[Urogenital tuberculosis. Starting with haematuria and a bladder mass].
We describe here in a case of genitourinary tuberculosis presenting with a haematuria and a bladder tubercle. Though imaging studies made genitourinary tuberculosis diagnostic feasible, the clinical presentation made runing out malignancy mandatory. Bladder tubercle was endoscopicary removed and histopathological analysis performed.


Do radiographers collimate? A retrospective analysis of radiographic collimation of common musculoskeletal examinations at an adult trauma centre.
Collimation of the primary beam is an important factor in radiography to reduce dose and improve image quality. The introduction of larger detector plates in direct digital radiography (DR) allows the exposed area to be calculated by removing cropping applied to the image. The aim of this study was to assess whether the exposed area was larger than a reference standard across five different projections on different body types, with the reference size being the corresponding cassette size used in traditional film/screen or computed radiography (CR). A retrospective clinical audit of five common musculoskeletal radiographic projections (AP knee, AP shoulder, horizontal beam lateral hip, lateral cervical spine and lateral facial bones), of 359 patients was undertaken. The electronic cropping was removed from projections, and the superior-inferior, antero-posterior and medio-lateral collimation size was measured, depending on the projection. The two measurements were multiplied to give an exposed field of view area. The three measurements were compared with a reference standard, being the size of the corresponding cassette size used in the department on film/screen or computed radiography. From the five projections, 1071 measurements were analysed. 416 (38.8%) of these measurements were less than or equal to the agreed reference standard. 655 (61.2%) were greater than the agreed reference standard. The study demonstrates that the majority (61.2%) of the measurements taken were above the reference standard. This results in an increase in radiation dose to patients and detrimental impacts on image quality.


Endophytic Diaporthe associated with Citrus: A phylogenetic reassessment with seven new species from China.
Phytopathogenic species of Diaporthe are associated with melanose, stem-end rot and gummosis diseases of Citrus. However, little is known about the occurrence of species of Diaporthe as endophytes and saprobes. In this study, we obtained 58 strains of Diaporthe, including 44 endophytic isolates from cultivated Citrus in China. The nuclear ribosomal internal transcribed spacer (ITS), partial sequences of translation elongation factor 1-α (EF1-α), beta-tubulin (TUB), and histone-3 (HIS) gene regions were analysed to determine the species of the isolates collected. In combined analysis of four gene regions, these strains grouped in 16 distinct clades in Diaporthe. The isolates were identified in Diaporthe arecae species complex, Diaporthe citri, Diaporthe citriasiana, Diaporthe citrichinensis, Diaporthe endophytica, Diaporthe eres, Diaporthe hongkongensis, and Diaporthe sojae based on molecular phylogeny and morphology. Seven new species are described from Citrus namely, Diaporthe biconispora, Diaporthe biguttulata, Diaporthe discoidispora, Diaporthe multigutullata, Diaporthe ovalispora, Diaporthe subclavata, and Diaporthe unshiuensis with descriptions and illustrations.


Self-harm in university students: A comparative analysis of data from the Multicentre Study of Self-harm in England.
Increases in poor mental health and suicide have been identified among university students in the UK. However, little is known about self-harm in this group. To describe and identify care needs of university aged-students who self-harm via comparisons with an age-equivalent non-student group who self-harm. Observational cohort data from The Multicentre Study of Self-harm in England were used to investigate students aged 18 to 24 years who presented to emergency departments for self-harm, 2003 to 2016. Data were collected via clinician reports and medical records from five hospitals in three English regions. Characteristics, rates, repetition, and mortality outcomes were investigated. The student sample included 3491 individuals (983, 28.2 % men; 2507, 71.8 % women; 1 unknown) compared to 7807 (3342, 42.8 % men; 4465, 57.2 % women) non-students. Self-harm increased over time in students (IRR 1.08, 95%CI 1.06-1.10, p < 0.01) but not in non-students (IRR 1.01, 95%CI 1.00-1.02, p = 0.15). There were differences in monthly distribution of self-harm with more presentations by students in October, November, and February. Characteristics were broadly similar, but students reported more problems with studying and mental health. Repetition (HR 0.78, 95%CI 0.71-0.86, p < 0.01) and mortality (HR 0.51, 95%CI 0.33-0.80, p < 0.01) were lower in students than non-students. Self-harm in students may be directly related the student experience, such as academic pressure, relocation, and the transition to independent living. Wellbeing initiatives targeting these factors, alongside mental health awareness training for academic and non-academic staff may help to support students at risk.


Effect of acute intravenous administration of delta-9-tetrahydrocannabinol on the episodic secretion of immunoassayable growth hormone in the rat.
Blood samples from unrestrained, unanesthetized, male rats (300-350 g) were obtained every 15 min. for 9 consecutive hrs. (1000-1900 h). Each rat received, intravenously, a vehicle injection (controls) or a 2.0 mg/kg dose of delta-9-tetrahydrocannabinol (THC) at 1300 h to determine the effect of this drug on the spontaneous episodic secretion of plasma immunoassayable rat growth hormone (rGH). Acute administration of THC suppressed the secretion of rGH, as is evident from mean plasma level (p less than .01), peak height (p less than .02), and integrated peak amplitude (p less than .02) analyses. Episodic secretion was inhibited in all animals (n = 7) receiving THC. Although further investigation is needed to define clearly the physiological mechanisms involved in this response, these data indicate that THC can inhibit the hypothalamic-pituitary control of normal episodic growth hormone secretion in the rat.


Electroacupuncture for Pain Relief After Endoscopic Sinus Surgery: A Randomized Controlled Trial.
Postoperative pain is a common problem after endoscopic sinus surgery (ESS). Electroacupuncture (EA) is proven to be effective in relieving postoperative pain. However, EA has not been studied in patients undergoing ESS. This study was designed to evaluate the efficacy and safety of EA compared to a sham control in relieving pain after ESS. A total of 62 patients were randomly allocated to receive either EA (n = 31) or sham EA (n = 31) for 5 sessions, 30 minutes per session for 4 days (2 hours before and 2 hours after surgery, and 3 sessions daily for the following 3 days). There were no significant differences between the 2 groups with regard to demographic characteristics. Compared to the sham EA group, the EA group showed a significantly greater reduction in the pain intensity of single daily scoring with a numerical rating scale at the day following surgery (postoperative day 1, POD1) (-1.35; 95% confidence interval [CI], -1.74 to -0.97; P < .001) and POD2 (-1.16; 95% CI, -1.55 to -0.77; P < .001), whereas no significant between-group difference was detected at the day of surgery (POD0), POD3 or POD6. Intraoperative heart rate and mean blood pressure in the EA group showed a more stable trend. A significant improvement was found for an actigraphy-measured average time of night wakings, recovery time from anesthesia, and quality of recovery-15 in the EA group. No severe adverse events occurred during the trial. Our results demonstrate that EA can serve as an effective adjuvant therapeutic tool for pain relief after ESS. PERSPECTIVE: This randomized sham-controlled, patient-and-assessor blinded trial provided evidence for the first time that EA can relieve postoperative pain and other symptom management in patients after ESS. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry, ChiCTR1900024183, http://www.chictr.org.cn/showproj.aspx?proj=40573.


Dual roles of proteasome in the metabolism of presenilin 1.
Presenilin 1 (PS1) has been identified as a causative gene for most early-onset familial Alzheimer's disease. Biochemical studies revealed that PS1 exists predominantly as two processed fragments in cells and brain tissues. We prepared stably transfected cells expressing the wild-type and familial Alzheimer's disease-associated mutants of PS1 and investigated the enzyme that participates in the metabolism of PS1. After treatment of the cells with proteasome inhibitors, the full-length PS1 was significantly accumulated. The levels of N- and C-terminal fragments were also increased. The accumulation of PS1 with a deletion of exon 10, which is unable to be processed, on treatment of the transfected cells with lactacystin indicated that proteasome can degrade full-length PS1. A synthetic peptide that includes the processing region of PS1 was cleaved by 20S proteasome at the putative processing sites after Met288 and Glu299. Metabolic labeling experiments showed that the appearance of the N-terminal fragment was attenuated by the inhibitor. Finally, 28-kDa N- and 20-kDa C-terminal fragments were generated by purified PS1 in vitro. These data indicated that the proteasome pathway is involved in PS1 processing. These results demonstrate that the proteasome pathway plays dual roles in processing and degradation of PS1.


Rigid High Temperature Heat-Shrinkable Polyimide Tubes with Functionality as Reducer Couplings.
Flexible and semi-rigid heat-shrinkable tubes (HSTs) have been used in thousands of applications, and here rigid high temperature HSTs are reported for the first time. These rigid HSTs are prepared with shape memory polyimides possessing glass transition temperatures (Tgs) from 182 to 295 °C, and the relationships between Tg and their molecular structures are studied. The polyimide HSTs (PIHSTs) can fix expanded diameters and shrink back to original diameters very well, and the mechanisms of their heat-shrinkage performance are discussed. Their differences from commercially available HSTs in heat-shrinkage are also analyzed. They can withstand low temperature of -196 °C, much lower than those of other HSTs. The PIHSTs can also connect subjects of different sizes by heat-shrinkage and then fix them upon cooling like reducer couplings, and the possible mechanisms of their reducer coupling effect are analyzed. With their unique characteristics, PIHSTs will expand the application areas of HSTs enormously.


Watching television is associated with childhood obesity: but is it clinically important?
To assess the impact of television viewing during childhood and adolescence on body mass index (BMI) in children up to the age of 15 years. Unselected birth cohort, assessed at birth and every 2 years from age 3 to 15 years. In all, 1037 individuals were assessed at age 3 years. At age 15 years, 976 (95% of living cohort) continued to participate. Parental estimates of weekday television viewing between age 5 and 11 years. Self-reports of television viewing at age 13 and 15 years. Weight and height were measured at each age to calculate BMI. BMI and prevalence of overweight at all ages were significantly associated with mean hours of television viewing reported in the assessments up to that age. These associations were stronger in girls than boys. The associations remained significant after adjusting for parental body mass indices and socio-economic status. Time spent watching television is a significant predictor of BMI and overweight in childhood. Although the effect size appears small, it is larger than the effect sizes commonly reported for nutritional intake and physical activity. Television viewing should be regarded as an important contributing factor to childhood obesity.


