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Risk avoidance

M L de Baat, D A Bas, S A M van Beusekom, S T J Droge, F van der Meer, M de Vries, P F M Verdonschot, M H S Kraak
According to the European Water Framework Directive (WFD), chemical water quality is assessed by monitoring 45 priority substances. However, observed toxic effects can often not be attributed to these priority substances, and therefore there is an urgent need for an effect-based monitoring strategy that employs bioassays to identify environmental risk. Algal photosynthesis is a sensitive process that can be applied to identify the presence of hazardous herbicides in surface water. Therefore, the aim of this study was to employ an algal photosynthesis bioassay to assess surface water toxicity to algae and to identify the compounds causing the observed effects...
July 18, 2018: Science of the Total Environment
Amélie Chaussade, Gaël Millot, Constance Wells, Hervé Brisse, Marick Laé, Alexia Savignoni, Laurence Desjardins, Rémi Dendale, François Doz, Isabelle Aerts, Irène Jimenez, Nathalie Cassoux, Dominique Stoppa Lyonnet, Marion Gauthier Villars, Claude Houdayer
Retinoblastoma (Rb) results from biallelic inactivation of the RB1 gene. Hereditary Rb patients i. e germline carriers of a RB1 mutation also have a risk of developing subsequent malignant neoplasms (SMN) such as osteosarcomas. This SMN risk is maximized by external beam radiotherapy treatments (EBRT), which is why these treatments are now avoided. Nevertheless, EBRT is still a matter of great concern, as EBRT-treated patients are in their adulthood and SMNs remain the major cause of death for patients. To decipher the relationship between RB1 genotype and SMN development in EBRT treated patients, we conducted a retrospective study in a cohort of 160 irradiated hereditary Rbs with fully resolved RB1 mutational status...
July 18, 2018: European Journal of Medical Genetics
Houssein H Ayoub, Hiam Chemaitelly, Ryosuke Omori, Laith J Abu-Raddad
OBJECTIVES: Hepatitis C virus (HCV) clearance rate (fclearance ) is defined as the proportion of infected persons who will spontaneously clear their infection after acute infection. We aimed to estimate fclearance using a novel approach that avoids limitations in existing estimates, and to clarify the link between fclearance and HCV viremic rate-the latter being the proportion of RNA positivity among those antibody positive. METHODS: A mathematical model was developed to describe HCV transmission...
July 18, 2018: International Journal of Infectious Diseases: IJID
Alireza Karimi Yazdi, Elham Davoudi-Dehaghani, Mahtab Rabbani Anari, Paanti Fouladi, Elmira Ebrahimi, Solmaz Sabeghi, Ali Eftekharian, Kiyana Sadat Fatemi, Hamed Emami, Zohreh Sharifi, Fatemeh Ramezanzadeh, Ardavan Tajdini, Sirous Zeinali, Saeid Amanpour
Hearing impairment (HI) caused by mutations in the connexin-26 gene (GJB2) accounts for the majority of cases with inherited, nonsyndromic sensorineural hearing loss. Due to the illegality of the abortion of deaf fetuses in Islamic countries, preimplantation genetic diagnosis (PGD) is a possible solution for afflicted families to have a healthy offspring. This study describes the first use of PGD for GJB2 associated non-syndromic deafness in Iran. GJB2 donor splicing site IVS1+1G>A mutation analysis was performed using Sanger sequencing for a total of 71 Iranian families with at least 1 deaf child diagnosed with non-syndromic deafness...
June 30, 2018: Cellular and Molecular Biology
K F Urbancic, D Pisasale, J Wight, J A Trubiano
Dapsone may be used for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in haematology patients receiving immunosuppressive therapy or after hematopoietic stem cell transplant (HSCT) in the setting of trimethoprim-sulfamethoxazole (TMP-SMX) adverse drug reaction (ADR) history. Dapsone-induced haematological toxicities such as oxidative haemolysis may limit use in these patients and modern assessments of dapsone allergy cross-reactivity in non-HIV patients with a sulphonamide allergy are largely absent. The aim of this single-centre, retrospective study was to describe dapsone usage in haematology patients requiring PJP prophylaxis, including HSCT recipients, over a 12-month period in terms of indications, incidence of dapsone-attributed oxidative haemolysis, and immune cross-reactivity in those previously labelled with a sulphonamide allergy, as well as describing potential opportunities for first-line TMP-SMX PJP prophylaxis reintroduction...
July 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Junfen Ma, Thomas R Kreil
The discussion on the facility risk mitigation was included in the 2017 viral clearance symposium for the first time. There were a few topics discussed in this session, including sanitization / cleaning against viruses, viral segregation as well as definition of a functionally closed system. Virus inactivation by disinfectants is critical for the biotechnology industry. The efficacy can be different, depending whether applied to surfaces, in solutions or in the gas phases, as well as the respective disinfectants, i...
