Association Of Other Factors Research Articles

Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review.

Hypertension is a globally prevalent condition, and low adherence to antihypertensive therapy is considered one of the main causes of poor blood pressure (BP) control. Non-adherence to antihypertensive treatment is a complex issue that can arise from various factors; however, gaining an understanding of this provides key targets for intervention strategies. This study aimed to provide an overview of the current status and recent developments regarding our understanding of the determinants of patients' adherence to antihypertensives. A systematic review was performed using the electronic databases MEDLINE/PubMed, Web of Science, Scientific Electronic Library Online (SciELO), and "Índex das Revistas Médicas Portuguesas", which included studies published between 2017 and 2021 following the PICOS model: (P) Adult patients with the diagnosis of primary hypertension, using at least one antihypertensive agent; (I) all interventions on both pharmacological and non-pharmacological level; (C) patient's adherence against their non-adherence; (O) changes in adherence to the therapeutic plan; and (S) any study design (except review articles) written in English, French, Spanish or Portuguese. Articles were reviewed by two researchers and their quality was assessed. Subsequently, determinants were classified according to their consistent or inconsistent association with adherence or non-adherence. Only 45 of the 635 reports identified met the inclusion criteria. Adherence was consistently associated with patient satisfaction with communication, patient-provider relationship, their treatment, and use of eHealth and mHealth strategies; a patient's mental and physical health, including depression, cognitive impairment, frailty, and disability, previous hospitalization, occurrence of vital events; drug treatment type and appearance; and unwillingness due to health literacy, self-efficacy, and both implicit and explicit attitudes towards treatment. There were discrepancies regarding the association of other factors to adherence, but these inconsistent factors should also be taken into account. In conclusion, the barriers to adherence are varied and often interconnected between socioeconomic, patient, therapy, condition, and healthcare system levels. Healthcare teams should invest in studying patients' non-adherence motives and tailoring interventions toindividual levels, by using a multifaceted approach to assess adherence. Further research is needed to analyze the impact of implicit attitudes, the use of new technological approaches, and the influence of factors that are inconsistently associated with non-adherence, to understand their potential in implementing adherence strategies.

Factors Influencing Outcome of Orbital Floor Reconstruction.

Introduction Orbital floor fractures are routinely encountered in facial trauma. Many factors influence the final outcome of the orbital floor surgery, time interval and the extent of other facial bone fractures are the two factors which can significantly influence the postoperative outcome following orbital floor reconstruction. Our study aims to find the ideal time for intervention and the association of other factors in the final outcome of orbital floor reconstruction. Methods A retrospective and prospective cohort study of patients who were operated at Pondicherry Institute of Medical Sciences for orbital floor fractures, between 2011 January and 2017 July. All the data were entered on an Excel work sheet and statistically analyzed. Results In our study 8 patients (8/29, 27.58%) had diplopia prior to surgery, 5 patients (5/29, 17.24%) had complete recovery following surgery and 3 patients (3/29, 10.34%) had persistence of diplopia postoperatively. Patients with diplopia operated prior to 7 days were found to have significant improvement in postoperative diplopia. Patients with 5 or more facial fractures were found to have persistence of diplopia, infraorbital numbness, and enophthalmos postoperatively. Conclusion Our study suggests that early intervention, before 7 days improves the outcome in patients with diplopia and provides a better result postoperatively. In our study preoperative diplopia and infraorbital numbness and postoperative persistence of enophthalmos, diplopia, and paresthesia were found more in patients with 5 or more facial bone fractures. Our study suggests a poor postoperative outcome when 5 or more facial bones are fractured.

Association of demographics, HCV co-infection, HIV-1 subtypes and genetic clustering with late HIV diagnosis: a retrospective analysis from the Japanese Drug Resistance HIV-1 Surveillance Network.

