2016-04-04T04-18-37Z
Source: International Journal of Current Research and Review
Tahia H. Saleem, Mohammed H. Hassan, Zeinab M. Mohey El Deen, Ahmed El-Abd Ahmed, Abdallah M. A.A. El-Ebidi, Heba M. Qubaisy, Omayma A. Hasan.
Introduction: Stroke and cerebrovascular disorders are already amongst the top 10 causes of childhood death. Patients with homocysteinemia may present with vascular thrombotic events, with or without the traditional risk factors for a stroke. Objectives: The aim of this study was to measure plasma homocysteine levels and lipid profile (serum cholesterol, triglycerides, HDL and calculation of LDL) in pediatric patients with ischemic or hemorrhagic stroke. Assess the role of homocysteinemia as an associated risk factor in pediatric ischemic stroke. Correlate the results with the clinical data of the patients. Materials and Methods: Across-sectional case control study was carried out on 60 pediatric patients, divided into two groups: group A contained 30 pediatric patients with ischemic stroke and group B contained 30 pediatric patients with hemorrhagic stroke, they were recruited from outpatient clinics or admitted to PICU (pediatric intensive care unit) in Assiut university children hospital and Qena university hospital, Upper Egypt, after approval of the university hospital ethical committee. The control group group C contained 30 healthy age and sex matched subjects. Biochemical assay of plasma homocysteine and lipid profile among the previously mentioned groups were done. Results: The plasma homocysteine level showed statistically significantly higher levels among group A when compared with group B and group C (P-Value 0.0001). There was no significant difference in plasma homocysteine among group B when compared with group C (P-Value 0.9). Regarding the lipid profile assay in the studied groups, serum triglyceride level, cholesterol and low density lipoprotein (LDL) were significantly high among group A in comparison with group B and group C (P-Value
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 4 Απριλίου 2016
BIOCHEMICAL ASSESSMENT OF HOMOCYSTEINE AND LIPID PROFILE IN PEDIATRIC STROKE: AN EGYPTIAN STUDY
EVALUATION OF THE EFFECTS OF PH AND TEMPERATURE ON THE ADSORPTION ISOTHERM OF ACTIVATED MEDICOAL FROM NIGERIA PLANTS. MAGNIFERAINDICA, PERSEAGRATISSIMA AND PSIDIUMGUAJAVA
2016-04-04T04-18-37Z
Source: International Journal of Current Research and Review
Edwin N. Oguegbulu, Emmanuel A. Nwokeboth.
Activated charcoal, also referred to as medicoal is known to be a versatile tool in the field of Pharmaceutical Medicine. This was successfully prepared from the stem parts of Mangiferaindica (Mango), Psidiumguajava (Guava) and Perseagratissima (Avagado pear) by process of carbonization and thermal activation. Liquid phase study was conducted using Freundlich isotherm model to evaluate the equilibrium adsorption data generated for methylene blue (MB) sulphanephthalein dye stuff on activated medicoal test samples. Ultra violet spectroscopic method was used to assess the effect of variation of pH and temperatures on the adsorption profile of all the medical samples, including the commercially available standard. The results were found to be statistically significant using the one-tail analysis of variance (ANOVA) at confidence interval of p ≤ 0.05. The research showed that the availability of negatively charged groups at the adsorbent surface is necessary for the adsorption of alkaline dye - stuff, thus the pH increase resulted to an increase in adsorption. The investigation also indicated that adsorption of locally sourced medicoal increases with temperature. The adsorption pattern of Perseagratissima compared favorably with that of the commercially available standard whereas Psidiumguajava ranked lowest.
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CORRELATION BETWEEN BMI AND ARTERIAL STIFFNESS IN MIDDLE AGED SUBJECTS
2016-04-04T04-18-37Z
Source: International Journal of Current Research and Review
Niruba R., T. Kannan Kumar, Subha K. C., Vijiyalakshmi.
