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Introdução: As infecções causadas por Acinetobacter spp apresentam importante relevância no cenário sanitário atual devido a sua gravidade e ao seu restrito arsenal terapêutico. Objetivo: Avaliar o desfecho clínico do uso de ampicilina-sulbactam (AMS) em dose aumentada em pacientes com infecção por Acinetobacter spp. Método: Foi conduzido um estudo retrospectivo de uma pequena coorte de 21 pacientes com infecção por Acinetobacter spp confirmadas por cultura, internados entre janeiro de 2020 e dezembro de 2023 em um hospital de ensino, dos quais 7 receberam tratamento com AMS 9 g ao dia (AMS-9) e 14 dose padrão (AMS-p), associado ou não a outros antimicrobianos. O diagnóstico das infecções foi realizado conforme as definições da ANVISA. Dados clínicos, epidemiológicos, laboratoriais e terapêuticos foram obtidos dos prontuários dos pacientes. Variáveis categóricas foram analisadas pelo teste Exato de Fisher e as contínuas pelo teste U de Mann-Whitney, sendo estas apresentadas como mediana e intervalo interquartil. Foram consideradas significativas variáveis com valores de p menores que 0,05. Resultados: No geral, a mediana de idade foi de 45 anos [36 – 56], 52,4% eram do sexo masculino. A mediana do escore de Charlson foi de 1 [0 – 2] e NEWS2 de 4 [1 – 7]. A mediana do tempo de internação foi de 40 dias [21 – 74]. A infecção mais frequente foi pneumonia hospitalar (28,6%), seguido de infecção primária de corrente sanguínea (19,1%), infecção de pele e partes moles (19,1%), infecção do trato urinário (14,3%), osteomielite (14,3%) e infecção de sistema nervoso central (4,8%). Um terço dos pacientes necessitou de internação em terapia intensiva. Houve predomínio da terapia combinada em ambos os grupos. Não se observou diferenças destes parâmetros entre os 7 pacientes tratados com AMS-9 e os 14 com AMS-p, exceto pelo escore de Charlson, que foi menor no primeiro grupo (0 [0 -1] vs. 1 [1 – 2], p = 0,01), e a resistência à amicacina (100,0 vs. 21,4%; p = 0,001) e a carbapenêmicos (100,0 vs. 28,6%; p = 0,001) que foi maior para AMS-9. A taxa de óbito não diferiu entre AMS-9 e AMS-p [28,6 vs. 21,4%; OR = 1,43 (0,13 – 12,87), p = 0,73]. Conclusão: O uso de AMS em dose aumentada não apresentou melhora no desfecho clínico dos pacientes. No entanto, a casuística observada é pequena e apresenta certas diferenças que podem ter interferido nesta avaliação. Futuros estudos são necessários para uma melhor compreensão deste manejo de infecções graves por Acinetobacter spp.

Biopolymer-based biomaterials, such as poly (l-lactic acid) (PLLA), have long been recognized as scaffolds for drug delivery applications due to their advantages, including biodegradability and biocompatibility. Ketoprofen (KET) is a non-steroidal anti-inflammatory drug known for its analgesic properties. Despite its potential, more research is needed on the effective production of scaffolds functionalized with KET for biomedical applications. This study, therefore, aimed to develop PLLA-based carriers to transport KET obtained using Rotary Jet Spinning (RJS) and evaluate the influence of KET at different concentrations. RJS allowed PLLA-KET scaffold production with high productivity and uniform fiber morphology. KET particles dispersed in the PLLA fibers were observed through scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Furthermore, the Fourier Transform Infrared Spectroscopy (FTIR) and X-ray diffraction (XRD) confirmed the presence of KET in the PLLA and that the crystalline structure of PLLA remained unchanged with the incorporation of KET, ensuring the material's structural integrity. Likewise, the thermogravimetric analysis showed the presence of KET affected the thermal stability of PLLA. Cell viability and confocal microscopy with preosteoblast cells demonstrated that PLLA-KET fibers maintained cell viability over time, indicating their compatibility with cell cultures, and revealed cell adhesion and distribution in the fibers varied with KET concentration. These results have significant implications, highlighting the potential use of PLLA-KET carriers in practical biomedical applications, such as drug delivery systems, bone implant devices, and dental applications, thereby advancing the field of biomaterials.