Late diagnosis of the human immunodeficiency virus (HIV) is a major concern epidemiologically, socially and for national healthcare systems. Although the association of certain demographics with late HIV diagnosis has been reported in several studies, the association of other factors, including clinical and phylogenetic factors, remains unclear. In the present study, we conducted a nationwide analysis to explore the association of demographics, clinical factors, HIV-1 subtypes/circulating recombinant form (CRFs) and genetic clustering with late HIV diagnosis in Japan, where new infections mainly occur among young men who have sex with men (MSM) in urban areas. Anonymized data on demographics, clinical factors and HIV genetic sequences from 39.8% of people newly diagnosed with HIV in Japan were collected by the Japanese Drug Resistance HIV-1 Surveillance Network from 2003 to 2019. Factors associated with late HIV diagnosis (defined as HIV diagnosis with a CD4 count <350 cells/μl) were identified using logistic regression. Clusters were identified by HIV-TRACE with a genetic distance threshold of 1.5%. Of the 9422 people newly diagnosed with HIV enrolled in the surveillance network between 2003 and 2019, 7752 individuals with available CD4 count at diagnosis were included. Late HIV diagnosis was observed in 5522 (71.2%) participants. The overall median CD4 count at diagnosis was 221 (IQR: 62-373) cells/μl. Variables independently associated with late HIV diagnosis included age (adjusted odds ratio [aOR] 2.21, 95% CI 1.88-2.59, ≥45 vs. ≤29 years), heterosexual transmission (aOR 1.34, 95% CI 1.11-1.62, vs. MSM), living outside of Tokyo (aOR 1.18, 95% CI 1.05-1.32), hepatitis C virus (HCV) co-infection (aOR 1.42, 95% CI 1.01-1.98) and not belonging to a cluster (aOR 1.30, 95% CI 1.12-1.51). CRF07_BC (aOR 0.34, 95% CI 0.18-0.65, vs. subtype B) was negatively associated with late HIV diagnosis. In addition to demographic factors, HCV co-infection, HIV-1 subtypes/CRFs and not belonging to a cluster were independently associated with late HIV diagnosis in Japan. These results imply the need for public health programmes aimed at the general population, including but not limited to key populations, to encourage HIV testing.

Prognostic Factors Associated With Extubation Failure in Acutely Brain-Injured Patients: A Systematic Review and Meta-Analysis.

Extubation failure in brain-injured patients is associated with increased morbidity. Our objective was to systematically review prognostic factors associated with extubation failure in acutely brain-injured adult patients receiving invasive ventilation in an ICU. MEDLINE, Embase, and Cochrane Central were searched from inception to January 31, 2022. Two reviewers independently screened citations and selected English-language cohort studies and randomized trials examining the association of prognostic factors with extubation failure. Studies were considered if they included greater than or equal to 80% adult patients with acute brain injury admitted to the ICU and mechanically ventilated for greater than or equal to 24 hours. Two reviewers extracted data on population, prognostic factors, extubation outcomes, and risk of bias (using the quality in prognostic factors tool). In the primary analysis, adjusted odds ratios (aOR) for each prognostic factor were pooled using random-effects models. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The search identified 7,626 citations, of which 21 studies met selection criteria. Moderate-certainty evidence suggested increased risk of extubation failure with older age (aOR, 3.0 for upper vs lower tertile; 95% CI, 1.78-5.07) and longer duration of mechanical ventilation (aOR, 3.47 for upper vs lower tertile; 95% CI, 1.68-7.19). Presence of cough (aOR, 0.40; 95% CI, 0.28-0.57) and intact swallow (aOR, 0.34; 95% CI, 0.21-0.54) probably decreased risk of extubation failure (moderate certainty). Associations of other factors with extubation failure were informed by low or very low certainty evidence. Patient age, duration of mechanical ventilation, and airway reflexes were associated with extubation failure in brain-injured patients with moderate certainty. Future studies are needed to determine the optimal application of these variables in clinical practice.

A retrospective analysis of the incidence, outcome and factors associated with the occurrence of euglycemic ketoacidosis in diabetic patients on sodium glucose co-transporter - 2 inhibitors undergoing cardiac surgery.

