The association between reproductive success with persistent organochlorine pollutants residue in feathers of spur-winged lapwing ( Vanellus spinosus L.)

Abstract

The reproductive and breeding success of wader species is negatively affected by various anthropogenic factors, including persistent organochlorine pollutants (POPs). We aimed to study the association of POPs in feathers with the reproductive success of the spur-winged lapwing (Vanellus spinosus). For this purpose, data on reproductive parameters and feather samples were collected from a breeding population consisting of 19 pairs near Boğazkent district in Antalya, Turkey. Mean concentrations of total polychlorinated biphenyls (ΣPCBs) and organochlorine pesticides (ΣOCPs) were found to be 54 ± 16 ng/g and 520 ng/g in all samples, respectively. In particular, PCB 151 and β-hexachlorocyclohexane had a negative association the various reproductive parameters in the species under consideration. Fledgling success (n = 25) was calculated to be 37.4%, which was negatively associated with the ΣOCP concentrations (r = − 0.99, p = 0.01). According to the results, POP residues are one of the associated factors on the reproductive success of spur-winged lapwing along, with agricultural activity and predation. It is indicated that the species needs a protection plan for prevention declining reproductive success and population size species in Turkey. Besides, our results suggest that bird feathers are a non-destructive bio-monitoring tools to estimate of contamination levels of organic pollutants in a population.

https://ift.tt/2uigdGa

Day-care center attendance and risk of Asthma—A systematic review

Publication date: Available online 7 July 2018

Source: Allergologia et Immunopathologia

Author(s): Carlos Ochoa Sangrador, Alba Vázquez Blanco

Abstract

Introduction and Objectives

Asthma and other wheezing disorders are common chronic health problems in childhood. We aim to evaluate whether the attendance by children under three years of age to day-care centers is a protector or risk factor in the development of recurrent wheezing or asthma in the following years of their lives.

Methods

Systematic review of published cohort or cross-sectional studies, without any time limitation. We searched in PubMed, Cinhal, Cuiden and Scopus (EMBASE included). The quality of the studies was evaluated using the Newcastle-Ottawa Scale. Disagreements were solved by mutual consensus. Weighted odds ratio (ORs) were estimated using RevMan 5.3, following random effects models.

Results

We selected 18 studies for qualitative analysis, nine cohort studies and nine cross-sectional studies. Day-care center attendance is associated with an increased risk of early recurrent wheezing (four studies; 50,619 subjects; adjusted OR 1.87 [1.21 to 2.88]; I² 91%) and asthma before the age of six (five studies; 5412 subjects; adjusted OR 1.59 [1.26 to 2.01]; I² 0%), but not later (five studies; 5538 subjects; adjusted OR 0.86 [0.55 to 1.32]; I² 76%).

Conclusions

Children attending day-care center during the first years of life have a higher risk of recurrent wheezing during the first three years and asthma before the age of six, but not later. This risk must be taken into account to inform parents in order to choose what kind of care children should have throughout infancy and to implement preventive measures to reduce its impact.

https://ift.tt/2KEIQbA

A reproductive and developmental screening study of the fungal toxin ochratoxin A in Fischer rats

Abstract

The presence of the mycotoxin ochratoxin A (OTA) in cereal grains is due to the growth of toxigenic Penicillium mold on stored crops. Human exposure to OTA is higher in infants, toddlers, and children than in adolescents and adults, based on exposure assessments of ng OTA consumed/kg body weight/day. Ochratoxin A is nephrotoxic and teratogenic in animals, but its effects on juveniles exposed during the reproduction and development period have not been studied. To address this, Fischer rats were exposed to 0, 0.16, 0.4, 1.0, or 2.5 mg OTA/kg diet throughout breeding, gestation, and lactation and its adverse effects were assessed in adult rats and their offspring on postnatal day (PND) 21. There were no effects on implantation but post-implantation fetotoxicity was observed in the 2.5 mg/kg dose group, corresponding to a calculated dose of 167.0 μg/kg bw/day in dams. Adverse effects on body and kidney weights and on clinical parameters indicative of renal toxicity were significant in adult rats exposed to 1.0 mg OTA/kg diet (55.2 and 73.3 μg/kg bw/day in adult males and females, respectively) and in PND21 rats at the 0.4 mg/kg dose (33.9 μg/kg bw/day in dams), suggesting that weanling rats were more sensitive to OTA than adults. Overall, nephrotoxicity was the primary effect of OTA in weanling rats exposed throughout gestation and lactation at sub-fetotoxic concentrations in diet.

https://ift.tt/2zjkXB7

Novel minor HLA DR associated antigens in type 1 diabetes

Publication date: Available online 7 July 2018

Source: Clinical Immunology

Author(s): Denise Müller, Tanja Telieps, Anne Eugster, Christina Weinzierl, Manja Jolink, Anette-Gabriele Ziegler, Ezio Bonifacio

Abstract

Type 1 diabetes is an autoimmune disease leading to insulin deficiency. Autoantibodies to beta cell proteins are already present in the asymptomatic phase of type 1 diabetes. Recent findings have suggested a number of additional minor autoantigens in patients with type 1 diabetes. We have established luciferase immunoprecipitation systems (LIPS) for anti-MTIF3, anti-PPIL2, anti-NUP50 and anti-MLH1 and analyzed samples from 500 patients with type 1 diabetes at onset of clinical disease and 200 healthy individuals who had a family history of type 1 diabetes but no evidence of beta cell autoantibodies. We show significantly higher frequencies of anti-MTIF3, anti-PPIL2 and anti-MLH1 in recent onset type 1 diabetes patients in comparison to controls. In addition, antibodies to NUP50 were associated with HLA-DRB1*03 and antibodies to MLH1 were associated with HLA-DRB1*04 genotypes.