Background: World wide prevalence of obesity has reached a pandemic proportion. Obesity and Arterial wall stiffness are independent predictors of cardiovascular diseases. We aimed to investigate how BMI affects arterial stiffness. Noninvasive method of measuring arterial stiffness can be applied to assess the elasticity of the vessel wall and reduce the cardiovascular morbidity. Study Design: Cross sectional observational study. Materials and Methods: Subjects n= 50 males, Age group 35-45 years. All participants had a sedentary life style, blood pressure and glycemic status were within normal limits. Subjects with history of peripheral vascular disease, smokers and any other illness that affects arterial compliance were excluded . Arterial stiffness was assessed from Augmentation index (AI) and stiffness index (SI). AI and SI was measured using IR1 model digital finger tip photo pulse plethysmograph. Results: Mean age = 38±2 years, Mean BMI = 26± 3, Mean Stiffness index = 7.4 ±1.4 m/s, Mean Augmentation index= 48 ±2.8 %.Pearson correlation was applied .BMI correlated positively with both augmentation index and stiffness index with r value is +0.437 and + 0.564 respectively. Conclusion: In our study both large and small artery stiffness were assessed. There was increase in arterial wall stiffness with increase in BMI. We conclude obesity affects arterial compliance, which might be the consequences of metabolic regulation, inflammatory pathways and other mechanisms
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ANGIOLIPOMA CAUSING COLOCOLIC INTUSSUSCEPTION: A RARE CASE REPORT
2016-04-04T04-18-37Z
Source: International Journal of Current Research and Review
M. Ganesan, A. Ajay Raja, A. Avinash.
Intussusception is defined as the telescoping of proximal segment of intestine into a distal segment of intestine. Intussusception is usually idiopathic, without an obvious anatomic lead point. Colocolic intussusception due to angiolipoma is very uncommon on the left side of the colon. The disease is diagnosed often late following disease progression which is attributed to its indolent course and its non specific symptomology. This cases is presented for its rarity.
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Acute ischemic lung injury due to pulmonary vascular obstruction
Abstract
Aim of the study
We have encountered cases of a distinctive myxomatous alveolar wall thickening around pulmonary infarctions and have termed it acute ischemic lung injury (AILI). In this study we determined if pulmonary infarction is the only cause of AILI and have elucidated its histological features.
Materials and Methods
We examined 2941 cases that underwent lobectomy, surgical lung biopsies for nodular lesions, or autopsies between 1994 and 2014. Cases were divided into pulmonary infarction and non-infarction groups. The histological features of AILI sought were lobule-based alveolar wall thickening (myxomatous or fibrous) with epithelial metaplasia and negligible inflammation. In order to further characterize AILI, we performed immunohistochemical staining using several antibodies.
Results
Thirty-four out of 69 cases in the infarction group (mean age 57.1 years, 30 males) had AILI, whereas only 1 (but with vascular obstruction) out of the remaining 2,872 in the non-infraction group had AILI. AILI was located around infarctions. Separation of the epithelial and endothelial basement membranes of the alveolar wall was observed in 75% of cases.
Conclusions
AILI is almost exclusively associated with lung infarction, presumably caused by vascular obstruction. We consider AILI to represent a distinct lung lesion other than pulmonary hemorrhage and infarction.
This article is protected by copyright. All rights reserved.
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A unilateral variation in the flexor digitorum superficialis with two distinct muscle bellies and associated tendons to the ring finger
Publication date: Available online 28 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Noman Saghir, Reyan Saghir, Shahab Shahid, Nadine Hachach-Haram, Kavan Johal, Nilesh Sojitra
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Autologous plasma and its supporting role in fat graft survival: a relevant vector to counteract resorption in lipofilling
Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Filip Stillaert, Bernard Depypere, Maarten Doornaert, David Creytens, Heidi De Clercq, Ria Cornelissen, Stan Monstrey, Phillip Blondeel
Fat grafting has become a widespread technique for different reconstructive and aesthetic purposes. However, the disadvantage of fat grafting is the unpredictable resorption rate that often necessitates repetitive procedures, which in turn may have an impact on the morbidity. During the immediate, post-graft, ischemic period, cells survive due to the process of plasmatic imbibition. This biological phenomenon precedes the ingrowth of neo-capillaries that eventually will nourish the graft and bring it in a homeostatic equilibrium at the long-term. Both partners, the graft and the recipient bed, will have to contribute to the revascularization process. Hypothetically, enrichment of the recipient site with autologous plasma could have a beneficial role to enhance fat graft survival. We investigated whether plasma supported the viability of lipoaspirate (LA) material. Plasma was isolated from a blood sample from 8 patients during elective lipofilling procedures. An in vitro study assessed the viability of LA cells using plasma as a culture medium compared to traditional culture media. In vitro analysis confirmed sustained viability of LA cells compared to standard media and control media during seven consecutive days. The behavior of the fat grafts in plasma showed similarities with those incubated in traditional culture media. In the nearby future, these findings could be translated to a clinical setting. Plasma is the only autologous substrate available in large quantities in the human body. The addition of supporting agents – such as plasma - could contribute to a better graft survival with more stable clinical outcomes at the long-term. The rationale behind the technique is based on the phenomenon of plasmatic imbibition and the reasoning that the extracellular matrix plays a pivotal role in cellular survival.