SGLT2i is a new class of drugs used for type 2 diabetes. SGLT2i are known to cause EuKA in the perioperative period. Euglycemic ketoacidosis (EuKA) can cause life-threatening metabolic acidosis in the perioperative setting. Though the event rate of SGLT2i associated diabetic ketoacidosis in nonoperative setting is low, incidence among peri-operative patients can be very high and remains unknown. The aim of this study was to find the incidence, analyze outcome, and establish correlation between risk factors and EuKA in cardiac surgical patients on SGLT2i. This is a retrospective study analyzing 24 cardiac surgical patients who were on SGLT2i for type 2 diabetes mellitus. Data collection included age, sex, BMI, preoperative HbA1C, albumin, creatinine, type of SGLT2i and timing of stopping before surgery, insulin administration in the immediate pre-operative period; use of CPB, GI infusion and inotropes in the intraoperative period; blood ketone, duration of ventilation, hydration status and length of postoperative stay in postoperative period. Patients were diagnosed to have EuKA if any one of the serially measured postoperative ketone values was more than 0.6 mmol/L (ketone positive). The collected data were used to find an association between the risk factors and the occurrence of EuKA. Of the 24 patients, 17 patients developed EuKA. (70.8.%). 10 of the 17 EuKA in our study required preoperative Insulin for diabetic control whereas none in the ketone negative patients required insulin. This was statistically significant (P = 0.019). Association of other factors to EuKA were not statistically significant. Though the event rate of SGLT2i associated Diabetic ketoacidosis in nonoperative setting is low, (17), the occurrence of EUKA in cardiac surgical patients on SGLT2i in our study was 70.8% (17 out of 24 patients). Patients who require insulin in addition to other oral hypoglycemic drugs for immediate preoperative glycemic control are at risk for the development of SGLT2 inhibitor-induced EuKA postoperatively. Missing the diagnosis of EuKA is fatal in these patients. We couldn't make a diagnosis in our first patient whom we lost. Since it was diagnosed in all our study patients by measuring serial ketone values, there was no mortality and insignificant morbidity. Cessation of SGLT2i before surgery, expectant watch for blood ketones, and treatment with GI infusion reduce morbidity and mortality in cardiac surgical patients.

Gender differences in concerns, stress levels and behavior changes in dental academics in Iran during the COVID-19 pandemic: A cross-sectional study.

Coronavirus disease 2019 (COVID-19) has placed a significant psychological burden on the healthcare personnel. Dental academics play a crucial role in the promotion of public oral health and the education of dental students. The aim of the study was to assess COVID-19-related concerns, stress and behavior changes in Iranian dental academics, determine the associated factors, and assess the potential gender differences. In this cross-sectional study, we shared a researcher-developed questionnaire with Iranian dental academics through social media and e-mail. The questionnaire contained 4 sections: Background (8 items and additional 6 knowledge questions); Concerns (18 items); Stress (based on the 15-item Impact of Event Scale (IES)); and Behavior Change (5 items). We divided the concerns by means of the principal component analysis (PCA) into 3 various components of the fear of infection, concerns over professional responsibilities and concerns over restrictions. The backward stepwise multilevel linear and logistic regression analyses served to discover the association of other factors with stress and behavior changes. Out of 274 respondents, 66% were female, and 78% were 45 years old or younger. Approximately half of the respondents demonstrated moderate to severe stress and the median (Me) for behavior change was 46.5 out of 50. The greatest concern expressed by the participants referred to the fear of becoming infected by their patients and spreading the virus to their loved ones. Being female, living with parents and not having any administrative role, along with greater fear of infection, concerns over restrictions and academic experience were associated with higher levels of COVID-19-related stress. Being female and having an administrative role, along with greater fear of infection and knowledge, and more daily patient visits were associated with desirable COVID-19-related behavior changes. The COVID-19 pandemic has significantly affected dental academics' psychological state, leading to various levels of concern, stress and behavior change. Supportive and educational programs must target those with high fear and stress levels to prevent undesirable behaviors.

Oral Manifestations in SARS-CoV-2 Positive Patients: A Systematic Review.

