Caucasian Females Research Articles

Ribavirin in Acute Hepatitis E Infection in Patients with Gynecological Cancer: A Case Series

Hepatitis E virus infection is usually a self-limited disease. However, during the last years there has been growing evidence for prolonged and chronic infection occurring in patients with immunosuppression. Also patients with malignant and rheumatic diseases have been identified to be at risk for chronic hepatitis E. However, their course and prognosis are not well characterized and there have been no reports of hepatitis E virus infection in patients with gynecological cancer. Here, we report three Caucasian females with breast and ovarian cancers presenting with elevation of aminotransferase levels during anticancer treatment. Although only few or no clinical hints suggested hepatitis E virus infection, the diagnosis of hepatitis E virus infection was confirmed by seroconversion, which might occur with some delay, and/or by polymerase chain reaction. While two patients had a self-limited course, the third patient with a high-risk oncological constellation required ribavirin in order to resume chemotherapy. These cases highlight the need for hepatitis E virus testing in patients with gynecological cancer and elevated aminotransferase levels. Further, these cases show that in selected high-risk patients, ribavirin treatment may be necessary based on the decision of a multidisciplinary team.

Electronically Verified Use of Internet-Based, Multimedia Decision Aids by Adolescents With Type 1 Diabetes and Their Caregivers.

Decision aids (DAs) are central to shared decision making (SDM) interventions, yet little is known about patients’ actual DA use. Adequate utilization of DAs could optimize SDM effectiveness. Electronic DAs enable more objective tracking and analysis of actual DA utilization than do paper DAs. This report is part of an ongoing randomized controlled SDM trial enrolling adolescents with type 1 diabetes and their caregivers (n = 153) who were considering use of an insulin pump or continuous glucose monitor. Extensive stakeholder engagement guided creation of two online DAs. After completing baseline measures, 133 dyads were randomized to SDM (access to the pertinent DA) or Usual Care (clinic routines for preparing candidates for adopting these devices). Utilization data showed that 80% of caregivers and 66% of youths logged into a DA at least once; youths and caregivers, respectively, dedicated a mean of 44.7 and 55.0 minutes to website use and viewed 72.2% and 77.4% of the DA content. Median total duration from enrollment to last DA logout was 48.2 days for adolescents and 45.6 days for caregivers. Bivariate comparisons showed that non-Hispanic, Caucasian females from households with higher socioeconomic status were significantly more likely to login to the assigned DA at least once. Hierarchical multiple regression showed that adolescent males with lower levels of health literacy demonstrated fewer DA logins (F = 2.59; P < 0.009), but identified no significant predictors of adolescents’ or caregiver’ duration of DA use or proportion of DA content viewed. Future SDM trials should seek to promote DA use, especially by non-White adolescents, perhaps with direct assistance with the initial DA login. Trials employing electronic DAs should routinely report and analyze utilization data.

Inhibition of return regarding body images in women with shape/weight-based self-worth

The present study examined attentional biases to female body images in young adult (aged 17–30 years) Caucasian females with high versus low levels of shape/weight-based self-worth. Using an inhibition of return (IOR) task, we measured how readily participants were able to disengage attention from nonthin and thin-ideal body images. In response to nonthin body images, the Low group (i.e., participants with low levels of shape/weight-based self-worth) displayed increased IOR toward the body images relative to the High group (i.e., participants with elevated shape/weight-based self-worth). Our results suggest that women with low levels of shape/weight-based self-worth possess a potential protective mechanism that allows them to more readily disengage attention from nonthin images compared to women who base their self-worth on shape/weight. These findings provide a new focus for investigating attentional processes in individuals at risk of eating disorders, as they relate to the ongoing processing of body-related imagery beyond initial attentional capture.

