Significance of the CONUT Score in the Prognosis of Colorectal Cancer Patients.

INTRODUCTION/OBJECTIVE: Nutritional status is related to the prognosis of colorectal cancer (CRC) patients. The CONUT (The Controlling Nutritional Status) score is a recent nutritional marker. This study aimed to examine the association of preoperative CONUT score with overall survival (OS) and disease-free survival (DFS), while the secondary aim was to assess the importance of preoperative nutritional status for the development of postoperative complications. Methods: The total number of CRC patients included in the study was 111. All patients underwent laboratory analyses within a week before surgery. Medical data were collected from archived data at the Zvezdara University Medical Centre. The CONUT score was analyzed in relation to the OS and DFS. Results: Using the Kaplan-Meier survival curve and Log-rank test, a statistically significant difference in OS and DFS between groups of patients with different CONUT scores was observed. Patients with higher CONUT scores have a longer duration of hospitalization after surgery, a longer total length of stay, and a more severe degree of postoperative complications. CONCLUSION: The CONUT score is related to short-term treatment outcomes, such as the length of intrahospital treatment and frequency and severity of postoperative complications, but also to long-term prognostic parameters. Early nutritional screening may be of prognostic significance.

Pediatric appendicular actinomycosis: a case report and literature review.

BACKGROUND: Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of pediatric ACM, such as orocervicofacial (55%) and other less common forms: abdominopelvic and thoracic. We report a case of a 16-year-old who presented with abdominal ACM in the setting of acute appendicitis. After the case report, we provide a short literature review of pediatric appendicular ACM cases published. CASE: A 16-year-old boy presented with nausea, vomiting, pain in the upper part of the abdomen and fever (37.5°C) lasting for 24 hours. On physical examination, the patient`s epigastrium and lower right abdominal quadrant were tender. White cell count and C-reactive protein (CRP) were elevated at 16,300/µL and 48.6mg/L respectively. Ultrasonography (US) showed appendicolith and edema of the appendiceal wall, focally with stratification as well as periappendiceal inflammation. The patient underwent a classic appendectomy, and the postoperative course was without complications. Histopathological analysis showed diffuse transmural neutrophilic infiltration of the appendix, focally with areas of necrosis and abscesses. There were numerous brightly eosinophilic colonies made of filamentous bacteria, located predominantly in submucosa. Special stains Grocott-Gomori`s Methenamine Silver and Gram were positive and a diagnosis of ACM was made. CONCLUSIONS: Although appendicitis is very common in the general population, appendicitis associated with ACM is very rare, accounting for 0.02% - 0.06%, especially in the pediatric population. Diagnosis can be very challenging because they usually present with non-specific symptoms, and can form masses that mimic malignancies. Although rare, clinicians and pathologists should be aware of this entity. Satisfactory results and complete cure are achieved with adequate antibiotic therapy and surgery. In most cases, if there are no associated diseases, early and accurate diagnosis ensure an excellent prognosis.

Cholesterol Metabolic Profiling of HDL in Women with Late-Onset Preeclampsia.

A specific feature of dyslipidemia in pregnancy is increased high-density lipoprotein (HDL) cholesterol concentration, which is probably associated with maternal endothelium protection. However, preeclampsia is most often associated with low HDL cholesterol, and the mechanisms behind this change are scarcely explored. We aimed to investigate changes in HDL metabolism in risky pregnancies and those complicated by late-onset preeclampsia. We analyze cholesterol synthesis (cholesterol precursors: desmosterol, 7-dehydrocholesterol, and lathosterol) and absorption markers (phytosterols: campesterol and ß-sitosterol) within HDL particles (NCSHDL), the activities of principal modulators of HDL cholesterol's content, and major HDL functional proteins levels in mid and late pregnancy. On the basis of the pregnancy outcome, participants were classified into the risk group (RG) (70 women) and the preeclampsia group (PG) (20 women). HDL cholesterol was lower in PG in the second trimester compared to RG (p < 0.05) and followed by lower levels of cholesterol absorption markers (p < 0.001 for campesterolHDL and p < 0.05 for ß-sitosterolHDL). Lowering of HDL cholesterol between trimesters in RG (p < 0.05) was accompanied by a decrease in HDL phytosterol content (p < 0.001), apolipoprotein A-I (apoA-I) concentration (p < 0.05), and paraoxonase 1 (PON1) (p < 0.001), lecithin-cholesterol acyltransferase (LCAT) (p < 0.05), and cholesterol ester transfer protein (CETP) activities (p < 0.05). These longitudinal changes were absent in PG. Development of late-onset preeclampsia is preceded by the appearance of lower HDL cholesterol and NCSHDL in the second trimester. We propose that reduced capacity for intestinal HDL synthesis, decreased LCAT activity, and impaired capacity for HDL-mediated cholesterol efflux could be the contributing mechanisms resulting in lower HDL cholesterol.