The COVID-19 pandemic has severely affected the human population by revealing many health problems, including within the oral cavity. This systematic review was designed to answer the question “Is there a relationship between oral manifestations and SARS-CoV-2 infection?”. Following the inclusion and exclusion criteria, twenty-seven studies were included (according to PRISMA statement guidelines). Based on the meta-analysis, nearly two-thirds of the SARS-CoV-2 positive patients reported oral symptoms, in particular taste alterations, xerostomia and ulcerations (54.73% [95% CI: 46.28–63.04%], 37.58% [95% CI: 26.35–49.53%], and 21.43% [95% CI: 13.17–31.06%], respectively). In conclusion, despite the conducted systematic review, the increased prevalence of oral manifestations in SARS-CoV-2 infection cannot be clearly established due to the possible association of other factors, e.g., individual or environmental factors.

Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review

Inflammatory bowel diseases (IBD) are chronic disorders that affect the gastrointestinal tract, including the oral cavity. This systematic review was designed to answer the question “Is there a relationship between oral health status and inflammatory bowel diseases?”. Following the inclusion and exclusion criteria, fifteen studies were included (according to PRISMA statement guidelines). Due to their heterogeneity, only six articles about the prevalence of periodontal disease in IBD patients were included in the meta-analysis. Both Crohn’s disease (CD) and ulcerative colitis (UC) patients had an increased odds of periodontitis coincidence compared to the controls, more than 2- and 3-fold, respectively. Moreover, in most studies, patients with IBD were characterized by higher values of caries indices. In conclusion, despite the conducted systematic review, the risk of oral diseases in IBD patients cannot be clearly established due to the possible association of other factors, e.g., sociodemographic or environmental factors.

Serum Phosphate Profile of Children With Severe Acute Malnutrition Treated With Locally Prepared Therapeutic Feeds: A Prospective Observational Study

Background: Malnutrition in children &lt; 5 years is a public health concern due to its associated high morbidity, mortality and serious long-term consequences. The World Health Organization (WHO) recommends 10 steps for the management of severe acute malnutrition (SAM) children which also involves correction of electrolyte disturbances. Treatment with diets having inadequate amounts of minerals like phosphate can result in refeeding syndrome and other abnormalities. We conducted the study among children with medically complicated SAM to evaluate their serum phosphate levels after receiving locally prepared therapeutic feeds and its associations of other factors. Methods: The study was conducted with 120 hospitalized SAM children aged 6 - 59 months with presence of other illnesses. All children were managed according to the WHO protocol and facility-based management of SAM guidelines of the government of India. Basic demographic details of the child were recorded. Weight of the child was recorded daily, while length/height and mid-upper arm circumference (MUAC) were recorded weekly. We evaluated changes in serum phosphate levels at three time points: on admission, during transition and at discharge. Binary logistic regression analysis was conducted to assess the association of hypophosphatemia with several other indicators. Results: Mean serum phosphate was 4.38 ± 1.07, 4.48 ± 1.16 and 5.13 ± 1.10 mg/dL on admission, during transition and at discharge, respectively. Hypophosphatemia was present among 30 (25%) children on admission, 28 (23.3%) children during transition and 10 (8.3%) children at discharge, which showed a decrease in the prevalence of hypophosphatemia from admission to transition and discharge using the current treatment. The finding also showed positive and significant changes in serum phosphate levels among children who were admitted without edema compared to those admitted with edema. Binary logistic regression estimates showed that older children, children with lower WAZ, hypokalemia, hyponatremia and anemia had higher odds of hypophosphatemia. Male children had lower odds of hypophosphatemia. Conclusion: The nutritional therapy with locally prepared starter and catch-up diet was effective in normalizing hypophosphatemia in the majority of children treated. Serum potassium and serum sodium levels were significantly associated with serum phosphate, indicating the need for careful monitoring of serum phosphate in the presence of hypokalemia and hyponatremia among SAM children. Int J Clin Pediatr. 2021;10(2-3):35-42 doi: https://doi.org/10.14740/ijcp458

Factors associated with gross motor development from birth to independent walking: A systematic review of longitudinal research