Graphical abstract

https://ift.tt/2u9q0xS

Silicone-Induced Foreign Body Reaction: An Unusual Differential Diagnosis of Posterolateral Hip Pain

Background. Silicone injection is commonly used for soft tissue augmentation for esthetic purposes. It is not without complications. Case presentation. We present a case of a 31-year-old woman presenting with refractory left lateral hip pain. Magnetic resonance imaging of the patient's pelvis revealed innumerable small low signal foci throughout the gluteus maximus and overlying subcutaneous fat bilaterally consistent with injectable material, possibly silicone. Conclusions. This case report emphasizes that silicone-induced granulomatosis must be considered in the differential diagnosis of hip pain when evaluating a patient who has had access to plastic surgery or clandestine operators.

https://ift.tt/2KWLUMc

Qualitative evaluation of hybrid layer formation using Er:YAG laser in QSP mode for tooth cavity preparations

Abstract

The purpose of this study was to evaluate the thickness and qualitative characteristics of the hybrid layer after two cavity preparation methods, using Er:YAG laser in QSP mode and conventional carbide burs. Additionally, two different adhesive techniques were investigated using etch-and-rinse and self-etch adhesive systems. Sixty sound human third molars were used and were randomly divided into four groups (n = 15). In the first two groups, large (4 mm length, 3 mm wide, and 3 mm deep) class I cavities were prepared using Er:YAG laser (2.94 μm) in QSP mode, while in the other two groups, the cavities were prepared using carbide burs. After cavity preparations, two different adhesive techniques with GLUMA® 2 Bond (etch-and-rinse) and Clearfil™ Universal Bond Quick (self-etch) were applied. For the qualitative evaluation of the formed hybrid layer, photomicrographs were taken using SEM, and elemental semi-quantitative analysis was performed using EDS to confirm the extent of the hybrid layer. One-way ANOVA was applied to verify the existence of statistically significant differences, followed by Tukey test for post hoc comparisons (Bonferroni corrected), and the level of significance was set at a = 0.05. The laser-treated groups exhibited higher hybrid layer thickness than bur-treated groups (p < 0.001). Between the laser-treated groups, etch-and-rinse technique presented higher hybrid layer thickness than self-etch technique (p < 0.001), while between the bur-treated groups, no significant differences were detected (p = 0.366). Er:YAG laser cavity preparations in QSP mode may be advantageous for adhesion of composite restorations, but more data are necessary to confirm its clinical effectiveness.

https://ift.tt/2J0UQOQ

What should we tell our worried patients with insomnia about blood pressure?

In this issue of Sleep Medicine Reviews, Jarrin and colleagues [1] report on a systematic review of the cross-sectional and longitudinal association between insomnia, hypertension and abnormal blood pressure (BP) levels across 64 studies comprised of 26 to 162,121 adults ages 18-100 years old. The authors' criteria allowed for the inclusion of studies with different designs (e.g., epidemiologic, case-control), comorbid conditions, and definitions of insomnia or hypertension. This systematic review is timely and very much needed, given that only one meta-analysis had been published to date on the increased risk of incident hypertension associated with any form of insomnia [2]; however, it did not allow for disentangling the critical issues discussed by previous investigators [3-5] such as the definition of insomnia, its chronicity, its objective severity, the measurement of BP and definition of hypertension, and the presence of important confounders in previous studies [e.g., sleep disordered breathing (SDB)].

https://ift.tt/2KTGAfH

Semilobar holoprosencephaly with cebocephaly associated with maternal early onset preeclampsia: a case report

The term holoprosencephaly was proposed by DeMyer and Zeman. It is a developmental defect of the embryonic forebrain with heterogeneous etiology including genetic and environmental factors. It is commonly asso...

https://ift.tt/2ziO07H

Deep neck infection and descending mediastinitis as lethal complications of dentoalveolar infection: two rare case reports

We report two cases of innocuous dentoalveolar infections which rapidly progressed to deep neck abscesses complicated by descending mediastinitis in a resource-constrained rural mission hospital in the Cameroon.

https://ift.tt/2lZptuX

The distinct role and regulatory mechanism of IL-17 and IFN-γ in the initiation and development of plaque vs guttate psoriasis

Publication date: Available online 7 July 2018

Source: Journal of Dermatological Science

Author(s): Kexiang Yan, Ling Han, Hui Deng, Xu Fang, Zhenghua Zhang, Guiqin Huang, Zhi Zhong Zheng, Qiong Huang, Jinhua Xu

Abstract

Background

Few studies have explored the differences of immunopathogenesis in plaque vs guttate psoriasis, especially on the inhibitory role of regulatory T cells (Tregs) on IL-17/ IFN-γ production and the impact of CD4+T cells on keratinocytes.

Objective

To investigate the percentage and inhibitory function of CD4+CD25^highTreg and differential expressions of IL-17/ IFN-γ in plaque vs guttate psoriasis, and the effects of CD4 + T cells on the proliferation of keratinocytes.

Methods

Peripheral blood mononuclear cells (PBMCs) were prepared from patients with the plaque and guttate psoriasis. The percentage of CD4+CD25^high Tregs, IL-17/IFN-γ- producing CD4+ or CD8 + T cells, and apoptosis and cell cycle of Hacat cells were determined by flow cytometry. The level of IFN-γ in supernatants was analyzed by ELISA.

