Ekram W Abd El-Wahab
Annals of Tropical Medicine and Public Health 2016 9(3):152-158
Background and Objectives: Quality of life may be reduced in patients with chronic liver diseases. The purpose of this study was to assess the impact of chronic viral liver diseases on health-related quality of life (HRQOL) among Egyptian patients compared to an interventional group of patients undergoing interferon (IFN) therapy and a control group of noninfected individuals via HRQOL specific assessment instruments focusing on liver disease. Subject and Methods: Quality of life was investigated in 150 patients with chronic viral liver disease, 150 patients undergoing IFN based therapy, and 150 matched controls. The generic short form (SF)-12 questionnaire, the Iowa Fatigue Scale (IFS), the chronic liver disease (CLD) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were applied to measure the HRQOL. Results: A significant difference in the mean IFS score was found among the three groups. Higher mean scores were observed among cases compared to controls [32.4 ± 11.3 vs 20.7 ± 5.8, OR (95% CI); 11.3 (9.6–13.7), P < 0.0001] and to the IFN group [32.4 ± 11.3 vs 25.1 ± 7.3, OR (95% CI); 5.8 (2.9–6), P < 0.0001]. The mean score was relatively higher among the IFN group compared to the controls [32.4 + 11.3 vs 25.1 ± 7.3, OR (95% CI); 7.3 (5.1–9.5), P < 0.0001]. Categorical scores of IFS in terms of cognitive, fatigue, energy, and productivity subscale were significantly lower among cases compared to the control and IFN groups. Mental and physical numeric and categorical scores for the absence of disability, CLD scale, and HADS were significantly worse in patients compared to the controls. Conclusion: Our results confirm that the quality of life is reduced in the patients with chronic viral liver disease in comparison with the healthy persons. Antiviral therapy with pegylated IFN-α and ribavirin can significantly improve physical and functional aspects of HRQOL.
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Τρίτη 3 Μαΐου 2016
Epidemiologic investigation of Middle East respiratory syndrome: Lessons learnt from Korea and China in new epidemics
Beuy Joob, Viroj Wiwanitkit
Annals of Tropical Medicine and Public Health 2016 9(3):210-210
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Annals of Tropical Medicine and Public Health 2016 9(3):210-210
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Study of retirement plan among dental professionals in Navi Mumbai, India: A comprehensive questionnaire survey
Treville Pereira, Subraj Shetty, Mayura Chande
Annals of Tropical Medicine and Public Health 2016 9(3):159-164
Background: Dentistry may appear to be a rewarding and satisfying job, but the fear of coming up short may haunt many dentists as they approach retirement. Planning for one's retirement is an issue that concerns all working individuals. The aim of this study was to assess the retirement plans among dental professionals in the City of Navi Mumbai, India. Materials and Methods: It was a cross-sectional study involving 180 dentists and conducted with the help of a self-reported questionnaire. Results: The response rate was 83.33% (150/180). There was a general agreement that the preferred retirement income would be achieved. Nearly, 83% of the dentists were in debt from banks in the form of loans which were taken either for a house, clinic, or a vehicle. Most of the dentists had a private practice and nearly 60% of the dentists were self-employed. Conclusion: Future planning for dentists is important as decisions can be made based on age, investment planning, and their financial status until retirement. In general, dentists are well prepared for their retirement. They have a significant amount of wealth for a comfortable living standard.
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Annals of Tropical Medicine and Public Health 2016 9(3):159-164
Background: Dentistry may appear to be a rewarding and satisfying job, but the fear of coming up short may haunt many dentists as they approach retirement. Planning for one's retirement is an issue that concerns all working individuals. The aim of this study was to assess the retirement plans among dental professionals in the City of Navi Mumbai, India. Materials and Methods: It was a cross-sectional study involving 180 dentists and conducted with the help of a self-reported questionnaire. Results: The response rate was 83.33% (150/180). There was a general agreement that the preferred retirement income would be achieved. Nearly, 83% of the dentists were in debt from banks in the form of loans which were taken either for a house, clinic, or a vehicle. Most of the dentists had a private practice and nearly 60% of the dentists were self-employed. Conclusion: Future planning for dentists is important as decisions can be made based on age, investment planning, and their financial status until retirement. In general, dentists are well prepared for their retirement. They have a significant amount of wealth for a comfortable living standard.
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Rare human neurocysticercosis: An emerging problem to be focused
Viroj Wiwanitkit
Annals of Tropical Medicine and Public Health 2016 9(3):201-201
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Annals of Tropical Medicine and Public Health 2016 9(3):201-201
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Detection of high-level aminoglycoside resistant pattern of Enterococci isolated from urine samples at a tertiary care hospital in Bengaluru
Smeeta Huidrom, Girish Narayanaswamy, Reena Dadlani
Annals of Tropical Medicine and Public Health 2016 9(3):165-169
Aims: Enterococcus species are major nosocomial pathogens and they most commonly cause urinary tract infections (UTIs), exhibiting vancomycin and high-level aminoglycoside resistance (HLAR) with increasing frequency, resulting in high mortality of patients with serious enterococcal infections. Detection of resistance is thus of paramount importance. The present study aims to detect and determine the HLAR pattern of Enterococci isolated from urine samples of patients diagnosed with UTI at our hospital. Materials and Methods: This study was carried out at a tertiary care hospital in Bengaluru for a period of 1 year from January 2013 to December 2013. A total of 105 enterococcal strains were isolated from urine samples and speciated as per the scheme of Facklam and Collins. Antibiotic susceptibility was determined for various drugs by Kirby–Bauer disc diffusion method. The results were interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Ninety-three of the 105 (88.6%) isolates showed high-level resistance to gentamicin and/or streptomycin. Combined resistance to both the aminoglycosides, high level gentamicin and streptomycin (HLAR), was seen only in Enterococcus faecalis 20/105 (19.04%). Of the two isolates of Enterococcus faecium, 1 (50%) was seen to be resistant to high level gentamicin. The HLAR E. faecalis and E. faecium isolates also showed concordant resistance to multiple antibiotics including vancomycin. Conclusion: This study highlights the need to screen for HLAR in patients suffering from enterococcal infections. Routine screening for HLAR is important to limit the spread of resistance and to have a surveillance program.