AimThe aim of this study is to gain more insight into child and environmental factors that influence gross motor development (GMD) of healthy infants from birth until reaching the milestone of independent walking, based on longitudinal research.BackgroundA systematic search was conducted using Scopus, PsycINFO, MEDLINE and CINAHL to identify studies from inception to February 2020. Studies that investigated the association between child or environmental factors and infant GMD using longitudinal measurements of infant GMD were eligible. Two independent reviewers extracted key information and assessed risk of bias of the selected studies, using the Quality in Prognostic Studies tool (QUIPS). Strength of evidence (strong, moderate, limited, conflicting and no evidence) for the factors identified was described according to a previously established classification.ResultsIn 36 studies, six children and 11 environmental factors were identified. Five studies were categorized as having low risk of bias. Strong evidence was found for the association between birthweight and GMD in healthy full‐term and preterm infants. Moderate evidence was found for associations between gestational age and GMD, and sleeping position and GMD. There was conflicting evidence for associations between twinning and GMD, and breastfeeding and GMD. No evidence was found for an association between maternal postpartum depression and GMD. Evidence for the association of other factors with GMD was classified as ‘limited’ because each of these factors was examined in only one longitudinal study.ConclusionInfant GMD appears associated with two child factors (birthweight and gestational age) and one environmental factor (sleeping position). For the other factors identified in this review, insufficient evidence for an association with GMD was found. For those factors that were examined in only one longitudinal study, and are therefore classified as having limited evidence, more research would be needed to reach a conclusion.

Prognostic indicators of survival in patients with small-cell lung cancer at a tertiary care center in Lebanon.

Objective:Small-cell lung cancer is a very aggressive tumor associated with high invasiveness and ease of metastasis and therefore poor prognosis. In the literature, several demographical, clinical as well as pathological factors including age, stage, gender and smoking were cited as independent prognosticators of survival.Material and Methods:This is a retrospective cohort study that includes 222 patients diagnosed with small-cell lung cancer between 2010 and 2019. Clinical and demographic data were extracted from their medical records. The Kaplan–Meier and logistic regression models of statistical analysis were used to evaluate the association of these variables with survival.Results:Forty-five percent of patients were found to be alive at the time of data collection. The median survival of patients with small-cell lung cancer was found to be 14 months. On univariate analysis, increasing age as well as stage (extensive disease) were found to be significantly associated with decreased survival at 3 years. On the contrary, both gender and smoking status at diagnosis were not shown to significantly influence survival. On multivariate analysis, both age as well as stage remained significantly associated with survival.Conclusion:Limited data exist in the literature regarding the prognostic indicators of survival in small-cell lung cancer, especially from the Middle East area. In our study, both age and stage at the time of diagnosis were found to significantly influence survival. Further studies are needed to assess the association of other factors with survival.

Vasomotor, urogenital, psychological, and somatic symptoms in association with CYP1B1 polymorphisms in Slovak women of different menopausal status.

The aim of this study was to examine if the Arg48Gly, Ala119Ser, Leu432Val, and Asn453Ser polymorphisms in the CYP1B1 estrogen-metabolizing gene are associated with menopausal symptom experience in healthy Slovak women aged 40-60 years. We also investigated the possible association of other factors with menopausal symptoms, including health status, physical activity, reproductive history, psychological status, and smoking. The total sample consisted of 367 women (mean age 49.11 ± 5.86 years), encompassing 180 premenopausal (mean age 45.06 ± 3.81 years), 29 peri-menopausal (mean age 49.41 ± 3.94 years), and 158 postmenopausal (mean age 53.71 ± 4.54 years) women. The research comprised anthropometric and bioelectrical impedance analysis measurements (BIA), blood or saliva samples collected for DNA analysis, and a specific menopausal questionnaire. CYP1B1 Arg48Gly is significantly associated with vasomotor, psychological, and somatic symptoms. It appears that the Gly/Gly genotype is a risk factor during the postmenopause and protective in the pre- and peri-menopause. CYP1B1 Ala119Ser was associated with all menopausal symptoms, with the Ser/Ser genotype increasing risk in the premenopause and offering protection in the peri- and postmenopause. Polymorphisms Leu432Val and Asn453Ser gave unequivocal results; independent of menopausal status, the Leu/Leu genotype was associated with increasing risk of vasomotor, urogenital, and psychological symptoms and the Asn/Asn genotype provided a protective effect against psychological symptoms. Our results suggest possible associations of CYP1B1 polymorphisms with the occurrence and manifestation of particular menopausal symptoms in healthy mid-life Slovak women.