Results

The percentage of CD4+CD25^highTregs in plaque psoriasis was significantly increased, and they can inhibit IFN-γ production from CD4+CD25- effector T cells. The percentage of CD8+IFN-γ+cells was also significantly increased in plaque psoriasis, and these cells positively correlated with disease severity. The percentage of CD4+CD25^highTregs was decreased and CD4+IFN-γ+/IFN-γ+IL-17+ cells were predominantly increased in guttate psoriasis. CD4+T cells from guttate psoriasis induce apoptosis of keratinocytes while they promote the proliferation of keratinocytes in plaque psoriasis by decreasing late apoptosis and increasing the percentage of G1 phase.

Conclusion

There was considerable discrepancy of the phenotype and function of T cells between plaque vs guttate psoriasis. IFN-γ and IL-17 from CD4+T cells play a crucial role in guttate psoriasis, however, IFN-γ and IL-17 from CD8+T cells are more important in the immunopathogenesis of plaque psoriasis.

https://ift.tt/2uefDce

Editorial Board

Publication date: September 2018

Source: Archives of Oral Biology, Volume 93

Author(s):

https://ift.tt/2zhoGil

In silico analysis of virulence genes in an emerging dental pathogen A.baumannii and related species

Publication date: Available online 7 July 2018

Source: Archives of Oral Biology

Author(s): J. Vijayashree Priyadharsini, A.S. Smiline Girija, A. Paramasivam

ABSTRACT

Objectives

Acinetobacter baumannii is an opportunistic pathogen which has recently been categorized as a high risk pathogen by World Health Organisation (WHO). The microbe has stealthily entered the oral cavity and has established itself as a potential pathogen by acquiring drug resistance and expression of several virulence genes. Surveillance on the type of virulence factors harboured by the organism will enable us to comprehend the mechanism of pathogenesis. The study was performed to screen for the presence of crucial virulence factors associated with Acinetobacter spp. as reviewed from the literature by employing computational tools.

Design

Nineteen genome sequences of Acinetobacter spp. with the predominance of different strains of A. baumannii were classified phylogenetically into clusters using in silico restriction digestion and pulse field gel electrophoresis (PFGE). Further, the frequency of common virulence genes in the genome of various Acinetobacter spp. was recorded using in silico PCR analysis.

Results

Based on PFGE pattern and phylogenetic tree the genomes of A. baumannii were clustered into 4 genotypes (G1-G4). Two species were excluded from the list since they were negative for almost all the virulence genes tested. Frequency of virulence genes in each of the 17 genomes analysed, found ompA and smpA to be the major virulence factors in A.baumannii and related species. Acinetobacter spp. belonging to genotypes 2 and 3 were found to harbour 1-15 and 6-10 potential genes encoding virulence factors respectively.

Conclusions

The present study showed numerous virulence genes in genomes analysed. In silico analysis of these virulence genes can be used as candidates to build novel therapeutic targets against the pathogen. An extensive study on the functional role of these genes could aid in stalling the propagation and dissemination of A.baumannii among susceptible individuals.

https://ift.tt/2u2tHq8

Fluoride removal studies using virgin and Ti (IV)-modified Musa paradisiaca (plantain pseudo-stem) carbons

Abstract

The preparation of carbons in virgin and Ti-modified forms under controlled conditions at low temperature from plantain pseudo-stem (Musa paradisiaca) was achieved. These prepared carbons were characterized for instrumental studies such as BET, FTIR, XRD, SEM with EDS and TGA to understand the chemistry and modification. The determination of IEP and pH_ZPC established the presence of positive surface sites on the virgin (VMPC) and Ti-modified (TiMPC) carbons to facilitate the sorption of fluoride. The fluoride removal efficiency as a function of time, pH, dose, initial fluoride concentration, temperature, and co-ion intervention was studied. The maximum fluoride removal of about 81.2 and 97.7% was achievable with VMPC and TiMPC, respectively, after 20 min at the pH of 2.04 and continued for the equilibrium of 60 min. Temperature was found to be influential both by way of initial increase followed by a decrease in the fluoride uptake of MPCs. Regeneration was very consistent up to 7 cycles with the residual fluoride concentration below the WHO guide line of 1.5 mg L⁻¹. Highest intervention due to hydrogen carbonate ions was observed during the fluoride removal process. Kinetic (pseudo-first-order, pseudo-second-order, and intra-particle diffusion) and isotherm models (Langmuir, Freundlich, and DKR) were checked for their compliance with the present sorption system. These low temperature synthesized MPCs are found to be effective candidates in the process of fluoride abatement in water.

https://ift.tt/2NxrB9G

Evaluation of Multimodality Management of Adenoid Cystic Carcinoma of the Head and Neck

Abstract

Adenoid cystic carcinoma is a relatively rare tumour arising from salivary glands of head and neck region. Surgery and radiotherapy form standard treatment modalities in the management of this tumor. In this analysis we present results of multimodality treatment in our cohort of patient. This retrospective analysis evaluated results of treatment in forty patients diagnosed with adenoid cystic carcinoma of the head and neck. Evaluation was done to identify prognostic factors affecting the disease free survival. A median disease free survival of 34 ± 2.42 (Median ± SE) versus 10 ± 5.45 months was seen in patients undergoing surgery followed by post operative radiotherapy versus radiotherapy alone (P = 0.01). A radiotherapy dose more than 60 Gy was associated with a better disease free survival compared with patients receiving less than 60 Gy (P = 0.01). Positive surgical margins and perineural invasion were associated with a poor treatment outcome (P = 0.02) Patients with c-kit positive status showed a poor local control rate (P = 0.05).

https://ift.tt/2NBXjCW

Forecasting riverine total nitrogen loads using wavelet analysis and support vector regression combination model in an agricultural watershed