Purpose This study was performed to evaluate the prognostic value of preoperative C-reactive protein to albumin ratio (CAR) in older patients with colorectal cancer (CRC) undergoing curative resection. Methods We retrospectively analyzed 244 older patients (aged 75 years or higher) with pathological stage II or III CRC who underwent curative surgery between 2008 and 2016. The optimal value of CAR was calculated and its correlation with the clinicopathological factors and prognosis was examined. Results The optimal cutoff value of the CAR was 0.085. High preoperative CAR was significantly associated with high carcinoembryonic antigen levels (P=0.001), larger tumor size (P

Abstract Background Intraductal oncocytic papillary neoplasm (IOPN), previously classified as a subtype of intraductal papillary mucinous neoplasm (IPMN), has been described as an independent disease by the WHO since 2019. IOPN is a rare tumor, with few reported cases. Herein, we report a case of resected non-invasive IOPN that formed a lesion protruding toward the duodenum from the accessory papilla. Case presentation An 80-year-old woman was referred to our hospital because of a giant mass in the pancreatic head detected on abdominal contrast-enhanced computed tomography (CT) performed for a close examination of a mass in the right breast. CT revealed a 90-mm-sized tumor with a mixture of solid and cystic components, with contrast enhancement in the pancreatic head, and a dilated main pancreatic duct. Esophagogastroduodenoscopy revealed a semi-circumferential papillary tumor protruding toward the duodenal lumen, which did not protrude from the papilla of Vater. Transpapillary biopsy led to a preoperative diagnosis of IPMN with an associated invasive carcinoma. As there were no distant metastasis, open subtotal stomach-preserving pancreaticoduodenectomy was performed. Analysis of the surgical specimen and histopathological examination revealed that the tumor was an IOPN that protruded toward the duodenal mucosa from the accessory papilla while replacing the duodenal mucosa with no obvious stromal invasion. Conclusion IOPN is a rare and poorly recognized tumor with few reported cases. There have been no reports describing IOPN forming a protruding lesion toward the duodenum from the accessory papilla. Therefore, further accumulation of cases such as this one is important to advance the study of IOPN.

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers, and surgical resection is the only potentially curative approach. However, the rate of recurrence remains high, particularly within the first 6 months, and is associated with a poor prognosis. The present study evaluated the clinical characteristics and risk factors for early recurrence in pancreatic ductal adenocarcinoma (PDAC) patients who underwent curative resection, regardless of the use of neoadjuvant chemotherapy, to identify predictive factors associated with early recurrence and poor outcomes as well as to determine the optimal treatment strategy for patients at high risk of early recurrence after surgical resection. Methods Patients who underwent pancreatic resection for PDAC at our institution from 2013 to 2021 were included in this study. We investigated the clinicopathological features of patients in groups: those with recurrence within 6 months, recurrence between 6 and 12 months, and recurrence beyond 12 months or no recurrence. A logistic regression analysis identified covariates associated with early recurrence at 6 and 12 months. Results The study included 403 patients with a median follow-up of 25.7 months. Recurrence was observed in 279 patients, with 14.6% recurring within 6 months, 23.3% within 6–12 months, and 62% after 12 months or not at all. The preoperative CA19-9 level, modified Glasgow prognostic score (mGPS), and positive peritoneal cytology were significant risk factors for early recurrence within 6 months, while positive peritoneal cytology, lymph node metastasis, and the absence of adjuvant chemotherapy were significant risk factors for recurrence within 12 months. For patients who received preoperative chemotherapy or chemoradiotherapy, the preoperative CA19-9 level, mGPS, and positive peritoneal cytology were significant independent risk factors for early recurrence within 6 months, while positive peritoneal cytology, lymph node metastasis, and the absence of adjuvant chemotherapy were significant independent risk factors for recurrence within 12 months. The study concluded that the overall survival after surgical resection for potentially resectable PDAC worsened according to the number of risk factors present in the patient. Conclusions We clarified that preoperative CA19-9, positive peritoneal cytology, and the lack of adjuvant chemotherapy were consistent predictors for early recurrence within 6 and 12 months. In addition, an increased number of risk factors affecting the patient was associated with a poorer overall survival after potentially curable resection. Calculating the number of risk factors for early recurrence may be an essential predictive factor when considering treatment strategies.