Patient-derived assessment tool using musculoskeletal ultrasound for validation of haemarthrosis.
Haemophilia patients experience painful joint episodes which may or may not be associated with haemarthrosis. We sought to validate a questionnaire developed by the Canadian Haemophilia Society using point-of-care musculoskeletal ultrasound (POC MSKUS) to confirm haemarthrosis. The questionnaire comprised of 20 questions (10 each associated with haemarthrosis and arthritis pain) and was administered to adult haemophilia patients reporting to the Haemophilia Treatment Centre (University of California San Diego). We confirmed the presence (or absence) of haemarthrosis using POC MSKUS [Joint Activity and Damage Exam (JADE)]. We fitted univariate and multivariate generalized estimating equations to identify symptoms associated with haemarthrosis. We evaluated 79 painful episodes in 32 patients [median age = 38 years (range 21-74)]. POC MSKUS detected haemarthrosis in 36 (46%) episodes. The strongest predictor for haemarthrosis pain was 'like a balloon swelling with water' (odds ratio [OR] 2.88 [CI .68;12.10]); 'no feeling of sponginess with movement' (OR .24[CI .07;.76]) was the strongest for arthritic pain. We identified four questions with the strongest OR for differentiating haemarthrosis pain from arthritic pain to develop an algorithm for haemarthrosis prediction. Answering these questions in "yes/no" fashion yielded estimates of the probability of haemarthrosis CONCLUSION: Objective diagnosis of haemarthrosis by MSKUS facilitated the development of a symptom-based prediction tool for diagnosis of haemarthrosis. The tool requires further validation and will be particularly helpful in situations where MSKUS is not readily available.


Effect of Indian brown seaweed Sargassum wightii as a functional ingredient on the phytochemical content and antioxidant activity of coffee beverage.
Seaweed is a novel food source that is packed with bioactive compounds but is rarely used in its raw/cooked form. An efficient nutrient delivery medium is required to make the potential health benefits of seaweeds accessible to the general population while maintaining its palatability. In this study, coffee infused with different seaweed concentrations (1%, 3%, 5%) were prepared and their physico-chemical, phenolics, flavonoids, antioxidants, rheology, thermal and spectral characteristics were observed. Increase in seaweed concentration resulted in increased acidity and decreased total soluble solids of the beverage with no distinct color change. Rheological measurements showed flow behavior index in the range of 1.09-1.34 indicating dilatant tendency of the seaweed-coffee infusions which gradually decreased towards a Newtonian nature with increase in seaweed concentration. Higher detection of flavonoids and ferric reducing antioxidant power was possible with increase in seaweed concentration from 1 to 5%. However, no significant changes in total phenols and 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity was observed. Sensory evaluation of the coffee drinks was done using fuzzy logic which showed highest sensory acceptability for the infusion with 1% seaweed concentration. Thermograms showed changes in flavor profile on increasing seaweed concentration which was later confirmed using Fourier transform-infrared spectroscopy. Results of the study highlight that coffee can be successfully used to mask the off-flavor of seaweed while disseminating its health benefits to the general population through an effective and extensively utilized food medium.


Study of Demographic Profile of Organophosphate Compound Poisoning with Special Reference to Early Versus Late Tracheostomy in Tertiary Care Hospital in Rural Area.
Tracheostomy is commonly performed life saving procedure. Organophosphorus compound poisoning is a very common emergency encountered in rural area where major population consists of agricultural workers. Ideal timing of tracheostomy is still controversial. Aim of the study is to assess the advantage of performing early (48 h-7 days) versus late tracheostomy (8-15 days) with regard to weaning from a ventilator, complications and length of hospital stay. This is a comparative retrospective interventional study in which 100 patients of organophosphorus poisoning who underwent tracheostomy during hospital stay due to prolonged intubation were analyzed. Study subjects were divided into two groups. Each group constitute of 50 patients each. Group A: Early tracheostomy (48 h-7 days) and Group B: Late tracheostomy (8-15 days). Early tracheostomy required a shorter duration of mechanical ventilator support (4-5 days) when compared to late tracheostomy (5-8 days), p < 0.05 and early tracheostomy facilitate early weaning. There was high incidence of complications in late tracheostomy group as compare to early tracheostomy group. Duration of hospital stay was also longer in Group B (mean 40 days) as compare to Group A (mean 32 days) with p < 0.05. We concluded that, early tracheostomy was associated with shorter duration of mechanical ventilator support, it helps for early weaning, shorted intensive care unit and hospital stay as compare to late tracheostomy.


Coordination-driven robust antibacterial coatings using catechol-conjugated carboxymethyl chitosan.
To prevent bacterial contamination on solid surfaces, a simple yet efficient antibacterial coating was developed in a substrate-independent manner by using the catechol-conjugated carboxymethyl chitosan (CMC-DOPA). The CMC-DOPA was firstly synthesized via an aza-Michael reaction with methyl acrylate and the subsequent acyl substitution with dopamine. The coating strategy consists of spin-coating-assisted deposition of CMC-DOPA on polydopamine-coated substrates and coordination-driven crosslinks between catechol groups and Fe3+ ions in sequence, producing the multilayered CMC-DOPA films. The film thickness was controllable depending on the concentration of CMC-DOPA. Compared to bare controls, the CMC-DOPA-coated substrates reduced the bacterial adhesion by up to 99.8 % and 96.2 % for E. coli and S. aureus, respectively. It is demonstrated that the CMC-DOPA coating can be a robust antibacterial coating across various pH environments, inhibiting bacterial adhesion by 78.7 %, 95.1 %, and 93.2 %, respectively, compared to the control, even after 7 days of acidic, physiological, and alkaline pH treatment. The current coating approach could be applied to various substrates including silicon dioxide, titanium dioxide, and polyurethane. Given its simple and versatile coating capability, we think that the coordination-driven CMC-DOPA coating could be useful for various medical devices and implants.


Chronic lymphocytic leukemia cell CD38 expression and inducible nitric oxide synthase expression are associated with serum IL-4 levels.
B cell chronic lymphocytic leukemia (CLL) CD38 expression is variable and may predict outcome. Inducible nitric oxide synthase (NOS2) expression regulates CLL cell apoptosis. IL-4 and IFN-gamma regulate B cell CD38 expression and NOS2 expression. We compared IL-4 and IFN-gamma serum levels between CLL patients and normal individuals, and determined whether serum IL-4 and IFN-gamma levels correlated with CLL cell CD38 expression and NOS enzyme activity. IL-4 levels, but not IFN-gamma levels, differed between normal individuals and CLL patients. Furthermore, there was an association of IL-4 levels, but not IFN-gamma levels, with CD38 and NOS2 expression in CLL patients.


Efficacy of selamectin against experimentally induced and naturally acquired ascarid (Toxocara canis and Toxascaris leonina) infections in dogs.
The efficacy of selamectin against adult ascarids was evaluated in eight controlled and masked studies in dogs. Three laboratory studies evaluated selamectin against experimentally induced infections of Toxocara canis; three laboratory studies evaluated selamectin against naturally acquired infections of T. canis; one laboratory study evaluated selamectin against naturally acquired infections of both T. canis and Toxascaris leonina; one field study evaluated selamectin against naturally acquired infections of ascarids (T. canis and/or T. leonina) in dogs presented as veterinary patients. Selamectin was administered topically to the skin of dogs in unit doses designed to deliver a minimum of 6mgkg(-1) (range, 6-12mgkg(-1)). In all studies, dogs were allocated randomly to treatment assignments (selamectin or vehicle control in laboratory studies: selamectin or reference product in the field study) on the basis of pretreatment fecal egg counts. For induced infections, there were significant reductions in geometric mean numbers of adult T. canis after a single application of selamectin (93.9-98.1%, P=0.0001), after two monthly applications (> or =88.3%, P< or =0.0001), and after three monthly applications (100%, P< or =0.0002). In the natural infection laboratory studies, when selamectin was administered twice at an interval of 30 days, the percentage reductions in geometric mean numbers of adult T. canis at necropsy were 84.6, 91.3, and 97.9%, and when selamectin was administered on days 0, 14, and 30, the percentage reductions were 91.1 and 97.6%. Geometric mean fecal T. canis egg counts were reduced by > or =92.9% (P< or =0.0067) at the end of the studies. In the field study, geometric mean fecal ascarid egg counts were reduced by 89.5 and 95. 5% (P=0.0001) for 14 and 30 days, respectively, after a single treatment with selamectin, and by 94.0% (P=0.0001) 30 days after the second treatment with selamectin. These reductions compared favorably with the egg count reductions from dogs treated with a reference product containing praziquantel, pyrantel embonate, and febantel. There were no adverse drug experiences or treatment-related mortalities during any of the studies. Selamectin, when administered topically in a unit dose providing a minimum dosage of 6mgkg(-1), was safe and effective against adult T. canis and T. leonina and in reducing the fecal excretion of T. canis eggs in dogs.


2D-QSAR and docking study of a series of coumarin derivatives as inhibitors of CDK (anticancer activity) with an application of the molecular docking method.
Quantitative Structure Activity Relationship (QSAR) analysis techniques are tools largely utilized in many research fields, including drug discovery processes. In this work electronic descriptors are calculated with the Gaussian 03W software using the DFT method with the BecKe 3-parameters exchange functional and Lee-Yang-Parr correlation functional, with Kohn and Sham orbitals (KS) developed on a Gaussian Basis of type 6-31G (d), in combination with five Lipinski parameters that have been calculated with ChemOffice software, in order to develop a statistically verified 2D-QSAR model able to predict the biological activity of new molecules belonging to the same range of coumarins rather than chemical synthesis and biological evaluations that require more time and resources. Two QSAR models against both MCF-7 and HepG-2 cell lines are obtained using the multiple linear regression method. The predictive power of these models has been confirmed by internal and external validation. The Leverage method was used to determine the domain of applicability of the 2D-QSAR models developed. The results indicate that the best QSAR model is the one that links the 2D descriptors with the CDK inhibitory activity of the cell line (HepG-2) R2 = 0.748, R2cv = 0.618, MSE = 0.03 for the learning series and R2 = 0.73, MSE = 0.18 for the test series. This model implies that coumarin inhibitory activity is strongly related to dipole moment and the number of hydrogen bond donors. The results obtained suggest the importance of studying structure-activity relationships as a principal axis in drug design. The docking procedure using AutoDOCK Tools was also used to understand the mechanisms of molecular interactions and consequently, to develop new inhibitors.


