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The ability of various soaking media in enhancing the temperature of waste materials, once they are exposed to microwaves has been investigated. Such information helps development of microwave techniques to destroy viruses, spores and other microorganisms by temperature enhancement if they may not be affected by microwave radiation itself. Oily media were observed to have higher elevation in temperature; however, they have the inherent drawback of sticking into the inner surface of the container. Such drawbacks can be minimized by using enclosed non-stick container for the microwave application. Among aqueous fluids, commonly found detergent solution showed the best performance in raising the temperature. Such material has many other advantages such as, low cost, non-toxic nature, environment friendliness, ready availability etc. [ABSTRACT FROM AUTHOR]

Background Screening for fetal chromosomal anomalies using cell-free DNA (cfDNA) became clinically available in 2012. Since then, it has been widely adopted by providers and pregnant women with or without risk factors for aneuploidy. Concomitantly, the use of invasive diagnostic testing has been steadily declining. Objective To determine the magnitude of decline and changes in indications for invasive prenatal testing over the past 6 years. Study Design This was an institutional review board (IRB) approved retrospective cohort study that included women who were referred to our genetic division for consultation between January 2010 and December 2015 and decided to have invasive testing. The total number of patients choosing either option was determined for each year over the entire period and grouped by following indications: advanced maternal age, abnormal maternal serum screening (MS), abnormal ultrasound finding (US), personal or family history of genetic anomaly (FH), and others. Patients, who were advanced maternal age (AMA), were offered noninvasive prenatal screening or chorionic villus sampling (CVS) or amniocentesis in addition to routine nuchal translucency screening. The proportion of AMA patients choosing each of the three options was determined in a 6-month interval over the entire study period. Statistical analysis included logistic regression and chi-square test. Results While the number of patients receiving genetic counseling at our unit remained unchanged over the study period, the number of invasive procedures declined steadily from 429 amniocentesis (amnio) and 154 CVS in 2010 to 72 amnio and 60 CVS in 2015 (p < 0.001). Over the same period, the distribution of indications for diagnostic testing changed significantly. The proportion of procedures performed due to AMA or MS declined significantly over time (p < 0.001). The proportion of procedures performed for AMA declined at an average yearly rate of 24% (95% CI: 19-29%) and those performed for MS declined at a yearly rate of 13% (95% CI: 6-20%). Over the same period, the proportion of procedures performed due to US, FH, and other indications combined increased (p < 0.001) at an average rate of 45% (95% CI: 36-55%). A total of 5,188 women (61% of the study cohort) had genetic counseling for AMA. The percentage of patients opting for invasive procedures with AMA as the sole indication declined significantly from 38% in 2010 to 2% in 2015 (p < 0.0001) at an average rate of 29% (95% CI: 27-31%) reduction every 6 months. The rate of AMA women opting for cf DNA increased precipitously from 28% in 2012 to 91% in 2015 (p < 0.0001) at an average rate of 66% increase (95% CI: 57-76%) every 6 months. Conclusion The use of invasive procedures to diagnose chromosomal and genetic anomalies has declined over the past years, primarily due to the availability of cfDNA testing for AMA and abnormal serum screening. The new reality is that fewer women opt for invasive procedures and do so primarily following abnormal ultrasound findings or due to a history of chromosomal or genetic anomalies. Given these trends, it is likely that future generations of maternal-fetal medicine (MFM) subspecialists will not have the opportunity to acquire the necessary skills to perform these procedures, when needed. [ABSTRACT FROM AUTHOR]

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INTRODUCTION: One-third of patients with gestational diabetes mellitus (GDM) require hypoglycemic agents. There is a subset of patients who control their postprandial values with diet, yet they have persistent fasting hyperglycemia requiring bedtime hypoglycemic agents (GDMHS). As fasting hyperglycemia is an independent risk factor for adverse pregnancy outcomes, we aimed to identify risk factors to predict (and subsequently counsel) GDM patients with a risk of isolated fasting hyperglycemia requiring treatment with bedtime hypoglycemic agents. METHODS: This was an IRB-approved retrospective cohort study of patients diagnosed with GDM after 24 weeks from 2016 to 2020. Patients monitored glucose four times daily (fasting and 2 hours postprandial); fasting hyperglycemia was defined as more than 50% fasting values greater than 90 mg/dL. Patients completely controlled with diet (GDMA1) were compared to those with GDMHS. A multivariate analysis assessed whether age, body mass index (BMI), fasting glucose tolerance test (GTT) value, HbA1c at diagnosis, history of polycystic ovarian syndrome or previous GDM, Asian race, or family history of diabetes predicted isolated fasting hyperglycemia. RESULTS: Four hundred five patients had GDM. 57% had GDMA1, and 28% had GDMHS. Compared to GDMA1, patients with GDMHS were older, had higher BMI, higher fasting GTT value, higher HbA1c, and higher incidence of previous GDM or family history of diabetes. After adjusting for confounders, higher HbA1c at GDM diagnosis (odds ratio [OR] 3.55), older age (OR 1.08), and higher fasting GTT value (OR 1.06) were significantly associated with an increased probability of persistent fasting hyperglycemia. Asian race was associated with decreased probability of fasting hyperglycemia but was confounded by lower fasting GTT and lower BMI. CONCLUSION: Our data suggest that elevated HbA1c, higher fasting GTT value, and older age may predict persistent isolated fasting hyperglycemia in GDM patients who are otherwise controlled with diet. These data can be used to educate and counsel patients to alleviate frustration encountered with persistent fasting hyperglycemia despite postprandial diet control. [ABSTRACT FROM AUTHOR]