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Microsurgical Skill Acquisition In A One-day Introductory Course With Performance Evaluation Using Software Assisted Scoring System
Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): C.J. Stewart, S.K.M. Yusoff, D. Widdowson, W.L. Lam
BackgroundRecent emphasis on microsurgical skill acquisition at an earlier stage of plastic surgery training has seen a shift towards objective competence based assessment. Yet no objective measures of spacing or alignment exist, with few validated models that assess ability. The authors propose a novel software analysis scoring system to objectively measure spacing, alignment and overall improvement in a one-day, introductory course setting.MethodsImages of standard 4mm latex strips that had been sutured by participants using the Microtrainer system were uploaded onto calibrated, online software. Sutures were analysed with regards to spacing, alignment and density. From these measurements, a total score was calculated; one on initial assessment at the course beginning (Score 1) and one on final assessment at the course end (Score 2), facilitating measurement of overall improvement.ResultsThirty-eight microsurgical anastomoses from 19 participants ranging from postgraduate years 1-7 were analysed. Seventeen participants had no previous experience of microsurgery. The mean average Score 1 of participants was -2 (range -12 to +22) and Score 2 was 22 (range +12 to +32) showing a significant improvement in candidate ability throughout the course of the day (p < 0.0001).ConclusionsMicrotrainer system software analysis provides a novel, reliable and consistent objective assessment for surgical trainees at all stages of training, without risk to patients. It has an associated cost for initial set-up, yet is timely, repeatable and can efficiently demonstrate progress in a one-day course setting.
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Autologous Fat Grafting in Onco-Plastic Breast Reconstruction; A Systematic Review on Oncological and Radiological safety, Complications, Volume Retention, and Patient/Surgeon Satisfaction
Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): J. Groen, V.L. Negenborn, D.J.W.R. Twisk, PhD. Rizopoulos, J.C.F. Ket, J.M. Smit, M.G. Mullender
ObjectiveThis study aims to give an up-to-date overview of literature on autologous fat grafting (AFG) in onco-plastic breast reconstruction, with regard to complications, oncological and radiological safety, volume retention, and patient/surgeon satisfaction.BackgroundAlthough AFG is increasingly being applied in onco-plastic breast reconstruction, a comprehensive overview of the available evidence of this procedure is still lacking.MethodsA systematic review following the PRISMA statement was conducted. Case series, cohort studies, and RCTs reporting on relevant outcomes of breast reconstruction with supplemental AFG were included.ResultsIn total, 43 studies were included reporting on 6260 patients with a follow-up ranging from 12 to 136 months. The average locoregional and distant oncological recurrence rates after breast reconstruction with AFG were 2.5% (95% CI 1.7–3.7) and 2.0% (95% CI 1.1–3.5). On radiological images fewer cysts and calcifications were seen compared to other types of breast surgery. However, more biopsies were performed based on radiological findings (3.7% vs. 1.6%), and more fat necrosis (9.0% vs. 4.7%) was seen after treatment with AFG. The total complication rate of 8.4% (95% CI 7.6–9.1) is lower than those reported after other reconstructive breast procedures. The mean volume retention was 76.8% (range 44.7%–82.6%) with a satisfaction rate of 93.4% for patients and 90.1% for surgeons.ConclusionsAFG in breast reconstruction is a promising technique. Safety does not seem to be compromised as cancer recurrence and complications are not increased. Whether AFG interferes with radiological follow-up is still open to discussion. Randomized trials with sound methodology are necessary to confirm these cautious conclusions.