Reaction time in gait initiation depends on the time available for affective processing.
Previous studies have reported that reaction time in gait initiation was affected by emotion eliciting pictures. This study examined the effect of a change in the delay between image onset and the imperative "go" on reaction time. From a standing posture, 19 young adults had to walk (several steps) toward pleasant or unpleasant images in two conditions. In the short condition, the word "go" appeared 500ms after image onset and participants were instructed to initiate gait as soon as possible after the word go appeared. In the long condition, the same procedure was used but the word "go" appeared 3000ms after image onset. Results demonstrated that motor responses were faster for pleasant pictures than unpleasant ones in the short condition. In contrast, no significant difference was found between both categories of pictures in the long condition. Moreover, we found that self ratings of valence of unpleasant pictures were less unpleasant in the long condition than in the short one whereas there was no difference for pleasant pictures between both conditions. This result reflected a change in the affective significance of unpleasant pictures in the long condition. We also found in the long condition, that the body was inclined forward and to the stance limb during the standing posture and importantly with a similar extent for pleasant and unpleasant pictures. This change clearly reflected a facilitation of the gait initiation process. Overall, results suggested that this gait facilitation when confronted to unpleasant pictures resulted from emotional regulation processes enabling to reappraise these pictures and to override the initial avoidance tendency that they caused.


Differentiation of benign and malignant tumors of the parotid gland: value of pulsed Doppler and color Doppler sonography.
To establish criteria for the differentiation of benign and malignant tumors of the parotid gland using color Doppler sonography (CDS) and pulsed Doppler sonography (PDS) we examined 37 patients with parotid tumors by gray-scale ultrasound, CDS, and PDS. Tumor vascularization displayed by CDS was graded subjectively on a 4-point scale (0 = no vascularization, 3 = high vascularization). From the Doppler spectrum, the highest systolic peak flow velocity, the resistive index (RI), and the pulsatility index (PI) were calculated. There were 11 malignant and 26 benign tumors. Tumor vascularization by CDS was grade 0 or 1 in 88.5% of benign lesions, whereas it was grade 2 or 3 in 82% of malignant lesions (P < 0.0001). The highest systolic peak flow velocity was statistically significantly higher in malignant lesions than in benign lesions. Using a threshold systolic peak flow velocity of 25 cm/s, sensitivity was 72% and specificity was 88% for the detection of a malignant tumor. Evaluation of tumor vascularization by CDS and PDS cannot differentiate between benign and malignant parotid tumors with certainty. However, high vascularization and high systolic peak flow velocity in tumor vessels should raise the suspicion of malignancy, even if tumor morphology on gray-scale sonography indicates a benign lesion.


Application of factorial design to study of heavy metals biosorption by waste biomass from beverage distillery.
A full factorial design leading to 20 sets of sorption runs was conducted to study the influence of four variables (bleaching earth and biomass concentrations, pH, and sorption time) on the iron, nickel, and chromium removal from stainless steel effluent using waste biomass from a beverage industry. Similar factor effects and interactions were found for each metal involved in this biosorption study, and the main factors were pH (positive effect) and biomass concentration (negative effect). Response surface methodology was adopted and an empirical linear polynomial model constructed on the basis of the specific uptake (mg of metal/g of biomass as dryweight) for each metal species. Under optimized process conditions (pH 4.0, biomass concentration of 2.0 g/L, absence of Celite), uptake values of 155 mg of Fe/g, 38 mg of Cr/g, and 0.4 mg of Ni/g were achieved after 3 h. This corresponded to a reduction in heavy metals concentration of approx 94% for Cr, 57% for Fe, and 25% for Ni.


Viable circulating tumour cell detection using multiplex RNA in situ hybridisation predicts progression-free survival in metastatic breast cancer patients.
Current approaches for detecting circulating tumour cells (CTCs) in blood are dependent on CTC enrichment and are based either on surface epithelial markers on CTCs or on cell size differences. The objectives of this study were to develop and characterise an ultrasensitive multiplex fluorescent RNA in situ hybridisation (ISH)-based CTC detection system called CTCscope. This method detects a multitude of tumour-specific markers at single-cell level in blood. Healthy blood samples spiked with tumour cell lines were used as a model system for the development and initial characterisation of CTCscope. To demonstrate the feasibility of CTC detection in patient blood, duplicate blood samples were drawn from 45 metastatic breast cancer patients for analysis by CTCscope and the CellSearch system. The association of CTCs with the tumour marker CA15-3 and progression-free survival (PFS) were assessed. CTCscope detected CTC transcripts of eight epithelial markers and three epithelial-mesenchymal-transition (EMT) markers for increased sensitivity. CTCscope was used to detect CTCs with minimal enrichment, and did not detect apoptotic or dead cells. In patient blood samples, CTCs detected by CellSearch, but not CTCscope, were positively correlated with CA15-3 levels. Circulating tumour cells detected by either CTCscope or CellSearch predicted PFS (CTCscope, HR (hazard ratio) 2.26, 95% CI 1.18-4.35, P=0.014; CellSearch, HR 2.50, 95% CI 1.27-4.90, P=0.008). CTCscope offers unique advantages over existing CTC detection approaches. By enumerating and characterising only viable CTCs, CTCscope provides additional prognostic and predictive information in therapy monitoring.


Isoniazid-induced hepatotoxicity in children with latent tuberculosis infection.
We aimed to determine overall incidence of severe and mild isoniazid (INH) hepatotoxicity and outcome of hepatotoxicity in children who were receiving INH for latent tuberculosis. Patients who had received isoniazid for treatment of latent tuberculosis were included in the study. Hepatotoxicity was classified according to the World Health Organization Toxicity Classification Standards. Among 1038 patients, overall hepatotoxicity was observed in 22 patients (2.2%), while 5 patients (0.48%) had moderate-severe hepatotoxicity; while other 17 patients had grade I-II hepatotoxicity (1.63%). Age and gender did not appear to be risk factors for hepatotoxicity. The median time for therapy rechallenge in patients with grade III-IV hepatotoxicity was 21 days (ranging from 14 to 25 days). Isoniazid hepatotoxicity is lower and generally reversible after cessation of INH in children. The grade of hepatotoxicity affects the duration for recovery of hepatotoxicity and restarting of INH therapy.


Description and evaluation of a health education program for women offenders.
One percent of the population of the United States consists of women offenders, who are at-risk for numerous preventable diseases. Since health promotion is not a high priority when women are incarcerated, the author used group education as one way of increasing participants' knowledge and self-efficacy. Results indicated that a group health education program is an excellent way to change participants' knowledge and self-efficacy in a women's prison population.


Oxidative stress-related biomarkers in autism: systematic review and meta-analyses.
Autism spectrum disorders (ASDs) are rarely diagnosed in children younger than 2 years, because diagnosis is based entirely on behavioral tests. Oxidative damage may play a central role in this pathogenesis, together with the interconnected transmethylation cycle and transsulfuration pathway. In an attempt to clarify and quantify the relationship between oxidative stress-related blood biomarkers and ASDs, a systematic literature review was carried out. For each identified study, mean biomarker levels were compared in cases and controls providing a point estimate, the mean ratio, for each biomarker. After meta-analysis, the ASD patients showed decreased blood levels of reduced glutathione (27%), glutathione peroxidase (18%), methionine (13%), and cysteine (14%) and increased concentrations of oxidized glutathione (45%) relative to controls, whereas superoxide dismutase, homocysteine, and cystathionine showed no association with ASDs. For the C677T allele in the methylene tetrahydrofolate reductase gene (MTHFR), homozygous mutant subjects (TT) showed a meta-OR of 2.26 (95% CI 1.30-3.91) of being affected by ASD with respect to the homozygous nonmutant (CC). Case-control studies on blood levels of vitamins suggest a lack of association (folic acid and vitamin B12) or rare association (vitamins A, B6, C, D, E). Sparse results were available for other biomarkers (ceruloplasmin, catalase, cysteinylglycine, thiobarbituric acid-reactive substances, nitric oxide) and for polymorphisms in other genes. Existing evidence is heterogeneous and many studies are limited by small sample size and effects. In conclusion, existing evidence suggests a role for glutathione metabolism, the transmethylation cycle, and the transsulfuration pathway, although these findings should be interpreted with caution, and larger, more standardized studies are warranted.


[When is aftercare useful in renal cell cancer?].
Diagnosis of tumor recurrence and of therapy-related side effects as well as psychological support are the main goals of a surveillance program of cancer patients. While the latter may represent a time-consuming effort, most diagnostic procedures are expensive. Whether we can efficiently detect tumor recurrence in renal cell carcinoma depends on various parameters of the recurrent disease (e.g., frequency, localization, or therapeutic options). Available data lend support to "lean" follow-up strategies in patients with renal cell carcinoma.


The use of botulinum toxin-a in the treatment of muscular temporomandibular joint disorders.
Botulinum toxin has been used mainly in the treatment of muscular temporomandibular joint disorders (TMD) and hyperactivity of the masticatory muscles. It is used also as a therapeutic option to relieve pain and help in functional recovery from dental, oral and maxillofacial surgery. The aim of our study was to investigate the efficacy of botulinum toxin injection in the treatment of muscular TMD. Of the 200 temporomandibular joint patients who applied for treatment, 25 patients with muscular dysfunction of the origin were included in the study. This patient group received drug, drug - physical therapy, occlusal splint therapy and botulinum toxin. These treatments were performed step by step. Botulinum toxin was applied, in accordance with reflex measurement in electromyography guidelines to nine patients whose results were not success from the other treatments had not been successful. Measurements were taken of bite force, pain and mouth openness. Sixteen patients were treated with drug-physical therapy-occlusal splint therapy, and botulinum toxin treatment was found to be successful in the case of nine patients. No side effects were observed at six months follow-up. Botulinum toxin injection for the treatment of muscular temporomandibular joint disorder is a viable treatment option in the case of patients who do not respond to conservative treatment methods.


The decline of tuberculosis epidemics under chemotherapy: a case study in Morocco.
Tuberculosis (TB) case notifications per capita fell by only 3-4% per year in Morocco between 1996 and 2005, despite implementation of the World Health Organization (WHO) DOTS strategy since the early 1990s. At the current pace of epidemic decline, there will be more than 10,000 new cases in 2050, the target year for global elimination. Analysis of cases reported by the National TB Control Programme, disaggregated by age, sex, clinical form of TB and region, for years 1996-2005. The validity of observed patterns was judged using four criteria: statistical validity, precision of measurement, biological plausibility and the consistency and strength of different lines of evidence. TB incidence (case numbers and rates) is higher in urban than in rural areas and higher in adult men than in women. The most infectious (smear-positive) form of the disease is more frequent in men with TB than women. Men aged 15-44 years accounted for half of all smear-positive cases in 2005. TB incidence has fallen more slowly than average among men, but the decline was also unexpectedly slow among women. In Morocco, men living in cities should be a focus for prevention and control. Globally, routine surveillance data should be more fully exploited to guide TB control activities.


