Simultaneous integrated boost on pathologic lymph nodes safely improves clinical outcomes compared to sequential boost in locally advanced cervical cancer: a multicenter retrospective study.

Objective: This multicenter study aimed to retrospectively evaluate the impact of high boost simultaneous integrated boost (SIB) to pathologic lymph nodes compared to Sequential boost (Seq) in patients with locally advanced cervical cancer (LACC). Materials and methods: 97 patients with pelvic and/or para-aortic (PAo) node-positive LACC treated by definitive chemoradiation were included. Two groups were analyzed: Sequential boost group and simultaneous integrated boost (SIB) group. Endpoints were Distant Recurrence Free Survival (DRFS), Recurrence Free Survival (RFS), Overall Survival (OS), locoregional pelvic and PAo control and toxicities. Results: 3-years DRFS in SIB and Seq groups was 65% and 31% respectively (log-rank p < 0.001). 3-years RFS was 58% and 26% respectively (log-rank p = 0.009). DRFS prognostic factors in multivariable analysis were SIB, PAo involvement and maximum pelvic node diameter ≥ 2cm. Adenocarcinoma histology and absence of brachytherapy tended to be prognostic factors. SIB provided the best pelvic control at first imaging with 97%. There was no significant difference in terms of toxicities between groups. Conclusions: Nodal SIB seems to be unavoidable in the treatment of node-positive LACC. It provides the best DRFS, RFS and pelvic control without additional toxicity, with a shortened treatment duration.

Malaria Infection in Patients with Sickle Cell Disease in Nigeria: Association with Markers of Hyposplenism.

Malaria is considered an important cause of morbidity and mortality among people living with sickle cell disease (SCD). This has partly been attributed to the loss of splenic function that occurs early in the disease process. We conducted a cross-sectional study and determined the frequency of malaria infection among SCD patients and explored the association with spleen's presence on ultrasonography and spleen function assessed using the frequency of Howell-Jolly bodies (HJBs). A total of 395 participants consisting of 119 acutely-ill SCD patients, 168 steady-state SCD controls, and 108 healthy non-SCD controls were studied. The prevalence of Plasmodium falciparum parasitemia was 51.3% in acutely-ill SCD patients, 31.7% in steady-state SCD controls, and 11.0% in the healthy non-SCD controls; however, the mean parasite density was significantly higher in the non-SCD controls compared to both SCD groups (p = 0.0001). Among the acutely-ill SCD patients, the prevalence of clinical malaria and severe malaria anemia were highest in children <5 years of age. The prevalence of parasitemia (p = 0.540) and parasite density (p = 0.975) showed no association with spleen presence or absence on ultrasonography. Similarly, the frequency of HJB red cells was not associated with the presence of parasitemia (p = 0.183). Our study highlights the frequency and role of malaria infection in acutely-ill SCD patients, especially in those younger than five years. Although we have found no evidence of an increased risk of malaria parasitemia or parasite density with markers of hyposplenism, the role played by an underlying immunity to malaria among SCD patients in malaria-endemic region is not clear and needs further studies.

Epidemiological study of gastrointestinal helminths among dogs from Northeastern Nigeria: a potential public health concern.

Understanding the epidemiology of canine parasitic infections, gastrointestinal helminthic infections in particular, is crucial for designing an efficient control programs targeted at minimizing the risks of zoonotic transmission. A total of 470 dogs attending veterinary clinics in Northeastern Nigeria were screened for gastrointestinal helminths using standard parasitological techniques. Epidemiological risk factors associated with the canine parasitic infections were assessed using multivariable logistic regression analysis. In total, 77.9% (366/470) of dogs had harboured one or more species of the gastrointestinal helminths: Ancylostoma caninum (40.2%), Toxocara canis (35.1%) Trichuris vulpis (26.6%), Spirocerca lupi (5.7%), Taenia/Echinococcus (12.3%), Dipylidium caninum (10.9%) and Diphyllobothriid ova (2.8%). Female dogs (OR=2.1; p=0.02), local breeds (OR=2.3; p<0.01), younger dogs (OR=3.2; p<0.001), dogs adopted as security guards (OR=1.8; p<0.01) and poor body condition score (OR=3.1; p<0.001) were strongly associated with A. caninum infection. For T. canis and T. vulpis, younger dogs (OR=2.5; p=0.02 and OR=2.3; p<0.01) and poor body condition score (OR=4.2; p<0.001 and OR=2.2; p<0.01) were the strong predictors for infection, whereas female dogs (OR=2.8; p=0.02), younger dogs (OR=4.1; p<0.001) and poor body condition score (OR=4.0; p<0.001) were strongly associated with D. caninum infection in dogs. The results revealed high prevalence of gastrointestinal helminths-some of which have zoonotic potential-among dogs underlying huge public health risk.

Highly efficient porous sorbent derived from asphalt for the solid-phase extraction of polycyclic aromatic hydrocarbons.

Polycyclic aromatic hydrocarbons (PAHs) are generated primarily during the incomplete combustion of organic matter and are ubiquitous environmental pollutants. For the first time, in this study, a mesoporous carbon derived from asphalt with high surface area (2300 m²g-1 with an average of 1.2 cm³ g-1) was utilized as a sorbent for the solid-phase extraction (SPE) of several PAHs in tap water samples. The factors influencing the extraction capability of the new material were investigated and the optimum conditions were determined to be as follows: Sample volume - 200 mL, no adjustment of sample pH, and sorbent amount - 50 mg. Under the most favorable SPE conditions, with gas chromatography-mass spectrometric analysis, the method exhibited a linear range of 0.5-50 µgL-1 with limits of detection between 0.004 and 0.026 µgL-1. The recoveries obtained from spiked tap water samples spiked at 1 µgL-1 and 5 µgL-1, were in the range 86.7-98.2% with relative standard deviations of <9%. The method was also applied to tap water samples collected from the local environment. The concentrations of PAHs detected ranged between 0.13 and 48 µgL-1. The reusability of the sorbent was tested with five consecutive SPE extraction, and no carryover of analytes was observed.

Symptomatic vitelline duct anomalies in children.

A wide variety of anomalies may occur as a result of the vitelline duct (VD) failing to obliterate completely. Most reports on symptomatic VD focus on Meckel's diverticulum, while other anomalies are given little attention. A retrospective review was conducted at our institution. According to the records 18 symptomatic children with VD anomalies were seen over 22 years, including 10 boys and 8 girls aged 11 days -14 years (median 7.5 months). Twelve patients aged below 10 years (median 28 days) had patent vitelline ducts (PVDs), 3 children aged 13 months, 13 years and 14 years respectively had Meckel's diverticulum (MD), presenting as inflammation, tapeworm incarceration and volvulus respectively. Two patients, both 8 years old, had umbilical sinus, and a 3-year-old had a vitelline cyst. Only 1 patient with PVD had an associated anomaly (intestinal malrotation). The diagnosis of PVD was obvious clinically, but in 1 patient the fistula was demonstrated by fistulogram. The diagnosis of MD was intraoperative in all 3 patients. Treatment was by various types of resection for PVD and MD and excision for umbilical sinuses and cysts. One patient with PVD developed postoperative intestinal obstruction from adhesions, requiring re-laparotomy and adhesiolysis. Two patients with PVD died from sepsis and anaesthetic-related complications, respectively. Although MD is the most commonly VD anomaly, PVD is the most common symptomatic presentation in our environment.