Background: Malnutrition and poor growth are major problems for many patients with cystic fibrosis (CF), and nutritional supplements can enhance the success of dietary strategies. The purpose of this study was to assess Scandishake (Scandipharm Ltd, U.K.), an energy dense (2.0 kcal/ml) oral supplement. Methods: The study design included a 4‐week monitoring period, followed by 8 weeks of supplementation with Scandishake. The subjects had anthropometry assessed at weeks 0, 4 and 12, and their dietary intake assessed at weeks 0 and 12. Results: Data from 26 patients (16 male, 10 female; age range 9–34 years) showed a significant mean weight increase of 1.9 kg (range 1.6–4 kg) and a mean increase of 0.5 cm (range 1.1–2.7 cm) in mid‐arm muscle circumference. There was also an increase in energy intakes, rising from a mean of 11.15 MJ (2665 kcals) to a mean of 13.42 MJ (3208 kcals) ( P < 0.01), and the mean of individual percentages of estimated average requirement (EAR) for energy increased from 120% (73–182%) to 143% (67–221%). Conclusion: The energy dense formulation of Scandishake makes it a useful adjunct in the treatment of malnutrition and the promotion of normal growth in patients with CF.
Attachment of the placenta to the uterus in pigs involves extracellular interaction between the expanding trophoblastic membrane and the thick glycocalyx present on the uterine epithelial microvilli. Formation of complexes between members of inter-alpha-trypsin inhibitor family may function in the maintenance of the extracellular matrix. This study investigated the change in the inter-alpha-trypsin inhibitor heavy chains (ITIH1, ITIH2, ITIH3 and ITIH4) during the oestrous cycle and early pregnancy in pigs. Gene expression of ITIH1, ITIH2, ITIH3 and ITIH4 was detected in the endometrium of cyclic and pregnant gilts; however, gene expression of ITIH was not altered throughout the oestrous cycle or early pregnancy. Western blot analysis with an ITIH antiserum identified the possible linkage forms of ITIH with the serine protease inhibitor, bikunin. Pregnancy altered the release of the various inter-alpha-inhibitor forms from the endometrium during the period of trophoblastic attachment. The results from this study indicate that the inter-alpha-trypsin inhibitor family plays an important role in maintenance of the uterine surface glycocalyx during placental attachment in pigs.
OCT-4 is a transcriptional regulator of pluripotent cells throughout embryonic and germ cell lineage development prior to cellular differentiation during murine, bovine and porcine peri-implantation development. In contrast to murine OCT-4 expression, bovine and porcine expression is detected in both the inner cell mass and trophoblast. Delayed down regulation of OCT-4 gene expression in farm species may be a consequence of the lengthened period of peri-implantation. Expression of OCT-4 mRNA has not been characterized during conceptus attachment to the uterine surface in the pig. The objective of the present study was to determine conceptus OCT-4 mRNA expression during porcine peri-implantation development from days 10-17 of gestation. Total RNA was extracted from multiple pools of conceptuses collected on days 10, 12, 13, 15 and 17 of pregnancy. Quantitative RT-PCR was utilized to assay conceptus OCT-4 mRNA synthesis. Day of conceptus development significantly affected (p < 0.001) OCT-4 mRNA expression. Conceptus expression of OCT-4 was greatest on days 10 and 12 of pregnancy being approximately 7.7- and 11.6-fold greater compared to expression on days 15 and 17, respectively. Results from the present study suggest that down regulation of OCT-4 may be critical in trophoblastic expansion and uterine epithelial attachment during establishment of pregnancy in the pig.
Introduction: Genetic testing is known to improve outcomes in high-risk women by finding cancers in the earliest most treatable stage or through prophylactic measures. However, these life-saving services may not be available to low-income women due to lack of insurance or access to genetic providers. To address this need, a collaboration between the Hereditary Cancer Clinic at Vanderbilt-Ingram Cancer Center (VICC) and the Robert E. Hardy Cancer Clinic at Nashville General Hospital at Meharry Medical College (MMC) was established in 2015 to systematically screen all MMC breast cancer patients for hereditary traits and refer them for genetic counseling (1). We hypothesized that high risk women could be accurately identified using this clinic based screening tool. Methods: MMC clinic staff screened breast cancer patients using a 10-item Family Cancer Risk Assessment tool (RISK) that has been designed for use in a busy clinic environment (2). We tested the accuracy of the RISK by comparing the results to a 3-generation pedigree and the current NCCN guidelines for referral of patients to genetic services (3). The project was approved by the IRBs at each institution and study data were collected and managed using RedCap electronic data capture tools hosted at Vanderbilt University (4). Summary statistics and Chi-square for significance were performed. Results: 73 breast cancer patients completed the RISK during their clinic visits and 41 (56%) had a high-risk score of 6 or more. All 41 patients have been referred for genetic counseling, with 18 (44%) women having completed a pedigree interview over the phone. 11 of these 18 patients (61%) were African-American; 5 (27.7%) were Caucasian; and one each (5% each) were of Asian and Hispanic ancestry. 9/18 were diagnosed < 50 years (Mean entire group =50 yrs; range 36 -57). 5/18 (27.7%) had triple negative markers on pathology and 2/18 were ER+/PR+/Her2+, and the remainder had ER+/PR+/HER2- cancers. Among the 18 patients with full pedigrees, 17 (95%) patients met current NCCN guidelines based on pedigree analysis. The one outlier had a revised RISK score based on updated information obtained during the pedigree interview. Genetic testing was offered to 10 patients seen in VICC clinic and 1 declined testing. The other 8 patients either failed (n=4) or are awaiting an appointment (n=4). No deleterious mutations were seen in those tested. 4 VUSs (BRCA2, NBN, SMARCA4, and RAD51D) were found in 3 of the 9 tested patients. No significant differences were found in race, age or type of tumor. Conclusion: Point of care risk assessment using the Family Cancer Risk Assessment screening tool is highly accurate for identifying patients at high genetic risk for hereditary breast cancer. While the tool was completed using pen and paper, it could easily be computerized for ease of administration and calculation of risk scores. This approach benefits the busy oncologist in identifying and referring appropriate patients for genetic testing. 1. Funds awarded by GreaterGood.org. 2. Joseph G. et al. 2012 Public Health Genomics. 3. National Comprehensive Cancer Network: Genetic/High-risk Breast_Ovarian (Version 2.2016). 4. Harris et al. 2009. J Biomed Inform. Citation Format: Wiesner GL, Rao SK, Ashworth DR, Thomas KA, Lammers PE. Highly accurate hereditary risk assessment tool for low-income breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-08-10.
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