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Annals of Tropical Medicine and Public Health 2016 9(3):165-169
Aims: Enterococcus species are major nosocomial pathogens and they most commonly cause urinary tract infections (UTIs), exhibiting vancomycin and high-level aminoglycoside resistance (HLAR) with increasing frequency, resulting in high mortality of patients with serious enterococcal infections. Detection of resistance is thus of paramount importance. The present study aims to detect and determine the HLAR pattern of Enterococci isolated from urine samples of patients diagnosed with UTI at our hospital. Materials and Methods: This study was carried out at a tertiary care hospital in Bengaluru for a period of 1 year from January 2013 to December 2013. A total of 105 enterococcal strains were isolated from urine samples and speciated as per the scheme of Facklam and Collins. Antibiotic susceptibility was determined for various drugs by Kirby–Bauer disc diffusion method. The results were interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Ninety-three of the 105 (88.6%) isolates showed high-level resistance to gentamicin and/or streptomycin. Combined resistance to both the aminoglycosides, high level gentamicin and streptomycin (HLAR), was seen only in Enterococcus faecalis 20/105 (19.04%). Of the two isolates of Enterococcus faecium, 1 (50%) was seen to be resistant to high level gentamicin. The HLAR E. faecalis and E. faecium isolates also showed concordant resistance to multiple antibiotics including vancomycin. Conclusion: This study highlights the need to screen for HLAR in patients suffering from enterococcal infections. Routine screening for HLAR is important to limit the spread of resistance and to have a surveillance program.
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Still the role of Prevotella corporis in oral and nonoral diseases is not clear?
Ali Mehrabi Tavana
Annals of Tropical Medicine and Public Health 2016 9(3):204-205
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Annals of Tropical Medicine and Public Health 2016 9(3):204-205
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Adenosine deaminase: A sensitive and cost-effective method for the detection of tuberculous pleural effusion in a developing state like Bihar, India
Mahasweta Mallik, Richa Bhartiya, Rashmi Singh, Manish Kumar, Naveen Kumar Bariar
Annals of Tropical Medicine and Public Health 2016 9(3):170-173
Background: Tuberculosis remains a worldwide public health hazard even today. To diagnose tuberculosis in exudative pleural effusion still remains a challenge. Tests such as Tuberculin test, direct AFB demonstration by microscope, Acid Fast Bacili (AFB) culture and PCR have low sensitivity in pleural effusion. In a poor state like Bihar (India) a panel of investigations is not possible for the patient. Aim: The aim of this study is to diagnose tuberculous pleural effusion by estimating Adenosine Deaminase in the pleural effusion fluid that is both cost-effective and sensitive. Setting and Design: 100 cases of pleural effusion were studied in Patna Medical College and ADA values were estimated. For tuberculosis, the cut-off value was taken as 40U/L at 37°C. Statistical analysis: The sensitivity and specificity of ADA were 97.05% and 95.83% respectively. Material and Method: Alongwith physical, chemical and microscopical examination of pleural fluid, culture for AFB was also done and ADA was estimated by Galanti and Giusti's colorimetric method. Results: ADA is highly sensitive and specific and its value is significant in detection of tuberculous pleural effusion. Conclusion: ADA is a useful method to diagnose tuberculous pleural effusion among the people in a developing state like Bihar.
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Annals of Tropical Medicine and Public Health 2016 9(3):170-173
Background: Tuberculosis remains a worldwide public health hazard even today. To diagnose tuberculosis in exudative pleural effusion still remains a challenge. Tests such as Tuberculin test, direct AFB demonstration by microscope, Acid Fast Bacili (AFB) culture and PCR have low sensitivity in pleural effusion. In a poor state like Bihar (India) a panel of investigations is not possible for the patient. Aim: The aim of this study is to diagnose tuberculous pleural effusion by estimating Adenosine Deaminase in the pleural effusion fluid that is both cost-effective and sensitive. Setting and Design: 100 cases of pleural effusion were studied in Patna Medical College and ADA values were estimated. For tuberculosis, the cut-off value was taken as 40U/L at 37°C. Statistical analysis: The sensitivity and specificity of ADA were 97.05% and 95.83% respectively. Material and Method: Alongwith physical, chemical and microscopical examination of pleural fluid, culture for AFB was also done and ADA was estimated by Galanti and Giusti's colorimetric method. Results: ADA is highly sensitive and specific and its value is significant in detection of tuberculous pleural effusion. Conclusion: ADA is a useful method to diagnose tuberculous pleural effusion among the people in a developing state like Bihar.
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Change of platelet count during hospitalization in patients with Ebola virus disease
Somsri Wiwanitkit, Viroj Wiwanitkit
Annals of Tropical Medicine and Public Health 2016 9(3):208-209
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Annals of Tropical Medicine and Public Health 2016 9(3):208-209
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Complementary and alternative medicine use decreases adherence to prescribed medication in diabetes patients
Sofa Dewi Alfian, Hadyana Sukandar, Nita Arisanti, Rizky Abdulah
Annals of Tropical Medicine and Public Health 2016 9(3):174-179
Context: The use of complementary and alternative medicine (CAM) is common among type 2 diabetes mellitus (T2DM) patients in Indonesia and may potentially affect adherence to prescribed diabetes medication, leading to uncontrolled blood sugar levels and complications. Aims: The objectives of this study were to analyze the association of CAM use with adherence to prescribed diabetes medication and to identify predictors of low adherence to prescribed diabetes medication. Settings and Design: A cross-sectional survey was done in a secondary health care facility in Bandung city, Indonesia. Data were collected between February and April 2014 from 114 respondents selected through consecutive sampling. Statistical Analysis Used: Chi-square test and ordinal logistic regression were used for statistical analysis. Results: The result showed that 64.9% of the respondents used CAM with herbal products (54.4%), ceragem (16.7%), and massage (12.3%) as the most widely used types. CAM use was found to significantly decrease adherence to prescribed diabetes medication (P < 0.05). The multivariate analysis suggested that the predictors of low adherence were CAM used [adjusted odds ratio (ORadj) 6.16; 2.44-15.52], gender (ORadj2.57; 1.05-6.31), and age (ORadj4.25; 1.53-11.31). Conclusions: CAM use decreased adherence to prescribed medication in T2DM patients. Gender and age were also associated with adherence. Instead of ignoring CAM use among patients, health professionals should have increased awareness and better training about CAM so that they can provide patients with relevant information and assist them in their decision-making regarding CAM use.