Abstract

In the context of non-point source pollution management and algal blooms control, the reliable nutrient forecasting is of critical importance. Considering the highly stochastic, non-linear, and non-stationary natures involved in riverine total nitrogen (TN) load time series data, some traditional statistical and artificial intelligence models are inherently unable to give accurate nutrient forecasts due to their mechanism and structure characteristics. In this study, based on the wavelet analysis (WA) and support vector regression (SVR), a promising combined WA-SVR model was proposed for forecasting riverine TN loads. The data pro-processing tool WA was employed to decompose the time series data of riverine TN load for revealing its dominator. Subsequently, all wavelet components were used as inputs to SVR for WA-SVR model. The continuous riverine TN loads during 2004–2012 in the ChangLe River watershed of eastern China were estimated by using a calibrated Load Estimator model. Performance criteria, namely, determination coefficient (R²), Nash-Sutcliffe model efficiency (NS), and mean square error (MSE) were applied to assess the performance of the developed models. The effects of different mother wavelets on the efficiency of the conjunction model were investigated. The results demonstrated that the mother wavelet played a crucial role for the successful implementation of the WA-SVR model. Among the 23 selected mother wavelet functions, dmey wavelet performed best in forecasting the daily and monthly TN loads. Furthermore, the performance of the optimal WA-SVR model was compared with that of single SVR model without wavelet decomposition. The comparison indicated that the hybrid model provided better accuracy than that of single SVR model. For daily riverine TN loads, the R², NS, and MSE values of WA-SVR model during the test stage were 0.9699, 0.9658, and 0.4885 × 10⁷ kg/day, respectively. For monthly riverine TN loads, the R², NS, and MSE values of the model during the test stage were 0.9163, 0.9159, and 0.3237 × 10¹⁰ kg/month, respectively. The overall results strongly suggested that the combined WA-SVR method can successfully forecast riverine TN loads in agricultural watersheds.

https://ift.tt/2zkYUKi

Evaluation of testicular function in prepubertal children

Abstract

Introduction

The assessment of testicular function is not currently performed in childhood. The aim of this review was to address the usefulness of serum Anti-Müllerian Hormone (AMH), inhibin B, and testicular volume (TV) evaluation in children.

Review

Serum AMH and inhibin B levels reflect Sertoli cells (SCs) health and number, SCs maturation degree and their exposure to FSH and to intra-tubular testosterone (T). These hormones might be helpful in discriminating between congenital central hypogonadism (cHH) and constitutional delay in growth and puberty (CDGP) and in case of clinical suspicious of precocious puberty. Furthermore, low AMH and/or inhibin B levels have been observed in children with primary testicular disorders, suggesting the existence of SC dysfunction. TV also provides useful information on testicular health. Recently, a medical calculator, requiring testis length and the stage of genital development, has been developed to easily derive TV.

Conclusions

The evidence supports the usefulness of AMH, inhibin B and TV evaluation for the early diagnosis of puberty disorders and primary testicular damage. We suggest the measurement of TV by using the medical calculator in all children and to reserve AMH and inhibin B measurements to those cases of no testicular growth, clinical suspicious of puberty disorders or in children at risk for spermatogenesis damage. This work-up might allow the early detection of testicular tubular damage which, in turn, may be useful to prevent the oncoming male infertility in adulthood.

https://ift.tt/2u8tjXh

Leukocyte- and platelet-rich fibrin: a new graft material in endoscopic repair of spontaneous CSF leaks

Abstract

Background

Spontaneous CSF leak is a challenging condition, with frequent recurrences following attempted surgical closure. The selection of graft materials depends on the experience of the operating surgeon. Leukocyte- and platelet-rich fibrin (L-PRF) is a second-generation platelet concentrate that has currently invaded every surgical specialty. To our knowledge, no previous reports about the use of L-PRF in repair of CSF leak were published. The study was conducted to assess the potential role of L-PRF in spontaneous CSF leaks repair.

Methods

This prospective controlled study was conducted on 40 patients who were randomly divided into 2 groups: In group A, L-PRF was used in addition to another layer, while patients in group B underwent multilayer repair using traditional graft materials.

Results

Preoperative HRCT scan showed bony dehiscence (n = 30) and opacity in a nearby sinus (n = 9). MRI findings varied between empty sella in 28 patients, and meningocele in 19 patients. Mean preoperatively measured CSF pressure was 26.6 cm H₂O. Cribriform plate was identified as the commonest site of leaks. Multiple skull defects were detected in 2 cases. Failure of repair was found in 3 patients (15%) of group B and 1 patient (5%) of group A, this difference was statistically insignificant (P value = 0.28). Significance correlation between recurrence of CSF leak and elevated intracranial pressure was observed (P value; 0.04).

Conclusion

L-PRF was found to be a good adjunct material in endoscopic spontaneous CSF leaks repair. It helps in decreasing the number of layers needed for defect closure.

https://ift.tt/2ueikue

Association of the infiltration of tumor-associated macrophages, expression of Smad7 protein and prognosis in oral squamous cell carcinoma

Publication date: Available online 7 July 2018

Source: Archives of Oral Biology

Author(s): wei Wei, Chen Hujie

Abstract

Objective

To explore the association between Smad7 expression and tumor-associated macrophage (TAM), and their relationship with clinicopathological features and prognosis in patients with oral squamous cell carcinoma (OSCC).

Methods

This study collected cancer tissues from 314 OSCC patients from May 2002 to May 2012 at our hospital. Immunohistochemistry was carried out to detect the density of CD68⁺ cells and Smad7.