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Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study
Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Dennis C. Nguyen, Kamlesh B. Patel, Rajiv P. Parikh, Gary B. Skolnick, Albert S. Woo
IntroductionThis biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release.MethodsPalatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosal off the maxilla; (2) dissection of nasal mucosa from soft palate musculature; (3) separation of nasal mucosa from palatine aponeurosis; (4) release of mucosa at the pterygopalatine junction; (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate and posterior nasal spine following each maneuver were measured.ResultsAt the midpalate, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p=0.72). At the posterior nasal spine, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p<0.001). Maneuver 4 yielded the greatest amount of movement of the lateral nasal mucosa at both the midpalate (4.2 mm, 40.8%) and posterior nasal spine (7.2 mm, 55.8%).ConclusionAt the midpalate, complete release of the lateral nasal mucosa achieves as much movement as the vomer flap. At the hard-soft palate junction, the maneuvers progressively add to the movement of the lateral nasal mucosa. The most powerful step is release of attachments along the posterior aspect of the medial pterygoid.
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Microsurgical Reconstruction of Oncological Scalp Defects in the Elderly
Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Filip Simunovic, Steffen U. Eisenhardt, Vincenzo Penna, Jan R. Thiele, G. Björn Stark, Holger Bannasch
The incidence of scalp tumors requiring radical excision increases with age. Free-flap surgery is the standard reconstructive option for large defects, however there is ongoing uncertainty about its safety in the elderly. We conducted a review of data and report on 19 cases older than 75 and 13 younger than 75 years. Data regarding patient demographics, types of tumors, surgery, size of defect, flaps used and prevalence of complications were analyzed. The patients in the elderly group had more accompanying medical conditions and a higher ASA Score. Squamous cell carcinoma was the predominant tumor in the elderly, and sarcoma in the younger patients. The defect size was similar in both groups. Most commonly used were the latissimus dorsi (LD) and the anterolateral thigh flap (ALT), with temporal vessels used for anastomosis. Surgery lasted longer in the younger patients. There was no difference in the duration of hospital stay. There was no significant correlation between age and the flap-related or medical complications. Revision surgery was more often required in younger patients. We conclude that free flap surgery is safe and reliable in the elderly population. The most commonly used flaps are the LD and the ALT flap. Advanced age should not be considered a risk factor for free flap surgery in these patients.
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Need for Sun cream with your manicure? - Dangers of UV nail dryers
Publication date: Available online 28 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): J. Wilson, J. Maraka
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A role for TENM1 mutations in Congenital General Anosmia
Abstract
Congenital general anosmia (CGA) is a neurological disorder entailing a complete innate inability to sense odors. While the mechanisms underlying vertebrate olfaction have been studied in detail, there are still gaps in our understanding of the molecular genetic basis of innate olfactory disorders. Applying whole-exome sequencing to a family multiply affected with CGA, we identified three members with a rare X-linked missense mutation in the TENM1 (teneurin 1) gene (ENST00000422452:c.C4829T). In Drosophila melanogaster, TENM1 functions in synaptic-partner-matching between axons of olfactory sensory neurons and target projection neurons and is involved in synapse organization in the olfactory system. We used CRISPR-Cas9 system to generate a Tenm1 disrupted mouse model. Tenm1−/− and point-mutated Tenm1A/A adult mice were shown to have an altered ability to locate a buried food pellet. Tenm1A/A mice also displayed an altered ability to sense aversive odors. Results of our study, that describes a new Tenm1 mouse, agree with the hypothesis that TENM1 has a role in olfaction. However, additional studies should be done in larger CGA cohorts, to provide statistical evidence that loss-of-function mutations in TENM1 can solely cause the disease in our and other CGA cases.
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Setting control of completely recyclable concrete with slag and aluminate cements
A completely recyclable concrete (CRC) is designed to have a chemical composition equivalent to the one of general raw materials for cement production. By doing so, this CRC can be used at the end of its service life in cement manufacturing without the need for ingredient adjustments. In one of the designed CRC compositions, blast-furnace slag cement (BFSC) was combined with calcium aluminate cement (CAC), which resulted in fast setting. In an attempt to control this fast setting, different retarders and/or the combination of lime and calcium sulfate were added to the system. The workability (slump and flow), setting time (ultrasonic transmission measurements and Vicat), strength development (compressive strength tests), and hydration behavior (isothermal calorimetry) were studied. It was found that the combined addition of lime and calcium sulfate results in a workable mixture that becomes even more workable if a retarder is also added to the system.