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Annals of Tropical Medicine and Public Health 2016 9(3):174-179
Context: The use of complementary and alternative medicine (CAM) is common among type 2 diabetes mellitus (T2DM) patients in Indonesia and may potentially affect adherence to prescribed diabetes medication, leading to uncontrolled blood sugar levels and complications. Aims: The objectives of this study were to analyze the association of CAM use with adherence to prescribed diabetes medication and to identify predictors of low adherence to prescribed diabetes medication. Settings and Design: A cross-sectional survey was done in a secondary health care facility in Bandung city, Indonesia. Data were collected between February and April 2014 from 114 respondents selected through consecutive sampling. Statistical Analysis Used: Chi-square test and ordinal logistic regression were used for statistical analysis. Results: The result showed that 64.9% of the respondents used CAM with herbal products (54.4%), ceragem (16.7%), and massage (12.3%) as the most widely used types. CAM use was found to significantly decrease adherence to prescribed diabetes medication (P < 0.05). The multivariate analysis suggested that the predictors of low adherence were CAM used [adjusted odds ratio (ORadj) 6.16; 2.44-15.52], gender (ORadj2.57; 1.05-6.31), and age (ORadj4.25; 1.53-11.31). Conclusions: CAM use decreased adherence to prescribed medication in T2DM patients. Gender and age were also associated with adherence. Instead of ignoring CAM use among patients, health professionals should have increased awareness and better training about CAM so that they can provide patients with relevant information and assist them in their decision-making regarding CAM use.
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Uvular amputation through traditional manual uvulectomy
Yassar Alamri
Annals of Tropical Medicine and Public Health 2016 9(3):213-213
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Annals of Tropical Medicine and Public Health 2016 9(3):213-213
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Experience with colposcopy at Aminu Kano Teaching Hospital, Kano, North-Western Nigeria
Usman Aliyu Umar, Ibrahim Adamu Yakasai
Annals of Tropical Medicine and Public Health 2016 9(3):180-183
Background: The first 2 years' experience of a colposcopy clinic at our teaching hospital was analyzed. Establishment of the clinic was supervised by consultants trained in colposcopy. Objective: To review the performance of the clinic from its inception in 2010. Materials and Methods: A study of 90 patients who were referred for colposcopy was conducted. Data were extracted from patients' folders and records in the colposcopy and histopathology register and analyzed using EPI INFOTM 7. Results: Fifty-one women were referred on account of abnormal Papanicolaou (Pap) smears indicating either low grade squamous lesion (44%) or high grade lesion (12.2%). Thirteen patients (14.4%) had persistent inflammatory smears while 26 patients (28.9%) where referred on account of suspicious cervix. Abnormal colposcopic findings were reported in 48 patients who subsequently had colposcopically directed punch biopsy. The result of the biopsy showed that 18 patients had cervical intraepithelial neoplasia (CIN) I. Only two of these had high grade lesion; the remaining had low grade lesion (81% concordance). Nineteen women had either CIN II or CIN III. Only two cases were reported as low grade lesions and one case as suspected invasive cervical cancer on colposcopy. The remaining had high grade lesion (85% concordance %). Overall, the colposcopic impression was in agreement with the histological diagnosis in 87% of the cases. Conclusion: Our initial experience with colposcopy shows good correlation/agreement between colposcopic impression and histological diagnosis. This has improved the detection rate of premalignant and malignant disease of the cervix in our center.
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Annals of Tropical Medicine and Public Health 2016 9(3):180-183
Background: The first 2 years' experience of a colposcopy clinic at our teaching hospital was analyzed. Establishment of the clinic was supervised by consultants trained in colposcopy. Objective: To review the performance of the clinic from its inception in 2010. Materials and Methods: A study of 90 patients who were referred for colposcopy was conducted. Data were extracted from patients' folders and records in the colposcopy and histopathology register and analyzed using EPI INFOTM 7. Results: Fifty-one women were referred on account of abnormal Papanicolaou (Pap) smears indicating either low grade squamous lesion (44%) or high grade lesion (12.2%). Thirteen patients (14.4%) had persistent inflammatory smears while 26 patients (28.9%) where referred on account of suspicious cervix. Abnormal colposcopic findings were reported in 48 patients who subsequently had colposcopically directed punch biopsy. The result of the biopsy showed that 18 patients had cervical intraepithelial neoplasia (CIN) I. Only two of these had high grade lesion; the remaining had low grade lesion (81% concordance). Nineteen women had either CIN II or CIN III. Only two cases were reported as low grade lesions and one case as suspected invasive cervical cancer on colposcopy. The remaining had high grade lesion (85% concordance %). Overall, the colposcopic impression was in agreement with the histological diagnosis in 87% of the cases. Conclusion: Our initial experience with colposcopy shows good correlation/agreement between colposcopic impression and histological diagnosis. This has improved the detection rate of premalignant and malignant disease of the cervix in our center.