Factors Associated With In-field Recurrence in Patients Treated With Liver SBRT

Stereotactic body radiation therapy (SBRT) is an emerging technique for treatment of primary and secondary liver malignancies. Reports in the literature of the impact of set up uncertainties and other factors influencing in-field recurrences are lacking. The aim of this study was to examine the magnitude and consistency of interfractional shifts, their association, and association of other factors with in-field recurrences in patients treated with liver SBRT. All patients treated with liver SBRT at a single institution between 2014 and 2016 with doses 40 – 50 Gy in 5 fractions were included. Tumor histologies included hepatocellular carcinoma (50%), cholangiocarcinoma (4%), liver metastases from colorectal (39%) and other cancers (7%). Median follow-up was 15 months. A bony match was performed using orthogonal kV images. A soft-tissue match was then performed using a cone beam CT (CBCT). The shift data included in this study are the shifts made after the CBCT. Respiratory motion management techniques included abdominal compression, respiratory gating or free breathing, with the target respiratory motion below 1 cm. No dedicated internal fiducial markers were used. Retrospective analysis of prospectively collected data was performed as a part of an institutional Quality Assurance process. A total of 46 patients met the eligibility criteria. Data on interfractional shifts were available for 22 patients. One- and two-year in-field control rates were 64% and 30%, respectively. Mean vector shift length was 0.37 cm (systematic error 0.14 cm, random error 0.29 cm), 86% of patients had no shifts greater than 1 cm, 96% of all the shifts performed were less than 1 cm. Inferior tumor location had lower interfractional shift values compared with other tumor locations (one sided t-test=1.81, p-value=0.047). Despite that, inferior tumor location was weakly associated with in-field recurrence on univariate analysis (HR=2.63, p-value=0.093; 95% CI 0.86, 8.06), with median time to in-field recurrence 11 months as opposed to 21 months in patients with other tumor locations. Liver metastasis histology was also weakly associated with in-field recurrence, compared with primary liver histologies (HR=1.63, p-value=0.087; 95% CI 0.93, 2.87). Radiation dose, motion management technique, planning target volume and interfractional shift magnitude were not associated with in-field recurrence. Set up uncertainty and reproducibility was acceptable and did not impact in-field recurrences. Cone beam CT with soft tissue matching appears to be an appropriate set-up verification method. Inferior tumor location was associated with higher in-field recurrences in this patient cohort, likely due to proximity of critical structures, such as small bowel, resulting in target volume coverage compromises. Detailed evaluation of dose distribution in patients with in-field recurrences is underway.

Examining associations between citizens' beliefs and attitudes about uncertainty and their earthquake risk judgments, preparedness intentions, and mitigation policy support in Japan and the United States

Although hazards are inherently uncertain, research on citizens’ judgments of risk, hazard preparedness, and support for mitigation policies has rarely accounted for citizens’ beliefs about the uncertainty of fields estimating hazard risk or in science as providing accurate, unbiased knowledge, nor citizens’ need to achieve quick, certain answers. Parallel online surveys of residents of earthquake-prone areas of Japan and the United States revealed that belief in scientific positivism increased policy support in both countries (as did need for closure among Americans), and belief in seismological uncertainty reduced judged earthquake risk in Japan, with small effect sizes. Preparedness was unaffected by these predictors. Associations of other factors (quake experience; trust in experts; demographics) with dependent variables were consistent with other studies, and Japanese-American differences were small on dependent variables and in most predictors. Motivation (i.e., high involvement with the topic, relevance of the fictional earthquake rupture forecast in a quasi-experiment embedded in the survey, and judged ability to use its information) strongly affected judged risk, preparedness and policy support. Low-motivation Japanese and high-motivation Americans exhibited associations most similar to overall findings for their nations. Implications of these findings for hazards research and risk communication are discussed.