Assessment of Environmental Impacts from Different Perspectives-Case Study of Egg Value Chain System in Serbia.

The environmental performance of various aspects of animal origin food supply chains has been the focus of research in recent years, and has provided useful information. However, there were no studies that covered the entire egg supply chain from different perspectives. The aim of this study was to analyze the majority of environmental impacts in the table egg supply chain comprising of three subsystems: farms, retail outlets and households, with quantification of each individual subsystem and the entire supply chain. All data were gathered from 30 farms, 50 retail stores and 300 households in Serbia. In parallel, the perception and ranking of environmental impacts along the supply chain were also evaluated. Finally, the quality function deployment for the environment was used to determine the degree of correlation between the set of environmental requirements and the identified environmental impacts. Results revealed that the greatest environmental impacts come from the production of feed for laying hens and the use of natural resources, and they contribute the most to the pollution of each individual environmental indicator. Additionally, the results show the differences in the environmental impacts of each individual subsystem and identify opportunities to mitigate them through the optimization of animal feed, energy consumption and household food waste management. The overall perspective of the egg supply chain points to climate change effects as the most important. The differences in the perceptions of environmental impacts along the entire egg supply chain suggest the need for promotion of mitigation strategies to all stakeholders that would encourage them to achieve sustainable development goals.

UV irradiation induces apoptosis in the human endometrial stromal cell line (ThESC).

PURPOSE: The treatment options of endometrial hyperplasia consist of surgical, interventional and medical therapies including apoptosis-inducing agents. The purpose of the study was to evaluate the effects of ultraviolet (UV) radiation on the viability and the type of cell death on the human endometrial stromal cells (ThESC) line. METHODS: We investigated the effect of UV exposure on human endometrial stromal cell line (ThESC) on cell viability using MTT assay as well as changes in cell morphology using phase microscopy and acridine orange (AO)/ethidium bromide (EB) cell staining. RESULTS: UV treatment significantly decreased the percentage of the viable ThESC cells compared to the viability of untreated control cells using MTT assay (p<0.05). In addition, UV treatment of ThESC cells for 60 and 90 min induced high level of cell morphology disruption, followed with loss of both the cell shape and the presence of defragmented debris and stained with intense red color. CONCLUSIONS: The obtained results suggest the potential role of UV light application as additional treatment option of benign endometrium hyperplasia alone or in combination with other treatment modalities.

Analytical quality by design development of an ecologically acceptable enantioselective HPLC method for timolol maleate enantiomeric purity testing on ovomucoid chiral stationary phase.

Official method in Ph. Eur. for evaluation of timolol enantiomeric purity is normal-phase high performance liquid chromatography (NP-HPLC) method. Compared to other HPLC modes, NP is depicted as quite expensive with high consumption of organic solvents which leads to chronic exposure of analysts to toxic and carcinogenic effects. In order to overcome above-mentioned drawbacks, the aim of this study was to develop new method with better eco-friendly features. This was enabled by using protein type Chiral Stationary Phase (CSP) in reversed-phase mode that required up to 10 % (v/v) of organic solvent. Therefore, an enantioselective HPLC method was developed and validated for quantification of (S)-timolol and its chiral impurity, (R)-isomer. Optimized separation conditions on ovomucoid column were set using Analytical Quality by Design (AQbD) approach in method development. Optimization step was performed following the Box-Behnken experimental plan and the influence of three critical method parameters (CMPs) towards enantioseparation of the above-mentioned peak pair was examined. CMPs included variation of acetonitrile content in the mobile phase (5-10 %, v/v), pH value of the aqueous phase (6.0-7.0) and ammonium chloride concentration in the aqueous part of the mobile phase (10-30 mmol L-1). The most relevant critical method attributes (CMAs) in this case were the separation criterion between studied critical pair and retention factor of the second eluting peak, (S)-timolol. Qualitative Design Space (DS) was defined by Monte Carlo simulations providing adequate assurance of method's qualitative robustness (π = 95 %). The selected working point situated in the middle of the DS was characterized by following combination of CMPs: acetonitrile content in the mobile phase 7 % (v/v), pH value of the aqueous phase 6.8 and concentration of ammonium chloride in aqueous phase 14 mmol L-1. In the next step, the quantitative robustness was tested by Plackett-Burman experimental design. The validation studies confirmed adequacy of the proposed method for its intended purpose. Finally, Analytical Eco-Scale metric tool was applied to confirm that developed method represents excellent green analytical method compared to the official one.