14C distribution and utilization in blue grama as affected by temperature, water potential and defoliation regimes.
Water stress and temperature effects on growth, translocation and reallocation of 14C assimilated by blue grama (Bouteloua gracilis (H.B.K.) Lag. ex Steud.) were studied for sods extracted from shortgrass prairie. The sods were kept at either 24°/16° or 34°/16°C (day/nigh) temperatures and were labeled at two phenological stages. Three soil water potential (Ψ s) regimes of approximately 0 to -1, 0 to -15, and 0 to -30 bars were maintained by wetting and drying cycles. Reproductive plants retained more 14C in aboveground organs, used more assimilated 14C for respiration, and allocated a higher proportion of photosynthate to the labile fraction than did plants labeled at a vegetative stage. Low temperature and a Ψ s of 0 to -30 bars resulted in greater 14C translocation to belowground organs, but a larger proportion of the 14C went into structural components. Sods stressed to-30 bars and maintained at higher temperatures had higher respiration losses of 14C. No significant differences in allocation and respiration uses of 14C were found among sods grown at field capacity and at 0 to-15 bars Ψ s.During regrowth of clipped sods, more than 60% of the labile 14C in belowground organs was respired within four weeks. Higher respiration losses of labile 14C were found in severely water stressed sods that regrew under the higher temperature regime. Use of labile 14C for regrowth of new foliage was greatest for sods kept under conditions of high temperatures and optimum to moderate Ψ s. Height growth and biomass increas of new foliage were significantly less for sods stresses to -30 bars. No significant differences in reallocation or respiration losses of 14C, growth, and biomass increases were observed for sods maintained at field capacity and 0 to -15 bars. These results suggested that physiological processes in blue grama were affected and could not recover fully when plants were subjected to severe water stress. However, upon relief of stress, those sods maintained at a moderate soil water stress level to 0 to -15 bars were capable of rapid recovery. Significance of these findings is discussed in the context of evolutionary success of blue grama in a semi-arid environment.


Electron microscopical studies of membrane injuries in blue fox spermatozoa subjected to the process of freezing and thawing.
Disintegration of blue fox sperm membranes is studied by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). In unfrozen spermatozoa studied by SEM, the plasmalemma and the acrosome appeared to be intact, except for a few cases of disruption of the former structure at the anterior part of the head. In semen frozen in 0.5-ml plastic straws by use of N2 vapor after dilution with Tris-fructose-citric acid with 8 vol % glycerol and 20 vol % egg yolk and thawed at 70 degrees C for 8 sec, the spermatozoa displayed different degrees of membrane damage. These alterations could be classified into three main categories of which the first included only minor changes in the plasmalemma, but vesiculation and disintegration of the outer part of the acrosomal membrane. In the second category (also the most frequent one) the outer part of the acrosomal membrane was extensively vesiculated, and the plasmalemma was discharged proximal to the equatorial segment. Extensive loss of plasmalemma and complete absence of the outer part of the acrosomal membrane characterized the last category of membrane damage. The functional implications of the three categories of membrane alterations are discussed.


Neuroradiologic study of hamartomas of the tuber cinereum and hypothalamus.
Five cases, four histologically proven, of hamartoma of the tuber cinereum and hypothalamus in children are reported. The ages of the patients range from 2 to 12 years. Three cases had pubertas praecox, and in all of these the hamartoma was located in the basal cistern between the chiasm and pons and had a collar button shape and size typical of hamartoma of the tuber cinereum. In the third case, a huge calcified mass in the suprasellar region was initially thought to be craniopharyngioma. The fourth case had a hamartoma within the substance of the hypothalamus and presented with hyponatremia and temporal lobe seizures.


History of Cholecystectomy and Risk of Clostridium Difficile Infection.
Cholecystectomy affects bile acid physiology. There is growing evidence that both primary and secondary bile acids play a role in the pathogenesis of Clostridium difficile infections (CDIs). The aim of this study is to elucidate the relationship and risk of CDI in patients with cholecystectomy. We performed a matched cohort study of patients in an integrated healthcare system in Northern California from January 2000 to December 2018. Patients with cholecystectomy (cases, n = 12,617) identified based on Current Procedure Terminology codes were age- and sex-matched to patients without cholecystectomy (controls, n = 37,851). We excluded those with history of CDI at baseline and calculated the hazard ratio (HR) for development of CDI after adjusting for confounders. We found total of 351 incident CDI during average of 4.66 years of follow-up among cases and controls. In multivariate analysis, cholecystectomy was associated with elevated risk of CDI (HR 1.53, 95% confidence interval 1.14-2.04) compared with controls. Stratified analysis shows this effect does not differ according use of proton pump inhibitors (Pinteraction = 0.142), antibiotics (Pinteraction = 0.387), and hospitalization (Pinteraction = 0.252). Cholecystectomy is associated with mild increased risk of incident CDI, but this effect is not influenced by use of proton pump inhibitors, antibiotics, or hospitalization. Future prospective studies should be conducted to validate these findings and evaluate bile acid changes after a cholecystectomy.


Peptidoglycan and teichoic acid from Staphylococcus epidermidis stimulate human monocytes to release tumour necrosis factor-alpha, interleukin-1 beta and interleukin-6.
Cytokines play a major role in the pathophysiology of septic shock. In this study, human peripheral blood monocytes were stimulated with peptidoglycan and teichoic acid, purified from a strain of Staphylococcus epidermidis. Polymyxin B (PM-B) was added to avoid the effects of possible contamination with endotoxin. Tumour necrosis factor-alpha (TNF), interleukin-1 beta (IL-1), and interleukin-6 (IL-6) in the supernates were measured by enzyme-linked immunosorbent assays. Peptidoglycan and teichoic acid induced TNF, IL-1, and IL-6 in a concentration-dependent manner. Teichoic acid was a weaker inducer than peptidoglycan, especially for IL-1. Lipopolysaccharide from an E. coli strain was used as a control, being 100-1000 times more potent than peptidoglycan and teichoic acid.


Allergic hemiglossitis as a unique case of food allergy: a case report.
A unique case of topical food allergy is presented with unilateral swelling of the tongue with ulceration. Only one similar case has been reported in 1972. 76 years old female patient presented at the Emergency Department with a unilateral painful swelling and ulcerations of the tongue after eating mint chocolate. However the swelling did not compromised the airways the presentation was rather frightening for the patient. The allergic reaction responded to the parenteral steroid and oral chlorphenamine treatment and the three month follow up only revealed minimal scar formations. Unilateral hemiglossitis is a rare form of allergic reactions which is usually self-limiting with full recovery of which takes an unusually long time.


The nonpeptide ANG-(1-7) mimic AVE 0991 attenuates cardiac remodeling and improves baroreflex sensitivity in renovascular hypertensive rats.
The nonpeptide Ang-(1-7) analog, AVE 0991, is recognized as having beneficial cardiovascular effects similar to those induced by Ang-(1-7). In this study, we evaluated the effects of AVE 0991 on cardiovascular functions and on cardiac and renal remodeling in rats with 2K1C renovascular hypertension. Fisher rats underwent surgery to induce 2K1C renovascular hypertension and were then treated with AVE 0991 (1 or 3mg/kg) for 28days. At the end of treatment, the blood pressure (BP), heart rate (HR), and baroreflex sensitivity were evaluated, in conscious animals. The rats were then euthanized and the heart and kidneys removed for subsequent histological analysis. Treatment with AVE 0991 in 2K1C rats restored the baroreflex sensitivity of both bradycardic and tachycardic components to levels comparable to those of normotensive SHAM rats. At a higher dose (3mg/kg), AVE 0991 was also anti-hypertensive in 2K1C rats. Furthermore, AVE 0991 reduced the heart weight, thickness of myocardial fibers, number of inflammatory cells, and area of collagen deposition in the hearts of 2K1C rats compared to SHAM rats. The inflammatory process and tissue area of collagen deposition were decreased in the clipped kidney of AVE 0091-treated 2K1C rats. Our data showed that oral treatment with AVE 0991 reduces blood-pressure cardiac remodeling and improves baroreflex sensitivity in 2K1C renovascular hypertensive rats.


Differential diagnosis of ascitic fluid: evaluation and comparison of various biochemical criteria with a special reference to serum ascites albumin concentration gradient and its relation to portal pressure.
Among various biochemical indices measured in 93 patients with ascites, ascitic LDH estimation was proved to be indiscreminatory, while ascites/serum LDH ratio has shown a diagnostic accuracy of 85 per cent. Ascitic total protein levels and ascites/serum total protein ratio (accuracy rates of 72 and 77% respectively) were limited, especially in differentiating the ascites due to heart failure. Serum ascites albumin gradient, showed a strong correlation to portal pressure (r, + 0.83 + 0.88), and was found to be the best diagnostic index (with an overall accuracy of 97 per cent) in distinguishing the 'transudative' from 'exudative' ascites. However, no index could discreminate the 'mixed' cases and provide the etiological diagnosis of the ascites.


Intermittent versus long-term tapering prednisolone for initial therapy in children with idiopathic nephrotic syndrome.
Forty-six children with steroid-responsive nephrotic syndrome were randomly allocated to receive two different prednisolone regimens for initial therapy. Twenty-nine children (group 1) received an intermittent regimen (60 mg/m2/day for 4 weeks, followed by 40/mg/m2/day on 3 days a week for 4 weeks); 17 children (group 2) had a long-term regimen (60 mg/m2/day for 4 weeks, followed by the same dose on alternate days for 4 weeks and the doses tapered by 10 mg/m2, given on alternate days every 4 weeks for 5 months). There was no difference between the two groups in the regimen used to treat relapses, steroid responsiveness, number of patients with relapses, and frequency of toxic reactions to steroids. However, the number of patients with a relapse within 6 months after initial therapy and the number of those with frequent relapses or steroid dependence were significantly higher in group 1 than in group 2 (P less than 0.05 for both). The data indicate that the long-term tapering regimen appears to be both safe and preferable to the intermittent regimen for initial therapy in children with idiopathic nephrotic syndrome.