Results

The densities of CD68TF_Mean and CD68TF_Hotspot shared a significant negative correlation with the immunoscore (IS) of Smad7, indicated that Smad7 was evidently increased with the decrease densities of CD68TF_Mean and CD68TF_Hotspot in OSCC tissues. Besides, low differentiation degree together with high TNM, T and N stage of OSCC patients presented decreased densities of CD68TF_Mean and CD68TF_Hotspot but increased expression of Smad7. Kaplan-Meier univariate survival analysis showed that the prognosis of OSCC patients was associated with differentiation degree, clinical stages, Smad7 expression, as well as densities of CD68TF_Mean and CD68TF_Hotspot. Cox regression analysis results demonstrated that N staging, the densities of CD68TF_Mean and CD68TF_Hotspot and Smad7 expression were independent risk factors influencing the survival rate of OSCC patients.

Conclusion

Decreased densities of CD68TF_Mean and CD68TF_Hotspot were negatively correlated with the increased Smad7 expression in OSCC tissues, both of which linked to clinicopathological features and prognosis of OSCC.

https://ift.tt/2lXace2

Commensal bacteria aggravate allergic asthma via NLRP3/IL-1β signaling in post-weaning mice

Publication date: Available online 7 July 2018

Source: Journal of Autoimmunity

Author(s): Chao Huang, Jian Wang, Xiaodong Zheng, Yongyan Chen, Rongbin Zhou, Haiming Wei, Rui Sun, Zhigang Tian

Abstract

Perturbation of commensal bacteria by antibiotic exposure aggravates ovalbumin (OVA)-induced allergic asthma in pre-weaning mice. However, the influence of dysbiosis of commensal bacteria on asthma development in post-weaning mice is still limited. Here, we treated 3-week-old post-weaning mice with antibiotics to disrupt commensal bacteria and then established OVA-induced allergic asthma by peritoneal sensitization using OVA/alum and intranasal challenge with OVA. Contrary to the protective function in pre-weaning mice, commensal bacteria in post-weaning mice aggravated OVA-induced asthma. Commensal bacteria in post-weaning mice promoted OVA-induced allergic asthma through maintenance of NLRP3/IL-1β expression in peritoneal macrophages (pMφ), which promoted recruitment of inflammatory cells, especially inflammatory monocytes, into the peritoneal cavity after OVA/alum sensitization. Further study showed that metronidazole- and vancomycin-sensitive bacteria are involved in maintenance of NLRP3/IL-1β signal in pMφ. Our results suggest that certain species of commensal bacteria in post-weaning mice aggravate OVA-induced allergic asthma through NLRP3/IL-1β signal pathway.

Graphical abstract

https://ift.tt/2u8eBzx

Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine

Abstract

Background

The goal of this prospective study was to compare the value of both conventional MRI and O-(2-¹⁸F-fluoroethyl)-L-tyrosine (FET) PET for response evaluation in glioblastoma patients treated with bevacizumab plus lomustine (BEV/LOM) at first progression.

Methods

After chemoradiation with concomitant and adjuvant temozolomide, 21 IDH wild-type glioblastoma patients at first progression (age range, 33–75 years; MGMT promoter unmethylated, 81%) were treated with BEV/LOM. Contrast-enhanced MRI and FET-PET scans were performed at baseline and after 8–10 weeks. We obtained FET metabolic tumor volumes (MTV) and tumor/brain ratios. Threshold values of FET-PET parameters for treatment response were established by ROC analyses using the post-progression overall survival (OS) ≤/>9 months as the reference. MRI response assessment was based on RANO criteria. The predictive ability of FET-PET thresholds and MRI changes on early response assessment was evaluated subsequently concerning OS using uni- and multivariate survival estimates.

Results

Early treatment response as assessed by RANO criteria was not predictive for an OS>9 months (P = 0.203), whereas relative reductions of all FET-PET parameters significantly predicted an OS>9 months (P < 0.05). The absolute MTV at follow-up enabled the most significant OS prediction (sensitivity, 85%; specificity, 88%; P = 0.001). Patients with an absolute MTV below 5 ml at follow-up survived significantly longer (12 vs. 6 months, P < 0.001), whereas early responders defined by RANO criteria lived only insignificantly longer (9 vs. 6 months; P = 0.072). The absolute MTV at follow-up remained significant in the multivariate survival analysis (P = 0.006).

Conclusions

FET-PET appears to be useful for identifying responders to BEV/LOM early after treatment initiation.

https://ift.tt/2KR01WG

Performance and recovery of a completely separated partial nitritation and anammox process treating phenol-containing wastewater

Abstract

Anammox process is considered as a promising technology for removing total nitrogen from low-strength ammonium and phenol-containing wastewater. However, it is still a challenge for the anammox process to treat high-strength ammonium and phenol-containing wastewater. A completely separated partial nitritation and anammox (CSPN/A) process was developed to remove total nitrogen from high-strength phenol-containing wastewater. About 92% of COD, 100% of phenol, and 82.4% of total nitrogen were successfully removed at a NH₄⁺-N concentration of 200 mg L⁻¹ with a phenol/NH₄⁺-N mass ratio of 0.5 in the CSPN/A process. Furthermore, a shock loading of 300 mg phenol L⁻¹ with a phenol/NH₄⁺-N mass ratio of 1.5 led to a complete failure of partial nitritation, but the performance was rapidly recovered by the increase of NH₄⁺-N concentration. Although the activities of ammonium-oxidizing bacteria and anammox bacteria were severely inhibited at a phenol/NH₄⁺-N mass ratio of 1.5, the enrichment of efficient phenol degraders in the CSPN stage could strengthen the performance robustness of partial nitritation and anammox process. Therefore, this study presented a new insight on the feasibility of the anammox process for treating high-strength ammonium and phenol-containing wastewater.