AB002. Tracheal surgery

AB002. Tracheal surgery

The ideal ear position in Caucasian females

PurposeEar position contributes significantly to facial appearance. However, while objective measurements remain the foundation for esthetic evaluations, little is known about how an ear should ideally be positioned regarding its rotational axis. This study aimed to further evaluate whether there exists a universally applicable ideal ear axis, and how sociodemographic factors impact such preferences. Materials and methodsAn interactive online survey was designed, enabling participants to change the axis of a female model's ear in terms of its forward and backward rotation. The questionnaire was sent out internationally to plastic surgeons and the general public. Demographic data were collected and analysis of variance was used to investigate respective preferences. ResultsA total of 1016 responses from 35 different countries (response rate: 18.5%) were gathered. Overall, 60% of survey takers chose the minus 10 or 5° angles to be most attractive. Significant differences were found regarding sex, ethnicity, country of residence, profession and respective ear axis preferences. ConclusionAcross multiple countries and ethnicities, an ear position in slight reclination of minus 5–10° is considered most pleasing in Caucasian females. However, sociodemographic factors significantly impact individual ear axis preferences and should be taken into consideration when performing reconstructive ear surgery.

CYP1A1 Ile462Val Polymorphism Is Associated with Cervical Cancer Risk in Caucasians Not Asians: A Meta-Analysis.

Objective: Previous studies have reported that Ile462Val polymorphism in the gene Cytochrome P450 1A1 (CYP1A1) is associated with the risk of cervical cancer, but inconsistent results have emerged. Hence, we performed this updated and cumulative meta-analysis to ascertain a more accurate association between CYP1A1 Ile462Val polymorphism and risk of cervical cancer.Methods: Studies involving the CYP1A1 Ile462Val polymorphism associated with cervical cancer risk were searched from the databases of PubMed, Scopus, ScienceDirect, and Chinese National Knowledge Infrastructure (CNKI). The strength of correlation was evaluated through calculating summary odds ratios (ORs) with the corresponding 95% confidence intervals (95% CIs). Subgroup analyses according to ethnicity, source of control and HWE were completed to further explore specific association between the polymorphism and the cancer risk.Results: Altogether, 11 eligible case-control studies were ultimately encompassed into the current meta-analysis, with 1,932 patients and 2,039 healthy controls. The total analysis revealed a borderline relationship between CYP1A1 Ile462Val polymorphism and cervical cancer risk in general population. Interestingly, after subgroup analyses based on ethnicity and source of control, the polymorphism increased the susceptibility of cervical cancer in Caucasian (G vs. A: OR = 1.97, 95% CI = 1.24–3.13; GG vs. AA: OR = 3 .24, 95% CI = 1.24–8.46; GA vs. AA: OR = 1.62, 95% CI = 1.25–2.10; GA+GG vs. AA: OR = 1.68, 95% CI = 1.16–2.43; GG vs. AA+GA: OR = 2.73, 95% CI = 1.05–7.10) and population-based (G vs. A: OR = 1.49, 95% CI = 1.10–2.02; GA vs. AA: OR = 1.41, 95% CI = 1.20–1.67; GA+GG vs. AA: OR = 1.40, 95% CI = 1.19–1.64) groups.Conclusion: The CYP1A1 Ile462Val polymorphism may enhance the susceptibility to cervical cancer in Caucasian females.

The relationship between negative metacognitive thoughts, pain catastrophizing and adjustment to chronic pain

Cognitive appraisals, most notably pain catastrophizing, play an important role in chronic pain. The role of metacognition and its impact on the relationship between pain catastrophizing and health are understudied. The identification of metacognition as a moderator of psychological constructs may have clinical and empirical implications. We hypothesized that negative metacognitive beliefs would moderate the relationships between pain catastrophizing and emotional functioning and physical activity. Participants (N=211) with mixed aetiology chronic pain were primarily Caucasian females with severe average pain intensity. Over the course of 2weeks, participants completed online daily-diary measures of pain catastrophizing, pain intensity, mood, physical activity and metacognition. Participants with higher average levels of daily pain intensity and negative metacognitive beliefs about worry reported higher levels of daily pain catastrophizing, as well as daily depression, and anxiety. Some aspects of metacognitive beliefs (i.e. dangerousness and uncontrollability of thoughts) were also negatively associated with average daily levels of positive affect. However, these effects were not interactive; metacognitive beliefs did not moderate the relationships of pain catastrophizing with other daily variables. From a daily coping perspective, findings reveal that people with stronger negative metacognitive beliefs report greater emotional distress on a day-to-day basis. However, negative metacognitive beliefs did not appear to modify the effects of pain catastrophizing on psychological and physical functioning at the daily level, suggesting that metacognitive beliefs may be better conceptualized as a more parallel indicator of emotional maladjustment to chronic pain whose effects do not reliably manifest in daily measurement models. Findings highlight the need to better characterize the value of metacognitive beliefs as an important predictor and therapeutic target. Despite limited evidence of a dynamic relationship between metacognition and daily adjustment to chronic pain, results emphasize the potential importance of interventions that target cognitive appraisal process beyond catastrophizing, including uncontrollability and danger-laden thought patterns.