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Liquid crystal devices with continuous phase variation based on high-permittivity thin films
Most liquid crystal devices use transparent conductive electrodes such as indium tin oxide (ITO) to apply a potential difference in order to achieve electro-optic switching. As an alternative, we study a device with narrow metallic electrodes in combination with dielectric layers with large dielectric permittivity. In this approach the applied voltage can be a continuous function of the lateral distance from the electrode line. Simulations for a one-dimensional beam-steering device show that the switching of the liquid crystal (LC) director depends indeed on the distance from the addressing electrodes and on the value of the relative permittivity. We show that in a device with electrodes spaced 60 μm apart, the LC director halfway between the electrodes shows a considerable reorientation, when a dielectric layer with permittivity of r = 550 is used, whereas no reorientation is observed for the uncoated reference sample at the same voltage. An added advantage is that the proposed configuration only contains dielectric materials, without resistive losses, which means that almost no heat is dissipated. This indicates that this technology could be used in low-power LC devices. The results show that using dielectric thin films with high relative permittivity in liquid crystal devices could form a cost-efficient and low-power alternative to many LC technologies where a gradient electric field is desirable.
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Characteristic times in a three scale model with overlapping domain decomposition
A three-scale diffusion model for textiles was given in Goessens et al. (2015): consisting of a fiber, yarn and room model. To analyze and simplify the model, its characteristic times were investigated in Goessens et al. (2015) [8, 9]. At these times the fiber and yarn model, and the yarn and room model, respectively, tend to reach a partial equilibrium concentration. Here an addition will be made to the model based upon the previous work. An overlap zone is considered between the yarn and room level. Then the overlapping domain decomposition technique is used to calculate the exchange of active ingredient from one level to another in this zone. The mass balance for the system with the overlap zone is calculated and tested in C-language.
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E-tweewielers: volwaardig alternatief voor woon-werkverkeer
Het Elmo@work-project liep in de periode 2013-2015. Het onderzocht of elektrische tweewielers een volwaardig transportmiddel kunnen zijn voor werkgerelateerde verplaat-singen. De bedrijven die in het project stapten, boden de werknemers een duurzaam verplaatsingsmiddel aan en droegen bij tot een meer leefbare omgeving. Dit artikel geeft de eindresultaten. Het onderzoek mondde uit in een draaiboek. Dit draaiboek kan werkgevers en werknemers be-geleiden bij de integratie van elektrische bedrijfsfietsen. Met dit draaiboek kunnen ondernemingen, instellingen, gemeenten, intercommunales, politiezones, enzovoort nagaan of elektrische mobiliteit een (deel) oplossing voor hun mobiliteit kan zijn. Het stappenplan kan een implementatie mogelijk maken.
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Stimulating green FTTH networks using home router virtualization
Telecom networks consume a considerable amount of electrical energy and according to the environmental guidelines, just as other businesses, telecom should aim at continuously lowering this consumption. Still in a telecom network a lot of the energy consumption is hidden under the radar, as a large part of the energy consumption is caused by the customer premises equipment (CPE), often installed by the network operator. As this equipment is consuming energy from the customer's side, the telecom operator is not confronted with the energy consumption of this equipment. This also means that the operator gains by any reduction in the cost of the CPE, regardless of whether this involves the installation of less energy efficient equipment. In this paper we investigate the use of a bridged CPE solution and a home router virtualization network solution, in which part of the functionality of a CPE is moved into the network operator equipment and as such reduce the energy consumption by equipment aggregation and specialization. In this paper, we show that this will at the same time reduce costs and as such could be a positive action for the operator, simultaneously reducing the power consumption of the CPE. On top of this bridged CPE, the incentives required to stimulate operators to introduce more energy efficient CPE equipment faster in the network are estimated. Finally, by means of game theory, we propose a method to investigate how the incentives should be placed in order to stimulate green FTTH massive deployments.
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Characteristic times for multiscale diffusion of active ingredients in coated textiles
A three-scale approach for textile models was given in [1]: a one-dimensional fiber model and a room model, with a meso-level in between, which is the yarn scale. To analyse and simplify the model, its characteristic times are investigated here. At these times the fiber and yarn model, and the yarn and room model, respectively, tend to reach an equilibrium concentration. The identification of these characteristic times is key in reducing the model to its variously scaled components when simplifying it.