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Outbreak of cholera at the Thai-Myanmar border: An issue in transboundary tropical medicine
Beuy Joob, Viroj Wiwanitkit
Annals of Tropical Medicine and Public Health 2016 9(3):200-201
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Annals of Tropical Medicine and Public Health 2016 9(3):200-201
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Postnatal depression and its associated factors among Northeastern Nigerian women
Dauda Sulyman, Kazeem Ayinde Ayanda, Lamaran Makama Dattijo, Bappah Muhammad Aminu
Annals of Tropical Medicine and Public Health 2016 9(3):184-190
Background: Postnatal depression is a serious psychiatric condition that occurs in puerperium. It is associated with increased morbidity and can overwhelm new mothers and interfere with the care of their babies. This study aimed to determine the prevalence rate of postnatal depression and assess factors that are associated with its development among northeastern Nigerian women. Materials and Methods: Edinburgh Postnatal Depression Scale (EPDS) questionnaire was administered to four hundred and eighty-three women who delivered at the maternity unit of a tertiary health institution in northeastern Nigeria. Their sociodemographic and clinical variables were also obtained using pro forma questionnaire designed by the researchers. Results: One hundred and eight respondents scored 13 or more points on EPNDS, making the prevalence rate of postnatal depression 22.4%. Factors that are associated with the development of postnatal depression are unemployment [odds ratio (OR) = 0.49, 95% (CI) = 0.27-0.86, P value = 0.018), lack of support from the husband (OR = 0.34, 95% CI = 0.19-0.60, P value = 0.000), and primiparity (OR = 0.56, 95% CI = 0.35-0.88, P value = 0.013); others are unplanned pregnancy (OR = 0.56, 95% CI = 0.35-0.88, P value = 0.013) and physical illness in the mother (OR = 1.81, 95% CI = 1.77-2.79, P value = 0.007). Conclusion: The study showed that a significant proportion of new mothers have postnatal depression. This may negatively affect their parenting skills and may have adverse effects on them and their children. Early detection and effective management, together with an efficient collaboration among psychiatrists, obstetricians, and other health workers who are involved in the care of new mothers, will go a long way in reducing the negative consequences that may result from this condition.
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Annals of Tropical Medicine and Public Health 2016 9(3):184-190
Background: Postnatal depression is a serious psychiatric condition that occurs in puerperium. It is associated with increased morbidity and can overwhelm new mothers and interfere with the care of their babies. This study aimed to determine the prevalence rate of postnatal depression and assess factors that are associated with its development among northeastern Nigerian women. Materials and Methods: Edinburgh Postnatal Depression Scale (EPDS) questionnaire was administered to four hundred and eighty-three women who delivered at the maternity unit of a tertiary health institution in northeastern Nigeria. Their sociodemographic and clinical variables were also obtained using pro forma questionnaire designed by the researchers. Results: One hundred and eight respondents scored 13 or more points on EPNDS, making the prevalence rate of postnatal depression 22.4%. Factors that are associated with the development of postnatal depression are unemployment [odds ratio (OR) = 0.49, 95% (CI) = 0.27-0.86, P value = 0.018), lack of support from the husband (OR = 0.34, 95% CI = 0.19-0.60, P value = 0.000), and primiparity (OR = 0.56, 95% CI = 0.35-0.88, P value = 0.013); others are unplanned pregnancy (OR = 0.56, 95% CI = 0.35-0.88, P value = 0.013) and physical illness in the mother (OR = 1.81, 95% CI = 1.77-2.79, P value = 0.007). Conclusion: The study showed that a significant proportion of new mothers have postnatal depression. This may negatively affect their parenting skills and may have adverse effects on them and their children. Early detection and effective management, together with an efficient collaboration among psychiatrists, obstetricians, and other health workers who are involved in the care of new mothers, will go a long way in reducing the negative consequences that may result from this condition.
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Change in T wave in severe fever with thrombocytopenia syndrome: A note
Viroj Wiwanitkit
Annals of Tropical Medicine and Public Health 2016 9(3):202-202
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Annals of Tropical Medicine and Public Health 2016 9(3):202-202
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Tick bite: Report of a rare case
Angoori Gnaneshwar Rao, Supraja Devi Chataraju
Annals of Tropical Medicine and Public Health 2016 9(3):191-193
Tick bites are uncommon and are vectors of a number of skin diseases; some are innocuous and others deleterious. Herein, we report a case of tick bite in a 50-year-old man who presented with an insect in the abdominal wall, unassociated with systemic involvement. Examination revealed the presence of a tick in the abdominal wall (near the right hypochondrium) with head embedded in it. There is an erythematous, edematous swelling surrounding the bite with elevated skin fold covering the head of the tick. Biopsy from the swelling after the removal of tick revealed foci of fibrinoid material with perivascular lymphocytes, neutrophils, and histiocytes in the dermis.
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Annals of Tropical Medicine and Public Health 2016 9(3):191-193
Tick bites are uncommon and are vectors of a number of skin diseases; some are innocuous and others deleterious. Herein, we report a case of tick bite in a 50-year-old man who presented with an insect in the abdominal wall, unassociated with systemic involvement. Examination revealed the presence of a tick in the abdominal wall (near the right hypochondrium) with head embedded in it. There is an erythematous, edematous swelling surrounding the bite with elevated skin fold covering the head of the tick. Biopsy from the swelling after the removal of tick revealed foci of fibrinoid material with perivascular lymphocytes, neutrophils, and histiocytes in the dermis.