Cholangiocarcinoma size on magnetic resonance imaging versus pathologic specimen: Implications for radiation treatment planning

PurposeThe accuracy of abdominal magnetic resonance imaging (MRI) in measuring gross tumor volume in patients with resectable cholangiocarcinoma (CC) is unknown. CC is a highly difficult tumor to visualize and treatment with dose-escalated radiation therapy requires clear tumor delineation. We aim to investigate the concordance between imaging and pathologic size in patients with resected CC to determine the usefulness of MRI for image guided treatment modalities. Methods and materialsThe records of 51 patients with resected CC who underwent preoperative MRI were evaluated. Each preoperative MRI was individually reviewed by a diagnostic radiologist (P.M.), who was blinded to pathologic measurements. A combination of dynamic multiphase contrast-enhanced T1- and T2-weighted images, original imaging reports, and pathologic reports were reviewed for greatest tumor dimensions. A general linear regression model was used to examine the outcome MRI minus pathology using MRI report, T1-weighted measurement, or T2-weighted measurement. A multivariable regression model was fit to assess the association of other factors with pathologic underestimation. ResultsThe median age was 69 years. Eleven tumors were categorized distal/extrahepatic, 17 hilar, and 23 intrahepatic CC. The median tumor size on pathology report was 3.00 cm (range, 0.3-19). The median tumor size from the MRI report was 3 cm (range, 0.80-16.20) and median tumor size on independent radiological review was 3 cm (range, 0.90-17) on the T1-weighted and 3 cm (range, 0.90-17) on the T2-weighted MRI sequences. When compared with pathologic tumor size, the MRI report dimension was found to underestimate tumor size by 4.1 mm (P = .04). On multivariable analysis, pathologic size underestimation was influenced by increasing tumor size (slope, −0.20; P < .001); however, underestimation was not affected by tumor location or MRI sequence. ConclusionsMRI underestimates tumor size, which was more pronounced with larger tumors, but not influenced by tumor location. The potential for gross tumor volume underestimation should be considered when planning highly conformal radiation therapy treatment of CC.

SEROPREVALENCE OF OXOPLASMA GONDII AND NEOSPORA CANINUM IN URBAN AND RURAL DOGS FROM SOUTHWESTERN NIGERIA

Background: Toxoplasma gondii and Neospora caninum are protozoans infecting a wide range of mammals; the etiologic agents of Toxoplasmosis and Neosporosis respectively, This study investigated the prevalence of antibodies to Toxoplasma gondii and Neospora caninum in dogs from southwestern Nigeria. Materials and Methods: A total of 233 serum samples were obtained from both urban and rural areas of Oyo state, Nigeria and tested by the western blotting technique for specific IgG to T. gondii and N. caninum. Results: The seroprevalence obtained for T. gondii was 19% (44/233) and 2.1% (5/233) for N. caninum in the dogs examined. Overall, the prevalence of antibodies to T. gondii was more significant than for N. caninum (P< 0.0001). T. gondii infection was also found to be more significant in roaming than in caged dogs (P< 0.05). There was no significant association of other factors (age, breed, history of rabies vaccination, use of dog and the level of education of owner) with the prevalence of T. gondii and N. caninum infection. Conclusion: This report revealed that T. gondii infection is more common than N. caninum infection in Nigerian dogs, it suggests that improper housing and feeding of dogs could increase the risk of exposure to T. gondii infection. This is the first study to investigate the seroprevalence of N. caninum antibodies in Nigerian dogs and T. gondii antibodies in dogs in southwestern Nigeria.