July 20, 2018: PDA Journal of Pharmaceutical Science and Technology
Chen Cheng, Na Tang, Jiaxin Li, Shiwei Cao, Tongtong Zhang, Xiaofei Wei, Haoyi Wang
BACKGROUND: Chimeric antigen receptor T (CAR-T) cells engineered with lentiviral and retroviral vectors have been successfully applied to treat patients with B cell malignancy. However, viral integration in T cells has the potential risk of mutagenesis, and viral vector production demands effort and is costly. Using non-integrative episomal vector such as minicircle vector to generate integration-free CAR-T cells is an attractive option. METHODS AND RESULTS: We established a novel method to generate minicircle vector within a few hours using simple molecular biology techniques...
July 20, 2018: Journal of Medical Genetics
Dan Ye, Tianbao Zhang, Guohua Lou, Weiwei Xu, Fengqin Dong, Guoping Chen, Yanning Liu
AIMS: Type 2 diabetes mellitus (T2DM), with non-alcoholic fatty liver disease (NAFLD) complication, may aggravate the disturbance of metabolism, increase the risk of non-alcoholic steatohepatitis, and promote the progress of liver fibrosis. Therefore, early detection of NAFLD in T2DM patients is critical in avoiding the adverse effects of the complication. This study aimed to identify circulating miRNAs for early diagnosis of the complication. MATERIALS AND METHODS: Plasma miRNA expression profiles of T2DM patients complicated with or without NAFLD were examined by miRNA array analysis and then were validated by qRT-PCR...
July 17, 2018: Life Sciences
Luca Gianotti, Marc G Besselink, Marta Sandini, Thilo Hackert, Kevin Conlon, Arja Gerritsen, Oonagh Griffin, Abe Fingerhut, Pascal Probst, Mohamed Abu Hilal, Giovanni Marchegiani, Gennaro Nappo, Alessandro Zerbi, Antonio Amodio, Julie Perinel, Mustapha Adham, Massimo Raimondo, Horacio J Asbun, Asahi Sato, Kyoichi Takaori, Shailesh V Shrikhande, Marco Del Chiaro, Maximilian Bockhorn, Jakob R Izbicki, Christos Dervenis, Richard M Charnley, Marc E Martignoni, Helmut Friess, Nicolò de Pretis, Dejan Radenkovic, Marco Montorsi, Michael G Sarr, Charles M Vollmer, Luca Frulloni, Markus W Büchler, Claudio Bassi
BACKGROUND: The optimal nutritional therapy in the field of pancreatic surgery is still debated. METHODS: An international panel of recognized pancreatic surgeons and pancreatologists decided that the topic of nutritional support was of importance in pancreatic surgery. Thus, they reviewed the best contemporary literature and worked to develop a position paper to provide evidence supporting the integration of appropriate nutritional support into the overall management of patients undergoing pancreatic resection...
July 17, 2018: Surgery
Erman Yıldız
Sexual minority populations are exposed to more forms of distress than heterosexual individuals, thereby increasing the risk of suicidal behavior. It therefore seems surprising that suicidal behavior in sexual minorities is not sufficiently addressed in the nursing literature.The aim of this review was to integrate evidence-based knowledge and experiences related to suicide in sexual minorities into the nursing literature. This study has been conducted according to PRISMA guidelines, which contains a basic systematic screening process...
August 2018: Archives of Psychiatric Nursing
Kun Li, Rui Li, Ya Ni, Peibei Sun, Ye Liu, Dan Zhang, Hefeng Huang
BACKGROUND: Sperm selection is essential for the health of offspring conceived via assistive reproductive technology (ART). Various methods of sperm preparation for in vitro fertilization and intracytoplasmic sperm injection have been developed to acquire sperm with better quality and to avoid potential genetic disorders. However, current sperm processing and selection techniques bypass the natural selection that occurs during fertilization in vivo. The aim of this study was to present a novel distance-progesterone-combined selection approach with an original device based on the human female reproductive tract, and to report on its effectiveness based on sperm progressive motility, as well as chemotaxis...
July 20, 2018: Journal of Translational Medicine
Ersin Sensoz, Fatih Mehmet Özkal, Volkan Acar, Ferit Cakir
Iatrogenic subtrochanteric fractures are rarely encountered after cannulated screw fixation of femoral neck fractures; however, when they do occur, there can be several complications. Many orthopedic surgeons have concerns about the potential for iatrogenic subtrochanteric fractures after screw fixation distal to the trochanter minor; therefore, some surgeons are typically reluctant to perform this procedure. This study focused on the risk of an iatrogenic subtrochanteric fracture after treating femoral neck fractures with cannulated screws...