EFFECTS OF L-ASCORBIC ACID AND ALPHA-TOCOPHEROL ON BIOCHEMICAL PARAMETERS OF SWIMMING-INDUCED OXIDATIVE STRESS IN SERUM OF GUINEA PIGS.

BACKGROUND: The purpose of this study is to determine the effect of L-ascorbic acid and alpha-tocopherol as well as combination of these vitamins with or without exposure to physical exercise on intensity of lipid peroxidation, activity of xanthine oxidase, activity of total antioxidative system, concentration of glutathione, and activity of catalase in the serum of guinea pigs. MATERIALS AND METHODS: The experimental measurements of intensity of lipid peroxidation, activity of xanthine oxidase, activity of total antioxidative system, concentration of glutathione, and activity of catalase were done in the serum of guinea pigs. The animals were exposed to the test load to achieve exhaustion and the test was terminated when the animal for the third time to sink into the water. RESULTS: The results of this study demonstrated that endurance exercise of guinea pigs induced oxidative stress response in terms of increased lipid peroxidation and activity of xanthine oxidase in the serum of experimental animals. Our study investigated the antioxidant activity of L-ascorbic acid and alpha-tocopherol also measuring three protective markers in the serum: total antioxidant activity, content of glutathione and activity of catalase. The results obtained show that the vitamins influence the concentrations of above mentioned biochemical parameters, which points out their protective effect of swimming-induced oxidative stress. CONCLUSION: Single or combined administration of L-ascorbic acid and alpha-tocopherol caused significant inhibition of these markers indicating the important antioxidant activity of the vitamins. Results lead to conclude that the combined treatments with vitamins with or without exposure to physical exercise showed the clear synergistic effect..

Inferring human mobility using communication patterns.

Understanding the patterns of mobility of individuals is crucial for a number of reasons, from city planning to disaster management. There are two common ways of quantifying the amount of travel between locations: by direct observations that often involve privacy issues, e.g., tracking mobile phone locations, or by estimations from models. Typically, such models build on accurate knowledge of the population size at each location. However, when this information is not readily available, their applicability is rather limited. As mobile phones are ubiquitous, our aim is to investigate if mobility patterns can be inferred from aggregated mobile phone call data alone. Using data released by Orange for Ivory Coast, we show that human mobility is well predicted by a simple model based on the frequency of mobile phone calls between two locations and their geographical distance. We argue that the strength of the model comes from directly incorporating the social dimension of mobility. Furthermore, as only aggregated call data is required, the model helps to avoid potential privacy problems.

Universality in voting behavior: an empirical analysis.

Election data represent a precious source of information to study human behavior at a large scale. In proportional elections with open lists, the number of votes received by a candidate, rescaled by the average performance of all competitors in the same party list, has the same distribution regardless of the country and the year of the election. Here we provide the first thorough assessment of this claim. We analyzed election datasets of 15 countries with proportional systems. We confirm that a class of nations with similar election rules fulfill the universality claim. Discrepancies from this trend in other countries with open-lists elections are always associated with peculiar differences in the election rules, which matter more than differences between countries and historical periods. Our analysis shows that the role of parties in the electoral performance of candidates is crucial: alternative scalings not taking into account party affiliations lead to poor results.

How the online social networks are used: dialogues-based structure of MySpace.

