Tandem versus single haematopoietic stem cell transplant and BV maintenance in relapsed/refractory Hodgkin lymphoma: A matched cohort analysis from the LYSA.

Autologous hematopoietic stem cell transplant (ASCT) is the standard curative treatment for patients with high-risk relapsed/refractory Hodgkin lymphoma (R/R HL). The AETHERA study showed survival gain with Brentuximab Vedotin (BV) maintenance after ASCT in BV-naive patients, which was recently confirmed in the retrospective AMAHRELIS cohort, including a majority of BV-exposed patients. However, this approach has not been compared to intensive tandem auto/auto or auto/allo transplant strategies, which were used before BV approval. Here, we matched BV maintenance (AMAHRELIS) and tandem SCT (HR2009) cohorts, and observed that BV maintenance was associated with better survival outcome in patients with HR R/R HL.

Factors influencing quality of life in children with tracheostomy with emphasis on home care visits: a multi-centre investigation.

OBJECTIVE: Only a few studies have assessed the quality of life in children with tracheostomies. This study aimed to evaluate the quality of life and the factors influencing it in these children. METHOD: This cross-sectional, two-centre study was conducted on paediatric patients living in the community with a tracheostomy by using the Pediatric Quality of Life Inventory. Clinical and demographic information of patients, as well as parents' socioeconomic factors, were obtained. RESULTS: A total of 53 patients met our inclusion criteria, and their parents agreed to participate. The mean age of patients was 6.85 years, and 21 patients were ventilator-dependent. The total paediatric health-related quality of life score was 59.28, and the family impact score was 68.49. In non-ventilator-dependent patients, multivariate analyses indicated that social functioning and health-related quality of life were negatively affected by the duration of tracheostomy. The Quality of Life of ventilator-dependent patients was influenced by care visits and the presence of pulmonary co-morbidities. CONCLUSION: Children with tracheostomies have a lower quality of life than healthy children do. Routine care visits by a respiratory therapist and nurses yielded significantly improved quality of life in ventilator-dependent children.

Preferences of different breast reduction techniques: Survey of board-certified plastic surgeons.

Background: Breast reduction is a common and safe procedure with predicted cosmetic outcomes. Many techniques have evolved over the recent decades. Aims: The aim of this study is to determine what type of breast reduction techniques are currently preferred among board certificated Saudi plastic surgeons and assess the surgeons' satisfaction, surgeon-reported patient satisfaction, and complication rates post breast reduction with the preferred techniques. Materials and Methods: This is a cross-sectional questionnaire-based study. The questionnaire was adapted from previously published studies and distributed to a small group before full-scale distribution to Saudi plastic surgeons by email and communication groups. Results: The mean age of the participants was 45.4 (± 8.9). Most participants were males (82%), and the majority held a Saudi board (44%), and 20% held a Canadian board. Significant differences between different board certifications, held fellowship, and years of experience emerged in terms of surgical preferences. The two most common complications reported by surgeons were suture splitting (34%) and excess scarring (24%). Conclusions: In Saudi Arabia, inverted T resection patterns with superior or superomedial pedicle designs are the standard techniques used in breast reduction, with higher satisfaction rates and fewer complications. Surgical preferences were significantly different between surgeons based on their training and held fellowships.

A 2D finite element model for shear wave propagation in biological soft tissues: Application to magnetic resonance elastography.

Dynamic elastography is a virtual palpation tool that aims at investigating the mechanical response of biological soft tissues in vivo. The objective of this study is to develop a finite element model (FEM) with low computational cost for reproducing realistically wave propagation for magnetic resonance elastography in heterogeneous soft tissues. Based on the first-order shear deformation theory for moderately thick structures, this model is developed and validated through comparison with analytical formulations of wave propagating in heterogeneous, viscoelastic infinite medium. This 2D-FEM is then compared to experimental data and a 3D-FEM using a commercial software. Our FEM is a powerful promising tool for investigations of magnetic resonance elastography.

Phylogenic analysis of serotype Asia1 foot-and-mouth disease virus from Sulaimani/Iraq using VP1 protein: heterogeneity with vaccine strain As1/Shamir/89.

Foot-and-mouth disease virus (FMDV) serotypes O, A and Asia1 are responsible for a significant number of disease outbreaks in Iraq. The current study can be considered as the first molecular characterization of serotype Asia1 in Iraq. The present investigation reports the detection of serotype FMDV Asia1 from local farms in Sulaimani districts in 2012 and 2014 outbreaks. Phylogenetic analysis of the complete VP1 gene has shown that FMDV Asia1 field isolates were under genetic novel variant Sindh-08 (group VII) including PAK/iso/11 and TUR/13 strains. The VP1 protein sequence of circulatory FMDV Asia1 genotype showed heterogeneity of nine amino acid substitutions within the G-H loop with the vaccine strain As1/Shamir/89 (JF739177) that is currently used in vaccination program in Iraq. Our result indicated that differences in VP1 protein at G-H loop of the locally circulated FMDV serotype Asia1 strain may be a reason for current vaccination failure.

[Pain therapy using stimulating catheters after total knee arthroplasty]. / Schmerztherapie mit Stimulationskathetern bei Kniegelenkersatz.