July 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Najla A Lakkis, Salim M Adib, Ghassan N Hamadeh, Rana T El-Jarrah, Mona H Osman
Lebanon has one of the highest estimated age-standardized incidence rate (ASR(w)) of bladder cancer (BC) worldwide. The aim of this study is to analyze the incidence rates for BC in Lebanon over a period of 7 years and to compare them to the rates in other countries. Data were obtained from the Lebanese National Cancer Registry for the currently available years 2005 to 2011. The calculated ASR(w) and age-specific rates were expressed as per 100 000 population. From 2005 to 2011, BC has been ranked as the third most common cancer in Lebanon...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
Patrick H Pun
Nephrologists are faced with a difficult dilemma in choosing the ideal dialysis prescription to maintain neutral potassium mass balance. Should potassium mass balance goals prioritize the normalization of serum potassium levels using low potassium dialysate at the expense of provoking intradialytic arrhythmias, or should mass balance goals favor permissive hyperkalemia using higher dialysate potassium to avoid rapid intradialytic fluxes at the risk of more interdialytic arrhythmias? This review examines the factors that determine potassium mass balance among HD patients, the relationships between serum and dialysate potassium levels and outcomes, and concludes by examining currently available approaches to reducing risk of arrhythmias while managing potassium mass balance...
July 19, 2018: Seminars in Dialysis
Narasimhan Ragavan, Kunal Dholakia, Malarvizhi Ramesh, Jens Uwe Stolzenburg
Robot-assisted laparoscopic radical prostatectomy (RRP) has traditionally been done using transperitoneal (TP) approach. This requires patients to be in the steep Trendelenburg position with antecedent risks of high intraoperative ventilatory pressure, post-operative confusion status, corneal and cerebral edema, deep vein thrombosis (DVT), predisposes risk of intestinal injury and slight delay in bowel recovery. Extraperitoneal (EP-RRP) approach circumvents the above given issues. Between July 2013 and October 2016, 57 patients underwent RRP for adenocarcinoma done by a single surgeon (NR)...
July 19, 2018: Journal of Robotic Surgery
Oleg Militsakh, William Lydiatt, Daniel Lydiatt, Erik Interval, Robert Lindau, Andrew Coughlin, Aru Panwar
Importance: Prescription opioid use contributes to drug-related adverse effects and risk for dependence and abuse. Multimodal analgesia (MMA) has been shown to be useful in reducing opioid use following orthopedic, gynecologic, and colorectal surgery, but adoption in head and neck surgery has lagged. Recently, we published findings related to the feasibility of MMA protocols in same-day thyroid, parathyroid, and parotid surgery. However, whether such strategies lead to effective and durable reduction in frequency of opioid prescriptions, and affect physician prescribing practices, remains unclear...
July 19, 2018: JAMA Otolaryngology—Head & Neck Surgery
Tormod Rogne, Trond Nordseth, Gudmund Marhaug, Einar Marcus Berg, Arve Tromsdal, Ola Sæther, Sven Gisvold, Peter Hatlen, Helen Hogan, Erik Solligård
BACKGROUND: The proportion of avoidable hospital deaths is challenging to estimate, but has great implications for quality improvement and health policy. Many studies and monitoring tools are based on selected high-risk populations, which may overestimate the proportion. Mandatory reporting systems, however, under-report. We hypothesise that a review of an unselected sample of hospital deaths will provide an estimate of avoidability in-between the estimates from these methods. METHODS: A retrospective case record review of an unselected population of 1000 consecutive non-psychiatric hospital deaths in a Norwegian hospital trust was conducted...
July 19, 2018: BMJ Quality & Safety
L Tabuenca-Del Barrio, M Mozo-Cuadrado, A Zubicoa-Eneriz, P Plaza-Ramos
OBJECTIVE: To report a case series of external ophthalmomyiasis in a region of Spain together with its common epidemiological factors and treatment. MATERIAL AND METHODS: A presentation is made of four clinical cases of patients with external ocular myiasis caused by Oestrus ovis larvae. RESULTS: Ocular myiasis is a parasitic infection by larval stages of flies. It can affect the ocular globe externally and / or internally, being the first one the most frequently condition founded...
July 16, 2018: Archivos de la Sociedad Española de Oftalmología
Chun Shing Kwok, Malcolm Bell, H Vernon Anderson, Khaled Al Shaibi, Rajiv Gulati, Jessica Potts, Muhammad Rashid, Evangelos Kontopantelis, Rodrigo Bagur, Mamas A Mamas
OBJECTIVES: This study aimed to evaluate discharge against medical advice (DAMA) in percutaneous coronary intervention (PCI) and how DAMA affects readmissions. BACKGROUND: DAMA is infrequent but associated with poor patient outcomes. DAMA in the context of PCI has not been described in the published reports. METHODS: The authors analyzed patients in the Nationwide Readmission Database between 2010 and 2014 with a PCI procedure who were either discharged home or against medical advice...
July 23, 2018: JACC. Cardiovascular Interventions
Gaelle Saint-Hilary, Veronique Robert, Mauro Gasparini, Thomas Jaki, Pavel Mozgunov
Quantitative methods have been proposed to assess and compare the benefit-risk balance of treatments. Among them, multicriteria decision analysis (MCDA) is a popular decision tool as it permits to summarise the benefits and the risks of a drug in a single utility score, accounting for the preferences of the decision-makers. However, the utility score is often derived using a linear model which might lead to counter-intuitive conclusions; for example, drugs with no benefit or extreme risk could be recommended...
January 1, 2018: Statistical Methods in Medical Research
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