Quantitative study of collective dynamics in online social networks is a new challenge based on the abundance of empirical data. Conclusions, however, may depend on factors such as user's psychology profiles and their reasons to use the online contacts. In this study, we have compiled and analysed two datasets from MySpace. The data contain networked dialogues occurring within a specified time depth, high temporal resolution and texts of messages, in which the emotion valence is assessed by using the SentiStrength classifier. Performing a comprehensive analysis, we obtain three groups of results: dynamic topology of the dialogues-based networks have a characteristic structure with Zipf's distribution of communities, low link reciprocity and disassortative correlations. Overlaps supporting 'weak-ties' hypothesis are found to follow the laws recently conjectured for online games. Long-range temporal correlations and persistent fluctuations occur in the time series of messages carrying positive (negative) emotion; patterns of user communications have dominant positive emotion (attractiveness) and strong impact of circadian cycles and interactivity times longer than 1 day. Taken together, these results give a new insight into the functioning of online social networks and unveil the importance of the amount of information and emotion that is communicated along the social links. All data used in this study are fully anonymized.

Spectral and dynamical properties in classes of sparse networks with mesoscopic inhomogeneities.

We study structure, eigenvalue spectra, and random-walk dynamics in a wide class of networks with subgraphs (modules) at mesoscopic scale. The networks are grown within the model with three parameters controlling the number of modules, their internal structure as scale-free and correlated subgraphs, and the topology of connecting network. Within the exhaustive spectral analysis for both the adjacency matrix and the normalized Laplacian matrix we identify the spectral properties, which characterize the mesoscopic structure of sparse cyclic graphs and trees. The minimally connected nodes, the clustering, and the average connectivity affect the central part of the spectrum. The number of distinct modules leads to an extra peak at the lower part of the Laplacian spectrum in cyclic graphs. Such a peak does not occur in the case of topologically distinct tree subgraphs connected on a tree whereas the associated eigenvectors remain localized on the subgraphs both in trees and cyclic graphs. We also find a characteristic pattern of periodic localization along the chains on the tree for the eigenvector components associated with the largest eigenvalue lambda(L)=2 of the Laplacian. Further differences between the cyclic modular graphs and trees are found by the statistics of random walks return times and hitting patterns at nodes on these graphs. The distribution of first-return times averaged over all nodes exhibits a stretched exponential tail with the exponent sigma approximately 1/3 for trees and sigma approximately 2/3 for cyclic graphs, which is independent of their mesoscopic and global structure.

[Application of recombinant activated factor VII in treatment of intracranial haemorrhage in haemophilic patient with inhibitor].

INTRODUCTION: Intracranial haemorrhage (ICH) is one of serious haemorrhagic syndromes among haemophilic patients and the potential cause of death. However, extensive use of coagulation factor concentrates can provoke the development of antibodies, i.e. inhibitors. Recombinant activated factor VII (rFVIIa) has been successfully used in treating haemorrhage in A or B haemophilic patients with inhibitors. CASE OUTLINE: A 31-year old patient was hospitalized at the local Clinical Centre to be prepared for dental surgery. His initial level of inhibitor was two Bethesda units. His condition deteriorated abruptly during hospitalization with signs of drowsiness and dysphasia. The initial CT of endocranium demonstrated haemorrhagic content. The patient received emergency treatment of 90 microg/kg/2h rFVIIa (NovoSeven) twice. The following day, after the first signs of ICH appeared, the patient developed tonic-clonic seizures characterized as epilepsy, which requiring antioedematous and anticonvulsive therapy. During the seizure, the patient bit his tongue, which resulted in massive bleeding from the wound and haematoma formation at the oral cavity floor. The first signs of resolution of ICH appeared three days after the first epileptic attack, and after following 11 days all signs completely withdrew. The patient received 29 doses of rFVIIa every 2 hours until the first signs of resolution of ICH and until bleeding from the injured tongue stopped. In the meantime, the patient had an episode of massive haematuria, which was successfully stopped with three doses of rFVIIa, 4.8 mg each. The titer of inhibitors was in the range of up to 26 units during hospitalization. The total dose of rFVIIa administered for treating ICH, tongue lesion, and haematuria was 153.6 mg. The patient also received 1 mg/kg of prednisone for three weeks for eradication of the inhibitors, and afterwards the dose was reduced to 0.5 mg/kg for the following month. CONCLUSION: If there is suspicion of ICH in haemophilic patients, it is necessary to administer replacement treatment, and if haemophilia with inhibitor is in question, as in our patient, immediate administration of rFVIIa is necessary followed by diagnostic procedures and the verification of ICH to determine further treatment and the dosage of rFVIIa, with clinical monitoring using radiological imaging.