Colorectal Cancer Study of Austria (CORSA): A Population-Based Multicenter Study

The COloRectal cancer Study of Austria (CORSA) is comprised more than 13,500 newly diagnosed colorectal cancer (CRC) patients, patients with high- and low-risk adenomas as well as population-based controls. The recruitment for the CORSA biobank is performed in close cooperation with the invited two-stage CRC screening project “Burgenland PREvention trial of colorectal Disease with ImmunologiCal Testing” (B-PREDICT). Annually, more than 150,000 inhabitants of the Austrian federal state Burgenland aged between 40 and 80 are invited to participate using FIT-tests as an initial screening. FIT-positive tested participants are offered a diagnostic colonoscopy and are asked to take part in CORSA, sign a written informed consent, complete questionnaires concerning dietary and lifestyle habits and provide an ethylenediaminetetraacetic acid (EDTA) blood sample as well as a stool sample. Additional CRC cases have been recruited at four hospitals in Vienna and a hospital in lower Austria. A major strength of CORSA is the population-based controls who are FIT-positive and colonoscopy-confirmed to be free of polyps and/or CRC.

Is Encephalitozoon cuniculi of Significance in Young Dogs With Neurological Signs?

Encephalitozoon cuniculi is a microsporidium belonging to the phylum Microspora. A few reports have described the clinical significance of E. cuniculi infection in young dogs. In American and Japanese household dog populations, the seroprevalence was found to be 21%, indicating its wide-spread existence. To evaluate the clinical significance of E. cuniculi in a cohort of young dogs with neurological signs, the presence of the organism and possible response to treatment were studied. Over a 1-year period, all young dogs (<3 years old) that were referred with neurological signs were examined for the presence of E. cuniculi. Dogs were selected if serology revealed a clearly elevated IgM titer (>100) and/or if an EDTA-blood sample and/or urine sample tested positive by polymerase chain reaction (PCR). Sixteen dogs with various neurological signs were included in this study. Additional work-up included magnetic resonance imaging and cerebrospinal fluid analysis, but these revealed no abnormalities or indication of infection. All dogs were treated with fenbendazole for 10–30 days. Neurological signs disappeared completely in five dogs, 11 dogs continued to show neurological signs, and five dogs deteriorated and were euthanized, after which necropsy was performed in three. At necropsy no evidence of an E. cuniculi infection was found. We concluded that, although IgM titers and PCR indicated an E. cuniculi infection, it is most likely of limited clinical significance in young dogs.

Impact of preheparinization and sample volume on routine hematology findings in healthy cats

Objectives It can be challenging to collect sufficient blood from feline patients for both a biochemical profile and a complete blood count (CBC). The ability to generate accurate hematologic and biochemical data from a single, small (<2 ml) sample could reduce patient stress and improve clinical efficiency. The objective of this study was to determine the impact of preheparinization and/or sample size on routine hematology findings in cats. Methods Blood was collected from 20 healthy cats; measured aliquots were placed directly into tubes containing either EDTA or lithium–heparin (Hep). Within 2 mins, specific volumes were removed from the Hep tubes and placed in additional EDTA tubes. Four distinct sample sizes/types were created from each cat: (1) 1.3 ml EDTA (criterion standard); (2) 0.5 ml EDTA; (3) 1.3 ml Hep + EDTA; and (4) 0.5 ml Hep + EDTA. Three CBCs were performed on each sample using an automated bench-top hematology analyzer. Drops of blood were contemporaneously used to create three air-dried stained slides from each tube. Triplicate results were averaged for statistical analysis; results were compared across all sample types and against the criterion standard. Significance was set at P <0.05. Results Preheparinization did not significantly impact determinations of erythrocyte number, hematocrit, hemoglobin concentration, mean cell volume and neutrophil count. Platelet counts for the non-traditional samples correlated poorly with the criterion standard, although numbers could be effectively estimated using stained slides. Cell morphology was well preserved across all sample types. Conclusions and relevance These results indicate that a 0.5 ml preheparinized EDTA blood sample can generate clinically useful hematologic data (excluding platelet count) in cats, using a bench-top analyzer. Our findings support the collection of a single small (<2 ml) sample that can be used for both biochemical and hematologic analyses. Further studies are needed to verify these findings using other hematology machines and in diseased cats.

