The relationship between red cell distribution width and prognostic scores in myelodysplastic syndrome

ABSTRACT Introduction: The myelodysplastic syndrome (MDS) represents a group of hematopoietic neoplasms that is characterized by clonal hematopoiesis, cytopenia and abnormal cellular maturation. Red cell distribution width (RDW) refers to the variation degree of erythrocyte size and it is a reflection of anisocytosis. Higher values have been linked to adverse outcomes, such as increased mortality, vascular events, kidney and liver disease and demonstrated to harbor poor prognosis in solid and hematological malignancies. The RDW value can be used as a contributing parameter for MDS diagnosis, as well as its prognosis. In this study, we essentially aimed to demonstrate the correlation between the RDW and MDS prognostic indexes. Materials and methods: Ninety-four MDS patients at the Aydın Adnan Menderes University Hematology Division were included in the study. The correlations between the RDW and laboratory values (either lactate dehydrogenase, albumin, globulin or ferritin) and the RDW prognostic scoring indexes (IPSS, WPSS, IPSS-R and LR-PSS) were investigated. The PASW for Windows, version 21.0 (SPSS Inc., Chicago, IL, USA), was used for statistical assessment. A p-value below 0.05 was the cut-off for the statistical significance. Results: The mean age of all the patients was 73 ±10 years. Patients were observed for 41.88 ± 25 months. The mean RDW value for all cases was 15.5 ± 2.39. We found a statistically significant difference of survival between RDW values below and above 15.5% (p = 0.016). A significant difference was also observed according to the prognostic scoring indexes (see below). Conclusion: An increase in RDW is probably related to dysplasia in the MDS and this constitutes a possible explanation for the poor outcome. Prognostic indexes might incorporate the RDW as a parameter in the future.

Is pectoralis muscle index a risk factor for mortality in left ventricular assist device patients?

SUMMARY OBJECTIVE: We aimed to investigate whether sarcopenia measured from pectoralis muscles is a risk factor for long-term mortality in left ventricular assist device patients. METHODS: Patients aged >18 years implanted with a left ventricular assist device in a single center between 2013 and 2019 were retrospectively included. Patients without a thoracic computed tomography scan performed within 3 months of left ventricular assist device implantation and without computed tomography scans appropriate for pectoralis muscle measurement were excluded. Pectoralis muscle measurements were made on thoracic computed tomography slices, and pectoralis muscle indices were calculated for each patient. Sarcopenia was defined as being in the gender-specific lowest tertile of pectoralis muscle index. Survival was compared between patients with and without sarcopenia. RESULTS: The study was conducted on 64 left ventricular assist device patients who met the inclusion criteria. Notably, 21 (32.8%) of the study patients were sarcopenic. Diabetes mellitus and sarcopenia were more common in patients with 2-year mortality in our cohort. Patients with sarcopenia had a worse 2-year survival (p<0.001). Sarcopenia had an adjusted hazard ratio of 4.04 (95% confidence interval (CI) 1.36-12.02, p=0.012), while diabetes mellitus was associated with an adjusted hazard ratio of 3.14 (95%CI 1.17-8.39, p=0.023). CONCLUSION: Sarcopenia defined by low pectoralis muscle index increases the risk for 2-year mortality in left ventricular assist device patients.

Late open conversion in ruptured abdominal aortic aneurysm after endovascular repair / Conversão tardia para cirurgia aberta em um aneurisma roto da aorta abdominal após reparo endovascular

Abstract Despite technological advances, the long-term outcomes of endovascular aortic aneurysm repair (EVAR) are still debatable. Although most endograft failures after EVAR can be corrected with endovascular techniques, open conversion may still be required. A 70-year-old male patient presented at the emergency unit with abdominal pain. Twice, in the third and fourth years after the first repair, a stent graft had been placed over a non-adhesive portion of the stent graft due to type Ia endoleaks. In the most recent admission, a CT scan showed type III endoleak and ruptured aneurysm sac. On this occasion the patient underwent late open conversion. The failure was repaired with total preservation of the main endovascular graft body and interposition of a bifurcated dacron graft. This case demonstrates that lifelong radiographic surveillance should be considered in this subset of patients. Late open conversion following EVAR of ruptured abdominal aortic aneurysms can be performed safely.