Age-induced and photoinduced changes in gene expression profiles in facial skin of Caucasian females across 6 decades of age

Intrinsic and extrinsic factors, including ultraviolet irradiation, lead to visible signs of skin aging. We evaluated molecular changes occurring in photoexposed and photoprotected skin of white women 20 to 74years of age, some of whom appeared substantially younger than their chronologic age. Histologic and transcriptomics profiling were conducted on skin biopsy samples of photoexposed (face and dorsal forearm) or photoprotected (buttocks) body sites from 158 women. 23andMe genotyping determined genetic ancestry. Gene expression and ontologic analysis revealed progressive changes from the 20s to the 70s in pathways related to oxidative stress, energy metabolism, senescence, and epidermal barrier; these changes were accelerated in the 60s and 70s. The gene expression patterns from the subset of women who were younger-appearing were similar to those in women who were actually younger. Broader application of these findings (eg, across races and Fitzpatrick skin types) will require further studies. This study demonstrates a wide range of molecular processes in skin affected by aging, providing relevant targets for improving the condition of aging skin at different life stages and defining a molecular pattern of epidermal gene expression in women who appear younger than their chronologic age.

Disruption of human stratum corneum lipid structure by sodium dodecyl sulphate.

Surfactants are major ingredients of body soaps and cleansers, and such harsh ones have been demonstrated to damage the skin. Stratum corneum (SC), the outermost barrier of the skin layer, is rich in intercellular lipids. This lipid structure can be disrupted by surfactants, impairing the barrier function of the skin. Thus, we investigated the surfactant-induced disruption of the intercellular lipid structure of human SC at the molecular level using synchrotron X-ray diffraction. SC samples from the breast of female Caucasians were treated with sodium dodecyl sulphate (SDS) and analysed by small-angle and wide-angle X-ray diffraction. We found that an aqueous SDS solution affected the long lamellar structure, which became disorganized. The final disordered lipid state was reached through two or more types of structural change. We propose that the disordered lipid state results from incorporation of SDS into the long lamellar structure. In contrast, the lattice constants in the short lamellar and the hydrocarbon-chain packing structures remained almost unchanged after SDS treatment. We conclude that the disruption of the long lamellar structure plays a key role in the damage to the SC caused by detergents. To our knowledge, this is the first report to clarify the details of the disorganization of the intercellular lipid structure upon surfactant application. The knowledge obtained herein may allow the development of skin restoration methods and cleanser products that do not affect skin barrier functions.

Treatment seeking for problematic pornography use among women.

Background and aimsPrevious studies examined psychological factors related to treatment seeking for problematic pornography use (PU) among males. In this study, we focused on females who seek treatment for problematic PU and compared them with non-problematic pornography users with regard to variables related to problematic PU. Second, we investigated the relationships between critical constructs related to problematic PU with the path analysis method, emphasizing the predictors for treatment seeking among women. We also compared our results with previous studies on males.MethodsA survey study was conducted on 719 Polish-speaking Caucasian females, 14–63 years old, including 39 treatment seekers for problematic PU.ResultsThe positive relationship between the mere amount of PU and treatment seeking loses its significance after introducing two other predictors of treatment-seeking: religiosity and negative symptoms associated with PU. This pattern is different from the results obtained in previous studies on males.DiscussionDifferent from previous studies on male samples, our analysis showed that in the case of women, mere amount of PU may be related to treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, which may indicate that in the case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU but also by personal beliefs about PU and social norms.ConclusionFor females, negative symptoms associated with PU, the amount of PU and religiosity is associated with treatment seeking. Those factors should be considered in treatment.