Summary: Background & Aims: Orange-fleshed Sweet Potato - OFSP, refers to one of the food crops obtained by biofortification. The study of the OFSP leaves can therefore expand its use and provide new elements with additional nutritional values for health promotion. The present study evaluated the effect of supplementing the flour obtained from the OFSP leaf on the adiposity and metabolic conditions of male Wistar rats. Methods: The research has a basic experimental character, being performed with male Wistar rats (n = 20) divided into Supplemented Group (n = 10), which received 2g of OFSP flour in 2mL of water via gavage, administered during 6 weeks. Unsupplemented rats received the same volume of water without the flour. At 69 days old and after 12 hours of fasting, the rats were weighed, measured the naso-anal length to calculate the Lee index and collected whole blood for analysis of: glucose, blood count, lipid profile and total antioxidant capacity (TAC). The histology of the adipose and hepatic tissue was performed. Results: As main results, lower weight and lower adipocyte volume were obtained in visceral fat and there was a reduction in VLDL-cholesterol in the Supplemented Group. Conclusions: It can be concluded that the It can be concluded that the supplementation with OFSP leaves was able to experience a reduction in the lipid profile and in the accumulation of fat in adipocytes. These effects correlate with combating free radicals and preventing damage related to oxidative stress, such as NCDs.

Introdução/objetivo: Estudos prévios identificaram que pacientes internados em Unidades Terapia Intensiva (UTI) e colonizados por Micro-Organismos Multidroga-Resistentes (MDRO) apresentam risco aumentado de desenvolver Infecções Relacionadas à Assistência à Saúde (IRAS) por estes mesmos agentes. Este estudo teve o objetivo de avaliar fatores de risco para o desenvolvimento de IRAS em pacientes sabidamente colonizados por MDRO e internados em UTI. Métodos: Entre janeiro e junho de 2023, todos os pacientes internados há mais 48 horas em UTI clínica, cirúrgica, neurológica e cardiológica do Hospital das Clínicas da Faculdade de Medicina de Botucatu foram submetidos semanalmente a coleta de swab oral, nasal e retal para identificação de colonizados. Todos eles foram avaliados quanto a presença de IRAS durante 30 dias, seguindo os critérios da Agência Nacional de Vigilância Sanitária de 2023, pela Comissão de Controle de IRAS da instituição. O método de regressão proporcional de Cox foi utilizado para avaliar os fatores de risco para desenvolvimento de IRAS entre os colonizados por MDRO, tanto em análise bivariada quanto múltipla, considerando-se significativo valores de p inferiores a 0,05. Resultados: Foram identificados 127 pacientes colonizados. Enterobactérias resistentes à carbapenêmicos foram os agentes mais prevalentes de colonização (48,0%), seguido de Pseudomonas aeruginosa (15,0%) e complexo Acinetobacter baumannii/calcoaceticus (11,8%). Vinte e dois (17,3%) pacientes desenvolveram IRAS (densidade de incidência – DI=4,07/1000 pacientes-dia), com mediana de tempo entre colonização-infecção de 3 dias (2–16). Pneumonia associada à ventilação mecânica foi a infecção com maior DI (1,29/1000 pacientes-dia), seguida de traqueíte (1,11/1000 pacientes-dia), infecção do trato urinário associado à sondagem vesical de demora e infecção de pele e partes moles, ambas com DI=0,55/1000 pacientes-dia. Foram identificados como fatores independentes associados ao desenvolvimento de IRAS em pacientes colonizados por MDRO: escore de Charlson (Hazard Ratio – HR=1,21 [95% IC 1,04–1,40], p=0,01), uso de nutrição parenteral (HR=5,72 [95% IC 1,47–22,24], p=0,01) e uso prévio de polimixinas (HR=6,22 [95% IC 1,79–21,59), p=0,004). Conclusão: Este estudo demonstra que a gravidade do paciente, uso de nutrição parenteral e tratamento antimicrobiano com polimixinas aumentam o risco de desenvolvimento de infecção em pacientes colonizados por MDRO internados em UTI.

Introduction Squamous cell carcinoma arising from a suprapubic cystostomy tract is a rare complication of an indwelling catheter and is caused by long‐term inflammation and mechanical irritation. Prognosis is relatively poor. Biomarkers in the cancer pathway have not been investigated. Case presentation A 61‐year‐old woman with a 34‐year history of suprapubic catheter placement presented with a rapidly growing elevated lesion around the cystostomy site. Tumor biopsy confirmed squamous cell carcinoma. Local excision with partial cystectomy was performed. Multiple metastases were identified 5 months later. The patient died 14 months after the initial treatment. Immunohistochemical analysis of the resected specimen revealed alterations in vascular endothelial growth factor, epidermal growth factor receptor, cyclooxygenase‐2, and Ki‐67. Conclusion We encountered a case of squamous cell carcinoma arising from a suprapubic cystostomy tract. Immunohistochemical analysis revealed activation of multiple carcinogenic pathways in cancer cells, including those for angiogenesis, signal transduction by epidermal growth factor receptor, inflammation, and cell proliferation.