Resumo Apesar dos avanços tecnológicos, os desfechos de longo prazo do reparo endovascular de aneurismas da aorta abdominal (endovascular aortic aneurysm repair - EVAR) ainda são objeto de debate. Embora a maioria das falhas de endoenxerto após EVAR possam ser corrigidas com técnicas endovasculares, conversão para cirurgia aberta ainda pode ser necessária. Um paciente de 70 anos de idade, do sexo masculino, apresentou-se no serviço de emergência com dor abdominal. Duas vezes, dois e quatro anos após o primeiro reparo, um enxerto foi colocado sobre uma porção não adesiva do stent devido a endoleak tipo Ia. Na mais recente hospitalização, a tomografia computadorizada mostrou endoleak tipo III e ruptura de um saco aneurismático. Nesta ocasião, o paciente foi submetido a conversão tardia para cirurgia aberta. A falha foi tratada com preservação total do corpo principal do enxerto endovascular e interposição de um enxerto tipo Dacron bifurcado. Este caso demonstra que a vigilância radiográfica ao longo de toda a vida deveria ser considerada nesse subgrupo de pacientes. Conversão tardia para cirurgia aberta após EVAR de aneurismas rotos da aorta abdominal pode ser realizada com segurança.

Somatic embryo-like structures of strawberry regenerated in vitro on media supplemented with 2,4-D and BAP.

Somatic embryo-like structures (SELS) were produced in vitro from leaf disk and petiole explants of two cultivars of strawberry (Fragaria × ananassa Duch) on Murashige and Skoog medium with different concentrations and combinations of 2,4‑dichlorophenoxyacetic acid (2,4-D), 6-benzylaminopurine (BAP) and sucrose to check the embryonic nature of these structures histologically. A large number of SELS could be regenerated in both cultivars on media with 2 - 4 mg L-1 2,4-D in combination with 0.5 - 1 mg L-1 BAP and 50 g L-1 sucrose. Histological examination of SELS revealed the absence of a root pole. Therefore these structures cannot be strictly classified as somatic embryos. The SELS formed under the tested culture conditions represent malformed shoot-like and leaf-like structures. The importance of these results for the propagation of strawberries via somatic embryogenesis is discussed.

New glucosinolates from resedaceae

Four glucosinolates have been isolated from the leaves and inflorescences of Ochradenus baccatus Del., three of them are new. The compounds were identified by spectroscopic analysis of their hydrolytic products to be 2-[O-hydroxyphenyl]-ethyl glucosinolate [I], 2-hydroxy-2-[O-hydroxyphenyl]-ethyl glucosinolate [II], m- hydroxybenzyl glucosinolate [III] and 2-hydroxy-[2',4'- dihydroxyphenyl]-ethyl glucosinolate [IV]

Steroidal alkaloids and saponins of solanum sepi cula [DUN]

The investigation of the alkaloidal fraction of S. sepicula [Dun], afforded in addition to choline chloride, four steroidal alkaloids and one steroidal saponine. The latter was isolated for the first time from the genus Solanum. The isolated compounds were identified by comparing their 1H and 13C NMR data with those of reported data

Macro and micromorphological study of the inflorescence and the fruit of ochradenus baccatus del growing in Egypt

The macro- and micromorphological characters of the inflorescence and fruit of Ochradenus baccatus Del. growing in Egypt are reported in order to find out the features of these diagnostic organs by which the plant could be easily identified in the entire and powdered forms

Phytochemical investigation of centaurea eryngioides lam growing in Egypt

Column chromatography of the light petroleum extract of C. eryngioides yielded lupeol acetate, lupeol, saturated hydrocarbon, sitosterol mixture and beta-sitosterol glucoside. The chloroform extract afforded the flavonoids: neglectin, neglectin-7-glucoside, pinocembrin and pinocembrin-5,7-diglycoside. GLC of the methylated fatty acids revealed the presence of 16 fatty acids. Analysis of the total hydrocarbons by GLC showed the presence of 18 different hydrocarbons. The fractionated extracts were examined for antimicrobial and antitumor activities to indicate promising activity