Proton Pump Inhibitors Not a Major Risk Factor for Hospital-acquired Clostridium difficile Infection in Young, African American Males

Introduction: Clostridium difficile infection (CDI) is the leading cause of healthcare-associated infections. Due to its increased morbidity and mortality, there is great need to identify associated demographics and risk factors. National epidemiology reveals a predominance of elderly, Caucasian females. Proton pump inhibitors (PPIs) have been associated with a 1.4-2.75x increased risk of CDI. The exact relationship between hospital-acquired CDI (HA-CDI) and PPIs is unclear. We performed a retrospective analysis to (1) Examine CDI epidemiology at Hahnemann University Hospital compared to national epidemiology and (2) Investigate the association between PPIs as a risk factor for HA-CDI.Figure: Demographic and PPI characteristics of the CDI cases and controls.Methods: We conducted a case-control study of HA-CDI from 08/2014 to 04/2017. Cases (n=229) were defined as confrmed diagnosis 72 hrs post-admission. Controls (n=454) were frequency matched in a 2:1 ratio based on age and length of stay. PPI was classified into 4 categories: dosage (20mg, 40mg), frequency (QD, BID), delivery (PO, IV) and duration (10 days). Student's T-test, Wilcoxon rank sum test, Chisquared test were used to compare risk factors between cases and controls. Results: HA-CDI cases had a mean age of 60 with male predominance (54%, n=123) vs. females (46%, n=106), and by race, 56% (n=120) African American and 36% (n=77) Caucasian. In our sample (cases & controls), 48% (n=328) were on a PPI with the combined majority 73% (n=239) on 40mg daily vs. 25% (n=83) on 40mg BID. PPIs were administered orally in 61% (n=200) vs. IV in 38% (n=123) of all combined patients with the majority exposed for 10+ days (59%, n=190). There were no statistically significant differences between cases and controls in PPI use, dosage, route of administration or duration. Conclusion: National CDI epidemiology reveals a predominance of elderly (51.9% age >65), Caucasian (78.6%) and female (59%) patients. In contrast, our CDI epidemiology showed a predominance of younger, African American males. PPIs are theorized to increase the risk of CDI due to increased gastric pH which may prevent protective flora from actively suppressing the germination of Clostridium difficile spores and toxin synthesis. However, given that there was no significant association detected between PPI and CDI in our sample, we must consider alternative risk factors that may uniquely predispose our distinct cohort to CDI. The relationship between PPI and CDI in unique demographic cohorts such as ours needs to be further explored in future studies.

Characteristics of Significant Fibrosis by Transient Elastography and Evaluation of Non-Invasive Fibrosis Tests in Patients With Primary Biliary Cholangitis

Introduction: Primary biliary cirrhosis (PBC) affects up to 40 thousand persons in the United States of America. Liver fibrosis can be assessed by transient elastography (TE) and serum tests such as Fibrosis-4 index (FIB- 4), aspartate transaminase to platelet ratio index (APRI) and aspartate transaminase to alanine transaminase ratio (AST/ALT). Comparison of serum tests with TE in PBC patients has not been studied. The aim was to characterize the population of PBC patients and assess liver fibrosis using transient elastrography (TE) and validated serum tests.Figure: Correlation of non significant fibrosis (F0-F1) and significant fibrosis (F2-F4) to validated serum tests in patients with primary biliary cholangitis (PBC).Table: Table. General characteristics and mean values for common lab testsMethods: This is a cross-sectional retrospective study focusing on patients with PBC. A total of 31 patients who have PBC and had TE from March 2014 to March 2017 were included. The correlation between the presence of significant fibrosis by TE and data of other non-invasive tests were performed with crosstab analysis. Chi-square tests were performed to determine statistical significance. Results: The study group was consisting mainly of patients with Caucasian ethnicity at 71 %, and the predominant gender was female at 90.3%. The results of LSMs showed a mean value of 5.6 ± 2.9 kPa. The LSM values corresponding to F2-F4 were seen in 4 of 31 patients (12.9%). A total of 85.7% were anti mitochondrial antibody (AMA) positive, 29.4 % were anti-nuclear antibody (ANA) positive. Twelve of 31 patients (39.3%) with available data were alcohol users at the time of the TE procedure. Among the four with F2-F4 fibrosis per TE measurements, 3 were females (75%) and the mean age was 66±7.1 years. The mean BMI was 27.9±8.3 kg/m2. Fibrosis-4-index tests showed statistical correlation with data from serum tests. For Fib-4-index 100% of patients with F2-F4 by LSM had a value of >1.45 and 64% of patients with F0-F2 had Fib-4 <1.45. For APRI score no patients had a positive value of >1 and no crosstab evaluation could be performed. Conclusion: Our study population were predominantly elderly Caucasian females consistent with other studies but other ethnicity groups are also represented. In PBC patients, Fib-4 was more predictive of significant fibrosis than APRI and AST/ALT, Fib-4 was better for excluding PBC patients with significant fibrosis than including. Considering the fact that liver biopsy is invasive. Use of these serum tests can be questionable if used alone but It can be a useful tool taking into consideration overall clinical context as well as additional tests used.