Abstract A 54‐year‐old woman presented to our hospital with a fever and cough. The patient had a medical history of follicular lymphoma treated with obinutuzumab. She was infected with an omicron variant of coronavirus disease 2019 and developed viral pneumonia. Antibiotics, molnupiravir, sotrovimab, and prednisolone were administered but were ineffective. The patient's symptoms and pneumonia persisted. She could not produce antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) because she was administered obinutuzumab. Finally, when we administered 300 mg of tixagevimab and cilgavimab, pneumonia immediately improved. However, the infection was prolonged for more than 4 months. Patients treated with anti‐CD20 monoclonal antibodies may have a prolonged SARS‐CoV‐2 infection. In such cases, tixagevimab/cilgavimab may be effective.

Abstract Several mountainous river basins in Japan do not have a consistent hydrological record due to their complex environment and remoteness, as discharge measurements are not economically feasible. However, understanding the flow rate of rivers during extreme events is essential for preventing flood disasters around river basins. In this study, we used the high-sensitivity seismograph network (Hi-net) of Japan to identify the time and peak discharge of heavy rain events. Hi-net seismograph stations are distributed almost uniformly at distance intervals of approximately 20 km, while being available even in mountainous regions. The Mogami River Basin in Northeastern Japan was selected as a target area to compare the seismic noise data of two Hi-net stations with the hydrological response of a nearby river. These stations are not located near hydrological stations; therefore, direct comparison of seismic noise and observed discharge was not possible. Therefore, discharge data simulated using a hydrological model were first validated with gauging station data for two previous rain events (10–23 July 2004 and 7–16 September 2015). Then, the simulated river discharge was compared with Hi-net seismic noise data for three recent events (10–23 July 2004, 7–16 September 2015, and 10–15 October 2019). The seismic noise data exhibited a similar trend to the time series of simulated discharge in a frequency range of 1–2 Hz for the selected events. Discharge values predicted from the noise data effectively replicate the simulated discharge values in many cases, especially the timing and amount of peak discharge. Simulated and predicted discharge near NIED Hi-net seismic stations in the Mogami River Basin for the event of October 2019 (Typhoon Hagibis).

Abstract Background Higher muscle echo intensity (EI) reflects higher content of fat and/or connective tissue within skeletal muscle, eventually inducing lower muscle strength, physical dysfunction, and metabolic impairment. Continuous exercise decreases muscle EI in older individuals; however, it is not well understood how several months’ rehabilitation exercise affects gradation-based EI. The purpose of this study was to investigate the effects of 6 months of rehabilitation exercise on gradation-based higher and lower EI in older men and women. Methods Twenty-seven men and women (7 men, 20 women; age, 75.6 ± 6.4 years; height, 154.3 ± 8.5 cm; weight, 55.8 ± 9.7 kg) participated in this study. This study was a one-group before-and-after trial. They needed long-term care for activities of daily living. They performed rehabilitation exercises consisting of resistance exercises using a hydraulic resistance machine, stretching, and aerobic exercises using a recumbent bicycle once or twice a week for 6 months. B-mode ultrasonographic transverse image was taken from thigh muscles, e.g., rectus femoris, vastus lateralis, and biceps femoris. We calculated gradation-based cross-sectional area (CSA) from thigh muscles by dividing 256 greyscale level to 10 different components levels (e.g., 0–24, 25–49, 50–74, …, 200–224 and 225–249 a.u.). Results Lowest EI (e.g., 0–24 a.u.) CSA of thigh muscle was significantly increased after the exercise (0.3 ± 0.3 to 1.0 ± 0.8 cm2; P