https://ift.tt/2KZyfnp

Enhanced degradation of isoproturon in soil through persulfate activation by Fe-based layered double hydroxide: different reactive species comparing with activation by homogenous Fe(II)

Abstract

Phenylurea herbicide residuals in soil may continuously contaminate surface water and groundwater due to unregulated and improper use. Herein, we reported a stable and active oxidation system including heterogeneous Fe-based layered double hydroxide materials as persulfate (PS) activators. Under mild conditions, 1% LDH in weight and 70 mM PS can completely degrade 500 mg/kg isoproturon in soil within 10 h, during which less than 0.1 ppm heavy metal leaching was detected. This remarkable performance was consistent in a broad pH range (3~11) and was resistant to various inorganic anions (Cl⁻, Br⁻, NO₃⁻, HCO₃⁻) and humic acid. Mechanism studies from scavenging tests, EPR, and fluorescence spectra collectively proved that besides •OH and •SO₄⁻, singlet oxygen (¹O₂) and superoxide (•O₂⁻) were also generated and were accounted for the oxidative degradation. This unique mechanism of generating diverse radicals was clearly distinguished from classic Fe(II)/PS system, significantly reduced the influence of varying parameters in water and soil matrix, and was suggestive to chemical oxidation system in soil remediation to avoid scavenging effects by background electrolytes or other components in water/soil matrix.

Graphical abstract

ᅟ

https://ift.tt/2Nx3V5t

Pediatric neuroanesthesia

Purpose of review Pediatric neuroanesthesia is a fascinating, yet challenging branch of anesthesia. This review highlights some of the recent insights into pediatric neuroanesthesia from the past 18 months. Recent findings Although there are incontrovertible evidences in animals suggesting that prolonged exposure to general anesthesia causes long-term neurological impairment, the translational relevance of these findings in humans is debatable. Early surgery for pediatric drug-refractory epilepsy is supported by emerging literature, but poses unique perioperative problems for the treating neuroanesthesiologist. Similarly, minimizing intraoperative blood loss and blood transfusion concerns every anesthesiologist managing small children. The usefulness of tranexamic acid in children is further enhanced by some studies in spine surgeries. Some pertinent issues related to intraoperative neuromonitoring are also discussed in the text. Summary There are several logistical and ethical problems of carrying out high-quality prospective studies in children but important findings on prevention of anesthetic neurotoxicity; minimizing intraoperative blood loss, intraoperative neurophysiological monitoring, examining optimal doses and choices of anesthetic agents in epilepsy surgery have been published recently. Correspondence to Dr Girija P. Rath, MBBS, MD, DM, Professor, Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Tel: +91 9810602272; e-mail: girijarath@yahoo.co.in Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2KWAdrU

Exploring the contribution of visual imagery to scene construction – evidence from Posterior Cortical Atrophy

Publication date: Available online 7 July 2018

Source: Cortex

Author(s): Siddharth Ramanan, Sara Alaeddin, Zoë-lee Goldberg, Cherie Strikwerda-Brown, John R. Hodges, Muireann Irish

Abstract

Posterior Cortical Atrophy (PCA) is a rare neurodegenerative syndrome characterised by profound visuoperceptual processing disturbances, attributable to focal parieto-occipital cortical atrophy. Despite relative sparing of the medial temporal lobes, converging evidence reveals significant autobiographical memory impairments in this syndrome, underscoring the crucial role of visual imagery for episodic memory processes. The contribution of visual imagery to complex constructive endeavours, however, remains unclear. Here, we investigated the capacity for atemporal scene construction in 5 well-characterised cases of PCA and contrasted their performance with 10 typical amnestic Alzheimer's Disease (AD) and 10 healthy older Control participants. Behavioural data were analysed using case-Control statistics comparing each PCA patient's scene construction scores to the mean scores of AD and Control groups. In keeping with their clinical phenotype, PCA patients demonstrated significant visuoperceptual and episodic memory impairments on standard neuropsychological tasks. Scene construction performance was grossly impaired in PCA, at a level comparable to that observed in the AD group, manifesting in impoverished and spatially fragmented scenes. Structural neuroimaging confirmed prominent grey matter intensity decrease predominantly in posterior cortical regions in PCA, in the absence of frank hippocampal atrophy. Using an a priori motivated region-of-interest approach across all participants, scene construction performance was found to correlate with grey matter intensity in the left angular gyrus, right precuneus, and right hippocampus. This study is the first to reveal compromised scene construction capacity in PCA, extending our understanding of the cognitive profile of this rare syndrome and pointing towards the fundamental contribution of visual imagery to atemporal forms of imagination.

https://ift.tt/2ucygx5

MRI diagnosis of megarectum in pregnant women

Description

A 33-year-old pregnant woman presented at 9 weeks' gestation for a voluntary abortion after an unwanted pregnancy. She had a history of long-standing abdominal distension and childhood constipation, and also a non-complicated pregnancy with normal vaginal delivery few years ago. The clinical examination revealed a distended abdomen. Ultrasound showed a great non-characterisable pelvic abdominal mass repressing pelvic organs, pushing forward and to the right the bladder and to the left the uterus. It also shows an early viable intrauterine pregnancy and no other intra-abdominal abnormalities (figure 1). MRI with multiplanary acquisitions shows that the pelvic mass seen on ultrasound examination has been a large rectum containing a giant fecaloma revealing a megarectum (figure 2). Therapeutic discontinuation of pregnancy was realised then the patient was operated. She had a mucosal proctectomy associated to a sigmoidectomy with colorectal anastomosis.1 The operative sequences were simple. This entity...