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TAS3 R a p i d Extraction Training
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the crash," he said. Crews used a newly introduced technique developed in Norway, "time-critical extraction". Instead of using conventional jaws of life and hydraulics to push the shattered chassis away from the patient, they used chains attached to a fire engine to pull them, getting her out and enabling medical treatment to take place within 10 minutes. http://ift.tt/1INuGxU http://ift.tt/1NXGQ3f Thx, Norwegian Air Ambulance (SNLA )! http://ift.tt/1rSwYVH R.I.P. http://ift.tt/24oGaCj ExEMTNor
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Adult Neandertal clavicles from the El Sidrón site (Asturias, Spain) in the context of Homo pectoral girdle evolution
Publication date: June 2016
Source:Journal of Human Evolution, Volume 95
Author(s): Antonio Rosas, Francisco Javier Rodriguez-Perez, Markus Bastir, Almudena Estalrrich, Rosa Huguet, Antonio García-Tabernero, Juan Francisco Pastor, Marco de la Rasilla
We undertook a three-dimensional geometric morphometric (3DGM) analysis on 12 new Neandertal clavicle specimens from the El Sidrón site (Spain), dated to 49,000 years ago. The 3DGM methods were applied in a comparative framework in order to improve our understanding of trait polarity in features related to Homo pectoral girdle evolution, using other Neandertals, Homo sapiens, Pan, ATD6-50 (Homo antecessor), and KNM-WT 15000 (Homo ergaster/erectus) in the reference collection. Twenty-nine homologous landmarks were measured for each clavicle. Variation and morphological similarities were assessed through principal component analysis, conducted separately for the complete clavicle and the diaphysis. On average, Neandertal clavicles had significantly larger muscular entheses, double dorsal curvature, clavicle torsion, and cranial orientation of the acromial end than non-Neandertal clavicles; the El Sidrón clavicles fit this pattern. Variation within the samples was large, with extensive overlap between Homo species; only chimpanzee specimens clearly differed from the other specimens in morphometric terms. Taken together, our morphometric analyses are consistent with the following phylogenetic sequence. The primitive condition of the clavicle is manifest in the cranial orientation of both the acromial and sternal ends. The derived condition expressed in the H. sapiens + Neandertal clade is defined by caudal rotation of both the sternal and acromial ends, but with variation in the number of acromia remaining in a certain cranial orientation. Finally, the autapomorphic Neandertal condition is defined by secondarily acquired primitive cranial re-orientation of the acromial end, which varies from individual to individual. These results suggest that the pace of phylogenetic change in the pectoral girdle does not seem to follow that of other postcranial skeletal features.
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TAS3 R a p i d Extraction Training
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the crash," he said. Crews used a newly introduced technique developed in Norway, "time-critical extraction". Instead of using conventional jaws of life and hydraulics to push the shattered chassis away from the patient, they used chains attached to a fire engine to pull them, getting her out and enabling medical treatment to take place within 10 minutes. http://ift.tt/1INuGxU http://ift.tt/1NXGQ3f Thx, Norwegian Air Ambulance (SNLA )! http://ift.tt/1rSwYVH R.I.P. http://ift.tt/24oGaCj ExEMTNor
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Laminar closure after expansive open-door laminoplasty: fixation methods and cervical alignments impact on the laminar closure and surgical outcomes.
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Sub-sensory vibratory noise augments the physiologic complexity of postural control in older adults
Postural control requires numerous inputs interacting across multiple temporospatial scales. This organization, evidenced by the "complexity" contained within standing postural sway fluctuations, enables diver...
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TAS3 R a p i d Extraction Training
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the crash," he said. Crews used a newly introduced technique developed in Norway, "time-critical extraction". Instead of using conventional jaws of life and hydraulics to push the shattered chassis away from the patient, they used chains attached to a fire engine to pull them, getting her out and enabling medical treatment to take place within 10 minutes. http://ift.tt/1INuGxU http://ift.tt/1NXGQ3f Thx, Norwegian Air Ambulance (SNLA )! http://ift.tt/1rSwYVH ExEMTNor
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Reply to “The Origin of the Abnormal Muscle Response Seen in Hemifacial Spasm Remains Controversial”
We thank Drs. Kaufmann and Wilkinson (Kaufmann and Wilkinson, 2016) for commenting on our paper (Kameyama et al., 2016), but we are disappointed that they have entirely misinterpreted the intent of our study. Lateral spread, which is responsible for an abnormal muscle response (AMR), takes place at or near the compression site and not, as they propose, at the facial nucleus, but our study does not exclude central hyperexcitability, which we believe is also relevant, based on many previous reports including our own (Kimura et al., 1975).
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Maturation of the P3 and concurrent oscillatory processes during adolescence
Developmental trajectories during adolescence may have lasting influence on mental health, social integration and cognitive abilities during adulthood (Kaiser and Gruzelier, 1999; Nuechterlein et al., 2014; Pantelis et al., 2009). Recent studies argue that social and cognitive abilities improve throughout the entire maturational period of life, including adolescence (Amso et al., 2014; Anderson et al., 2001; Blakemore and Choudhury, 2006).An event-related potential measured with the electroencephalogram (EEG), the P3, is suited to investigate maturation of neural processes activated during cognitive tasks (Polich et al., 1990; van Dinteren et al., 2014b).
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Epstein–Barr virus associated multi-organ smooth muscle tumours following renal transplantation
A 19-year-old girl underwent renal transplantation for end-stage renal disease. She had been Epstein–Barr virus (EBV)-naïve pre-transplant and seroconverted 15 months later but had been well.
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Primary melanoma of the stomach treated by BRAF inhibitor and immunotherapy
In January 2014 a 75 years-old man was admitted to the emergency department because of melena. The laboratory tests showed severe anaemia (haemoglobin 6.3g/dl). An emergency esophagogastroduodenoscopy found a bleeding pigmented brown ulcerate lesion with irregular margins of 4cm (Figs. 1 and 2). Several biopsies were performed and the final histological diagnosis revealed primary melanoma of the stomach. The lesion was BRAF V600E mutated. Extensive dermatological and ophthalmological evaluation excluded other primary lesions.
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French national consensus clinical guidelines for the management of ulcerative colitis
Ulcerative colitis (UC) is a chronic inflammatory bowel disease of multifactorial etiology that primarily affects the colonic mucosa. The disease progresses over time, and clinical management guidelines should reflect its dynamic nature. There is limited evidence supporting UC management in specific clinical situations, thus precluding an evidence-based approach.