Introdução: As infecções causadas por enterobactérias resistentes a carbapênicos (CRE) representam um importante desafio na atualidade, seja por sua incidência crescente nos hospitais, seja pelo escasso arsenal terapêutico disponível. Nos últimos anos, tornou-se disponível no Brasil a ceftazidima-avibactam (CAZ-AV), uma opção terapêutica atrativa para tratamento das infecções por CRE por sua potência e segurança comparada aos antimicrobianos mais amplamente utilizados como polimixinas, aminoglicosídeos e tigecilina. Objetivo: Este estudo teve o objetivo de avaliar uma série de casos de pacientes tratados com CAZ-AV bem como seu desfecho clínico. Método: Foi avaliada uma série de casos de pacientes com infecção por CRE e tratados com CAZ-AV durante os anos de 2020 e 2021 no Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP, quanto as características epidemiológicas, clínicas, laboratoriais e resultado terapêutico. Variáveis categóricas foram comparadas pelo teste Exato de Fisher e as contínuas pelo teste U de Mann-Whitney, sendo considerado significativo um valor de p menor que 0,05. Resultados: Foram avaliados 46 pacientes tratados com CAZ-AV. A média de idade foi de 55,6 ± 14,8 anos e do escore de Charlson de 2,0 ± 2,0. A média do tempo de internação foi de 59,3 ± 42,1 dias. A principal CRE identificada foi Klebsiella pneumoniae, em 91,3% dos pacientes e a resistência às polimixinas foi observada em 78,3% dos isolados. A infecção mais comum foi do trato urinário (32,6%), seguido de infecção de sítio cirúrgico (26,1%), infecção de corrente sanguínea (23,9%) e pneumonia (17,4%). Dezessete pacientes (37,0%) estavam em terapia intensiva. O tempo médio de uso de CAZ-AV foi de 11,6 ± 5,6 dias. A mortalidade geral foi de 30,4%, não diferindo entre os diferentes sítios de infecção (p = 0,69). Houve uma tendência de maior mortalidade em pacientes sob cuidados intensivos (47,1 vs 20,7%; p = 0,06) e naqueles sob terapia substitutiva renal (75,0 vs 26,2%; p = 0,07). Conclusão: Apesar da elevada mortalidade, a CAZ-AV mostra-se uma importante opção terapêutica para infecções por CRE considerando a gravidade dos pacientes avaliados.

Introdução: A mensuração dos impactos da pandemia de covid-19 nas taxas de infecções relacionadas à assistência em saúde (IRAS) e no perfil de resistência dos germes hospitalares é um desafio atual. O uso indiscriminado de antimicrobianos, a gravidade dos pacientes internados e a sobrecarga dos serviços de saúde podem aumentar a incidência das infecções nosocomiais causadas por bactérias multidroga resistentes (MDR). Objetivo: Avaliar as taxas de infecção de corrente sanguínea (ICS) do período pré-pandêmico (01/01/2018-29/02/2020) e do período pandêmico (01/03/2020-31/08/2021) em um hospital de ensino, identificar os germes responsáveis e comparar as densidades de incidência. Método: Todas as hemoculturas positivas para bactérias MDR (VRE, KPC, MRSA, A. baumannii resistente a carbapenêmicos, P. aeruginosa resistente a carbapenêmicos) no período estudado foram identificadas e foram calculadas as densidades de incidência de ICS. As análises estatísticas foram realizadas através do software Epi Info (CDC). Resultados: Identificamos um aumento da densidade de incidência de ICS no período pandêmico, se comparado ao período pré-pandêmico (0.70 × 0.48, OR 1.43 [1.14-1.79 p < 0.001]). Com relação aos germes estudados, houve aumento de densidade de incidência de ICS por bactérias produtoras de carbapenemase no período pandêmico (0.95 × 2.73, OR 2.87 [1.84-4.54 p < 0.001]), mas não houve variação estatisticamente significativa para nenhum outro germe estudado. Conclusão: O aumento global observado das taxas de infecção de corrente sanguínea durante a pandemia pode ser entendido como um reflexo do aumento do número de pacientes graves, que utilizam dispositivos invasivos, em um cenário de superlotação dos serviços em saúde. O aumento na densidade de incidência de ICS por KPC pode estar relacionado ao uso indiscriminado de antimicrobianos, principalmente no contexto de tratamentos empíricos de pneumonias bacterianas presumidas em leitos de terapia intensiva, especialmente com carbapenêmicos.