Astaxanthin inhibits oxidative stress and apoptosis in diabetic retinopathy.
The pathophysiology of diabetic retinopathy (DR) is thought to be influenced by oxidative stress. Astaxanthin (ASX) is a natural product with antioxidant effect, but it is not clear whether its mechanism of inhibiting the development of DR is related to anti-oxidation. Rats were intraperitoneally injected with streptozotocin (60 mg/kg) to create DR rat models followed by ASX (20 mg/kg) for 45 days. Retinal tissue was examined by Hematoxylin and Eosin staining. By using Enzyme-linked immunosorbent assay (ELISA), 2,7-Dichlorodrhydrofluorescein diace (DCFH-DA) probes, immunohistochemistry and western blot, it was feasible to evaluate the contents of inflammation-related factors (tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6 and macrophage inhibitory cytokine-1 (MIC-1)), oxidative stress-related indicators (glutathione (GSH), malonic dialdehyde (MDA), glutathione peroxidase (GPx), reactive oxygen species (ROS) and Total antioxidant capacity (T-AOC)), antioxidant enzymes (hemoxgenase-1(HO-1) and Quinone Oxidoreductase 1 (NQO1)), and apoptosis-related proteins (Bcl-2, Bcl2 Associated X Protein (BAX), and cleaved-caspase-3). Additionally, antioxidant proteins downstream of the nuclear factor E2 related factors (Nrf-2) pathway, expression levels of Nrf2/ Kelch-like ECH-associated protein 1(Keap 1) pathway-associated proteins, and nuclear and cytoplasmic levels of Nrf2 were assessed using immunohistochemistry, western blot, or quantitative real-time polymerase chain reaction (qRT-PCR). ASX alleviated retinal tissue damage by increasing overall retina thickness and ganglion cell layer (GCL) cell numbers and exerted the anti-inflammatory, anti-oxidative stress, and anti-apoptosis effects in DR rats. Additionally, ASX could inhibit the expression of Keap1, promote the transport of Nrf2 from cytoplasm to nucleus and facilitate the expressions of HO-1, NQO1, γ-glutamylcysteine synthetase, (γ-GCS) and GPx. ASX exerted antioxidant effects through Nrf2/keap1 pathway, thereby alleviating apoptosis, inflammation, and oxidative stress in retinal tissues of DR rats.


Effects of lumbar spinal fusion on the other lumbar intervertebral levels (three-dimensional finite element analysis).
The risk of accelerating the degeneration of adjacent disc levels after lumbar spinal fusion is a controversial issue. A finite element model consisting of L1 to L5 lumbar spines was used to assess the effect on adjacent disc level after lumbar spinal fusion. We compared intact, L4/5 posterior interbody fusion (PLF), and L4/5 posterior lumbar interbody fusion (PLIF) models. The loading conditions applied were compressive force, compressive force plus flexion moment, and compressive force plus extension moment. Evaluations were made for von Mises stress on each vertebral end-plate, Tresca stress of all the annulus fibrosus, and Tresca stress of the annulus fibrosus from the posterior surface of the disc to the neural foramen. As the result, the von Mises stress adjacent to the fusion level was higher than the other nonfusion levels; it was higher under conditions of flexion moment loading plus compression loading [112% (2.59 PMa) in the PLF model and 117% (2.72 Mpa) in the PLIF model] than in the intact model. The Tresca stress of all the annulus fibrosus adjacent to the fusion level was higher than that on other nonfusion intervertebral levels; it was higher under conditions of flexion moment loading plus compression loading [127% (0.57 PMa) in the PLF model and 209% (0.89 Mpa) in the PLIF model] than in the intact model. The Tresca stress of the annulus fibrosus from the posterior surface of the disc to the neural foramen adjacent to the fusion level was higher than that on other nonfusion intervertebral levels; and it was higher under conditions of flexion moment loading plus compression loading [107% (1.48 PMa) in the PLF model and 112% (1.54 Mpa) in the PLIF model] than in the intact model. These findings demonstrate that with lumbar fusion, stresses on the vertebral end-plate and the annulus fibrosus were high adjacent to the fusion level; furthermore, stresses were higher in the PLIF model than in the PLF model. These results suggested that lumbar spinal fusion might bring with it a risk of damage to the annulus fibrosus and the vertebral end-plate adjacent to the fusion level.


Sarcocystis schneideri n. sp. (Sarcocystidae) infecting the barber skink Eumeces schneideri schneideri (Scincidae) Daudin, 1802. A light and ultrastructural study.
The current study provides the first record of infection with Sarcocystis species in the barber skink Eumeces schneideri schneideri (Scincidae) captured from the north region of Egypt around the cities of El-Hamam and Al-Dabaa, Mersa Matruh Governorate, Egypt. Morphology of the parasite cysts was described using light and transmission electron microscopy. Five out of 80 (6.25%) of the examined skinks were found to be infected. The infection was recorded firstly by light microscopy as spindle-shaped cysts embedded in the muscle tissue. The cysts were microscopic and measured 250-900 μm in length × 50-100 μm in width (mean, 575 × 75 μm). The validity of this species was confirmed by means of ultrastructural characteristics of the primary cyst wall (0.28 μm thick) which revealed the presence of irregularly shaped crowded and osmiophilic knob-like projections underlined by a thin layer of ground substance measuring 0.15-0.17 μm (mean, 0.16 μm). This layer consisted mainly of fine, dense homogenous granules enclosing the developing metrocytes and merozoites that usually contain nearly all the structures of the apical complex and fill the interior cavity of the cyst. Several septa derived from the ground substance divided the cyst into compartments. The merozoites were banana-shaped and measured 3-5 μm in length and 1.5-2.5 in width with centrally or posteriorly located nuclei. The morphological and morphometric data obtained during study were compared with those recorded previously from organisms within the Scincidae family. It was observed that this parasite possessed some distinguishing characteristics from the comparable species, which should be considered as a new species of the Sarcocystis genus, and the proposed name was Sarcocystis schneideri n. sp. with new host and locality records in Egypt.


Lynestrenol induced therapeutic amenorrhea: effects of dose reduction on serum sex-hormones and lipids.
The effect of reducing the dose of peroral lynestrenol by half on serum sex-hormone, lipid and lipoprotein status was studied in 21 mentally retarded women with therapeutic amenorrhea (TA). They had previously received 5 or 10 mg peroral lynestrenol daily for periods ranging from 32 to 196 months. Dose halving of lynestrenol resulted in an increase in serum total testosterone (T) by 16% (p less than 0.05), sex-hormone binding globulin (SHBG) by 39% (p less than 0.01) and high-density lipoprotein cholesterol (HDL-C) by 28% (p less than 0.001). Both the mean serum total and free concentrations of norethisterone (NET and fNET) decreased by 60% (p less than 0.001). The serum concentrations of 17-beta-estradiol (E2), its free fractions (fE2) and free T (fT) were not significantly altered. Significant correlations were observed between the change in HDL-C and the change in T (r = 0.45, p less than 0.05), between the change in SHBG and the change in T (r = 0.62, p less than 0.01), fT (r = 0.43, p less than 0.05) and E2 (r = 0.51, p less than 0.05). The elevation of HDL-C was probably caused by the reduced serum NET concentrations. This also resulted in an increase in serum SHBG concentration, which is regarded as an indicator of the overall estrogen/androgen ratio.


Preliminary studies on cryopreservation of snakehead (Channa striata) embryos.
This paper reports the findings of the ongoing studies on cryopreservation of the snakehead, Channa striata embryos. The specific objective of this study was to collect data on the sensitivity of C. striata embryo hatching rate to low temperatures at two different developmental stages in the presence of four different cryoprotectants. Embryos at morula and heartbeat stages were selected and incubated in 1M dimethyl sulfoxide (Me2SO), 1M ethylene glycol (EG), 1M methanol (MeOH) and 0.1M sucrose solutions at different temperatures for a period of time. Embryos were kept at 24 °C (control), 15 °C, 4 °C and -2 °C for 5 min, 1h and 3h. Following these treatments, the embryos were then transferred into a 24 °C water bath until hatch to evaluate the hatching rate. The results showed that there was a significant decrease of hatching rate in both developmental stages following exposure to 4 °C and -2 °C at 1h and 3h exposure in each treatment. Heartbeat stage was more tolerant against chilling at -2 °C for 3h exposure in Me2SO followed by MeOH, sucrose and EG. Further studies will be conducted to find the best method to preserve embryos for long term storage.


Continuous low-dose aspirin therapy in robotic-assisted laparoscopic radical prostatectomy does not increase risk of surgical hemorrhage.
Withdrawal of oral antiplatelet therapy (OAT) is a major risk factor for stent thrombosis, myocardial infarction, and cerebral strokes. In order to minimize the risk for thrombotic complications, since 2007 robotic-assisted laparoscopic radical prostatectomy (RARP) has taken place under continuous OAT with aspirin at our institution. In this retrospective study we analyzed the risk for perioperative bleeding and surgical outcome after RARP with OAT. All patients who underwent RARP with aspirin OAT at our institution since 2007 were included in this analysis. The OAT group was compared with a group that underwent RARP without OAT, which contained twice the number of patients. Matching of the two groups was performed with regard to the tumor stage and whether a lymph node dissection or nerve-sparing was performed. Thirty-eight patients were assigned to the OAT group and 76 to the control group. A difference in the decrease of postoperative hemoglobin concentration was not detectable between the two groups (mean drop of 2.9±1.4 g/dL and 2.9±1.1 g/dL, respectively; P=.93). RARP was completed in all OAT patients without conversion to open surgery. Two of the 38 patients (5.3%) in the OAT group and none in the control group required blood transfusions (P=.11). Equivalent rates of positive surgical margins for pT2 tumors were detected (16% OAT versus 14% control group; P=1.0). No adverse cardiovascular events occurred in either group during the hospitalization. Continued perioperative OAT with aspirin in RARP is safe, feasible, and not associated with increased blood loss.


[Breech Presentation: CNGOF Guidelines for Clinical Practice - Case Selection for Trial of Labour].
The objective of this chapter is to examine on the basis of the knowledge currently available the criteria available before labour for selecting women who would be eligible for trial of vaginal delivery. Bibliographical research in French and English using the Medline and Cochrane databases between 1980 and 2019 and the recommendations of international societies. It is recommended to offer women who wish to attempt a vaginal delivery at term a pelvimetry to decide with them on their mode of delivery (Grade C). The pelvimetric standards used at the time of the PREMODA study were anteroposterior diameter of inlet≥105mm, a transverse diameter of inlet≥120mm, a transverse interspinous diameter≥100mm. However, since there is no evidence about which pelvic measures to use, nor any evidence to set decision-making thresholds other than those set in published studies, the selected decision-making thresholds can be adjusted according to gestational age at delivery or fetal biometrics (Professional consensus). There is no argument for recommending the practice of pelvimetry in the case of delivery before 37 weeks gestational age (Professional consensus) and in the case of breech presentation discovered at the time of beginning of labour, the absence of pelvimetry alone does not contraindicate the attempt of vaginal delivery (Professional consensus). There is insufficient data to recommend the systematic use of fetal weight estimation and/or biparietal diameter measurement as acceptance criteria for a vaginal delivery attempt. In the event of a known fetal weight estimation before birth greater than 3800g, a cesarean section is to be preferred (Professional consensus). The breech presentation is not in itself a contraindication to an attempt of vaginal delivery for a small fetus for gestational age (Professional consensus). The presentation of the non-frank breech is not in itself a contraindication to an attempt of vaginal delivery (Professional consensus). In the case of premature breech delivery, current data do not allow to recommend one delivery route over another (Professional consensus). It is recommended to check the absence of hyperextension of the fetal head by ultrasound before an attempt of vaginal delivery (Professional consensus) and to prefer a cesarean section if such a position is found (Professional consensus). It is not recommended to propose a caesarean section with the sole reason of nulliparity (Grade C). The history of cesarean section is not in itself a contraindication to an attempt of vaginal delivery in the case of fetal breech presentation (Professional consensus). Premature rupture of the membranes is not in itself a contraindication to an attempt of vaginal delivery (Professional consensus). A number of the factors analyzed in this chapter are to be incorporated into the decision-making process in order to choose with the woman whose fetus is in breech presentation the delivery route.