Macro and micromorphology of the flowers and fruit of gomphocarpus sinapics biosis family Asclepiadaceae growing in Egypt

The macro- and micromorphological characters of the flower, fruit and seed of Astragalus trigonus DC, Fabaceae [Papilionaceae], growing in Egypt were presented

Macro and micromorphology of the leaf, stem and root ot gomphocarpus cynicus biosis family Asclepiadaceae growing in Egypt

The macro- and micromorphology of the leaves, stems, and roots of Gomphocarpus sinaicus Boiss. were presented aiming to find out their diagnostic characters, by which the plant can be easily identified from other allied species

Chemical constituents of gomphocarpus cynicus biosis, family asclapiasceae

A systematic fractionation of Gomphocarpus sinaicus Boiss. Family Asclepiadaceae extracts yielded lupeol acetate, lupeol, B-sitosterol, B-sitosterol-o-glucoside, oleanolic acid and two flavonoidal compounds. The structures were determined by spectral means and comparison with authentic samples. Preliminary results indicated the presence of cardiac glycosides. The fatty acids were analyzed by GC. different extracts of this plant were screened for anti-tumor antimicrobial and cardiac activities

Alkaloids and steroidal sapogenins of the corms of merendra persica l

From the corms of Merendra persica L. [Liliaceae], six alkaloids [colchicine, beta and gamma-lumicolchicine, gamma-lumi-3-demethylcolchicine, 3-demethylcolchicine and demecolcine], three steroidal sapogenins [gitogenin, ruscogenin and diosgenin] and beta-sitosterol were isolated. The identification of the isolated compounds was based on spectroscopic [UV, IR, NMR and MS] and chromatographic evidences

Iridoid glucosides from gentiana kurroo royle

From the ethyl acetate fraction and the aqueous residue of the ethanolic extract of Gentiana kurroo royle roots and rhizomes, six known iridoid glucosides [6-cinnamoyl-6-0-cinnamoyl-,6-0-vanilloyl-, and 6-0-feruloylcatalpol, aucubin and catalpol] were isolated. The isolated glucosides were identified by TLC and HPLC and spectroscopic evidences [UV. IR. PMR and 13 C-NMR]

Macro and micromorphological study of centaurea aegyptiaca L

The macro and micromorphology of the root, stem and leaf of Centaurea aegyptiaca L. Growing in Egypt are presented with the view of finding out the characters of the diagnostic features by which these organs can be identified in both the entire and powdered forms

Pharmacognostical study of calicotome villosa poir growing in Libya

On the continuation of pharmacognostical study of Calicotome villosa Poir., a macro- and micromorphological study of leaves and stems was presented with the view of finding out the diagnostic characters for identification of these organs in both entire and powdered forms

Pharmacognostical study of calicotome villosa poir growing in Libya Part I Phytochemical screening of aerial parts and macro-and micromorphology of fruits

A preliminary phytochemical screening of the aerial parts of Calicotome villosa poir. growing in Libya revealed the presence of tannins, flavonoids, steroids and/or triterpenes, coumarins, saponins, and carbohydrates. Moreover, macro-and micromorphology of the fruit is presented with the view of finding out diagnostic characters for identification of the plant

Pharmacognostical study of the rhizomes and roots of gentina kurroo rovle

A macro and micromophological study of the rhizomes and roots of Gentiana kurroo royle [Gentianaceae] is presented with the aim of their identification in the entire and powdered forms. A preliminary phytochemical investigation revealed the presence of sterols ans/or triterpenes, carbohydrates and/or glycosides and flavonoids. TLC and HPLC chromatographic analysis of this ethyl acetate fraction of the ethanolic extract revealed the presence of at least five iridoid glycosides. Five of them were isolated and the major one was identified as 6-cinnamoylcatalpol: Preliminary pharmacological screening revealed that this plant possesses smooth muscle relaxant effect and prevent histamine release from mast cells