Retinyl propionate and climbazole combination demonstrates clinical improvement to the appearance of hyperpigmentation and deep wrinkling with minimal irritation.

To evaluate a combination of retinyl propionate and climbazole (RPC) compared to 0.1% retinol for its efficacy, tolerance and ageing appearance. Forty-five healthy Caucasian females, ages 40-70, with moderately photodamaged facial skin, were recruited for a 16-week randomized, double-blind, IRB-approved facial study. The efficacy of RPC treatment was compared to 0.1% retinol, in the same product base formulation, with twice daily, split-face product application. Changes in overall photodamage, fine lines and wrinkles, pigmentation and irritation were visually evaluated and measured by instrumentation. Subjective appraisal of efficacy was self-assessed from images where subjects were blinded to treatment and time point. Irritancy potential was also evaluated in a 5-day randomized, double-blind, IRB-approved patch study. Treatment with RPC resulted in significant (P < 0.05) improvement in ageing attributes compared to 0.1% retinol treatment, with minimal irritation. More than 50% of subjects showed improvement to deep wrinkles in the crow's feet area after 5 weeks of product application, and continued improvement to deep wrinkles was observed throughout the course of the study. Similarly, improvement was observed for the appearance of lines and wrinkles in the nasolabial fold (NLF) and for mottled hyperpigmentation. The results from subjective self-assessment confirmed in vivo clinical assessments. In a separate patch study, significantly less irritation was observed with the RPC product as compared to the 0.1% retinol control product. RPC delivered significant skin anti-ageing benefits comparable or greater than 0.1% retinol, with minimal irritation.

Abstract: Subjective and Objective Facial Dynamics Using Dermal Fillers Formulated for Facial Movement Adaptation

INTRODUCTION: The fear of looking unnatural is a well-known concern for patients contemplating dermal aesthetic procedures. Facial dynamics is an increasing area of clinical focus extending beyond 3-D volume restoration, as naturalness of clinical outcomes at rest and with animation may vary. We evaluated the dynamic face using subjective and objective methods following treatment with dermal fillers formulated with physicochemical properties for facial movement adaptation. METHODS: Thirty Caucasian females (40–65 years) with moderate to severe, bilateral wrinkles in the lower face were treated with HA fillers (20mg/mL with XpresHAn TechnologyTM) and followed 4 weeks post-optimal correction. Subjective, dynamic assessments evaluated pre- versus post- expressions in motion (2D videos), using a series of standardized expressions. Facial dynamics were objectively evaluated and quantified using 3-D stereophotogrammetry (Canfield Scientific, Inc), including a younger, untreated Caucasian female cohort (N=20; 25–35 years). Satisfaction of treated subjects was assessed using a 5-point Likert scale. RESULTS: Subjective facial dynamics revealed naturalness of the lower face in motion to be at least maintained in 100% of subjects (naturalness maintained or enhanced). Collectively, 83.3% of subjects were rated with enhanced attractiveness and looked younger, without compromise in naturalness. Rater agreement was high for individual assessments of attractiveness, youthfulness, and naturalness (70.0% – 83.3%). Subject satisfaction ratings were consistent with treating investigator assessment, with post-treatment improvement across all items assessed based on proportions of subject agreement (strongly agree or agree). Highest levels of subject satisfaction (>80%) observed post-treatment pertained to overall facial appearance is pleasing (90.0%); overall facial appearance looking natural (100%); face looking natural when relaxed (96.7%) and when smiling (93.3%), and looking younger than actual age (83.3%). For specific anatomic areas (marionette lines), global dynamic assessment using 3-D stereophotogrammetry showed significantly higher levels of stretch in older (20.1%, pre-treatment) versus younger subjects (17.7%; p<=.05), with stretch levels significantly reduced post-treatment (17.9%; p<=.05) such that older subjects post-treatment resembled younger subjects. CONCLUSION: Dermal fillers formulated with XpresHAn TechnologyTM resulted in subjective dynamic assessments characterized by improvements in attractiveness and youthfulness, without compromising naturalness. Objective facial dynamics provided quantitative evidence of stretch levels resembling a younger phenotype, in areas specifically prone to dynamic volumetric effects of facial aging. This work underscores the importance of objective dynamic assessment as the fourth dimension of facial aesthetics.