Chemiluminescence from singlet oxygen under laminar flow condition in a micro-channel.
Singlet oxygen was generated by reaction of sodium hypochlorite and hydrogen peroxide in a micro-channel. The two reagent solutions were delivered into the micro-channel by syringe pumps, providing a laminar flow. Such a laminar flow forms a liquid-liquid interface instantly in a micro-channel, and then the interface collapses gradually through molecular diffusion with the residence times. The chemiluminescence from the singlet oxygen was emitted in the course of the collapse of the interface under laminar flow condition. The chemiluminescence intensity was observed continuously and stably in the micro-channel as long as the reagents were fed into the channel. We examined the features of the chemiluminescence emitted in the micro-channel by changing the flow rates of reagents and the detection points in the micro-channel. The data obtained were considered along with the residence times and diffusion lengths. We also examined the effects of antioxidants, such as sodium azide, histidine, nitroblue tetrazolium, and 2-propanol on the chemiluminescence intensity.


Clinical features associated with a delayed diagnosis of cystic fibrosis.
The majority of patients with cystic fibrosis (CF) are diagnosed in the first decade of life. In a small number of patients, the diagnosis is not made until later. In this study, the clinical and genetic features of patients diagnosed after the age of 10 were examined. All living patients in Northern Ireland diagnosed prior to 1983, when neonatal screening was introduced, were studied. A total of 103 patients were identified of whom 18 were diagnosed after the age of 10. The relationships between late diagnosis and clinical presentation, sputum microbiology, pancreatic sufficiency, nutritional status, genotype and distance from the regional CF centres was determined by multiple regression analysis. All 18 late-diagnosed patients had a sweat (chloride >70 mmol/l). Late diagnosis was significantly related to carriage of the R117H mutation (r(2) = 0.45) and pancreatic sufficiency (r(2) = 0.37). There was a weak relationship with pulmonary function (r(2) = 0.09). In Northern Ireland, late diagnosis in mainly associated with pancreatic function and carriage of the R117H mutation.


Benefits of a laparoscopic approach for second colorectal resection after colectomy or proctectomy -a retrospective study.
A laparoscopic approach generally provides several benefits in patients who undergo colon or rectal surgery without jeopardizing oncological outcomes. However, there is a paucity of studies on comparative outcomes of laparoscopic versus open approaches for second primary colorectal lesions after colectomy or proctectomy. From patients with colorectal disease who underwent surgery between 2008 and 2022 at our hospital, we collected 69 consecutive patients who had previous colorectal surgery for this retrospective study. Based on the second surgery approach (laparoscopic or open), patients were classified into the Lap (n = 37) or Op group (n = 32). Patients' baseline data and perioperative and postoperative outcomes were compared between the two groups. Four patients (11%) of the Lap group needed conversion to laparotomy. The intraoperative blood loss was lower in the Lap group than the Op group (median: 45 ml vs. 205 ml, p = 0.001). The time to first bowel movement was shorter in the Lap group than the Op group (median: 2.8 days vs. 3.6 days, p = 0.007). The operative time, frequencies of postoperative morbidities, and overall survival did not differ between the two groups. Laparoscopic surgery appeared feasible and beneficial for selected patients undergoing second colorectal resection after colectomy or proctectomy regarding blood loss and bowel function recovery without affecting other outcomes.


NS1: A corner piece in the dengue pathogenesis puzzle?
Soluble dengue virus NS1 protein induces proinflammatory immune responses via Toll-like receptor 4 and disrupts endothelial cell integrity, resulting in vascular leakage (Beatty et al. and Modhiran et al., this issue).


Enhancing effect of platelet-derived microvesicles on the invasive potential of breast cancer cells.
Platelets (PLTs) have been postulated to play a role in cancer progression and metastasis. Recently, it was demonstrated that PLT-derived microvesicles (PMVs) transfer various surface receptors and/or adhesion molecules to target cells and modulate their biological responses. In this work, it was hypothesized that PMVs interact with breast cancer cells, increasing their invasiveness. PMVs (isolated from outdated PLT concentrates) were incubated with three human breast cancer cell lines (MDA-MB-231, BT-549, and T47D), and their effects on in vitro invasiveness of these cells (adhesion, expression of matrix metalloproteinases [MMPs], and chemoinvasion), as well as their interactions with stroma, were evaluated. We found that PMVs 1) transferred PLT-derived integrin CD41 to the surface of breast cancer cells and enhanced their adhesion to endothelial cells; 2) increased CXCR4 expression and chemotaxis toward a stromal-derived factor-1 gradient in invasive MDA-231 and BT-549 cells; 3) increased phosphorylation of the mitogen-activated protein kinase p42/44 and AKT signaling pathways; 4) stimulated the production of MMPs in invasive MDA-231 and BT-549 cells and their chemoinvasion across the reconstituted basement membrane Matrigel; and 5) induced the secretion of MMP-9 by marrow fibroblasts and stimulated the secretion of both MMP-2 and MMP-9 in cocultures of fibroblasts with MDA-MB-231 cells. It was shown than PMVs enhance the in vitro invasive potential of invasive breast cancer cell lines and therefore could mediate the progression of breast cancer. These findings warrant further evaluation of the implications of PLT transfusions in cancer patients.


Rapid and specific RIA of serum estrone sulfate with selective solid phase extraction.
The methods commonly used to evaluate conjugated steroids require hydrolysis and chromatographic purification. To avoid these steps, a simple method involving selective solid phase extraction and RIA using a highly specific antiserum for estrone sulfate (E1S) has been evolved. A Bond-Elut C2 cartridge was used for solid phase extraction of estrone (E1) and E1S; recoveries were 80 and 90% respectively. The intra- and inter assay precision of the assay at 3 serum levels, were 6.5, 10.4 and 4.4 and 12.7, 13.9 and 7.4% respectively. Accuracy, tested by linearity and recovery tests, was acceptable. A good correlation exists between a conventional enzymatic method and the proposed method. The latter is less time consuming and more reliable, thus providing a rapid assay to evaluate E1 and E1S in the same serum sample.


Decreasing incidence of type 2 diabetes mellitus in the United States, 2007-2012: Epidemiologic findings from a large US claims database.
To explore epidemiological trends in type 2 diabetes mellitus (T2D) in the US between 2007 and 2012 using a large US claims database, with a particular focus on demographics, prevalence, newly-diagnosed cases, and comorbidities. Truven Health MarketScan® Databases were used to identify patients with claims evidence of T2D in the years 2007 and 2012. Newly-diagnosed T2D was characterized by an absence of any T2D claims or related drug claims for 6months preceding the index claim. Demographic and comorbidity characteristics of the prevalent and new-onset T2D groups were compared and analyzed descriptively for trends over time. The overall prevalence of T2D remained stable from 2007 (1.24 million cases/15.07 million enrolled; 8.2%) to 2012 (2.04 million cases/24.52 million enrolled; 8.3%), while the percentage of newly-diagnosed cases fell dramatically from 2007 (152,252 cases; 1.1%) to 2012 (147,011 cases; 0.65%). The mean age of patients with prevalent T2D was similar in 2007 (60.6y) and 2012 (60.0y), while the mean age of newly-diagnosed T2D patients decreased by 3years from 2007 (57.7y) to 2012 (54.8y). Hypertension and hyperlipidemia were the most common comorbidities, evident in 50-75% of T2D patients, and increased markedly from 2007 to 2012 in both prevalent and new-onset T2D populations. Cardiovascular disease decreased slightly in prevalent (-0.9%) and new-onset (-2.8%) cases. This large US health claims database analysis suggests stabilization in prevalence and declining incidence of T2D over a recent 5-year period, a downward shift in age at T2D diagnosis, but increases in several comorbidities.


What is the impact of ferroptosis on diabetic cardiomyopathy: a systematic review.
Iron overload increases the production of harmful reactive oxygen species in the Fenton reaction, which causes oxidative stress in the body and lipid peroxidation in the cell membrane, and eventually leads to ferroptosis. Diabetes is associated with increased intracellular oxidative stress, inflammation, autophagy, microRNA alterations, and advanced glycation end products (AGEs), which cause cardiac remodeling and cardiac diastolic contractile dysfunction, leading to the development of diabetic cardiomyopathy (DCM). While these factors are also closely associated with ferroptosis, more and more studies have shown that iron-mediated ferroptosis is an important causative factor in DCM. In order to gain fresh insights into the functions of ferroptosis in DCM, this review methodically summarizes the traits and mechanisms connected with ferroptosis and DCM.


Are segmentectomy and lobectomy comparable in terms of curative intent for early stage non-small cell lung cancer?
In 1995, Ginsberg et al. compared lobectomy with limited resection including segmentectomy and wide-wedge resection for stage I lung cancer in a randomized controlled trial and found that limited resection should not be applied to otherwise healthy patients with clinical stage IA lung cancer who can tolerate lobectomy. However, recent advances in diagnostic technology have improved the precision of detecting early-stage and small lung cancers. Therefore, whether radical segmentectomy, anatomical segmentectomy with hilar and mediastinal lymph node dissection (that is more valuable than wedge resection in terms of oncological aspects) and lobectomy are comparable in terms of curative intent for patients with early-stage non-small cell lung cancer (NSCLC) remains controversial. The role of segmentectomy differs according to tumor or patient characteristics. High resolution computed tomography findings of tumor size, location, and the presence or ratio of a ground glass opacity (GGO) component and the maximum of standardized uptake value on fluorine-18-2-deoxy-D-glucose positron emission tomography are important for selecting surgical procedures because the malignant potential of even early-stage NSCLC is variable. The ongoing JCOG0802/WJOG4607L, JCOG1211, and CALGB140503 trials will disclose the influence of segmentectomy for patients with early-staged NSCLCs that are small peripheral tumors based on preoperative high-resolution computed tomography findings about preserved pulmonary function and long-term prognosis. Segmentectomy is a key surgical procedure that general thoracic surgeons will need to master considering that it can be converted to lobectomy if the surgical margin is insufficient or lymph node metastasis is intraoperatively confirmed.


