Search

Objective: To assess the long-term risk factors predicting residual/recurrent cervical intraepithelial neoplasia (CIN 2-3) and time to recurrence after large loop excision of the transformation zone (LLETZ).Design: Retrospective study.Setting: Colposcopy clinic.Population: 242 women with CIN 2-3 treated between 1996 and 2006 and followed up until June 2016.Methods: Age, margins, and high-risk human papillomavirus (HR-HPV) were estimated using Cox proportional hazard and unconditional logistic regression models. The cumulative probability of treatment failure was estimated by Kaplan-Meier analysis.Main Outcome Measure: Histologically confirmed CIN 2-3, HR-HPV, margins, age.Results: CIN 2-3 was associated with HR-HPV (HR = 30.5, 95% confidence interval [CI] = 3.80-246.20), age >35 years (HR = 5.53, 95% CI = 1.22-25.13), and margins (HR = 7.31, 95% CI = 1.60-33.44). HR-HPV showed a sensitivity of 88.8% and a specificity of 80%. Ecto+ /endocervical+ (16.7%), uncertain (19.4%) and ecto- /endocervical+ margins (9.1%) showed a higher risk of recurrence (odds ratio [OR] = 13.20, 95% CI = 1.02-170.96; OR = 15.84, 95% CI = 3.02-83.01; and OR = 6.60, 95% CI = 0.88-49.53, respectively). Women with involved margins and/or who were HR-HPV positive had more treatment failure than those who were HR-HPV negative or had clear margins (P-log-rank <0.001).Conclusions: HR-HPV and margins seem essential for stratifying post-LLETZ risk, and enable personalised management. Given that clear margins present a lower risk, a large excision may be indicated in older women to reduce the risk.Tweetable Abstract: After LLETZ for CIN 2-3, recurrences appear more often in women with positive HR-HPV and involved margins and aged over 35. [ABSTRACT FROM AUTHOR]

A versatile route has been developed for the synthesis of 2‐arylindoles using a Pd‐catalyzed tandem process. Under reductive conditions, different 2‐arylindoles were synthesized from phenylglyoxal and aniline. This synthetic methodology involves a tandem reaction of four steps with high regioselectivity. Alternatively, 2‐anilinoacetophenones intermediates also can be using to give access to the corresponding 2‐arylindoles. [ABSTRACT FROM AUTHOR]

Herein, we report a new straightforward catalytic synthesis of 2,3-disubstituted indoles from α-diketones 1 and N-substituted anilines 2 by employing a palladium(II) trifluoroacetate/1,1′-bis(diphenylphosphino)ferrocene ([Pd(tfa)2]/dppf; 1:1.5) under reductive conditions and without an external oxidant. The tandem reaction involves ketoenamine and ketoamine as intermediates and a final dehydration-annulation reaction to obtain the 2,3-disubstituted indole. New palladium hydride species, which catalyze the reaction, could not be isolated but Pd-H species were observed by NMR and IR spectroscopy and mass spectrometry (FAB+) studies. This work presents a new regioselective route with a plausible mechanism to synthesize 2,3-disubstituted indoles under reductive conditions. [ABSTRACT FROM AUTHOR]

Perceptual range is one of the main determinants of dispersal success in fragmented landscapes, which are composed of scattered remnants of original habitat in a matrix of variable composition. How perceptual range varies according to land use is essential information to estimate the functional connectivity of landscapes. We determined for the first time how different types of land use affect the perceptual range of a species, using as model organisms two neotropical marsupials endemic to the Atlantic Forest in Brazil ( Philander frenatus and Didelphis aurita). We released and tracked the movements of 196 individuals in three types of land use commonly found in fragmented landscapes: manioc plantation, mowed pasture and abandoned pasture. We also determined how orientation to the nearest forest fragment is affected by distance to the fragment, wind speed, body mass and sex using a model selection approach. The type of land use affected the perceptual ranges of both marsupials. The estimated perceptual ranges for P. frenatus and D. aurita were 100 and 200 m in the mowed pasture, respectively, 50 and <30 m in the abandoned pasture and 30 and 50 m in the plantation. The orientation of both species decreased with increasing distance to the fragment, but for D. aurita orientation also increased with the wind speed and body mass. These results agree with previous studies depicting a general pattern of increased perceptual range with lower vegetation obstruction in the matrix and larger body mass and wind speed, depending on the use of visual versus olfactory cues by animals. Our findings allow more realistic estimates of functional connectivity in fragmented landscapes based on basic information on the biology of each species and the type of matrix. [ABSTRACT FROM AUTHOR]

Contents Acrosin is an acrosomal protease synthesized as an inactive precursor, proacrosin, which is processed via autoproteolysis into active forms alpha- and beta-acrosin. In this paper, a comparative study on the immunoreactivity of acrosin during in vitro capacitation of frozen and fresh (control) canine sperm using Western blot analysis is reported. Semen samples were obtained by digital stimulation and ejaculates processed as fresh and frozen samples and then capacitated for 0, 30, 60 and 90 min. At each time period, samples were analyzed with monoclonal antibody C5F10 by Western blot. The antibody specifically recognized, in fresh and frozen/thawed spermatozoa, a 40-, 32- and 27-kDa bands corresponding to proacrosin, alpha- and beta-acrosin, respectively, during capacitation. Western immunoblots showed that the beta-acrosin reactivity in fresh sperm was directly proportional to the time of capacitation, whereas a decreased reactivity of active form of acrosin was observed with frozen-thawed sperm (p < 0.05). These results suggest that proacrosin is activated to beta-acrosin earlier in frozen/thawed dog spermatozoa than in fresh dog spermatozoa. [ABSTRACT FROM AUTHOR]

