In vivo models of subclonal oncogenesis and dependency in hematopoietic malignancy.

Cancer evolution is a multifaceted process leading to dysregulation of cellular expansion and differentiation through somatic mutations and epigenetic dysfunction. Clonal expansion and evolution is driven by cell-intrinsic and -extrinsic selective pressures, which can be captured with increasing resolution by single-cell and bulk DNA sequencing. Despite the extensive genomic alterations revealed in profiling studies, there remain limited experimental systems to model and perturb evolutionary processes.

Successful use of intra venous tenecteplase for acute ischemic stroke in pregnancy.

Intravenous thrombolysis (IVT) with tenecteplase or alteplase is the standard of care in, patients with Acute Ischemic Stroke (AIS) presenting within 3-4.5 h. However here, are no established guidelines for such treatment during pregnancy.

Spontaneous Isolated Superior Mesenteric Artery Dissection With Thrombosis: A Case Report of a Rare Presentation of Acute Abdominal Pain.

Spontaneous isolated superior mesenteric artery dissection is a very rare vascular disease that involves the superior mesenteric artery or its branches, with an incidence as low as 0.08%. The majority of cases occur in patients of Asian descent.

Multimodality imaging review for suspected ovarian torsion cases in children.

Objectives: Ovarian torsion (OT), although rare, can be described as a complete or partial twist of the ovary with impairment of blood flow. Although occurring at any age, it is more common in children and during pregnancy. Presenting symptoms are non-specific but include either persistent or intermittent acute abdominal pain, making early diagnosis difficult.

Reductive Stress Causes Pathological Cardiac Remodeling and Diastolic Dysfunction.

Redox homeostasis is tightly controlled and regulates key cellular signaling pathways. The cell's antioxidant response provides a natural defense against oxidative stress, but excessive antioxidant generation leads to reductive stress (RS). This study elucidated how chronic RS, caused by constitutive activation of nuclear erythroid related factor-2 (caNrf2)-dependent antioxidant system, drives pathological myocardial remodeling.

Effect of Aging on NK Cell Population and Their Proliferation at Ex Vivo Culture Condition.

Age-associated changes in natural killer (NK) cell population, phenotype, and functions are directly attributed to the risk of several diseases and infections. It is predicted to be the major cause of the increase in mortality. Based on the surface density of CD56, NK cells are subdivided into two types, such as CD56 and CD56 cells, which represent cytokine production and cytotoxicity.

Laser Science and its Applications in Prosthetic Rehabilitation.

The minimal invasive nature of lasers, with quick tissue response and healing has made them a very attractive technology in various fields of dentistry which serves as a tool to create a better result than ever before. The rapid development of lasers and their wavelengths with variety of applications on soft and hard tissues may continue to have major impact on the scope and practice in prosthetic dentistry. The purpose of this article is to make every clinician familiar with the fundamentals of lasers and different laser systems to incorporate into their clinical practices.

Costs of bariatric surgery in a randomised control trial (RCT) comparing Roux en Y gastric bypass vs sleeve gastrectomy in morbidly obese diabetic patients.

Aim: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand.

Methods: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery. Healthcare costs of medications, laboratory investigations and hospital clinic visits for one year prior to enrolment into the RCT were also calculated.

Tuberculosis, Fiji, 2002-2013.

During 2002-2013, a total of 1,890 tuberculosis cases were recorded in Fiji. Notification rates per 100,000 population increased from 17.4 cases in 2002 to 28.

Disruption of nuclear factor (erythroid-derived-2)-like 2 antioxidant signaling: a mechanism for impaired activation of stem cells and delayed regeneration of skeletal muscle.

Recently we have reported that age-dependent decline in antioxidant levels accelerated apoptosis and skeletal muscle degeneration. Here, we demonstrate genetic ablation of the master cytoprotective transcription factor, nuclear factor (erythroid-derived-2)-like 2 (Nrf2), aggravates cardiotoxin (CTX)-induced tibialis anterior (TA) muscle damage. Disruption of Nrf2 signaling sustained the CTX-induced burden of reactive oxygen species together with compromised expression of antioxidant genes and proteins.

Tuberculosis diagnostics in Fiji: how reliable is culture?

Settings: Acid-fast bacilli (AFB) smear microscopy and Mycobacterium tuberculosis culture are the first-line diagnostic tests for tuberculosis (TB). The contamination of TB cultures significantly reduces the reliability of TB diagnosis.

Objective: To investigate factors associated with TB culture contamination in Fiji, and the relative diagnostic performance of culture compared to microscopy.

Evaluation of the implementation of the Xpert® MTB/RIF assay in Fiji.

Setting: All Xpert® MTB/RIF tests performed in the three TB (tuberculosis) treatment centres in Fiji from June 2012 to February 2013.

Objectives: To determine 1) the number of Xpert tests performed in each centre, 2) the association between sputum quality and Xpert results, 3) the agreement of Xpert with acid-fast bacilli (AFB) smear microscopy and TB culture and 4) error rates.

Design: Retrospective review of records.

Changing from single-drug to fixed-dose combinations: experience from Fiji.

Background: Fixed-dose combinations (FDCs) of first-line anti-tuberculosis drugs were introduced in Fiji in 2011, and there have been concerns about treatment response.