Introdução: As infecções de corrente sanguínea por fungos do gênero Candida, também denominadas candidemias, são uma importante causa de sepse tardia em pacientes hospitalizados. Durante o período pandêmico, diversos estudos apontaram aumento de sua incidência em pacientes com covid-19. Objetivo: Este estudo teve o obejtivo de avaliar a incidência das candidemias durante a pandemia da covid19 e os fatores associados a esta co-infecção em um hospital de ensino. Método: Foi analisada uma coorte retrospectiva de 89 pacientes com hemocultura positiva para fungos do gênero Candida, internados entre março de 2020 e fevereiro de 2022, no Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP. O diagnóstico da covid-19 foi confirmado por reação em cadeia da polimerase em tempo real, sendo os pacientes analisados segundo a presença ou não da infecção pelo SARS-Cov-2. Teste Exato de Fisher foi usado para comparar as densidades de incidência e os fatores categóricos associados a co-infecção, enquanto que para as variáveis contínuas foi usado o Teste U de Mann-Whitney. Foram considerados significativos valores de p menores que 0,05. Resultados: Dos 89 pacientes com candidemia, 26 (29,2%) tinham infecção pela covid-19. A densidade de incidência de candidemia foi de 2,26 casos/ 1000 pacientes-dia nos pacientes com covid19 e 0,23 casos/ 1000 pacientes-dia nos demais [OR = 9,69 (5,89 – 15,53), p < 0,01]. As principais espécies causadoras da candidemia foram C. albicans, C. glabrata e C. tropicalis tanto nos pacientes com covid19 como nos demais. Houve uma tendência em maior incidência de C. krusei nos pacientes com covid19 (15,4 vs 3,2%, p = 0,06). Na análise dos fatores associados à co-infecção, os pacientes com covid19 e candidemia foram mais submetidos a corticoterapia (92,3 vs 18,5%, p < 0,01) e mais internação em terapia intensiva (92,3 vs 55,6%, p = 0,03) que os demais pacientes, enquanto que estes últimos foram mais submetidos a cirurgia abdominal (0,0 vs 44,4%, p < 0,01). A mortalidade em 30 dias foi semelhante entre os grupos, com 30,8% nos pacientes covid19 e 40,7% nos demais (p = 0,73). Conclusão: Estes achados corroboram a elevada incidência de candidemia em pacientes com covid-19 e sua associação com o uso de corticoides e necessidade de cuidados intensivos.

Harutake Sawazaki,1,2 Yuichi Arai,3 Yuji Ito,4 Kimiya Sato,5 Hitoshi Tsuda,5 Takashi Yamaga,2 Hiroyuki Sakurai2 1Department of Urology, Tama-Hokubu Medical Center, Higashimurayama, Japan; 2Department of Pharmacology and Toxicology, Kyorin University School of Medicine, Mitaka, Japan; 3Department of Urology, National Defense Medical College, Tokorozawa, Japan; 4Department of Pathology, Tama-Hokubu Medical Center, Higashimurayama, Japan; 5Department of Basic Pathology, National Defense Medical College, Tokorozawa, JapanCorrespondence: Harutake SawazakiDepartment of Urology, Tama-Hokubu Medical Center, 1-7-1 Aobacho, Higashimurayama, Tokyo, 189-8511, JapanTel +81-42-396-3811Fax +81-42-396-3076Email harutake_sawazaki@Tokyo-hmt.jpPurpose: L-type amino acid transporter 1 (LAT1), a Na+-independent amino acid transporter, is highly expressed in various cancer types. We evaluated the prognostic value of LAT1 expression in non-muscle-invasive bladder cancer (NMIBC).Patients and Methods: We retrospectively reviewed 119 consecutive patients who underwent initial transurethral resection of bladder tumor. Of these, 75 patients with NMIBC were included in this study. Patients were classified into two groups according to the proportion of LAT1-positive cells, as determined by immunohistochemistry. Associations between LAT1 expression and clinicopathological factors were analyzed. Cox multivariate analyses were performed to identify independent predictors of intravesical recurrence (IVR). The LAT1 integrated risk model was compared with the European Organization for Research and Treatment of Cancer (EORTC) risk model to evaluate the predictive ability for IVR based on the c-index.Results: The median follow-up was 37 months. Twenty-eight patients (37.3%) had IVR. LAT1 expression was not correlated with any other clinicopathological factors. Patients with high LAT1 expression had a worse IVR-free survival than that of patients with low LAT1 expression (P = 0.038). Cox multivariate analyses indicated that tumor multiplicity and high LAT1 expression were independent predictors of IVR. The LAT1 integrated risk model had a significantly improved performance over the EORTC model for assessing recurrence risk (c-index: 0.695, improvement: 0.091, P = 0.001). When patients were stratified into three groups according to the score calculated by the LAT1 integrated risk model, the 2-year IVR-free survival rates were 93.3% in patients with 0 points, 66.9% for those with 2 points, and 37.5% for those with 4 points.Conclusion: High LAT1 expression was an independent predictor of IVR in patients with NMIBC. The LAT1 integrated risk model had good predictability for IVR.Keywords: non-muscle-invasive bladder cancer, L-type amino acid transporter 1, transurethral resection of bladder tumor, intravesical recurrence