Negative control of the poly(A)-binding protein mRNA translation is mediated by the adenine-rich region of its 5'-untranslated region.
Translation of the mRNA for the poly(A)-binding protein (PABP) may be autoregulated by the binding of PABP to the A-rich segment of its 5'-untranslated region (UTR). To test this hypothesis, we examined the effect of different fragments of the 5'-UTR from human PABP cDNA on the translation of the beta-galactosidase (beta-Gal) reporter gene. Presence of the A-rich sequence from the 5'-UTR of PABP mRNA inhibited expression of the chimeric beta-Gal gene in transfected HeLa cells. The differences in expression of beta-Gal polypeptide was due to the translational repression of beta-Gal mRNA containing the A-rich 5'-UTR of PABP mRNA. The A-rich region of the 5'-UTR located within nucleotides 58-146 of PABP mRNA was sufficient to mediate translational control of this mRNA expression. We also examined the effect of overexpression of PABP mRNA in HeLa cells. The ectopic PABP mRNA without the A-rich 5'-UTR region was translated efficiently, whereas the translation of the endogenous PABP mRNA was substantially inhibited in the transfected cells. In contrast, the ectopic PABP mRNA containing the A-rich 5'-UTR region did not show similar effect on the translation of the endogenous PABP mRNA in these cells. These results suggest that feedback control of mRNA translation is involved in regulating PABP expression in HeLa cells.


Electron spin resonance (esr) investigations on blood of patients with leukemia.
ESR investigations of lyophilized blood of patients with acute lymphatic leukemia exhibit an increase in spin concentration and an additional peak not present in control samples. This peak disappears almost completely concomittantly with a reduction in spin concentration after treating the patients with prednisolone, vincristine, and doxorubicin or after addition of 5mM of CuCl2 to blood samples. The results show that the ESR spectra of lyophilized blood samples can be utilized to follow the effect of therapy. Moreover, they suggest that the leukemic blood possesses a high concentration of antioxidants.


Development and validation of CAPS and AFLP markers for white rust resistance gene in Brassica juncea.
White rust, caused by Albugo candida, is a very serious disease in crucifers. In Indian mustard (Brassica juncea), it can cause a yield loss to the extent of 89.9%. The locus Ac2(t) controlling resistance to white rust in BEC-144, an exotic accession of mustard, was mapped using RAPD markers. In the present study, we developed: (1) a more tightly linked marker for the white rust resistance gene, using AFLP in conjunction with bulk segregant analysis, and (2) a PCR-based cleaved amplified polymorphic sequence (CAPS) marker for the closely linked RAPD marker, OPB06(1000). The data obtained on 94 RILs revealed that the CAPS marker for OPB06(1000) and the AFLP marker E-ACC/M-CAA(350) flank the Ac2(t) gene at 3.8 cM and 6.7 cM, respectively. Validation of the CAPS marker in two different F(2) populations of crosses Varuna x BEC-144 and Varuna x BEC-286 was also undertaken, which established its utility in marker-assisted selection (MAS) for white rust resistance. The use of both flanking markers in MAS would allow only 0.25% misclassification and thus provide greater efficiency to selection.


Morally-Relevant Similarities and Differences Between Assisted Dying Practices in Paradigm and Non-Paradigm Circumstances: Could They Inform Regulatory Decisions?
There has been contentious debate over the years about whether there are morally relevant similarities and differences between the three practices of continuous deep sedation until death, physician-assisted suicide, and voluntary euthanasia. Surprisingly little academic attention has been paid to a comparison of the uses of these practices in the two types of circumstances in which they are typically performed. A comparative domains of ethics analysis methodological approach is used in the paper to compare 1) the use of the three practices in paradigm circumstances, and 2) the use of the practices in paradigm circumstances to their use in non-paradigm circumstances. The analytical outcomes suggest that a bright moral line cannot be demonstrated between any two of the practices in paradigm circumstances, and that there are significant, morally-relevant distinctions between their use in paradigm and non-paradigm circumstances. A thought experiment is employed to illustrate how these outcomes could possibly inform the decisions of hypothetical deliberators who are engaged in the collaborative development of assisted dying regulatory frameworks.


Characterisation of kinase-selective inhibitors by chemical proteomics.
Low-molecular-weight inhibitors of protein kinases are extensively used as research tools in signal transduction analysis and constitute a rapidly growing class of therapeutics for targeted intervention in human diseases. To determine how kinase-selective drugs interfere with cellular physiology on the molecular level, experimental strategies relying on the affinity capture of cellular targets in combination with protein identification by mass spectrometry have been established for a variety of kinase inhibitors. Importantly, these chemical proteomic methods permit the direct analysis of kinase inhibitor selectivity in biological systems and have led to new insights into the cellular modes of action of kinase-selective small molecule antagonists.


Treatment Strategies for Congenital Diaphragmatic Hernia: Change Sometimes Comes Bearing Gifts.
To report treatment strategies' evolution and its impact on congenital diaphragmatic hernia (CDH) outcome. Registry-based cohort study using the CDH Study Group database, 1995-2013. International multicenter database. CDH patients entered into the registry. Late presenters or patients with very incomplete data were excluded. Patients were divided into three Eras (1995-2000; 2001-2006; 2007-2013). Treatment strategies and outcomes. One-way ANOVA, X2 test, and X2 test for trend were used. A Sydak-adjusted p < 0.0027 was considered significant. Prevalence or mean (SE) are reported. Patients: 8,603; included: 7,716; Era I: 2,146; Era II: 2,572; Era III: 2,998. From Era I to Era III, significant changes happened. Some severity indicators such as gestational age, prevalence of prenatal diagnosis, and inborn patients significantly worsened. Also, treatment strategies such as the use of prenatal steroids and inhaled nitric oxide, age at operation, prevalence of minimal access surgery, and the use of surfactant significantly changed. Finally, length of hospital stay became significantly longer and survival to discharge slightly but significantly improved, from 67.7 to 71.4% (p for trend 0.0019). Treatment strategies for patients registered since 1995 in the CDH Study Group significantly changed. Survival to discharge slightly but significantly improved.


Micrographic Surgery and Dermatologic Oncology Fellowship Selection Criteria.
Obtaining a fellowship position for Micrographic Surgery and Dermatologic Oncology (MSDO) is becoming very competitive. Applicant qualities desired by MSDO fellowship directors have not been previously explored in a systematic way. To characterize the prevailing practices of selecting MSDO fellows. Cross-sectional study based on an anonymous online survey of MSDO fellowship directors. There were 34 completed surveys. Selection criteria with the highest importance to fellowship directors were the ability to work well and get along with others, interview, work ethic, and letter of recommendation from the Mohs micrographic surgery director at the applicant's residency. The criteria with the lowest importance were advanced degrees, medical licensing examination scores, and membership in Alpha Omega Alpha. Specific applicant factors that were looked upon most positively by fellowship directors include applicant from own institution and applicant's personal reasons and circumstances, whereas factors that were most unfavorable include applicant's desire to practice in the same city/area as the fellowship location and graduate of foreign medical school. Although variations existed, MSDO fellowship directors collectively placed greater importance on criteria that reflect interpersonal skills than on objective measures of academic performance, which highlights the importance of "fit."


Are there any gender differences in frequency of self-reported somatic symptoms of depression?
The purpose of this study was to evaluate whether self-reported somatic symptoms of depression, as measured by the Beck Depression Inventory-II (BDI-II), are more frequent in women than in men with major depressive disorder. A sample of 105 male and 105 female adult psychiatric outpatients diagnosed with major depressive disorder was classified according to endorsed changes in appetite, changes in sleeping pattern, and fatigue (i.e., "somatic depression") symptoms on the BDI-II. The female to male ratio of somatic symptoms was approximately 2:1. Subsequent analyses found that change in appetite robustly distinguished between women and men and that fatigue partially distinguished between women and men. The sample was largely Caucasian and composed of patients with high rates of comorbidity who presented to a service known for specializing in cognitive therapy. In outpatients with major depressive disorder, the higher prevalence of "somatic depression" in women is largely attributable to changes in appetite.


A cross-sectional investigation of disfluencies in typically developing Spanish-English bilingual children.
This study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children. A cross-sectional sample of 106 bilingual children (50 boys; 56 girls) enrolled in kindergarten through Grade 4, produced a total of 212 narrative retell language samples in English and Spanish. A specialized fluency coding system was implemented to index the percentage of total (%TD) and stuttering-like disfluencies (%SLD) in each language. Large-scale reference databases were used to classify children's dual language proficiency profiles (balanced, English dominant, Spanish dominant) based on language sample analysis measures of morphosyntax and lexical diversity. The bilingual Spanish-English children in this study did not demonstrate significant cross-linguistic differences for mean %TD or %SLD. However, the mean %TD and %SLD in both languages exceeded the risk threshold based on monolingual English-speaking norms. English dominant bilingual children demonstrated significantly lower %TD in English than Spanish. Spanish dominant children demonstrated significantly lower %SLD in Spanish than English. This study included the largest sample size of bilingual Spanish-English children investigated to date from a fluency perspective. The frequency of disfluencies was found to be variable across participants and change dynamically as a function of grade and dual language proficiency profiles, indicating the need for studies that employ larger sample sizes and longitudinal designs.


Antireflux operations without catheter.
Forty-three patients are presented in whom 80 ureters were transplanted by Cohen's method without leaving a catheter in the bladder. No complications were observed and the incidence of urinary tract infection and dysuria was lower. The late results of the operation were good in every case.


[Possible development of pulmonary scar cancers in patients with pulmonary fibrosis due to cytostatica and X-ray therapy (case-study) (author's transl)].
In two patients with chronic pulmonary fibrosis their history and findings of autopsy suggested, that X-ray therapy in a 31-year old male and Cytostatica-drug therapy in a 52 years old female have had an influence to development of a scar cancer. These cases are discussed with informations of the literature.


Cognition and resective surgery for diffuse infiltrative glioma: an overview.
Compared to classical oncological outcome measures such as time to progression and survival, the importance of cognitive functioning in patients with diffuse infiltrative brain tumors has only recently been recognized. Apart from the relatively low incidence and the invariably fatal outcome of gliomas, the general assumption that cognitive assessment is time-consuming and burdensome contributes to this notion. Our understanding of the effects of brain surgery on cognition, for instance, is largely based on studies in surgical patients with refractory epilepsy, with only a limited number of studies in surgical patients with gliomas. The impact of other factors affecting cognition in glioma patients such as direct tumor effects, radiotherapy and chemotherapy, and medical treatment, including anti-epileptic drugs and steroids, have been studied more extensively. The purpose of this paper is to provide an overview of cognition in patients with diffuse infiltrative gliomas and the impact of resective surgery as well as other tumor and treatment-related factors.