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TAS3 R a p i d Extraction Training
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the crash," he said. Crews used a newly introduced technique developed in Norway, "time-critical extraction". Instead of using conventional jaws of life and hydraulics to push the shattered chassis away from the patient, they used chains attached to a fire engine to pull them, getting her out and enabling medical treatment to take place within 10 minutes. http://ift.tt/1INuGxU http://ift.tt/1NXGQ3f Thx, Norwegian Air Ambulance ! ExEMTNor
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Reply to “The Origin of the Abnormal Muscle Response Seen in Hemifacial Spasm Remains Controversial”
Source:Clinical Neurophysiology
Author(s): Shigeki Kameyama, Jun Kimura
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TAS3 R a p i d Extraxion Training
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the crash," he said. Crews used a newly introduced technique developed in Norway, "time-critical extraction". Instead of using conventional jaws of life and hydraulics to push the shattered chassis away from the patient, they used chains attached to a fire engine to pull them, getting her out and enabling medical treatment to take place within 10 minutes. http://ift.tt/1INuGxU http://ift.tt/1NXGQ3f Thx, Norwegian Air Ambulance ! ExEMTNor
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Epstein–Barr virus associated multi-organ smooth muscle tumours following renal transplantation
A 19-year-old girl underwent renal transplantation for end-stage renal disease. She had been Epstein–Barr virus (EBV)-naïve pre-transplant and seroconverted 15 months later but had been well.
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Primary melanoma of the stomach treated by BRAF inhibitor and immunotherapy
In January 2014 a 75 years-old man was admitted to the emergency department because of melena. The laboratory tests showed severe anaemia (haemoglobin 6.3g/dl). An emergency esophagogastroduodenoscopy found a bleeding pigmented brown ulcerate lesion with irregular margins of 4cm (Figs. 1 and 2). Several biopsies were performed and the final histological diagnosis revealed primary melanoma of the stomach. The lesion was BRAF V600E mutated. Extensive dermatological and ophthalmological evaluation excluded other primary lesions.
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French national consensus clinical guidelines for the management of ulcerative colitis
Ulcerative colitis (UC) is a chronic inflammatory bowel disease of multifactorial etiology that primarily affects the colonic mucosa. The disease progresses over time, and clinical management guidelines should reflect its dynamic nature. There is limited evidence supporting UC management in specific clinical situations, thus precluding an evidence-based approach.
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Sex-dependent effects of stress on brain correlates to empathy for pain
Publication date: Available online 3 May 2016
Source:International Journal of Psychophysiology
Author(s): Cristina Gonzalez-Liencres, Anja Breidenstein, Oliver T. Wolf, Martin Brüne
Empathy is a fundamental attribute required for appropriate social functioning. The extent to which we empathize with others in pain is influenced by numerous factors. Being highly social species, humans face social stress on a regular basis, which undoubtedly affects how we react to our environment. It is not yet known how social stress may modulate our neural mechanisms when we empathize with others in painful circumstances, and its effects on empathic behavior are still unclear. For this reason, we recorded the electroencephalography (EEG) of healthy men and women, half of which were previously exposed to psychosocial stress, while they observed photographs of hands in painful and neutral situations. At the behavioral level, stress induced higher unpleasantness ratings to painful stimuli, and lower ratings to neutral pictures, independent of sex. At the neurophysiological level, we found that early (N110 over fronto-central sites) event-related potentials (ERPs) were not affected by stress, while late (P3 over centro-parietal regions) components showed a sex-dependent differential effect of stress. Correlation analyses further indicated a strong association between N110 with trait markers of empathy in all participants, while P3 was associated with the change in cortisol in stressed males. Our findings suggest that sex-dependent effects of social stress on the neural responses to empathy for pain give rise to comparable behaviors in men and women in the paradigm we employed, implying that each sex may engage in distinct mechanisms to cope with stress. Moreover, stress seems to modulate late neural mechanisms of empathy but not our early perception.
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Firefighter Paramedic - Madeira Beach Fire Department
MADEIRA BEACH FIRE DEPARTMENT 250 MUNICIPAL DRIVE MADEIRA BEACH, FLORIDA 33710 Updated: May 02, 2016 Job Classification: Firefighter/Paramedic Madeira Beach Fire Department is currently seeking a Firefighter/Paramedic. Consideration will be given to Paramedics enrolled in a firefighting academy and FF/EMTs enrolled in a Paramedic program, both with expected graduation of 12 months from the first day ...
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Educational review of Perioperative Medicine for the Junior Clinician
Corrugated fiberboard, most commonly known as cardboard, was invented in 1874. Before this time, manufacturers used sturdy wooden boxes for shipment of wholesale items to retailers. Our industrious forefathers in the 18th and 19th centuries did not see those wooden crates as an object to be discarded but as a spark to ignite reform, change, and progress (or at least irritate passers-by). While cardboard might have robbed us of the opportunity to participate in the original application of this great change force, we still have the linguistic remnant in our vocal armamentarium: the soapbox.
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The role of intraoperative transesophageal echocardiographic monitoring in a patient with hypertrophic cardiomyopathy undergoing laparoscopic surgery
Hypertrophic cardiomyopathy (HCM) presents a significant perioperative challenge. Anesthetic drugs, patient positioning, and surgical technique can provoke worsening left ventricular outflow tract obstruction and hemodynamic deterioration. In this case report, we present the perioperative management of a 70-year-old male with a history of HCM who underwent a robotic laparoscopic prostatectomy. Discussion focuses on the utilization of echocardiographic guidance in the care of patients with HCM undergoing noncardiac surgery, as well as the pathophysiology of laparoscopic insufflation and its effects on left ventricular outflow tract obstruction in HCM.
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Difficult airway in Mowat-Wilson syndrome
Mowat-Wilson syndrome is a rare congenital syndrome involving multiple system abnormalities. The most consistently present components include facial deformity, mental retardation, and Hirschsprung disease. We report the anesthetic management of a case of Mowat-Wilson syndrome, with a difficult airway, who underwent Duhamel's procedure and colostomy closure.
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Comparison of dexamethasone or intravenous fluids or combination of both on postoperative nausea, vomiting and pain in pediatric strabismus surgery
Strabismus surgery is perhaps a pediatric surgical procedure that has the strongest evidence of postoperative nausea and vomiting (PONV) risk. This randomized controlled blind study was designed to evaluate the efficacy of combined therapy of dexamethasone and intraoperative superhydration vs their monotherapy on the incidence and severity of PONV and on pain intensity after pediatric strabismus surgery.