During the COVID-19 pandemic, an increase in the incidence of bloodstream infections caused by fungi of the Candida genus, also known as candidemia, was observed in patients with SARS-CoV-2 infection. This study aimed to assess the incidence of candidemia, the factors related to COVID-19-associated candidemia (CAC), and prognostic factors. A non-concurrent cohort of 87 cases of patients aged over 18 years with candidemia between March 2020 and February 2022 was evaluated. Incidence density (ID) was calculated by the number of patient-days during the period. All causes of mortality within 30 days of observation were considered. Logistic regression and Cox proportional hazards regression were used, respectively, to determine factors associated with CAC and prognostic factors. Values <0.05 were considered significant. The ID of CAC was eight times higher than candidemia in patients without COVID-19 [2.40 per 1000 person-days vs. 0.27 per 1000 person-days; P  < .01]. The corticosteroid therapy was as an independent factor associated with CAC [OR = 15.98 (3.64–70.03), P  < .01], while abdominal surgery was associated with candidemia in patients without COVID-19 [OR = 0.09 (0.01–0.88), P  = .04]. Both patients with and without COVID-19 had a high 30 days-mortality rate (80.8% vs. 73.8%, respectively; P  = .59). Liver disease [HR = 3.36 (1.22–9.27); P  = .02] and the Charlson score [HR = 1.17 (1.01–1.34); P  = .03] were independent factors of death, while the use of antifungals [HR = 0.15 (0.07–0.33); P  < .01] and removal of the central venous catheter [HR = 0.26 (0.12–0.56); P  < .01] independently reduced the risk of death. These findings highlight the high incidence of candidemia in COVID-19 patients and its elevated mortality. [ABSTRACT FROM AUTHOR]

Abstract Background Most evidence regarding lateral lymph node dissection for rectal cancer is from expert settings. This study aimed to evaluate the safety and efficacy of this procedure in a practice-based cohort. Methods A total of 383 patients who were diagnosed with stage II–III mid-to-low rectal cancer between 2010 and 2019 and underwent primary resection with curative intent at a general surgery unit were retrospectively reviewed. After propensity matching, 144 patients were divided into the following groups for short- and long-term outcome evaluation: mesorectal excision with lateral lymph node dissection (n = 72) and mesorectal excision (n = 72). Results This practice-based cohort was characterized by a high pT4 (41.6%) and R1 resection (10.4%) rate. Although the operative time was longer in the lateral dissection group (349 min vs. 237 min, p

Evaluation of combined ability can eliminate lines that are inefficient and enable the subsequent program steps to be more successful. The objective of this study was to predict the general (gi) and specific (sij) combination ability of popcorn S1 progenies for early selection. A total of 288 topcrosses were performed under a randomized complete block design with two replicates at two sites (Campinas and Capão Bonito, São Paulo State, Brazil). Diallel analyses were performed using mixed models and the maximum likelihood restricted/best unbiased linear prediction method. Evaluated traits included grain yield (GY; kg ha-1), weight of 100 grains (g), and popping expansion (PE; mL g-1). Ear components were also evaluated, including ear length, ear diameter (cm), and the number of grain rows (unit). The S1 progeny 32 presented the highest gi for GY in Campinas, whereas progeny 46 presented the highest gi for GY in Capão Bonito. The S1 progeny, 114 was an important parent for the popcorn breeding program, because it presented high gi for the traits of agronomic interest at both sites. Combination 86×IAC12 exhibited a high sij, and the 86 parent presented the second-highest gi for PE in Campinas, and it should be used for high PE genotypes

