Biodegradable drug-eluting stents: Targeting urothelial tumors of upper urinary tract

INTRODUCTION & OBJECTIVES: Urothelial tumors of upper urinary tract are ranked among the most common types of cancers worldwide. The current standard therapy to prevent recurrence is intravesical Bacillus Calmetteâ Guerin (BCG) immunotherapy, but it presents several disadvantages such as BCG failure and intolerance. Another way is to use chemotherapy, which is generally better tolerated that BCG. In this case, drugs such as epirubicin, doxorubicin, paclitaxel and gemcitabine are used. Nevertheless, intravesical chemotherapy only prevents recurrence in the short-term. These failings can be partially attributed to the short residence time and low bioavailability of the drug within the upper urinary tract and the cancer cells, resulting in a need for frequent drug instillation. To avoid these problems, biodegradable ureteral stents impregnated by supercritical fluid CO2 (SCF) with each of the four anti-cancer drugs were produced. MATERIAL & METHODS: Four formulations with different concentrations of gelatin and alginate and crosslink agent were tested and bismuth was added to confer radiopaque properties to the stent. The preliminary in vivo validation studies in female domestic pigs was conducted at the University of Minho, Braga, after formal approval by the institutionâ s review board and in accordance with its internal ethical protocol for animal experiments. Paclitaxel, epirubicin, doxorubicin and gemcitabine were impregnated in the stents and the release kinetics was measured in artificial urine solution (AUS) for 9 days by UV spectroscopy in a microplate reader. The anti-tumoral effect of the developed stents in transitional cell carcinoma (TCC) and HUVEC primary cells, used as control, was evaluated. RESULTS: The in vivo validation of this second-generation of ureteral stents performed was herein demonstrated. Biodegradable ureteral stents were placed in the ureters of a female pigs, following the normal surgical procedure. The animals remained asymptomatic, with normal urine flow. The in vitro release study in AUS of the stent impregnated showed a higher release in the first 72h for the four anti-cancer drugs impregnated after this time the plateau was achieved and the stent degraded after 9 days. The direct and indirect contact of the anti-cancer biodegradable stents with the TCC and HUVEC cell lines confirm the anti-tumor effect of the stents impregnated with the four anti-cancer drugs, reducing around 75% of the viability of the TCC cell line after 72h and no killing effect in the HUVEC cells. CONCLUSIONS: The use of biodegradable ureteral stent in urology clinical practice not only reduce the stent-related symptoms but also open new treatment therapyâ s, like in urothelial tumors of upper urinary tract. Furthermore, we have demonstrated the clinical validation in vivo pig model. This study has thus shown the killing efficacy of the anti-cancer drug eluting biodegradable stents in vitro for the TCC cell line, with no toxicity observed in the control, non-cancerous cells.The direct and indirect contact of the anti-cancer biodegradable stents with the TCC and HUVEC cell lines confirm the anti-tumor effect of the stents impregnated with the four anti-cancer drugs, reducing around 75% of the viability of the TCC cell line after 72h and no killing effect in the HUVEC cells. This study has thus shown the killing efficacy of the anti-cancer drug eluting biodegradable stents in vitro for the TCC cell line, with no toxicity observed in the control, non-cancerous cells.

Os efeitos do processo de insolvência nas relações patrimoniais entre os cônjuges

Dissertação de mestrado em Direito Judiciário

Atrioventricular pacemaker. Incidence and causes of reprogramming in long-term follow-up

OBJECTIVE: To assess the incidence of problems requiring reprogramming of atrioventricular pacemakers in a long-term follow-up, and also the causes for this procedure. METHODS: During the period from May '98 to December '99, 657 patients were retrospectively studied, An actuarial curve for the event reprogramming of the stimulation mode was drawn. RESULTS: The follow-up period ranged from 12 to 178 months (mean = 81 months). Eighty-two (12.4%) patients underwent reprogramming of the stimulation mode as follows: 63 (9.5%) changed to VVI,(R/C); 10 (1.5%) changed to DVI,C; 6 (0.9%) changed to VDD,C; and 3 (0.5%) changed to DOO. The causes for the reprogramming were as follows: arrhythmia conducted by the pacemaker in 39 (37.6%) patients; loss of atrial sensitivity or capture, or both, in 39 (38.6%) patients; and microfracture of atrial electrode in 5 (4.9%) patients. The stimulation mode reprogramming free probability after 15 years was 58%. CONCLUSION: In a long-term follow-up, the atrioventricular pacemaker provided a low incidence of complications, a high probability of permanence in the DDD,C mode, and the most common cause of reprogramming was arrhythmia conducted by the pacemaker.