Neisseria meningitidis serogroup C causing primary polyarthritis in an octogenarian

A man in his 80s presented to the hospital with a 36-hour history of fever, myalgia, bilateral shoulder and right knee pain. Joint fluid aspirates from his shoulders and right knee isolated Gram-negative diplococci. After failing to grow on standard and selective media, Neisseria meningitidis was identified by 16s PCR and subsequently typed as serogroup C. He had no clinical features of meningitis or meningococcaemia. Blood cultures were negative and an EDTA blood sample was negative for meningococcal ctrA gene. Urine PCR was negative for Neisseria gonorrhoeae. He was treated successfully with two arthroscopic joint washouts of his right knee, aspirates of both shoulders, 40 days of intravenous ceftriaxone and intensive physiotherapy as both an inpatient and outpatient. In the literature, we have not found any previously documented cases of serogroup C meningococcus causing polyarticular primary septic arthritis in this age group or guidance on duration of antibiotic treatment. Literature on the impact of rehabilitation to baseline function was also found to be lacking. Although rare, primary meningococcal arthritis (PMA) should be considered as a differential diagnosis in cases of acute polyarticular septic arthritis. Polyarticular PMA in older adults may require prolonged rehabilitation before one might expect to return to premorbid function.

Identification of molecular species of phosphatidylcholine hydroperoxides in native and copper-oxidized triglyceride-rich lipoproteins in humans

Background Triglyceride-rich lipoproteins are considered to be independent predictors of atherosclerotic cardiovascular disease. The molecular basis of its atherogenicity is uncertain. Here, we aim to identify molecular species of phosphatidylcholine hydroperoxides (PCOOH) in triglyceride-rich lipoproteins. For comparison, copper-oxidized triglyceride-rich lipoproteins were investigated as well. Methods A fasting EDTA blood sample was collected from six healthy human volunteers to isolate two major triglyceride-rich lipoproteins fractions – very low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL) using sequential ultracentrifugation. Triglyceride-rich lipoproteins and plasma samples were studied for PCOOH by liquid chromatography (LC) coupled with Orbitrap mass spectrometry. Results Twelve molecular species of PCOOH in triglyceride-rich lipoproteins and/or plasma were identified using the following criteria: (1) high-resolution mass spectrometry (MS) with mass accuracy within 5 ppm, (2) retention time in LC and (3) fragmentation pattern in MS2 and MS3. PC36:4-OOH was most often detected in VLDL, IDL and plasma. The ratio of total PCOOH to phosphatidylcholine progressively increased with the duration of oxidation in both VLDL and IDL. Conclusion This study demonstrated the presence of 12 molecular species of PCOOH in native triglyceride-rich lipoproteins. The frequent detection of PCOOH in triglyceride-rich lipoproteins provides a molecular basis of the atherogenicity of triglyceride-rich lipoproteins. PCOOH in triglyceride-rich lipoproteins might serve as a molecular basis of the atherogenicity of triglyceride-rich lipoproteins.

Cell-free DNA as a prognostic marker for response to taxan-based chemotherapy in patients with prostate cancer (CaP).

228 Background: PSA is of limited value for predicting response to chemotherapy in castration resistant CaP patients. Nevertheless there is no better biological marker to control therapy response. cfDNA showed significant results in prostae cancer diagnostics and predicting recurrence after radical prostatectomy. We analyzed for the first time the role of cfDNA in castration resistant CaP predicting response to chemotherapy. Methods: We analyzed cfDNA isolated from an EDTA blood sample from 58 patients taken before initiating a first or second-line taxan based chemotherapy. 54 (93,1%), 8 (13,8%) and 3 (5.1%) of the patients had bone, lymph node or parenchymatous metastases respectively. Patients were selected according to PSA response after at least 3 cycles of chemotherapy to 30% (A), 50% (B) and 80% (C) decrease under chemotherapy. The concentration of cfDNA at the beginning of the therapy was correlated to PSA resonse at the end of the treatment. Results: Mean PSA and cfDNA concentration at therapy initiation was 391 (0,1-2663)ng/ml and 32,5 (8,93-136,63)ng/ml. In group A there was a trend of higher cfDNA concentration in the patients not achieving a PSA decrease of at least 30% (24,6ng/ml versus 35.5ng/ml) not reaching statistical significance (p=0,078). Conclusions: Patients with PSA decrease of less than 30% and PSA progression under chemotherapy have the poorest outcome. cfDNA is easy to investigate and is probably of importance to distinguish patients profiting from chemotherapy in a palliative setting. These data should be validated in a larger patient cohort.