Crystallization and preliminary X-ray studies of Bacillus pumilus IPO xylanase.
The xylan-degrading enzyme xylanase, from Bacillus pumilus IPO, has been crystallized. The crystals are monoclinic, space group P21 with a = 40.8 A, b = 66.8 A, c = 34.7 A and beta = 103.0 degrees. The asymmetric unit contains one molecule of Mr 22,500. The crystals diffract to at least 2.5 A resolution, and they are suitable for X-ray crystal structure analysis at high resolution.


Congenital Malaria in Newborns Delivered to Malaria-infected Mothers in the Hilly Region of Northern India: Is it Deadly?
Malaria is endemic in many states of India. Though there are reports of maternal and congenital malaria from endemic areas, however, there remains a paucity of data from hilly terrains. The present study evaluated the prevalence, clinical and microbiological spectrum of maternal and congenital malaria at a tertiary health care facility in Northern India over a period of 18 months. In this observational study, mothers along with their newborns were evaluated for malaria by maternal, placental, and cord blood smear examination and rapid point-of-care diagnostic serological tests. Positive cases were confirmed by polymerase chain reaction. Mother-newborn duos were followed up till discharge from the hospital. A total of 843 mothers delivered during the study period and were screened along with their newborns and placentae. A total of Ten (1.18%) mothers had evidence of malarial parasitemia (Plasmodium vivax, n=7 and Pl. falciparum, n=3), however, none of the placental and cord blood samples were positive for malaria. Overall, 127 (15.1%) neonates required admission in neonatal intensive care unit for various morbidities. Incidence of small for gestational age (SGA) was high (n=210; 24.9%). Multivariate logistic regression analysis demonstrated maternal malaria to be an independent contributor for SGA [Odds Ratio (95% Confidence Interval), 10.7 (2.06 - 49.72)]. However, only 2% variance of SGA could be explained by maternal malaria alone. We report an encouragingly lower incidence of maternal malaria in mothers attending for delivery and a 'Zero' incidence for placental and congenital malaria during the study period as compared to national data (upto 7.4% in non-immune mothers), although maternal malaria could be a causative factor for SGA.


[Healthy nutrition - prerequisite for life enjoyment and quality of life].
Bad nutritional habits can cause or enhance various, especially chronic, diseases. The right amount of calories, an adequate composition and the distribution of the meals over the day are the basis of good nutrition. A coordinating office could improve the information of our population, since many different professions must cooperate. Nutritions education must be improved. Industry, professional organisations, nutritionists, consumer organisations and specialists for communication must cooperate to solve the difficult problem of nutritional habits and to demonstrate that good nutrition can--as the gastrotonomy of the future--help to enjoy life.


Persistent downregulation of hippocampal CREB mRNA parallels a Y-maze deficit in adolescent rats following semi-chronic amphetamine administration.
We investigated possible differences in the impact of chronic amphetamine administration during adolescence and adulthood on aspects of behaviour and brain chemistry. Adult (n=32) and adolescent (n=32) male Sprague-Dawley rats were given either D-amphetamine sulphate (10 mg kg(-1) daily, i.p.) or saline (1 mL kg(-1), i.p.) for 10 days. Rats were subsequently tested for anxiety-like behaviour, learning and memory, and sensorimotor gating. Nine weeks later, rats received saline (1 mL kg(-1)) or acute amphetamine challenge (1.5 mg kg(-1)) and the expression levels of mRNA for tyrosine kinase B (TrkB) or cAMP response element-binding protein (CREB) were measured in the hippocampus. The adolescent amphetamine pretreated group revealed a deficit in exploration on the Y-maze during a 6 h retention test. The frequency of visits to the novel arm was 35% lower for the amphetamine group compared with controls. In parallel, a 43% decrease in hippocampal CREB mRNA, but not TrkB mRNA, was observed in periadolescent rats treated chronically with amphetamine 9 weeks earlier. None of the effects were detected in the adult treated cohort. Chronic amphetamine treatment during periadolescence resulted in altered behaviour on the Y-maze and persistent downregulation of hippocampal CREB mRNA expression. Given that this group had intact spatial learning and reference memory, it would appear that the deficits observed on the Y-maze reflect a dysfunction in response to novelty. Because no effects of amphetamine treatment were observed in the adult cohort, these data suggest idiosyncratic sensitivity of periadolescence to the long-term effects of psychostimulants.


[Alcohol withdrawal delirium: What's new for an old disease?]
The management of alcohol withdrawal syndrome is a frequent work in both community medicine and hospital wards. One of the most severe complications of alcohol withdrawal is Delirium Tremens (DT). The purpose of this development is to update knowledge on this complication in terms of diagnosis, evaluation and therapeutic approaches. It also proposes a reflection on the trajectory of care during and after DT.


Autophagy and Akt-mTOR signaling display periodic oscillations during torpor-arousal cycles in oxidative skeletal muscle of Daurian ground squirrels (Spermophilus dauricus).
Whether hibernation accelerates or suppresses autophagy is still unknown. In the current study, we examined changes in autophagy in oxidative soleus (SOL) muscle in summer active (SA), pre-hibernation (PRE), torpor (TOR), interbout arousal (IBA), and post-hibernation groups of Daurian ground squirrels (Spermophilus dauricus). Here, the SOL muscle showed no significant atrophy during hibernation in regard to muscle wet weight, fiber cross-sectional area, or MuRF1 protein level. Autophagy-related proteins beclin1 and Atg7 increased significantly, whereas LC3-II decreased significantly in the PRE group compared with the SA group. However, neither the expression nor activity of cathepsin L showed any differences between the SA and PRE groups. In addition, beclin1, LC3-II, and the LC3-II/LC3-I ratio increased, p62 decreased, LC3 puncta increased, p62 puncta decreased, and cathepsin L activity increased in the TOR group compared with the PRE group. In contrast, beclin1, LC3-II, and the LC3-II/LC3-I ratio decreased, p62 increased, LC3 puncta decreased, p62 puncta increased, and cathepsin L activity declined in the IBA group compared with the TOR group. Moreover, the phosphorylation of Akt (Ser473) and mTOR (Ser2448) changed significantly during hibernation and showed an inverse relationship with autophagy changes. In conclusion, autophagy proteins displayed periodic oscillation in the torpor-arousal cycle, which may be advantageous in maintaining SOL muscle mass during the entire hibernation period. Furthermore, the Akt-mTOR signaling was decreased in TOR and increased in IBA group in the SOL muscle of Daurian ground squirrels during hibernation.


Rapid discrimination of the identity of infant formula by triple-channel models.
Infant formula is related to children's life and health. However, the existing identification methods for infant formula are time-consuming, costly and prone to environmental pollution. Therefore, a simple, efficient and less polluting identification method for infant formula is urgently needed. The aim of this study was to distinguish between goat and cow infant formula using HS-SPME-GC-MS and E-nose combined with triple-channel models. The results indicated that the main difference of them attributed to thirteen volatile compounds and three sensor variables. Based on this, the linear discriminant and partial least squares discriminant analyses were conducted, and a multilayer perceptron neural network model was constructed to identify the commercial samples. There was a high percentage of correct classifications (>90%) in samples. Together, our work demonstrated that the volatile compounds of infant formula combined with chemometric analysis were effective and rapid for detecting two infant formulas.


Familial double testicular tumors: identical chromosome changes in seminoma and embryonal carcinoma of the same testis.
An identical abnormal chromosome, i(12p), and a marker chromosome of unknown origin were seen in 2 tumors of different histology (seminoma and embryonal carcinoma) in the same testis. A younger brother of the patient also had undergone orchiectomy for 2 seminomas in the left testis 2 years previously. These findings are discussed in relation to the possible cellular background of testicular tumors and their genetic parameters.


Clinical course and prognostic factors in patients with malignant pheochromocytoma and paraganglioma: A single institution experience.
Malignant pheochromocytoma (PCC)/paraganglioma (PG) are rare neuroendocrine malignancies, and their clinical courses and prognoses are not well understood. This study aimed to evaluate prognostic factors associated with the survival of malignant PCC/PG. This retrospective study reviewed 299 patients with PCC and 46 with PG treated between 1997 and 2013 at our single tertiary hospital. Malignant PCC/PG was defined as the presence of distant metastasis or recurrence at sites where neuroendocrine tissue is normally not present. Twenty-seven patients (9%) were confirmed with malignant PCC and six patients (13%) with malignant PG. Twenty-seven patients (82%) had distant metastases, nine patients (27%) presented with a metastasis at the initial diagnosis, whilst 24 patients (73%) were diagnosed with malignant PCC/PG during follow-up (median, 4.3 year). The median survival was 7.2 years, and the 5 year survival rate was 75.4%. Older age (>45 years), larger tumor size (>6 cm), synchronous metastasis, and absence of surgical excision were associated with poor survival by univariate analysis. By multivariate analysis, older age (HR = 4.3, P = 0.02) and synchronous metastasis (HR = 4.3, P = 0.01) were significantly associated with a poor prognosis. Patients with malignant PCC/PG have diverse clinical courses. Poor survival was independently associated with older age and synchronous metastasis.


The effect of epinephrine on tracheal fluid flow and surfactant efflux in fetal sheep.
A marked decrease in fetal tracheal fluid flow and an increase in pulmonary surfactant efflux were found after infusion of epinephrine into fetal sheep. The data suggest that endogenous catecholamines may play a role in preparing the fetal lung for birth.


CITRX thioredoxin is a putative adaptor protein connecting Cf-9 and the ACIK1 protein kinase during the Cf-9/Avr9- induced defence response.
Tomato Cf-9, a receptor-like protein (RLP), confers resistance to races of the fungal pathogen Cladosporium fulvum that express the Avr9 avirulence gene. CITRX (Cf-9-interacting thioredoxin) was previously identified in a yeast two-hybrid screen as a protein interacting with the cytoplasmic domain of Cf-9 and shown to be a negative regulator of the cell death induced after Cf-9/Avr9 interaction. ACIK1 is a Ser/Thr protein kinase that is specifically required for the Cf-9 and Cf-4 dependent defence response in tomato. In this paper we present data suggesting that CITRX may act as an adaptor recruiting the ACIK1 kinase to the cytoplasmic domain of Cf-9 upon elicitation with the Avr9 peptide. Interestingly, the catalytic activities of both CITRX and ACIK1 are not required for their interaction.