Treatment delay and radiological errors in patients with bone metastases

During routine investigations, we are surprised to find that therapy for bone metastases is sometimes delayed for a considerable period of time. To determine the extent of this delay and its causes, we reviewed the medical records of symptomatic patients seen at our hospital who had been recently diagnosed as having bone metastases for the last four years. The treatment delay was defined as the interval between presentation with symptoms and definitive treatment for bone metastases. The diagnostic delay was defined as the interval between presentation with symptoms and diagnosis of bone metastases. The results of diagnostic radiological examinations were also reviewed for errors. The study population included 76 males and 34 females with a median age of 66 years. Most bone metastases were diagnosed radiologically. Over 75% of patients were treated with radiotherapy. The treatment delay ranged from 2 to 307 days, with a mean of 53.3 days. In 490 radiological studies reviewed, we identified 166 (33.9%) errors concerning 62 (56.4%) patients. The diagnostic delay was significantly longer for patients with radiological errors than for patients without radiological errors (P < 0.001), and much of it was due to radiological errors. In conclusion, the treatment delay in patients with symptomatic bone metastases was much longer than expected, and much of it was caused by radiological errors. Considerable efforts should therefore be made to more carefully examine the radiological studies in order to ensure prompt treatment of bone metastases.

A comparison of public and private obstructive sleep apnea clinics

The aim of the present study was to compare the clinical findings and polysomnography results obtained at public and private clinics in Brazil, the follow-up after diagnosis, and the therapeutic aspects related to continuous positive airway pressure. Patients who snore and who have obstructive sleep apnea were retrospectively divided into two groups, i.e., public clinic (N = 307) and private clinic (N = 317). Data concerning age, sex, body mass index (BMI), neck circumference, medical history, sleepiness scale, follow-up after diagnosis, and acceptance of continuous positive airway pressure therapy were collected. Mean age was 50 ± 12 (range: 15-80) for public patients and 48 ± 12 years (range: 19-91) for private patients. Mean BMI was 30 ± 6 (range: 19-67) for public patients and 31 ± 6 kg/m² (range: 21-59) for private patients. The public clinic had a significantly higher frequency of women than the private clinic (M:F ratio of 2.0:1 and 6.9:1, respectively). The condition of private patients (apnea-hypopnea index = 31 ± 25) was more severe than that of public patients (apnea-hypopnea index = 25 ± 24 events/h; P = 0.0004). In the public and private clinics, 19 and 15% of patients were snorers, respectively, and 81 and 85% of them had sleep apnea. After diagnosis, follow-up was longer in the private group. The continuous positive airway pressure acceptance was similar for both groups (32 vs 35%), but patients from the public clinic abandoned treatment more than private ones (65 vs 13%). Social status was significant in terms of the severity of obstructive sleep apnea age and gender distribution. Private patients look for a diagnosis earlier in the course of the disease than public patients, adhere more to follow-up, and abandon continuous positive airway pressure treatment less than public patients do.

Changes in the fecal concentrations of cortisol and androgen metabolites in captive male jaguars (Panthera onca) in response to stress

In the present study we determined the efficacy of the measurement of fecal cortisol and androgen metabolite concentrations to monitor adrenal and testicular activity in the jaguar (Panthera onca). Three captive male jaguars were chemically restrained and electroejaculated once or twice within a period of two months. Fecal samples were collected daily for 5 days before and 5 days after the procedure and stored at -20ºC until extraction. Variations in the concentrations of cortisol and androgen metabolites before and after the procedure were determined by solid phase cortisol and testosterone radioimmunoassay and feces dry weight was determined by drying at 37ºC for 24 h under vacuum. On four occasions, fecal cortisol metabolite levels were elevated above baseline (307.8 ± 17.5 ng/g dry feces) in the first fecal sample collected after the procedure (100 to 350% above baseline). On one occasion, we did not detect any variation. Mean (± SEM) fecal androgen concentration did not change after chemical restraint and electroejaculation (before: 131.1 ± 26.7, after: 213.7 ± 43.6 ng/g dry feces). These data show that determination of fecal cortisol and androgen metabolites can be very useful for a noninvasive assessment of animal well-being and as a complement to behavioral, physiological, and pathological studies. It can also be useful for the study of the relationship between adrenal activity and reproductive performance in the jaguar.