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Catheterisation of a persistent left superior vena cava

We present a case of a 62-year-old woman with end-stage renal disease who displayed a persistent left superior vena cava detected following placement of haemodialysis catheter through the left internal jugular vein (IJV). The diagnosis was confirmed by left internal jugular vein cathetogram, computed tomography (CT) thorax and transthoracic echocardiography. The catheter was removed without immediate complications. She remained well during the outpatient follow-up.

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Atypical presentation of cat scratch disease: Parinauds oculoglandular syndrome with facial nerve paresis

A 28-year-old man presented to our clinic over the course of 3 weeks with symptoms that progressed from mild headaches to fever, fatigue, myalgia and an enlarged right preauricular lymph node with ipsilateral conjunctivitis and upper eyelid weakness. Our differential included Epstein Barr Virus/Cytomegalovirus mononucleosis, bacterial conjunctivitis and lymphoma. We evaluated with CBC, EBV IgM Ab, lactate dehydrogenase level and a CMV IgG Ab which were all within normal limits. During his third visit, we discovered our patient had been scratched by two stray kittens he had adopted 2 months prior. We confirmed the diagnosis with a positive Bartonella henselae IgG level and diagnosed him with cat scratch disease presenting as Parinaud's oculoglandular syndrome. He was treated with a 5-day course of Azithromycin 250 mg with definitive improvement.

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Squamous cell carcinoma of scrotum mimicking as scrotal abscess

Description 

A 60-year-old man was referred to our urology department with complaints of non-healing scrotal wound for the last three months. He initially presented to a primary care centre with complaints of painful scrotal swelling and discharging scrotal wound for 15 days. The discharge card given to the patient mentioned that the patient was provisionally diagnosed as scrotal abscess and underwent incision and drainage. On local examination, an irregular appearing, ulcerated scrotal wound with everted margins was present (figure 1). The local examination of inguinal region and general physical examination was normal. Routine blood/urine investigations were within normal limits. Wedge biopsy from wound margins was performed under local anaesthesia. The histopathology came as a surprise to us as it revealed proliferating squamous epithelial cells disposed of as nests and solid masses suggestive of well-differentiated squamous cell carcinoma (figure 2). Further workup including contrast-enhanced CT abdomen/pelvis and chest X-ray...

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Hungry bone syndrome secondary to prostate cancer successfully treated with radium therapy

A 50-year-old man with a history of prostate cancer with extensive bone metastasis and hypocalcaemia presented with muscle aches and cramps. Physical exam was significant for Chvostek's and Trousseau's sign. Laboratory assessment was consistent with profound hypocalcaemia. This was believed to be due to hungry bone syndrome secondary to advanced prostate cancer. He was treated with intravenous calcium, vitamin D and calcitriol. He also received three doses of radium²²³ therapy. After therapy, hypocalcaemic episodes resolved. Follow-up after 2.5 years showed continued resolution of hypocalcaemia.

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IgG4-related disease coexisting with autoimmune haemolytic anaemia

An 85-year-old man presented with a pale appearance and generalised pruritic papules. Laboratory investigations disclosed eosinophilia, autoimmune haemolytic anaemia, mixed hyperbilirubinaemia, cholestasis and elevated serum IgG4 levels. Abdominal sonography and CT showed progressive dilatation of biliary trees, with diffuse pancreatic enlargement and a subtle capsule-like low-density rim around the pancreatic head and body. Endoscopic retrograde cholangiopancreatography found no stone-related biliary obstruction, while endoscopic transpapillary biopsy demonstrated chronic inflammation only. Nevertheless, the diagnosis of IgG4-related disease with coexisting autoimmune haemolytic anaemia was presumed. The clinical picture and laboratory abnormalities improved after administration of moderate dose of methylprednisolone.

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Perimesencephalic non-aneurysmal subarachnoid haemorrhage

Description 

A 51-year-old woman, without any relevant personal or family history, presented to the emergency department with acute severe occipital headache.

She has no focal neurological deficits or meningeal signs on examination.

Her funduscopy was normal.

Routine bloods including full blood count, renal profile, coagulation screening and cardiac enzymes were unremarkable.

Her baseline chest X-ray and ECG were also normal.

An initial non-contrast CT of the brain was reported as normal.

However, her subsequent CSF analysis at 12 hours post onset of symptoms revealed the presence of red blood cells (14 800/cmm in Tube 1 and 15 000/cmm in Tube 3) and xanthochromia, which raised the suspicion that a careful check of the CT images is needed.

The subtle perimesencephalic haemorrhage was seen on the subsequent review of the axial view (figure 1A) and sagittal view (figure 1B) of the CT brain, with a characteristic distribution of cisternal...

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Management of prematurely erupted teeth in newborns

The majority of natal and neonatal teeth are prematurely erupted primary teeth, whereas few are supernumerary in origin. They most commonly occur in mandibular central incisor region and often can lead to difficulty to the mother during breast feeding and tongue ulceration in newborn. Moreover, since majority of these have poorly developed roots and are mobile, there is always a fear of aspiration into respiratory passage. Extraction therefore is the most commonly rendered treatment for these teeth. This paper comprises cases of natal and neonatal teeth describing about their clinical characteristics and sequel. This paper has also highlighted the factor which needs to be considered during the management of natal/neonatal teeth and protocol followed at our centre.