Elementary Teachers’ Perspectives on the Use of Multicultural Literature in Their Classrooms

This qualitative study set out to determine how multicultural literature was used and perceived by US elementary school teachers, and how the beliefs of teachers shape perceptions, selection, interpretation, and the teaching of multicultural literature (Ketter &amp; Lewis, 2001).Twenty-six (26) elementary school teachers across the country responded to this study. An invitational email with a web-survey hyperlink was utilized. Variables pertaining to participant background, definition, selection acquirement and application of “multicultural” literature, the elementary school community and district mandates were addressed in the web survey. Findings revealed that all participants used multicultural literature sometime during the school year. The majority of participants were Caucasian females teaching in suburban schools, which did not have a mandated multicultural curriculum. Regardless of mandates, the majority applied a “narrow” definition for multicultural literature using the words “cultural”, “race,” and “nationality.” Other findings indicated that elementary school teachers used multicultural literature more frequently when they had strong administrative support, regardless of their students’ or their own ethnicity.

Bioimpedance analysis vs. DEXA as a screening tool for osteosarcopenia in lean, overweight and obese Caucasian postmenopausal females.

We aimed at evaluating the efficiency of a newly developed, advanced Bioimpedance Analysis (BIA-ACC®) device as a screening tool for determining the degree of obesity and osteosarcopenia in postmenopausal women with normal or decreased bone density determined by Dual-Energy X-Ray absorptiometry (DEXA) in a representative sample of Greek postmenopausal women. This is a single-gate cross-sectional study of body composition measured by BIA-ACC® and DEXA. Postmenopausal females with BMI ranging from 18.5 to 40 kg/m2 were subjected to two consecutive measurements of DEXA and BIA-ACC® within 5-10 minutes of each other. We used Pearson's co-efficient to examine linear correlations, the intraclass correlation co-efficient (ICC) to test reliability, Bland-Atman plots to assess bias and Deming regressions to establish the agreement in parameters measured by BIA-ACC® and DEXA. Last, we used ANOVA, with Bonferroni correction and Dunnett T3 post hoc tests, for assessing the differences between quantitative and Pearson's x2 between qualitative variables. Our sample consisted of 84 overweight/obese postmenopausal women, aged 39-83 years, of whom 22 had normal bone density, 38 had osteopenia and 24 had osteoporosis based on DEXA measurements, using quota sampling. ICCs and Deming regressions showed strong agreement between BIA-ACC® and DEXA and demonstrated minimal proportional differences of no apparent clinical significance. Bland-Altman plots indicated minimal biases. Fat, skeletal and bone mass measured by BIA-ACC® and DEXA were increased in the non-osteopenic/non-osteoporotic women compared with those of the osteopenic and osteoporotic groups. BIA-ACC® is a rapid, bloodless and useful screening tool for determining body composition adiposity and presence of osteo-sarcopenic features in postmenopausal women. Women with osteopenia and osteoporosis evaluated by DEXA had decreased fat, skeletal and bone mass compared with normal bone density women, suggesting concordance in the change of these three organ masses in postmenopausal women.

A single center kidney transplant experience among ten Caucasian females with end-stage renal disease due to scleroderma .