A review of the development of regional sludge treatment centres and a baseline characterisation of Irish sewage sludges

This Study assessed the development of sludge treatment and reuse policy since the original 1993 National Sludge Strategy Report (Weston-FTA, 1993). A review of the 48 sludge treatment centres, current wastewater treatment systems and current or planned sludge treatment and reuse systems was carried out Sludges from all Regional Sludge Treatment Centres (areas) were characterised through analysis of selected parameters. There have been many changes to the original policy, as a result of boundary reviews, delays in developing sludge management plans, development in technology and changes in tendering policy, most notably a move to design-build-operate (DBO) projects. As a result, there are now 35 designated Hub Centres. Only 5 of the Hub Centres are producing Class A Biosolids. These are Ringsend, Killamey, Carlow, Navan and Osberstown. Ringsend is the only Hub Centre that is fully operational, treating sludge from surrounding regions by Thermal Drying. Killamey is producing Class A Biosolids using Autothermal Thermophilic Aerobic Digestion (ATAD) but is not, as yet, treating imported sludge. The remaining three plants are producing Class A Biosolids using Alkaline Stabilisation. Anaerobic Digestion with post pasteurisation is the most common form of sludge treatment, with 11 Hub Centres proposing to use it. One plant is using ATAD, two intend to use Alkaline Stabilisation, seven have selected Thermal Drying and three have selected Composting. While the remaining plants have not decided which sludge treatment to select, this is because of incomplete Sludge Management Plans and on DBO contracts. Analysis of sludges from the Hub Centres showed that all Irish sewage sludge is safe for agricultural reuse as defined by the Waste Management Regulations {Use of Sewage Sludge in Agriculture) (S.I. 267/2001), providing that a nutrient management plan is taken into consideration and that the soil limits of the 1998 (S.I. 148/1998) Waste Management Regulations are not exceeded.

Odour nuisance in Ireland and the potential use of olfactometry for the control of odours

Odour nuisance in other European countries has led to the development of techniques which employ panels of human assessors for the determination of environmental odours. Odour measurement is not widely practised in Ireland, yet local authorities are frequently in receipt of odour derived public complaints. This dissertation examines the fundamentals of odour nuisance in terms of how we perceive odours, common sources of environmental odours, the principles of odour measurement (in particular the Sutch pre-standard on olfactometry) and the extent to which odour nuisance is a problem in Ireland. The intention is to provide a reference document for use by those interested parties in the country who may be variously involved in policy making, legislative development, enforcement of environmental law or any person who has an interest in odours and the public nuisance they can give rise to. In particular the aim was to provide previously undocumented information on the prevalence of odour nuisance in Ireland, the exercision of the available powers to control odours, and the possible value of odour measurement as part of a regulatory process. A questionnaire was circulated to all local authorities in the country and 82% responded with information on their experiences and views on the subject of odours. The results of the survey are presented in summary and detailed form.

Lifetime Prevalence of Transient Loss of Consciousness in an Urban Russian Population

Abstract Background: Most international studies on epidemiology of transient loss of consciousness (TLC) were performed many years ago. There are no data about the lifetime prevalence of TLC in Russia. Objective: To identify the lifetime prevalence and presumed mechanisms of TLC in an urban Russian population. Methods: 1796 individuals (540 males [30.1%] and 1256 females [69.9%]) aged 20 to 69 years (mean age 45.8 ± 11.9 years) were randomly selected and interviewed within the framework of multicentre randomised observational trial. Results: The overall prevalence of TLC in the studied population was 23.3% (418/1796), with the highest proportion (28%) seen in 40-49 year age group. TLC was significantly more common in women than in men (27.5% vs 13.5%). The mean age of patients at the time of the first event was 16 (11; 23) years, with 333 (85%) individuals experiencing the first episode of TLC under 30 years. The average time after the first episode of TLC was 27 (12; 47) years. The following mechanisms of TLC were determined using the questionnaire: neurally-mediated syncope (56.5%), arrhythmogenic onset of syncope (6.0%), nonsyncopal origin of TLC (1.4%), single episode during lifetime (2.1%). Reasons for TLC remained unidentified in 34% cases. 27 persons (6.5%) reported a family history of sudden death, mainly patients with presumably arrhythmogenic origin (24%). Conclusion: Our findings suggest that the overall prevalence of TLC in individuals aged 20-69 years is high. The most common cause of TLC is neurally-mediated syncope. These data about the epidemiology can help to develop cost-effective management approaches to TLC.

Implementation of a unified userspace time handling library under the Linux OS

An appropriate assessment of end-to-end network performance presumes highly efficient time tracking and measurement with precise time control of the stopping and resuming of program operation. In this paper, a novel approach to solving the problems of highly efficient and precise time measurements on PC-platforms and on ARM-architectures is proposed. A new unified High Performance Timer and a corresponding software library offer a unified interface to the known time counters and automatically identify the fastest and most reliable time source, available in the user space of a computing system. The research is focused on developing an approach of unified time acquisition from the PC hardware and accordingly substituting the common way of getting the time value through Linux system calls. The presented approach provides a much faster means of obtaining the time values with a nanosecond precision than by using conventional means. Moreover, it is capable of handling the sequential time value, precise sleep functions and process resuming. This ability means the reduction of wasting computer resources during the execution of a sleeping process from 100% (busy-wait) to 1-1.5%, whereas the benefits of very accurate process resuming times on long waits are maintained.