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Hypomelanosis of Ito with gynaecomastia and dental anomaly

Hypomelanosis of Ito is a rare neurocutaneous syndrome. Cutaneous involvement is characterised by streaks and swirls of hypopigmentation arranged in a Blaschkoid pattern. Neural involvement along with other systemic features are seen. We report a case of a 13-year-old boy who presented with the characteristic skin involvement of hypomelanosis of Ito, mental retardation, teeth abnormalities and gynaecomastia along with psoriasis.

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Laws of attraction: management of magnetic foreign body ingestion

Description 

An 11-year-old girl with global developmental delay presents with a 4-day history of nausea, vomiting and abdominal pain after the ingestion of multiple foreign bodies. She was haemodynamically stable with no gross abnormalities on laboratory tests. An abdominal X-ray was obtained which demonstrated two radio-opaque foreign bodies in the left lower quadrant without free air (figure 1A). On physical examination the patient had significant point tenderness in the left lower quadrant with guarding. The decision was made to proceed to the operating room where a diagnostic laparoscopy was performed. On entering the abdomen, there was no significant free fluid or gross contamination. After running the bowel, two magnets were identified in adjacent loops of small intestine with evidence of bowel wall ischaemia in-between. Approximately 15 cm of jejunum was inspected and the foreign bodies which included two magnets and an earring (figure 1B) were...

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Papillary thyroid cancer nodal metastases mimicking a slow-flow lymphatic malformation

Description 

A 28-year-old Caucasian man was referred to the head and neck clinic with a 2-year history of a right-sided neck lump, which had started to cause discomfort. Physical examination revealed two discrete non-tender neck masses in the region of the right sternocleidomastoid muscle, with no bruit or palpable pulse.

CT demonstrated multiple right-sided thin-walled cystic lesions within the upper to lower jugular chain and posterior triangle (levels II–V) forming a multiloculated cystic lesion measuring 10 cm in craniocaudal dimension. Ultrasound assessment suggested a multiloculated cystic mass with thin walls and no intralesional flow, extending along the posterior margin of the right sternocleidomastoid muscle, posterolateral to the right internal jugular vein. The thyroid and major salivary glands appeared unremarkable. Fine-needle aspiration cytology (FNAC) proved inconclusive. The abnormality was presumed to be a slow-flow lymphatic malformation; however, injection sclerotherapy did not result in resolution, confirmed on an MRI scan performed...

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Gastrointestinal beriberi: a forme fruste of Wernickes encephalopathy?

Gastrointestinal symptoms, such as anorexia, nausea, vomiting and abdominal pain, are very common in patients with Wernicke's encephalopathy (WE). Mild thiamine deficiency may have only gastrointestinal symptoms. We are reporting two patients with thiamine deficiency who predominantly had gastrointestinal symptoms. Case 1: a 38-year-old man had gastrointestinal problems for about 2–3 years. It gradually became severe. The patient came to the neurology outpatient department for his recent-onset vertigo and headache. Clinical examinations fulfilled Caine's criteria of WE. Gastrointestinal symptoms responded dramatically to intravenous thiamine. Case 2: a 21-year-old woman developed drug-induced hepatitis and gastritis. Associated nausea, vomiting and abdominal pain progressively increased over the weeks. The patient responded only to intravenous thiamine administration.

We suggest that a suspicion for gastrointestinal beriberi should arise if gastrointestinal symptoms (anorexia, nausea, vomiting and abdominal pain) are refractory to the usual therapies.

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Plane palsy: a case of transient facial weakness during an aircraft flight

Changes in atmospheric pressure have been reported to cause a transient lower motor neuron weakness of the facial nerve. We report the case of a passenger on an international flight who developed a unilateral facial weakness after take-off which resolved within 45 min. The effect is thought to be due to an ischaemic neuropraxia of the facial nerve caused by increased middle ear pressure compressing the facial nerve in an exposed facial canal. The condition has been commonly reported in scuba-divers but less frequently in airline passengers. Treatment is not necessary.

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Arterial fragility in kyphoscoliotic Ehlers-Danlos syndrome

Pathogenic variants in the lysyl-hydroxylase-1 gene (PLOD1) are responsible for the kyphoscoliotic type of Ehlers-Danlos syndrome (EDS). The disease is classically responsible for severe hypotonia at birth, progressive kyphoscoliosis, generalised joint hypermobility and scleral fragility. Arterial fragility is an important feature of the disease, but its characterisation remains limited. We report the clinical history of a 41-year-old woman who presented repeated arterial accidents, which occurred in previously normal medium size arteries within a limited time span of 2 years. Molecular investigations revealed compound heterozygosity for two PLOD1 gene deletions of exons 11–12 and 14–15. Arterial fragility is an important characteristic of kyphoscoliotic EDS. It manifests as spontaneous arterial rupture, dissections and dissecting aneurysms which may occur even during early childhood. This fragility is particularly likely to manifest during surgical intervention. Early medical management and surveillance may be indicated, but its modalities remain to be defined.

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Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes

A young female vaper presented with insidious onset cough, progressive dyspnoea on exertion, fever, night sweats and was in respiratory failure when admitted to hospital. Clinical examination was unremarkable. Haematological tests revealed only thrombocytopenia, which was long standing, and her biochemical and inflammatory markers were normal. Chest radiograph and high-resolution CT showed diffuse ground-glass infiltrates with reticulation. She was initially treated with empirical steroids and there was improvement in her oxygenation, which facilitated further tests. Since the bronchoscopy and high-volume lavage was unyielding, a video-assisted thoracoscopicsurgical biopsy was done later and was suggestive of lipoid pneumonia. The only source of lipid was the vegetable glycerine found in e-cigarette (EC). Despite our advice to quit vaping, she continued to use EC with different flavours and there is not much improvement in her clinical and spirometric parameters.

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