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Hermitian Veronesean caps
In [J. Schillewaert and H. Van Maldeghem, Quadric Veronesean caps, Discrete Mathematics], a characterization theorem for Veronesean varieties in PG (N, K), with K a skewfield, is proved. This result extends the theorem for the finite case proved in [J. A. Thas and H. Van Maldeghem, Quart. J. Math. 55 (2004), 99-113]. In this paper, we prove analogous results for Hermitian varieties, extending the results obtained in the finite case in [B. Cooperstein, J. A. Thas and H. Van Maldeghem, Forum Math. 16 (2004), 365-381] in a non-trivial way.
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Racial differences in acute kidney injury of hospitalized adults with diabetes
Journal of Diabetes and its Complications
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The association between osteoporotic hip fractures and actinic lesions as a biomarker for cumulative sun exposure in older people—a retrospective case–control study in Argentina
Journal of Bone and Mineral Metabolism
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Facilitators and barriers for effective academic-community collaboration for disaster preparedness and response
Journal of Public Health Management and Practice
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Pharmacokinetics of cefoperazone/sulbactam in critically ill patients receiving continuous venovenous hemofiltration
European Journal of Clinical Pharmacology
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An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness
American Journal of Pharmaceutical Education
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Procalcitonin-guided therapy for the initiation of antibiotics in the emergency department: a systematic review
The American Journal of Emergency Medicine
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Acute pneumonia
Critical Care Nursing Quarterly
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Urgent surgery after emergency presentation for colorectal cancer has no impact on overall and disease-free survival: a propensity score analysis
BMC Cancer
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Mental health outcomes of burn: A longitudinal population-based study of adults hospitalized for burns
Burns
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Neuropsychiatric predictors of post-injury headache after mild-moderate traumatic brain injury in veterans
Headache: The Journal of Head and Face Pain
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Variation in ICU utilization and mortality after blunt splenic injury
Journal of Surgical Research
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A randomized trial of clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated wound infection
Clinical Infectious Diseases
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The Effectiveness of Exercise on Recovery and Clinical Outcomes in Patients With Soft Tissue Injuries of the Hip, Thigh, or Knee: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Journal of Manipulative and Physiological Therapeutics
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The incidence of deep venous thrombosis before arthroscopy among patients suffering from high-energy knee trauma
Knee Surgery, Sports Traumatology, Arthroscopy
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Injury Patterns After the Landslide Disaster in Oshima, Tokyo, Japan on October 16, 2013
Disaster Medicine and Public Health Preparedness
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Single centre experience of combat-related vascular injury in victims of Syrian conflict: Retrospective evaluation of risk factors associated with amputation
Injury
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Threat of secondary chemical contamination of emergency departments and personnel: an uncommon but recurrent problem
Disaster Medicine and Public Health Preparedness
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The prevalence of crash risk factors in a population-based study of motorcycle riders
Injury
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Obturator nerve transfer to the branch of the tibial nerve innervating the gastrocnemius muscle for the treatment of sacral plexus nerve injury
Neurosurgery
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Association of renal stress/damage and filtration biomarkers with subsequent AKI during hospitalization among patients presenting to the emergency department
Clinical Journal of the American Society of Nephrology
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Current outcomes of the bi-directional cavopulmonary anastomosis in single ventricle patients: analysis of risk factors for morbidity and mortality, and suitability for Fontan completion
Objectives: The bi-directional cavopulmonary anastomosis forms an essential staging procedure for univentricular hearts. This review aims to identify risk factors for morbidity, mortality, and suitability for Fontan completion. Methods: A total of 114 patients undergoing cavopulmonary anastomosis between 1992 and 2012 were reviewed to assess primary - mortality and survival to Fontan completion - and secondary outcome endpoints - re-intubation, new drain, and ICU stay. Median age and weight were 8 months and 6.9 kg, respectively. In 83% of patients, 1-3 interventions had preceded. Norwood-type procedures became more prevalent over time. Results: Extubation occurred after a median of 4 hours, median ICU stay was 2 days; 10 patients (8.8%) needed re-intubation and 18 received a new drain. Higher central venous pressure and transpulmonary gradient were risk factors for new drain insertion (p<0.01). Higher pre-operative pulmonary pressure correlated with increased inotropic support and prolonged intubation (p=0.01). Need for re-intubation was significantly affected by younger age at operation (p=0.01). Hospital and pre-Fontan mortality were 11.4 and 5.3%, respectively. Operative mortality was independently affected by younger age (p=0.013), lower weight (p=0.02), longer bypass time (p=0.04), and re-intubation (p=0.004). Interstage mortality was mainly influenced by moderate ventricular function (p=0.03); 82% of survivors underwent or are candidates for Fontan completion. Conclusion: The cavopulmonary anastomosis remains associated with adverse outcomes. Age at operation decreases with rising prevalence of complex univentricular hearts. Considering the important impact of re-intubation on hospital mortality, peri-operative management should focus on optimising cardio-respiratory status. Once this selection step is taken, successful Fontan completion can be expected, provided that ventricular function is maintained.