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LMA-ProSeal insertion by novice doctors as affected by a 90° bend created by an intubating stylet: a randomized clinical trial
This study aimed to test the hypothesis that insertion of the supraglottic device LMA-ProSeal (ProSeal) by novice doctors in anesthetized patients can be improved by using an intubating stylet to create a 90° bend and that better sealing pressure is achieved.
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The influence of patient position on withdrawal force of lumbar epidural catheters after total knee arthroplasty: A randomized trial
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Regional anesthesia practice in China: a survey
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Postoperative muscular cramp caused by lower limb ischemia related to the unilateral popliteal arteriovenous fistula
The arteriovenous fistula abnormally connects an artery and vein, and results in blood flow that bypasses the capillary beds. This disease state is rare, whether the cause is congenital or acquired [1]. We report a patient who experienced a postoperative muscular cramp caused by lower limb ischemia, related to a unilateral popliteal arteriovenous fistula.
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New technique targeting the C5 nerve root proximal to the traditional interscalene sonoanatomical approach is analgesic for outpatient arthroscopic shoulder surgery
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A comparison of prophylactic use of meperidine, meperidine plus dexamethasone, and ketamine plus midazolam for preventing of shivering during spinal anesthesia: a randomized, double-blind, placebo-controlled study
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Outpatient laparoscopic sleeve gastrectomy: first 100 cases
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Pectoralis-serratus interfascial plane block vs thoracic paravertebral block for unilateral radical mastectomy with axillary evacuation
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Entropy vs standard clinical monitoring using total intravenous anesthesia during transvaginal oocyte retrieval in patients for in vitro fertilization
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Genome-wide comparative analysis of the codon usage patterns in plants
Abstract
Codon usage analysis has been a classical area of study for decades and is important for evolution, mRNA translation, and new gene discovery. Recently, genome sequencing has made it possible to perform studies of the entire genome in plant kingdoms. The base composition of the coding sequence, codon usage pattern, codon pairs, and related indicators of relative synonymous codon usage (RSCU), including the Fop, Nc, RSCU, CAI and GC contents, were analyzed. We found that the GC content of single-celled algae is the highest, whereas dicotyledons are the lowest. Moreover, the base composition of plants is similar within the same family. In addition, the GC content of the second base of the codon is lower than the first and third base. In conclusion, the codon usage characteristics are opposite in Gramineae, single-celled algae, fern and dicotyledon, moss, and Pinaceae. Furthermore, the degree of codon usage bias is decreasing with evolution. Therefore, we hypothesize that the lower the plants, the more that they must optimize codons and that higher plants no longer need to optimize codons.
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New insights into the evolutionary history of resistance gene candidates in coconut palms and their expression profiles in palms affected by lethal yellowing disease
Abstract
The nucleotide binding site and leucine rich repeat (NBS–LRR) class of R genes is the most comprehensively studied in terms of sequence evolution; however, in coconut palm and, more generally, in the family of Arecaceae, our understanding of the evolution of these genes is rather limited. In this study, disease resistance gene candidates (RGCs) of the nucleotide binding site (NBS) type of coconut palm were used to investigate evolutionary relationships in Arecaceae, Poaceae and Brassicaceae species. The results indicate a species-specific evolution of RGCs in coconut palm. However, strikingly similar RGCs between species of Arecales indicate a high conservation of specific RGCs of this family, suggesting a monophyletic origin of three genera. The phylogenetic relationship between RGCs of Arecales and Brassicales suggests that these sequences possibly emerged before being divided between monocots and dicots. Finally the comparative analysis of the expression of four RGCs in healthy coconut palm and those affected with lethal yellowing disease revealed differences in their expression profiles. This study provides new insights for future efforts towards the improvement of disease resistance in coconut palm and other species of Arecaceae.
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A major QTL and a candidate gene for heading date in an early maturing rice mutant induced by gamma ray irradiation
Abstract
Flowering time is an important trait associated with crop yield and quality. In a previous report, genome variation of significant DNA polymorphism was observed in the early maturing type rice mutant (EMT1) compared to that of wild type (WT). To identify quantitative trait loci (QTL) for flowering time, we constructed a linkage map of 36 InDel- and 6 SNP-markers with F2 plants derived from the cross "WT × EMT1". One potential major QTL region was detected on chromosome 6. One gene of the QTL region, Heading date 1 (Hd1), exhibited relatively high nonsynonymous substitutions in the QTL region. To evaluate reliable allele segregation related to expected Mendelian ratio, M6-3 marker developed in the Hd1 gene exhibited clear monogenic segregation (1:2:1) in heterozygous F3 plants. Both GI and Hd1 were highly induced at 56 days after sowing (DAS) in EMT1 and at 70 DAS in WT. The expression of Hd3a was significantly induced at 63 DAS, when Hd1 transcripts were slightly decreased compared with those at 56 DAS, while Hd1 was induced up to 84 DAS. These findings suggested that in EMT1, Hd1 could not suppress Hd3a under LD conditions, while OsMADS50 and LFY, which are involved in temperature responsive pathways, were significantly induced at 56 DAS, 14 days earlier than in WT.
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RNA modifications: what have we learned and where are we headed?
Nature Reviews Genetics. doi:10.1038/nrg.2016.47
Authors: Michaela Frye, Samie R. Jaffrey, Tao Pan, Gideon Rechavi & Tsutomu Suzuki
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Genetic variation: Linking TF binding to disease risk using pooled ChIP–seq
Nature Reviews Genetics. doi:10.1038/nrg.2016.55
Author: Bryony Jones
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A second family with CATSHL syndrome: Confirmatory report of another unique FGFR3 syndrome
Here we describe the second reported family with the CATSHL syndrome, a condition resulting from a unique mutation in the fibroblast growth factor receptor 3 (FGFR3) gene. Our family confirms the consistent and unique phenotype of this condition, and the specificity of the mutation in FGFR3. The CATSHL syndrome appears to be an autosomal dominant disorder with full penetrance. © 2016 Wiley Periodicals, Inc.