A Study on Subfertile Women Suffering from Polycystic Ovarian Syndrome with Hyperprolactinaemia and Hypothyroidism as Associated Factors

Objective: This study tried to evaluate association of other factors of subfertility in women suffering from polycystic ovarian syndrome (PCOS). Methods: Fifty subfertile women suffering from PCOS attending infertility unit of the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during July 2010 and June 2011, were evaluated. Results: In out study, Age, BMI and duration of marriage range was 20 38 years, 17.70 33.20 kg/m2 and 1 16 years, respectively. Serum FSH was normal (1.0 10.0 mIU/ml) in all 50 (100%) women. Hyperprolactinaemia (serum prolactin &gt;25 ng/ml) was seen in 60%. Hypothyroidism (serum TSH &gt;4 ìIU/ml) was seen in 74% women. Serum LH (&gt;10 mIU/ml) was raised in 74%. USG finding of lower abdomen was abnormal in 75% cases. Conclusion: This study concludes that hyperprolactinaemia and subclinical hypothyroidism were associated causes of subfertility other than PCOS. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20980 J Bangladesh Coll Phys Surg 2013; 31: 140-143

Incidence and risk of anemia in type-2 diabetic patients in the absence of renal impairment

Aim: To determine the incidence of anemia in type-2 diabetic patients with normal renal function and assess the association of other factors related to diabetes with the risk of anemia. Methods: The study group comprised 72 patients with type-2 diabetes. Patients were divided into groups according to glycemic control, gender and age. Serum creatinine, hematocrit, hemoglobin concentration, blood glucose and glycated hemoglobin (HbA1c) of subjects were measured. The presence of anemia was defined by a he- moglobin level 7.5%) compared to those with controlled diabetes (≤7.5%) and in patients of age ≥ 60 yrs compared to those of age < 60 yrs (p < 0.05). The odds of anemia was similar in males and females (p = 0.26). Conclusion: This study indicated that poor glycemic control and old age are associated with the incidence of anemia in type-2 diabetics with normal renal function. Our findings suggest that treatment criteria for diabetes should include routine hematological tests and take into consideration the inevitable consequences of ageing, and poor glycemic control.

Low incidence of methylation of the promoter region of the FANCF gene in Japanese primary breast cancer

The link between BRCA1 dysfunction and basal-like breast cancer or triple-negative breast cancer (TNBC) has been suggested; however, the associations of other factors involved in the Fanconi anemia (FA)/BRCA pathway with the pathogenesis of basal-like breast cancer remain unidentified. FANCF protein is a component of the FA core complex. The methylation of CpG islands in the FANCF gene plays an important role in occurrence of ovarian cancer and also is an important regulator of cisplatin sensitivity of ovarian cancer. The purpose of this study is to investigate the frequency of FANCF methylation, and to discuss its involvement in the pathogenesis of TNBC and its potency as a predictor of cisplatin sensitivity for breast cancer. The methylation of the FANCF gene promoter was investigated, using methylation-specific PCR, in genomic DNA of 99 invasive breast carcinoma specimens obtained from Japanese patients. FANCF methylation was recognized in only 4 of 99 cases (4.0%). No significant correlation was found between FANCF methylation and the expression of ER, PR, HER2, and TNBC. FANCF methylation is a rare event in Japanese primary invasive breast cancer. This suggests it is not involved in the pathogenesis of TNBC, and it could not be used as a predictor of cisplatin sensitivity in breast cancer.

Mutational Analysis of the Ribosomal Protein Rpl10 from Yeast

Yeast Rpl10 belongs to the L10e family of ribosomal proteins. In the large (60 S) subunit, Rpl10 is positioned in a cleft between the central protuberance and the GTPase-activating center. It is loaded into the 60 S subunit at a late step in maturation. We have shown previously that Rpl10 is required for the release of the Crm1-dependent nuclear export adapter Nmd3, an event that also requires the cytoplasmic GTPase Lsg1. Here we have carried out an extensive mutational analysis of Rpl10 to identify mutations that would allow us to map activities to distinct domains of the protein to begin to understand the molecular interaction between Rpl10 and Nmd3. We found that mutations in a central loop (amino acids 102-112) had a significant impact on the release of Nmd3. This loop is unstructured in the crystal and solution structures of prokaryotic Rpl10 orthologs. Thus, the loop is not necessary for stable interaction of Rpl10 with the ribosome, suggesting that it plays a dynamic role in ribosome function or regulating the association of other factors. We also found that mutant Rpl10 proteins were engineered to be unable to bind to the ribosome accumulated in the nucleus. This was unexpected and may suggest a nuclear role for Rpl10.