3 B-Lines=+1. C) IVC: \u3c 2.5 cm and \u3e 50% respiratory variation in diameter=-1, 1.5-2.5 cm, \u3c 50% respiratory variation = 1, \u3e 2.5 cm and \u3c 50% respiratory variation = +1. D) IJV: \u3e 40% respiratory variation =-1, 20-40% respiratory variation = 1, \u3c 20%=+1. VAS score ranges from-4 to +4. A score near zero indicates euvolemia, a score near-4 indicates hypovolemia, and a score near +4 indicate hypervolemia. Data for SM and BU compared to each other. Comparisons were performed using the Spearman\u27s correlation coefficient tests, the nonparametric equivalent to a paired t-test. Results: 23 patients with IVSA included in the study. Twelve (52%) were female, 12 (57%) were White and the mean age was 55.5 years with a range from 27-90. There were no clear cut-points to divide the total scores into the three categories of hypovolemia, euvolemia and hypervolemia. There was a trend toward a zero or negative score for hypovolemia and euvolemia. The positive (\u3e 0) total score, was significant in the VAS score hypervolemia compared to SM (correlation coefficient=0.51, p = 0.013). Overall there was a significant association between the VAS score using BU and the clinical impression of volume status (correlation coefficient= 0.51, p = 0.013). Conclusions: VAS score using BU correlates with the clinical impression of volume status measurements. This can help standardize and aid in the diagnosis of volume status during BU

Increasing maternal age associates with lower placental CPT1B mRNA expression and acylcarnitines, particularly in overweight women

Older pregnant women have increased risks of complications including gestational diabetes and stillbirth. Carnitine palmitoyl transferase (CPT) expression declines with age in several tissues and is linked with poorer metabolic health. Mitochondrial CPTs catalyze acylcarnitine synthesis, which facilitates fatty acid oxidization as fuel. We hypothesized that the placenta, containing maternally-inherited mitochondria, shows an age-related CPT decline that lowers placental acylcarnitine synthesis, increasing vulnerability to pregnancy complications. We assessed CPT1A, CPT1B, CPT1C and CPT2 mRNA expression by qPCR in 77 placentas and quantified 10 medium and long-chain acylcarnitines by LC-MS/MS in a subset of 50 placentas. Older maternal age associated with lower expression of placental CPT1B, but not CPT1A, CPT1C or CPT2. CPT1B expression positively associated with eight acylcarnitines and CPT1C with three acylcarnitines, CPT1A negatively associated with nine acylcarnitines, while CPT2 did not associate with any acylcarnitine. Older maternal age associated with reductions in five acylcarnitines, only in those with BMI≥ 25 kg/m2, and not after adjusting for CPT1B expression. Our findings suggest that CPT1B is the main transferase for placental long-chain acylcarnitine synthesis, and age-related CPT1B decline may underlie decreased placental metabolic flexibility, potentially contributing to pregnancy complications in older women, particularly if they are overweight

Unfold thy snowy pinions [music] : a Maori love song /

119784 (Publisher number). Caption title.; For voice and piano.; Pl. no.: 119784.; "No. 1 in F min"--Cover.; Also available online http://nla.gov.au/nla.mus-vn3889726