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Exome sequencing identifies a de novo frameshift mutation in the imprinted gene ZDBF2 in a sporadic patient with Nasopalpebral Lipoma-coloboma syndrome
Nasopalpebral lipoma-coloboma syndrome (NPLCS, OMIM%167730) is an uncommon malformation entity with autosomal dominant inheritance characterized by the combination of nasopalpebral lipoma, colobomas in upper and lower eyelids, telecanthus, and maxillary hypoplasia. To date, no genetic defects have been associated with familial or sporadic NPLCS cases and the etiology of the disease remains unknown. In this work, the results of whole exome sequencing in a sporadic NPLCS patient are presented. Exome sequencing identified a de novo heterozygous frameshift dinucleotide insertion c.6245_6246 insTT (p.His2082fs*67) in ZDBF2 (zinc finger, DBF-type containing 2), a gene located at 2q33.3. This variant was absent in parental DNA, in a set of 300 ethnically matched controls, and in public exome variant databases. This is the first genetic variant identified in a NPLCS patient and evidence supporting the pathogenicity of the identified mutation is discussed. © 2016 Wiley Periodicals, Inc.
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When rumination counts: Perceived social support and heart rate variability in daily life
Abstract
Rumination and social support could modulate cardiac activity. Although both variables are somehow interrelated, they are often studied independently, and their interplay is seldom considered. We aimed to analyze the interaction of rumination and perceived social support on vagally mediated heart rate variability (HRV) in daily life. The sample consisted of 117 healthy participants (57% female, mean age = 27.9, SD = 5.5 years). Ambulatory HRV (root mean squared successive differences), respiration, body position, and body movements were recorded continuously on three consecutive weekdays. Momentary social, situational, and cognitive-affective variables (affect, ruminative thoughts, perceived social support) were assessed using a computerized diary. There was a significant interaction between momentary rumination and perceived social support on ambulatory HRV: When participants were involved in social interactions with low social support, concurrent rumination was associated with attenuated HRV. However, when rumination was accompanied by a strong sense of support, HRV significantly increased. The quality of social interactions and rumination seem to interact in daily life to predict cardiac autonomic control. The results stress the necessity to consider the interplay of psychological and social factors in order to evaluate beneficial or adverse effects on cardiac health.
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Single nucleotide polymorphism coverage and inference of N-acetyltransferase-2 acetylator phenotypes in wordwide population groups.
Objective: Several algorithms have been proposed to reduce the genotyping effort and cost, while retaining the accuracy of N-acetyltransferase-2 (NAT2) phenotype prediction. Data from the 1000 Genomes (1KG) project and an admixed cohort of Black Brazilians were used to assess the accuracy of NAT2 phenotype prediction using algorithms based on paired single nucleotide polymorphisms (SNPs) (rs1041983 and rs1801280) or a tag SNP (rs1495741). Methods: NAT2 haplotypes comprising SNPs rs1801279, rs1041983, rs1801280, rs1799929, rs1799930, rs1208 and rs1799931 were assigned according to the arylamine N-acetyltransferases database. Contingency tables were used to visualize the agreement between the NAT2 acetylator phenotypes on the basis of these haplotypes versus phenotypes inferred by the prediction algorithms. Results: The paired and tag SNP algorithms provided more than 96% agreement with the 7-SNP derived phenotypes in Europeans, East Asians, South Asians and Admixed Americans, but discordance of phenotype prediction occurred in 30.2 and 24.8% 1KG Africans and in 14.4 and 18.6% Black Brazilians, respectively. Paired SNP panel misclassification occurs in carriers of NATs haplotypes *13A (282T alone), *12B (282T and 803G), *6B (590A alone) and *14A (191A alone), whereas haplotype *14, defined by the 191A allele, is the major culprit of misclassification by the tag allele. Conclusion: Both the paired SNP and the tag SNP algorithms may be used, with economy of scale, to infer NAT2 acetylator phenotypes, including the ultra-slow phenotype, in European, East Asian, South Asian and American populations represented in the 1KG cohort. Both algorithms, however, perform poorly in populations of predominant African descent, including admixed African-Americans, African Caribbeans and Black Brazilians. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
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Mouse model for molybdenum cofactor deficiency type B recapitulates the phenotype observed in molybdenum cofactor deficient patients
Abstract
Molybdenum cofactor (MoCo) deficiency is a rare, autosomal-recessive disorder, mainly caused by mutations in MOCS1 (MoCo deficiency type A) or MOCS2 (MoCo deficiency type B) genes; the absence of active MoCo results in a deficiency in all MoCo-dependent enzymes. Patients with MoCo deficiency present with neonatal seizures, feeding difficulties, severe developmental delay, brain atrophy and early childhood death. Although substitution therapy with cyclic pyranopterin monophosphate (cPMP) has been successfully used in both Mocs1 knockout mice and in patients with MoCo deficiency type A, there is currently no Mocs2 knockout mouse and no curative therapy for patients with MoCo deficiency type B. Therefore, we generated and characterized a Mocs2-null mouse model of MoCo deficiency type B. Expression analyses of Mocs2 revealed a ubiquitous expression pattern; however, at the cellular level, specific cells show prominent Mocs2 expression, e.g., neuronal cells in cortex, hippocampus and brainstem. Phenotypic analyses demonstrated that Mocs2 knockout mice failed to thrive and died within 11 days after birth. None of the tested MoCo-dependent enzymes were active in Mocs2-deficient mice, leading to elevated concentrations of purines, such as hypoxanthine and xanthine, and non-detectable levels of uric acid in the serum and urine. Moreover, elevated concentrations of S-sulfocysteine were measured in the serum and urine. Increased levels of xanthine resulted in bladder and kidney stone formation, whereas increased concentrations of toxic sulfite triggered neuronal apoptosis. In conclusion, Mocs2-deficient mice recapitulate the severe phenotype observed in humans and can now serve as a model for preclinical therapeutic approaches for MoCo deficiency type B.
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