Satoko Kawarasaki,1 Honami Sawazaki,1 Hiroaki Iijima,2 Su-Ping Ng,1 Jungin Kwon,1 Shinsuke Mohri,1 Mari Iwase,1 Huei-Fen Jheng,1 Haruya Takahashi,1 Wataru Nomura,1,3 Kazuo Inoue,1,3 Teruo Kawada,1,3 Tsuyoshi Goto1,3 1Laboratory of Molecular Function of Food, Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji 611-0011, Japan; 2Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan; 3Research Unit for Physiological Chemistry, The Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto 606-8317, JapanCorrespondence: Tsuyoshi GotoLaboratory of Molecular Function of Food, Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji 611-0011, JapanTel +81-774-38-3753Fax +81-774-38-3752Email goto.tsuyoshi.6x@kyoto-u.ac.jpPurpose: Sodium-glucose co-transporter-2 (SGLT2) inhibitors have various pleiotropic effects, including body weight reduction, and therefore have the potential to be used in various applications. However, such effects have not been fully investigated; thus, non-clinical studies using animal models are needed. In animal experiments, SGLT2 inhibitors are usually administered by oral or dietary methods. However, the detailed characteristics of these dosing methods, especially to induce their pleiotropic effects, have not been reported. Therefore, we compared the preventive effects of canagliflozin, an SGLT2 inhibitor, on body weight gain following oral gavage and dietary administration methods in a mouse model of diet-induced obesity.Methods: Canagliflozin was dosed by oral gavage or dietary administration for 9 weeks to 6-week-old C57BL/6N mice fed a high-fat diet, and parameters related to obesity were evaluated.Results: The suppression of body weight gain, fat mass, and hepatic lipid content was observed following both dosing methods, whereas the effect on body weight tended to be stronger in the dietary administration group. In adipose tissue, fatty acid synthase expression was significantly decreased in the dietary administration group, and its expression was significantly correlated with fat mass. However, the expression of genes related to fatty acid oxidation was unchanged, indicating that the preventive effect on body weight gain was mediated mainly through the suppression of lipid synthesis rather than the promotion of lipid oxidation.Conclusion: Canagliflozin prevented body weight gain through the suppression of lipid synthesis via both dosing methods, although there were some differences in the efficacy. The findings of our study can help to identify new mechanisms of action of SGLT2 inhibitors and potential applications.Keywords: SGLT2 inhibitor, obesity, dosing method

The popcorn is a culture profitable for producers of various technological profiles, mainly due to the higher added value of popcorn in comparison with common maize. With the use of phenotypic correlation in breeding programs, the efficiency in selecting certain favorable character can increase or decrease their expression. The objective was to evaluate agronomic traits of hybrids popcorn in the southwest region of Mato Grosso, Brazil, as well as to estimate the phenotypic correlation. The experimental design was randomized blocks with 15 treatments and 3 replications. The following characters were evaluated: plant height and ear, expansion capacity, number of piruas, weight of grains and production components. The IAC9614.83 stood with the largest grain weight of 2.49 t ha-1, followed by the hybrids IAC367, IAC144.6102, AP6005, BASSO5802, BASSO5803. The expansion capacity showed a negative correlation with number of piruas -0.69. The grain weight showed a positive correlation with the number of rows of grains of 0.71. It is concluded that IAC 144.6102, AP8203, VYP212 were adequate for the test by presenting favorable aspects for the commercialization of grain.

Abstract We have identified “N”-shaped Y/X amplitude spectral ratios in S-coda records from a significant number of OBSs (ocean bottom seismometers) belonging to in-line-type ocean bottom networks of S-net and ETMC deployed around the Japan Trench and Sagami Trough, respectively. The “N”-shape reflects a sharp peak and notch at approximately 5–13 Hz and 10–23 Hz, respectively. This shape does not characterize OBSs belonging to node-type ocean bottom network of DONET deployed near the Nankai Trough. For S-net stations, the “N”-shape is not clearly formed for stations installed within grooves dug in the seafloor. We interpret the “N”-shaped Y/X amplitude spectral ratio is caused by the natural vibrations of a cylindrical pressure vessel that is placed sideways (long-axis lies in the horizontal plane) on the seafloor. The notch and peak frequencies in the Y/X amplitude spectral ratio likely correspond to natural frequencies of longitudinal (X-direction) and torsional and/or bending (Y-direction) vibrations, respectively. These natural vibrations are not observed for buried OBSs or those installed within grooves in the seafloor probably because they are better coupled to the seafloor. We propose a simple model to evaluate the extent to which the peak and notch have formed, which depends on the natural frequencies and coupling of the pressure vessel. We suggest users of in-line-type OBSs carefully examine if there are different responses between the X and Y components when frequencies about > 3 Hz are used. When installing OBS networks in the future, installing OBSs and cables within grooves dug in the seafloor or by burial will be effective in suppressing such natural vibrations.