The Experience of European Integration and the Potential for Integration in South America

The experience of the European Union is the most significant and far-reaching among all attempts at regional integration. It is, therefore, the most likely to provide some lessons for those world regions that are just beginning this complex process. In turn, the Common Market of the South (MERCOSUR) and the Andean Community (CAN) are among the regional integration projects that have reached the greatest level of formal accomplishment after the EU. MERCOSUR is a customs union that aspires to become a common market, while avowing the commitment to advance towards political integration. For its part, CAN is a customs union that has already developed supranational institutions such as a Commission, a Parliament and a Court of Justice. In both cases, however, words have progressively tended to wander far from deeds. One reason underlying this phenomenon may be a misunderstanding of the European experience with integration. In this article, we discuss the theories that have been developed to account for integration in Europe and may prove useful to understand integration elsewhere and put forward a set of lessons that could be drawn from the European experience. Subsequently, we introduce a description of the experience of integration in South America and reflect (critically) on how the theories and lessons drawn from the EU could be applied to this region –and beyond.

Understanding sources of the change in international business cycles

Macroeconomic activity has become less volatile over the past three decades in most G7 economies. Current literature focuses on the characterization of the volatility reduction and explanations for this so called "moderation" in each G7 economy separately. In opposed to individual country analysis and individual variable analysis, this paper focuses on common characteristics of the reduction and common explanations for the moderation in G7 countries. In particular, we study three explanations: structural changes in the economy, changes in common international shocks and changes in domestic shocks. We study these explanations in a unified model structure. To this end, we propose a Bayesian factor structural vector autoregressive model. Using the proposed model, we investigate whether we can find common explanations for all G7 economies when information is pooled from multiple domestic and international sources. Our empirical analysis suggests that volatility reductions can largely be attributed to the decline in the magnitudes of the shocks in most G7 countries while only for the U.K., the U.S. and Italy they can partially be attributed to structural changes in the economy. Analyzing the components of the volatility, we also find that domestic shocks rather than common international shocks can account for a large part of the volatility reduction in most of the G7 countries. Finally, we find that after mid-1980s the structure of the economy changes substantially in five of the G7 countries: Germany, Italy, Japan, the U.K. and the U.S..

Harmonization guidelines for HLA-peptide multimer assays derived from results of a large scale international proficiency panel of the Cancer Vaccine Consortium.

PURPOSE: The Cancer Vaccine Consortium of the Cancer Research Institute (CVC-CRI) conducted a multicenter HLA-peptide multimer proficiency panel (MPP) with a group of 27 laboratories to assess the performance of the assay. EXPERIMENTAL DESIGN: Participants used commercially available HLA-peptide multimers and a well characterized common source of peripheral blood mononuclear cells (PBMC). The frequency of CD8+ T cells specific for two HLA-A2-restricted model antigens was measured by flow cytometry. The panel design allowed for participants to use their preferred staining reagents and locally established protocols for both cell labeling, data acquisition and analysis. RESULTS: We observed significant differences in both the performance characteristics of the assay and the reported frequencies of specific T cells across laboratories. These results emphasize the need to identify the critical variables important for the observed variability to allow for harmonization of the technique across institutions. CONCLUSIONS: Three key recommendations emerged that would likely reduce assay variability and thus move toward harmonizing of this assay. (1) Use of more than two colors for the staining (2) collect at least 100,000 CD8 T cells, and (3) use of a background control sample to appropriately set the analytical gates. We also provide more insight into the limitations of the assay and identified additional protocol steps that potentially impact the quality of data generated and therefore should serve as primary targets for systematic analysis in future panels. Finally, we propose initial guidelines for harmonizing assay performance which include the introduction of standard operating protocols to allow for adequate training of technical staff and auditing of test analysis procedures.

Polysomy 8 defines a clinico-cytogenetic entity representing a subset of myeloid hematologic malignancies associated with a poor prognosis: report on a cohort of 12 patients and review of 105 published cases.