The distributional diversity and assemblages of fish larvae in the Gulf of California indicated two main seasonal stages and two transitional periods: in winter, the tropical water mass is confined to the south-east portion of the mouth of the Gulf and larval fish assemblages are dominated by subtropical and temperate-subarctic species; in summer; tropical water invades the Gulf and assemblages are dominated by tropical species. Both seasonal stages are separated by transitional periods coinciding with strong latitudinal temperature gradients. During the autumn and spring transitional periods, the Gulf of California splits into three regions: a northern region where temperate and subarctic species spawn from autumn to spring, a southern region dominated by tropical and subtropical species year round and a central region where tropical and temperate assemblages merge. Seasonal changes in the location of the regions, as well as the borders between them, show expansion and contraction of the northern and southern faunas related to the general oceanic circulation patterns during the year. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Adolescent Plaque Psoriasis: Our Experience Using Etanercept".

Objective: To assess the long-term risk factors predicting residual/recurrent cervical intraepithelial neoplasia (CIN 2-3) and time to recurrence after large loop excision of the transformation zone (LLETZ)., Design: Retrospective study., Setting: Colposcopy clinic., Population: 242 women with CIN 2-3 treated between 1996 and 2006 and followed up until June 2016., Methods: Age, margins, and high-risk human papillomavirus (HR-HPV) were estimated using Cox proportional hazard and unconditional logistic regression models. The cumulative probability of treatment failure was estimated by Kaplan-Meier analysis., Main Outcome Measure: Histologically confirmed CIN 2-3, HR-HPV, margins, age., Results: CIN 2-3 was associated with HR-HPV (HR = 30.5, 95% confidence interval [CI] = 3.80-246.20), age >35 years (HR = 5.53, 95% CI = 1.22-25.13), and margins (HR = 7.31, 95% CI = 1.60-33.44). HR-HPV showed a sensitivity of 88.8% and a specificity of 80%. Ecto + /endocervical + (16.7%), uncertain (19.4%) and ecto - /endocervical + margins (9.1%) showed a higher risk of recurrence (odds ratio [OR] = 13.20, 95% CI = 1.02-170.96; OR = 15.84, 95% CI = 3.02-83.01; and OR = 6.60, 95% CI = 0.88-49.53, respectively). Women with involved margins and/or who were HR-HPV positive had more treatment failure than those who were HR-HPV negative or had clear margins (P-log-rank <0.001)., Conclusions: HR-HPV and margins seem essential for stratifying post-LLETZ risk, and enable personalised management. Given that clear margins present a lower risk, a large excision may be indicated in older women to reduce the risk., Tweetable Abstract: After LLETZ for CIN 2-3, recurrences appear more often in women with positive HR-HPV and involved margins and aged over 35., (© 2019 Royal College of Obstetricians and Gynaecologists.)

Objectives/hypothesis: Endoscopic sinus surgery (ESS) is indicated in select pediatric patients with medically refractory sinus disease. Our objectives were to examine indications and rates of readmission following ambulatory pediatric ESS and identify specific subgroups that may benefit from inpatient admission., Study Design: Retrospective database review., Methods: The Pediatric Health Information Systems (PHIS) 2004-2016 database was retrospectively reviewed for patients age <18 years who underwent ambulatory ESS between January 2011 and December 2016 and were readmitted within 30 days postoperatively. Data regarding demographics, extent of surgery, comorbidities, adjunctive procedures, and cost were collected. A multivariable mixed-effects logistic regression model was employed for analysis., Results: We identified 3,669 unique pediatric ESS cases with 128 readmissions within 30 days (3.5%; 95% confidence interval [CI]: 2.9%-4.1%). Median cost of readmission was $980 (mean, $5,890; standard deviation, $13,421). The most common indication for readmission was epistaxis (17.2%), followed by nausea/abdominal pain (14.1%). Respiratory infection (13.3%) and sinusitis (10.2%) presented a combined readmission rate exceeding that of epistaxis alone. Multivariable analysis indicated age <3 years (odds ratio [OR]: 3.41, 95% CI: 1.96-5.93) and a prior diagnosis of asthma (OR: 2.88, 95% CI: 1.99-4.18) or cystic fibrosis (OR: 1.57, 95% CI: 1.00-2.44) significantly increased the risk of readmission. Extent of ESS and simultaneous adenoidectomy, septoplasty, or turbinate reduction had no significant impact on readmission rates., Conclusions: ESS is a relatively safe outpatient surgical procedure in pediatric patients, with an overall readmission rate of 3.5%. Clinicians should consider careful preoperative evaluation of very young patients and those with cystic fibrosis or asthma to optimize perioperative management and determine if postoperative admission is warranted, given their significantly higher readmission rates., Level of Evidence: NA Laryngoscope, 129:2681-2686, 2019., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)