Promoter region sequence differences in the A and G gamma globin genes of Brazilian sickle cell anemia patients

Fetal hemoglobin (HbF), encoded by the HBG2 and HBG1 genes, is the best-known genetic modulator of sickle cell anemia, varying dramatically in concentration in the blood of these patients. This variation is partially associated with polymorphisms located in the promoter region of the HBG2 and HBG1 genes. In order to explore known and unknown polymorphisms in these genes, the sequences of their promoter regions were screened in sickle cell anemia patients and correlated with both their HbF levels and their βS-globin haplotypes. Additionally, the sequences were compared with genes from 2 healthy groups, a reference one (N = 104) and an Afro-descendant one (N = 98), to identify polymorphisms linked to the ethnic background.The reference group was composed by healthy individuals from the general population. Four polymorphisms were identified in the promoter region of HBG2 and 8 in the promoter region of HBG1 among the studied groups. Four novel single nucleotide polymorphisms (SNP) located at positions -324, -317, -309 and -307 were identified in the reference group. A deletion located between -396 and -391 in the HBG2 promoter region and the SNP -271 C→T in the HBG1 promoter region were associated with the Central African Republic βS-globin haplotype. In contrast, the -369 C→G and 309 A→G SNPs in the HBG2 promoter region were correlated to the Benin haplotype. The polymorphisms -396_-391 del HBG2, -369 SNP HBG2 and -271 SNP HBG1 correlated with HbF levels. Hence, we suggest an important role of HBG2 and HBG1 gene polymorphisms on the HbF synthesis.

Decreased brain-derived neurotrophic factor plasma levels in psoriasis patients

Brain-derived neurotrophic factor (BDNF) is associated with neuroplasticity and synaptic strength, and is decreased in conditions associated with chronic stress. Nevertheless, BDNF has not yet been investigated in psoriasis, a chronic inflammatory systemic disease that is exacerbated by stress. Therefore, our aim was to determine BDNF plasma levels in psoriasis patients and healthy controls. Adult patients (n=94) presenting with psoriasis for at least 1 year were enrolled, and age- and gender-matched with healthy controls (n=307) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants had neither a previous history of coronary artery disease nor current episode of major depression. BDNF plasma levels were determined using the Promega ELISA kit. A general linear model was used to compare BDNF levels in psoriasis patients and controls, with age, gender, systolic blood pressure, serum fasting glucose, blood lipid levels, triglycerides, smoking status, and body mass index examined. After adjusting for clinical and demographic variables, significantly decreased BNDF plasma levels were observed in psoriasis patients (P=0.01) (estimated marginal means of 3922 pg/mL; 95%CI=2660-5135) compared with controls (5788 pg/mL; 95%CI=5185-6442). Similar BDNF levels were found in both mild and severe cases of psoriasis. Our finding, that BDNF is decreased in psoriasis, supports the concept of a brain-skin connection in psoriasis. Further studies should determine if BDNF is increased after specific psoriasis treatments, and associated with different disease stages.

Influência do teor de nitrogênio no cultivo de Spirulina maxima em duas temperaturas - Parte I: Alteração da composição da biomassa

Spirulina maxima é uma cianobactéria de grande interesse para a produção de substâncias nutritivas e terapêuticas. É mesofílica, essencialmente fotoautotrófica, sendo suas principais fontes de nitrogênio os nitratos, uréia ou sais de amônio em meios com alta alcalinidade [1, 2, 3, 10, 16]. Spirulina maxima foi cultivada em fermentadores, expostos a luz com intensidade de 2400lux, contendo 3L do meio proposto por PAOLETTI, PUSHPARAJ & TOMASELLI [7] com concentração de 2,5g/L de KNO3, em meio modificado com 0,2g/L de KNO3 e em meio sem fonte de nitrogênio, denominados respectivamente meios 2,5N, 0,2N e SN, visando observar as alterações provocadas em sua composição final. Em culturas crescidas a 35ºC observou-se redução do teor de proteínas na massa celular seca de 28,84% e de 32,87%, aumento do teor de carboidratos de 30,34% e de 54,21% e aumento dos lipídios totais de 287,90% e 277,37%, quando se utilizou os meios 0,2N e SN, respectivamente, em comparação com o meio 2,5N. O teor de cinzas mostrou variação desprezível. Quando a temperatura de cultivo foi reduzida para 25ºC, ocorreu uma redução do teor de proteínas da massa seca de 40,28% e 39,02%, aumento de teor de carboidratos de 88,90% e de 91,15% e aumento do teor de lipídios totais em 321,25% e de 307,08%, quando se utilizou os meios 0,2N e SN em comparação com o meio 2,5N, respectivamente. Os resultados mostraram alterações sensíveis na composição da biomassa seca, com a diminuição do teor de nitrogênio e da temperatura de cultivo, exceto no teor de cinzas que não foi significativo.

Julkaise ja tuhoudu?

Kirjallisuusarvostelu

Onko lasten osallisuus turvattu oikeuksista puhumalla?

Perhe, lasten oikeudet ja osallisuus -seminaari 20.11.2013 Jyväskylässä.