There is limited information on kidney transplant recipients with end-stage renal disease (ESRD) due to scleroderma. We conducted an observational study on kidney transplant recipients with ESRD due to scleroderma who received kidney transplant at our center between 01/1994 and 06/2013. During the study period, there were 10 kidney transplant recipients, all of whom were Caucasian females. Seven of them were living-donor kidney transplant recipients, and the mean age at time of transplant was 56.6±11.99 years. The mean post-transplant follow-up was 76.75±56.18 months; the mean dialysis vintage was 46.4±80.35 months, ranging from 8 to 272months; and the mean serum creatinine (Cr) levels at 3, 6, and 12 months were 1.31±0.47 mg/dL, 1.35±0.51 mg/dL, and 1.34±0.49 mg/dL, respectively. There were 5 graft failures with median graft survival of 101months. None had recurrence of scleroderma renal crisis. In those without graft failure, the mean serum Cr at last follow-up was 0.96±0.39 mg/dL. Six patients were on angiotensin converting enzyme inhibitors (ACE-I) after transplant. In univariate analysis, none of the factors including, age at time of transplant, dialysis vintage, use of ACE-I, living-donor transplant, cytomegalovirus infection, and serumCr at 1year were predictive of graft failure. In our study, we hoped to find outcomes and various factors associated with graft failure in these patients. We found a wide variation in outcomes after kidney transplantation. More studies are needed to assess the factors that may influence the graft survival in this rare disease. .

Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis.

Fusarium species have emerged as an important human pathogen in skin disease, onychomycosis, keratitis and invasive disease. Onychomycosis caused by Fusarium spp. The infection has been increasingly described in the immunocompetent and immunosuppressed hosts. Considering onychomycosis is a difficult to treat infection, and little is known about the genetic variability and susceptibility pattern of Fusarium spp., further studies are necessary to understand the pathogenesis and better to define the appropriate antifungal treatment for this infection. Accordingly, the objective of this study was to describe the in vitro susceptibility to different antifungal agents and the genetic diversity of 35 Fusarium isolated from patients with onychomycosis. Fusarium spp. were isolated predominantly from female Caucasians, and the most frequent anatomical location was the nail of the hallux. Results revealed that 25 (71.4%) of isolates belonged to the Fusarium solani species complex, followed by 10 (28.5%) isolates from the Fusarium oxysporum species complex. Noteworthy, the authors report the first case of Neocosmospora rubicola isolated from a patient with onychomycosis. Amphotericin B was the most effective antifungal agent against the majority of isolates (60%, MIC ≤4μg/mL), followed by voriconazole (34.2%, MIC ≤4μg/mL). In general, Fusarium species presented MIC values >64μg/mL for fluconazole, itraconazole and terbinafine. Accurate pathogen identification, characterisation and susceptibility testing provide a better understanding of pathogenesis of Fusarium in onychomycosis.

Rs10767664 Gene Variant in Brain-Derived Neurotrophic Factor Is Associated with Diabetes Mellitus Type 2 in Caucasian Females with Obesity

Background: The role of brain-derived neurotrophic factor (BDNF) variants on diabetes prevalence, basal adipokine levels, body weight, and cardiovascular risk factors remains unclear in obese patients. Objective: This study is aimed at analyzing the effects of rs10767664 BDNF gene polymorphism on diabetes mellitus prevalence, body weight, cardiovascular risk factors, and serum adipokine levels in obese female patients. Design: A total of 507 obese women were enrolled in a prospective way. Biochemical evaluation and anthropometric measures were recorded. Results: The frequency of diabetes mellitus in the group of patients with non-T allele was 20.1 and 28.3% in T-allele carriers. Logistic regression showed a risk of diabetes mellitus of 1.33 (95% CI 1.17-2.08) in subjects with T allele adjusted by age and body mass index (BMI). T-allele carriers with diabetes mellitus have a higher weight, BMI, waist circumference, blood pressure, glucose, homeostasis model assessment insulin resistance (HOMA-IR), insulin, and C-reactive protein (CRP) levels than non-T-allele carriers. Conclusion: rs10767664 polymorphism of BDNF gene is associated with prevalence of diabetes mellitus in obese female patients. T-allele carriers with diabetes mellitus have a higher weight, fat mass, blood pressure, level of insulin, glucose, HOMA-IR, and CRP than non-T-allele carriers.

P131 An audit of home testing kits

IntroductionUmbrella Health recently introduced sexually transmitted infections (STI) home testing kits for asymptomatic adults from Birmingham and Solihull. An audit was undertaken to consider patient demographics, service utility and effectiveness.MethodsAll...