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Aortopathy associated with congenital heart disease: a current literature review
In patients born with congenital heart disease, dilatation of the aorta is a frequent feature at presentation and during follow-up after surgical intervention. This review provides an overview of the pathologies associated with aortopathy, and discusses the current knowledge on pathophysiology, evolution, and treatment guidelines of the aortic disease associated with congenital heart defects.
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Antiplasmodial activity and phytochemical analysis of extracts from selected Ugandan medicinal plants
Publication date: 20 June 2016
Source:Journal of Ethnopharmacology, Volume 186
Author(s): Madina Mohamed Adia, Seyedeh Noushin Emami, Robert Byamukama, Ingrid Faye, Anna-Karin Borg-Karlson
Ethnopharmacological relevanceResistance of the parasites to known antimalarial drugs has provided the necessity to find new drugs from natural products against malaria. The aim of the study was to evaluate the in vitro antiplasmodial activity of some plants used by Traditional Medical Practitioners (TMPs) of Prometra and Rukararwe in malaria treatment in Uganda to provide scientific proof of the efficacies claimed by these Herbalists.Materials and methodsThe air dried samples of Clerodendrum rotundifolium (leaves), Microglossa pyrifolia (leaves), Momordica foetida (leaves) and Zanthoxylum chalybeum (stem bark) used for malaria treatment by TMPs were successively extracted with ethyl acetate, methanol and water to yield twelve extracts. The extracts were tested against the chloroquine-sensitive (NF54) and chloroquine-resistant (FCR3) Plasmodium falciparum strains in vitro using the micro Mark III test which is based on assessing the inhibition of schizont maturation. A compound A was extracted and purified from the stem bark of Z. chalybeum and its structure was identified and confirmed by spectroscopic methods.ResultsMost of the extracts tested (92%) showed an antiplasmodial activity with IC50<50µg/mL. In spite of successive extractions with different solvents, potent anti-plasmodial activity (IC50<5µg/mL) was observed in the ethyl acetate, methanol and aqueous extracts of M. pyrifolia and C. rotundifolium. Preferential enrichments of activity into water (IC50<15µg/mL) and Ethyl acetate (IC50<5µg/mL) were seen in the case of M. foetida and Z. chalybeum respectively. The most active extracts were from C. rotundifolium and M. pyrifolia with IC50 values less than 2µg/mL. Phytochemical analysis of the extracts revealed the presence of saponins, tannins, flavonoids, alkaloids and cardiac glycocides. Fagaramide isolated from Z. chalybeum had a higher activity (IC50 2.85µg/mL) against the chloroquine-resistant strain than against the chloroquine-senstive (IC50 16.6µg/mL) strain used in the study.ConclusionThe plant extracts analysed in this study presented an average antiplasmodial activity (58%). This study revealed for the first time the antiplasmodial activity of the plant C. rotundofolium. It's the first time the compound fagaramide (N-isobutyl-3-(3,4-methylene dioxyphenyl)−2E-propenamide) has been isolated from Z. chalybeum as one of the compounds that contribute to the activity of this plant against P. falciparum.