BACKGROUND: Epidural analgesia and continuous femoral nerve blocks are often used for pain therapy after total knee arthroplasty. The additional use of a continuous sciatic nerve block is controversially discussed. To avoid the problem of inaccurate placement a stimulating catheter may be useful. The aim of this study was to compare the effectiveness of a continuous femoral nerve block with an additional continuous sciatic nerve block for improved functional recovery and pain relief. MATERIAL AND METHODS: An open randomized prospective controlled study was carried out with 54 patients to receive either a stimulating catheter placed in the femoral nerve sheath or two stimulating catheters placed in the femoral and in the sciatic nerve sheath or an epidural analgesia. Pain was recorded with the visual analogue scale at rest and with passive motion of the knee during the first 3 postoperative days. The angle of nearly pain-free bending of the knee, side effects and opioid consumption were recorded. RESULTS: The reported pain scores and opioid consumption did not differ significantly between the groups. However, functional recovery up to the third postoperative day was significantly worse in the femoral catheter group. CONCLUSION: Using stimulating catheters for pain therapy the three methods are largely comparable and other parameters should be used for individual selection.

Photo-polymerization shrinkage-stress kinetics in resin-composites: methods development.

OBJECTIVES: Studies of free shrinkage-strain kinetics on restoratives have begun to multiply. However, there have been fewer investigations of the more difficult problem of concurrent stress-kinetic measurements. The aim was to outline design parameters for a new methodology for this problem, amenable especially to light-cured materials, and to present illustrative results for a range of restorative composites. METHODS: Absolute values of stress measurable for a given material and geometry are dependent upon the stiffness of the measurement system. In an infinitely stiff system, the measured stress would also tend towards infinity. Real teeth and their cavities are not infinitely stiff; they have elastic and visco-elastic compliance. Consequently, it is important that some minimal, but essentially constant compliance be allowed, whatever the final or time-dependent modulus of the material may be. This goal has been realised by measurement of the time-development, for a disk-geometry specimen (phi=10, h approximately 1.0 mm) of stress (S(r)), with a calibrated cantilever beam-geometry load cell. A novel specimen-holder design was used for this purpose, held in a rigid base assembly. Specimen thicknesses (or gap-widths) of 0.8 and 1.2 mm were specifically investigated on four representative resin-composites. Concurrent measurements were made of the end-displacement of the cantilever load cell, relative to a lower glass plate retaining the specimen. RESULTS: Load-calibration of the cantilever load cell gave an end-displacement per unit stress of circa 6 microm/MPa. This compares with literature values for cuspal compliance or displacement of circa 20 microm. Re-normalisation of the stress-data was implemented. This was accomplished assuming Hooke's law behavior at each instant and equivalent to a stiffer system, with a correction (multiplier) factor of 4 on the raw-stress values. For the materials examined, resultant maximum-stress levels determined were circa 5-8 MPa Stress-levels obtained at 1.2mm thickness were slightly higher (11-15%) than the level of stress obtained at 0.8 mm thickness. This is attributable to the greater mass of material undergoing shrinkage at 1.2 mm, offset slightly by the different C-factors. SIGNIFICANCE: The new device is a practical and self-contained system for rapid and accurate measurement of stress-kinetics in photo-polymerising and also self-cure materials.

Two triterpene saponins from Achyranthes bidentata.

Bidentatoside II(1) and chikusetsusaponin V methyl ester (2) are two further triterpene saponins isolated from the roots of Achyranthes bidentata. Chemical and homo and heteronuclear two-dimensional (2D) NMR techniques have led to the structural elucidation of 1 which is a new seco-glycoside of oleanolic acid and the full 1H- and 13C-NMR assignments of 2. These compounds did not show any potentiation of the in vitro cytotoxicity of cisplatin in the HT 29 human colon cancer cell line.

Bidentatoside I, a new triterpene saponin from Achyranthes bidentata.

Bidentatoside I (1) is a new triterpene saponin bearing an unusual dioxopropionic acid unit, isolated from the roots of Achyranthes bidentata. Structural elucidation was performed mainly by chemical and homo- and heteronuclear 2D NMR techniques. This compound did not show any potentiation of the in vitro cytotoxicity of cisplatin in the HT 29 human colon cancer cell line.

Optimal specimen geometry in bonded-disk shrinkage-strain measurements on light-cured biomaterials.

OBJECTIVES: The aim was to determine the effect on apparent shrinkage-strain values of varying specimen aspect ratio in the bonded-disk configuration. Thereby one source of possible inter-laboratory variation might be understood and eliminated. METHODS: The bonded-disk procedure was followed and applied to three representative resin-composites. However, specimen sub-groups were examined, each of different diameters (3.5, 5.0, 7.0 and 9.0 mm), corresponding to C-factors in the range 0.45-7.0. RESULTS: For each material, no statistically significant difference was apparent between data obtained with 7 and 9 mm diameter specimens. However, statistically significant reductions (p < 0.05, Scheffé and SNK) were apparent at 5.0 and 3.5 mm diameter, in the range 14-18% of the maximum 'true' value. For each material, the diameter (d)-dependence of apparent shrinkage-strain (epsilon) was given by the curve fit expression: epsilon = A - B/d2. SIGNIFICANCE: For accurate determination of maximum final equilibrium shrinkage-strain values, a high aspect ratio (7-9:1) of the bonded-disk should be utilised. This is important for accurate comparison of data from proposed low-shrinkage amalgam-replacement materials.

A new major triterpene saponin from the roots of Cucurbita foetidissima.

Foetidissimoside B (1), a novel triterpene saponin, was isolated from the roots of Cucurbita foetidissima. Based on spectroscopic data, especially direct and long-range heteronuclear 2D NMR analysis and on chemical transformations, the structure of 1 was elucidated as 3-O-beta-D-glucuronopyranosyl-echinocystic acid 28-O-beta-D-glucopyranosyl-(1-->3)-beta-D-xylopyranosyl(1-->3)-[beta- D-xylopyranosyl (1-->4)]-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranoside . Compound 1 did not show any ability to potentiate in vitro cisplatin cytotoxicity in a human colon cancer cell line.