Background: Oral Mucositis (OM) remains the most common side effect of chemotherapy affects negatively on patients' quality of life. Subjects and Methods: Convenience samples of patients who received chemotherapy were followed from first or second cycle of chemotherapy until OM occurrence. We reviewed 75 female patients with breast cancer who received chemotherapy with mean age (47.2 SD ± 8.62861). We used WHO scale to assess the severity of OM. Demographic and other variables (age, number of cycle before appearance of signs of OM, WBC count, neutropenia count, creatinine and BMI) were filled in questionnaire. Results: 81.3% of reviewed patients were suffering from OM and (52.4%) of them were shown score 2 according to WHO classification, Taxane included chemotherapy protocol was the only significant variable that associated with OM occurrence (p=0.009). Conclusion: In this study; Taxane is the only risk factor that significantly associated with occurrence of OM. [ABSTRACT FROM AUTHOR]

Bone marrow ( BM) fibrosis is associated with poor prognosis in patients with de novo myelodysplastic syndromes ( MDS). TP53 mutations and TP53 (p53) overexpression in MDS are also associated with poor patient outcomes. The prevalence and significance of TP53 mutations and TP53 overexpression in MDS with fibrosis are unknown. We studied 67 patients with de novo MDS demonstrating moderate to severe reticulin fibrosis ( MDS-F). Expression of TP53 was evaluated in BM core biopsy specimens using dual-colour CD34/ TP53 immunohistochemistry with computer-assisted image analysis. Mutation analysis was performed using next-generation sequencing, or Sanger sequencing methods. TP53 mutations were present in 47·1% of cases. TP53 mutation was significantly associated with TP53 expression ( P = 0·0294). High levels of TP53 expression (3 + in ≥10% cells) were associated with higher BM blast counts ( P = 0·0149); alterations of chromosomes 5 ( P = 0·0009) or 7 ( P = 0·0141); complex karyotype ( P = 0·0002); high- and very-high risk IPSS-R groups ( P = 0·009); and TP53 mutations ( P = 0·0003). High TP53 expression independently predicted shorter overall survival ( OS) by multivariate analysis ( P = <0·001). Expression of TP53 by CD34-positive cells was associated with shorter OS and leukaemia-free survival ( P = 0·0428). TP53 overexpression is a predictor of poor outcome in patients with MDS-F. [ABSTRACT FROM AUTHOR]

Lipoblastoma typically occurs in childhood and is associated with rearrangements of the PLAG1 gene. We present a patient with an isolated mass thought to be a lipoblastoma clinically, radiographically, and histologically. The lesion was diagnosed as a PIK3CA‐adipose lesion after the tissue was negative for PLAG1 rearrangement and contained a somatic PIK3CA mutation (H1047R). Although PIK3CA variants are associated with PROS (PIK3CA‐related overgrowth spectrum), this report illustrates a non‐syndromic, lipoblastoma phenotype caused by a PIK3CA mutation. [ABSTRACT FROM AUTHOR]

Peripheral T-cell lymphoma ( PTCL), not otherwise specified ( NOS), represents a heterogeneous group of nodal and extranodal lymphomas that express a variety of T-cell antigens indicative of mature T-cell lineage. Most cases of PTCL express CD4 and lack CD8 expression and have a T-helper immunophenotype. Although the immunophenotype of PTCL is usually stable over time, immunophenotypic switch or evolution from T-helper to T-suppressor or vice versa has been rarely reported. Herein, we report a patient who presented with nasal PTCL, NOS, that was CD8+ and negative for Epstein-Barr virus, with concurrent skin lesions that had a CD8+/ TIA-1+ T-cell immunophenotype. Patient received multi-agent chemotherapy and matched unrelated donor stem cell transplant, and subsequently suffered a cutaneous relapse with a CD4+/ TIA-1(−) immunophenotype. Molecular analysis of the neoplasm biopsied at presentation showed one monoclonal T-cell receptor gamma gene rearrangement, and a second oligoclonal peak. At the time of CD4-positive recurrence, the oligoclonal peak was rather prominent, suggesting that the emergence of this peak is related with the phenotypic evolution from CD8+ to CD4+ predominant. These results highlight the utility of sequential immunophenotypic and molecular analysis of PTCL cases at the time of relapse to better understand the mechanisms of disease. [ABSTRACT FROM AUTHOR]