Graphical abstract
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Belamcanda chinensis (L.) DC-An ethnopharmacological, phytochemical and pharmacological review
Publication date: 20 June 2016
Source:Journal of Ethnopharmacology, Volume 186
Author(s): Le Zhang, Kunhua Wei, Jianping Xu, Dawei Yang, Chunhong Zhang, Zhipeng Wang, Minhui Li
Ethnopharmacological relevanceBelamcanda chinensis (L.) DC is the sole species in the genus Belamcanda Adans. (Iridaceae), found mainly in Northeast Asia. Bombus chinensis has long been used in traditional Chinese medicine for its multiple therapeutic uses in the form of antipyretic agents, antidote, expectorant, antiphlogistic and analgesic.Aim of the reviewThis manuscript comprehensively summarizes the various studies published in recent years on the botany, ethnopharmacology, phytochemistry, biological activity and toxicology of B. chinensis. We hope to provide a foundation for future studies on the mechanism of action and development of better therapeutic agents based on B. chinensis.Material and methodsAll information available on B. chinensis was collected using electronic search engines, such as PubMed, SciFinder Scholar, CNKI, TPL (www.theplantlist.org), Google Scholar and Web of Science.ResultsThe analysis shown that ethno-medical uses of B. chinensis have been recorded in China, Japan and Korea since a long time. Based on a phytochemical investigation, this plant contains flavonoids, terpenoids, quinones, phenolic compounds, ketones, organic acids, etc. Crude extracts and pure compounds isolated from B. chinensis exhibited various biological effects.ConclusionsIn light of its long traditional use and the modern phytochemical and pharmacological studies summarized here, B. chinensis is known to be a promising medicinal plant with the isolated extracts and chemical components showing a wide range of biological activities. Thus, it is imperative that the necessary programs and value assessment of B. chinensis be established for further studies. It is also important that the synergistic or antagonistic effects of this traditional herbal medicine are investigated in depth to identify more bioactive components by bioactivity-guided isolation strategies, and to illustrate the mechanisms of action targeting on ethnomedical uses. Future clinical studies can also focus on the main therapeutic aspects, toxicity and adverse effects of B. chinensis.
Graphical abstract
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Experimental polyethylene–hydroxyapatite carrier-based endodontic system: an in vitro study on dynamic thermomechanical properties, sealing ability, and measurements of micro-computed tomography voids
The dynamic thermomechanical properties, sealing ability, and voids formation of an experimental obturation hydroxyapatite-reinforced polyethylene (HA/PE) composite/carrier system were investigated and compared with those of a commercial system [GuttaCore (GC)]. The HA/PE system was specifically designed using a melt-extrusion process. The viscoelastic properties of HA/PE were determined using a dynamic thermomechanical analyser. Human single-rooted teeth were endodontically instrumented and obturated using HA/PE or GC systems, and then sealing ability was assessed using a fluid filtration system. In addition, micro-computed tomography (μCT) was used to quantify apparent voids within the root-canal space. The data were statistically analysed using one-way anova and post hoc tests. The HA/PE composite exhibited important modulus and damping changes with an increase of temperature. The HA/PE system was more flexible than GC as the modulus of GC appeared to be significantly higher than that of HA/PE as a result of the high positive glass transition temperature (Tg). However, HA/PE and GC presented similar sealing abilities. In conclusion, because sealing ability and voids formation were comparable between the tested materials, the experimental HA/PE system may be considered a suitable alternative material for root-canal obturation. Moreover, HA/PE possesses specific viscoelastic behaviour and lower melting points, which may facilitate root-canal retreatments.
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Beyond appendicitis; radiologic review of unusual and rare pathology of the appendix.
Beyond appendicitis; radiologic review of unusual and rare pathology of the appendix.
Abdom Radiol (NY). 2016 Mar;41(3):568-581
Authors: Hines JJ, Paek GK, Lee P, Wu L, Katz DS
Abstract
Appendicitis is a very common cause of acute abdominal pathology, however, many other pathologic conditions of the appendix can be diagnosed utilizing CT. Examples of these conditions include primary appendiceal neoplasms, secondary inflammation of the appendix, stump appendicitis, endometriosis, appendicitis within a hernia, appendiceal diverticulosis and intussusception and intraluminal foreign bodies. The purpose of this article is to review appendiceal pathology outside of acute appendicitis, describe corresponding imaging findings on CT, and to illustrate various CT findings of appendiceal disease with representative cases.
PMID: 27039327 [PubMed - as supplied by publisher]
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