Lapin liikenneturvallisuussuunnitelma : Toimenpiteet vuosina 2015-2018

Lapin liikenneturvallisuussuunnitelma vuosille 2015 – 2018 tukee alueella tehtävää liikenneturvallisuustyötä. Suunnitelman eettinen perusta on ajatus, että kenenkään Lapin teillä liikkuvan ei tarvitse joutua vakavan liikenneonnettomuuden uhriksi. Tavoite on yhtenevä jokaisen liikkujan omien tavoitteiden kanssa. Tilastojen mukaan piittaamattomuus liikennesäännöistä on merkittävin taustatekijä Lapissa tapahtuneissa vakavissa liikenneonnettomuuksissa. Kuolemaan johtaneiden liikenneonnettomuuksien tutkijalautakunnan selvitysten mukaan onnettomuuksien taustalta löytyy mm. laiminlyöntejä nopeusrajoitusten noudattamisessa ja turvavyön käyttämisessä sekä päihteiden vaikutuksen alaisena ajamista. Lapille ja koko Pohjois-Suomelle ominaisia muusta maasta poikkeavia piirteitä ovat maastoajoneuvoliikenteen onnettomuuksien ja porokolareiden suuri määrä. Lapin liikenneturvallisuussuunnitelmassa esitetyt lyhyemmän aikavälin toimenpiteet kohdistuvat valtakunnallisen suunnitelman tavoin ajokuntoon, liikennekäyttäytymiseen sekä taajamien ja maanteiden liikenneturvallisuuden parantamiseen. Lisäksi toimenpiteitä kohdistetaan maastoajoneuvoliikenne- ja porokolarionnettomuuksien vähentämiseen. Yhteistyötä liikenneturvallisuuden parantamiseksi tehdään myös Barentsin alueen maiden kesken. Työhön kuuluu parhaiden käytäntöjen vertailu ja hyödyntäminen, liikenneturvallisuusongelmien analysointi ja esitysten tekeminen niiden ratkaisemiseksi. Lapin nykyinen liikennejärjestelmä perustuu vahvasti maantieyhteyksiin. Matkailun volyymin kasvaminen, kaivostoiminnan laajeneminen, energiaa tuottavien voimaloiden rakentaminen sekä Koillisväylän avautuminen synnyttävät tulevaisuudessa uutta liikennettä, mikä vaatii panostamista liikenneturvallisuuteen myös pidemmällä aikavälillä liikennejärjestelmäsuunnittelun tasolla.

Food webs in the era of molecular revolution – Like resolving the Gordian knot with a tricorder

Living nature consists of countless organisms, which are classified into millions of species. These species interact in many ways; for example predators when foraging on their prey, insect larvae consuming plants, and pathogenic bacteria drifting into humans. In addition, abiotic nature has a great initiative impact on life through many factors (including sunlight, ambient temperature, and water. In my thesis, I have studied interactions among different life forms in multifaceted ways. The webs of these interactions are commonly referred to as food webs, describing feeding relationships between species or energy transfer from one trophic level to another. These ecological interactions – whether they occur between species, between individuals, or between microorganisms within an individual – are among the greatest forces affecting natural communities. Relationships are tightly related to biological diversity, that is, species richness and abundances. A species is called a node in food web vocabulary, and its interactions to other species are called links. Generally, Artic food webs are considered to be loosely linked, simple structures. This conception roots into early modern food webs, where insects and other arthropods, for example, were clumped under one node. However, it has been shown that arthropods form the greatest part of diversity and biomass both in the tropics and in Arctic areas. Earlier challenges of revealing the role of insects and microorganisms in interactions webs have become possible with the help of recent advances in molecular techniques. In the first chapter, I studied the prey diversity of a common bat, Myotis daubentonii, in southwestern Finland. My results proved M. daubentonii being a versatile predator whose diet mainly consists of aquatic insects, such as chironomid midges. In the second chapter, I expanded the view to changes in seasonal and individual-based variation in the diet of M. daubentonii including the relationship between available and observed prey. I found out that chironomids remain the major prey group even though their abundance decreases in proportion to other insect groups. Diet varied a lot between individuals, although the differences were not statistically significant. The third chapter took the study to a large network in Greenland. I showed that Artic food webs are very complex when arthropods are taken into account. In the fourth chapter, I examined the bacterial flora of M. daubentonii and surveyed the zoonotic potential of these bacteria. I found Bartonella bacteria, of which one was described as a new species named after the locality of discovery. I have shown in my thesis that Myotis daubentonii as a predator links many insect species as well as terrestrial and aquatic environments. Moreover, I have exposed that Arctic food webs are complex structures comprising of many densely linked species. Finally, I demonstrated that the bacterial flora of bats includes several previously unknown species, some of which could possibly turn in to zoonosis. To summarize, molecular methods have untied several knots in biological research. I hope that this kind of increasing knowledge of the surrounding nature makes us further value all the life forms on earth.

Le Petit journal. Supplément du dimanche

1896/10/04 (Numéro 307).