Tetrasomy, pentasomy, and hexasomy 8 (polysomy 8) are relatively rare compared to trisomy 8. Here we report on a series of 12 patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative disorder (MPD) associated with polysomy 8 as detected by conventional cytogenetics and fluorescence in situ hybridization (FISH). In an attempt to better characterize the clinical and hematological profile of this cytogenetic entity, our data were combined with those of 105 published patients. Tetrasomy 8 was the most common presentation of polysomy 8. In 60.7% of patients, polysomy 8 occurred as part of complex changes (16.2% with 11q23 rearrangements). No cryptic MLL rearrangements were found in cases in which polysomy 8 was the only karyotypic change. Our study demonstrates the existence of a polysomy 8 syndrome, which represents a subtype of AML, MDS, and MPD characterized by a high incidence of secondary diseases, myelomonocytic or monocytic involvement in AML and poor overall survival (6 months). Age significantly reduced median survival, but associated cytogenetic abnormalities did not modify it. Cytogenetic results further demonstrate an in vitro preferential growth of the cells with a high level of aneuploidy suggesting a selective advantage for polysomy 8 cells.

How much does the amphioxus genome represent the ancestor of chordates?

One of the main motivations to study amphioxus is its potential for understanding the last common ancestor of chordates, which notably gave rise to the vertebrates. An important feature in this respect is the slow evolutionary rate that seems to have characterized the cephalochordate lineage, making amphioxus an interesting proxy for the chordate ancestor, as well as a key lineage to include in comparative studies. Whereas slow evolution was first noticed at the phenotypic level, it has also been described at the genomic level. Here, we examine whether the amphioxus genome is indeed a good proxy for the genome of the chordate ancestor, with a focus on protein-coding genes. We investigate genome features, such as synteny, gene duplication and gene loss, and contrast the amphioxus genome with those of other deuterostomes that are used in comparative studies, such as Ciona, Oikopleura and urchin.

Spatial Interactions in Hedonic Pricing Models: The Urban Housing Market of Aveiro, Portugal

Spatial heterogeneity, spatial dependence and spatial scale constitute key features of spatial analysis of housing markets. However, the common practice of modelling spatial dependence as being generated by spatial interactions through a known spatial weights matrix is often not satisfactory. While existing estimators of spatial weights matrices are based on repeat sales or panel data, this paper takes this approach to a cross-section setting. Specifically, based on an a priori definition of housing submarkets and the assumption of a multifactor model, we develop maximum likelihood methodology to estimate hedonic models that facilitate understanding of both spatial heterogeneity and spatial interactions. The methodology, based on statistical orthogonal factor analysis, is applied to the urban housing market of Aveiro, Portugal at two different spatial scales.

Consumers’ sensory acceptability of pork from immunocastrated male pigs

Boar taint is the off-odour or off flavour of cooked pork. Currently, the most common method of controlling boar taint is surgical castration. However, immunocastration has been used in some parts of the world as an alternative to surgical castration. The aim of this study was to evaluate the sensory acceptability of meat from immunocastrated pigs (IM) compared with meat from females (FE), surgically castrated (CM) and entire males (EM). Twenty animals of each type were evaluated by 201 consumers in 20 sessions. Longissimus thoracis muscle of the different animals was cooked in an oven at 180 °C for 10 min. Consumers scored the odour and the flavour of the meat in a 9-point category scale without an intermediate level. There were no significant differences in consumer’s evaluation of meat from IM, CM, and FE. In contrast, EM meat presented a higher percentage of dissatisfied scores and was significantly (P & 0.05) less accepted than meat from CM, IM and FE. Consumers’ acceptability of EM meat was always lower, independently of its androstenone levels. However meat with low levels of androstenone was more accepted that meat with medium or high levels of this substance. It can be concluded that immunocastration produced pork that was accepted by the consumers, and was indistinguishable from pork from CM or FE.

Developments in the scientific and clinical understanding of gout.

Gout is the most common form of inflammatory arthritis in the elderly. In the last two decades, both hyperuricemia and gout have increased markedly and similar trends in the epidemiology of the metabolic syndrome have been observed. Recent studies provide new insights into the transporters that handle uric acid in the kidney as well as possible links between these transporters, hyperuricemia, and hypertension. The treatment of established hyperuricemia has also seen new developments. Febuxostat and PEG-uricase are two novel treatments that have been evaluated and shown to be highly effective in the management of hyperuricemia, thus enlarging the therapeutic options available to lower uric acid levels. Monosodium urate (MSU) crystals are potent inducers of inflammation. Within the joint, they trigger a local inflammatory reaction, neutrophil recruitment, and the production of pro-inflammatory cytokines as well as other inflammatory mediators. Experimentally, the uptake of MSU crystals by monocytes involves interactions with components of the innate immune system, namely Toll-like receptor (TLR)-2, TLR-4, and CD14. Intracellularly, MSU crystals activate multiple processes that lead to the formation of the NALP-3 (NACHT, LRR, and pyrin domain-containing-3) inflammasome complex that in turn processes pro-interleukin (IL)-1 to yield mature IL-1 beta, which is then secreted. The inflammatory effects of MSU are IL-1-dependent and can be blocked by IL-1 inhibitors. These advances in the understanding of hyperuricemia and gout provide new therapeutic targets for the future.