Objective: To evaluate the treatment response to FDCs among tuberculosis (TB) patients.

Methods: A retrospective cohort study was undertaken of treatment outcomes of new TB cases registered from January 2010 to April 2013 and weighing ⩾30 kg.

Clinical characteristics and treatment outcomes of tuberculosis cases hospitalised in the intensive phase in Fiji.

Settings: Tuberculosis (TB) is an ongoing public health challenge in Fiji. Clinical case detection and management are critical for effective TB control. Most TB cases in Fiji are hospitalised for the intensive phase of treatment.

Sputum smear conversion and treatment outcomes for tuberculosis patients with and without diabetes in Fiji.

Settings: Three tuberculosis (TB) treatment centres under the Fiji National Tuberculosis Programme.

Objectives: To determine the prevalence of diabetes mellitus (DM) among TB patients for the period 2010-2012, and to evaluate sputum smear conversion and anti-tuberculosis treatment outcomes, comparing patients with and without DM.

Design: A retrospective descriptive study using routinely collected data from the TB register and in-patient folders.

Mentorship for operational research capacity building: hands-on or hands-off?

Mentorship is a key feature of operational research training courses run by the International Union Against Tuberculosis and Lung Disease and Médecins Sans Frontières. During the recent South Pacific paper writing module, the faculty discussed 'hands-on' mentorship (direct technical assistance) vs. 'hands-off' mentorship (technical advice).

Characteristics of government workers and association with diabetes and hypertension in the Cook Islands.

Setting: Twenty government departments in Rarotonga, Cook Islands.

Objective: To determine the characteristics, presence of selected non-communicable disease (NCD) risk factors and prevalence of diabetes mellitus (DM) and hypertension among government workers who participated in 'wellness checks' in 2012.

Design: Cross-sectional study involving analysis of survey data.

Sputum smear microscopy referral rates and turnaround time in the Tonga Islands.

Setting: The National Tuberculosis Programme and the National Reference Laboratory, located on the main island of Tonga, Tongatapu, and three district hospital laboratories located on the outer islands.

Objectives: To compare Tongatapu with Tonga's outer islands with respect to sputum referral rates, numbers of samples per patient, sample quality, test results and time from sending sample to obtaining results and from obtaining results to treatment initiation.

Design: Retrospective study involving record review of laboratory and TB treatment registers in Tonga's four hospitals from 2003 to 2012.

Tuberculosis notifications, characteristics and treatment outcomes: urban vs. rural Solomon Islands, 2000-2011.

Setting: All provincial tuberculosis (TB) management units in the Solomon Islands.

Objective: To compare TB notifications, characteristics and treatment outcomes in urban vs. rural areas.

Building operational research capacity in the Pacific.

Operational research (OR) in public health aims to investigate strategies, interventions, tools or knowledge that can enhance the quality, coverage, effectiveness or performance of health systems. Attention has recently been drawn to the lack of OR capacity in public health programmes throughout the Pacific Islands, despite considerable investment in implementation. This lack of ongoing and critical reflection may prevent health programme staff from understanding why programme objectives are not being fully achieved, and hinder long-term gains in public health.

The trend of tuberculosis cases over 60 years in Fiji's largest treatment centre: 1950-2010.

Setting: P J Twomey Hospital, National Tuberculosis Programme, Fiji.

Objectives: To review the trend in numbers of tuberculosis (TB) cases registered each year from 1950 to 2010 at P J Twomey Hospital, Fiji's largest TB treatment centre and central TB unit, and to consider trends in the context of key TB control events in Fiji.

Design: Descriptive study of data from medical records and TB registers, including age, sex, ethnicity, TB diagnosis and smear result.

Audit of the practice of sputum smear examination for patients with suspected pulmonary tuberculosis in Fiji.

Background: In Fiji, patients with suspected pulmonary tuberculosis (PTB) currently submit three sputum specimens for smear microscopy for acid-fast bacilli, but there is little information about how well this practice is carried out.

Methods: A cross-sectional retrospective review was carried out in all four TB diagnostic laboratories in Fiji to determine among new patients presenting with suspected PTB in 2011: the quality of submitted sputum; the number of sputum samples submitted; the relationship between quality and number of submitted samples to smear-positivity; and positive yield from first, second and third samples.

Results: Of 1940 patients with suspected PTB, 3522 sputum samples were submitted: 997 (51.

Screening tuberculosis patients for diabetes mellitus in Fiji: notes from the field.

Diabetes (DM) is a problem in Fiji and threatens tuberculosis (TB) control efforts. A review was conducted of all TB patients registered in Fiji in 2011 to assess routine practices of screening for DM. Of 221 TB patients, 138 (62%) had their DM status recorded in their case folders; 18 (13%) had a known history of DM.

Relationship between education and training activities and tuberculosis case detection in Fiji, 2008-2011.

Due to concerns about under-reporting of the tuberculosis (TB) case burden in Fiji, efforts have been put into national training, education and awareness activities in the formal health sector and among village health workers, health volunteers and the community since 2010. There has been an absolute increase in TB registrations, and TB case notification rates during the period of training activities in 2010 (21.3 per 100 000 population) and 2011 (23.