qPCR and mtDNA SNP analysis of experimentally degraded hair samples and its application in forensic casework

A mitochondrial DNA (mtDNA) quantification PCR (qPCR) method was developed and applied in a study with experimentally degraded hair samples (first study) and in a criminal case (second study). In the first study, the amount of detectable mtDNA decreased drastically after an incubation time of 1 month on a moist tissue in a heating cabin at 37°C. In the second study, when the qPCR assay showed positive quantification results, further analysis of 32 mtDNA single-nucleotide polymorphisms (SNPs) via SNaPshot technique was always possible, indicating that successful mtDNA SNP analysis of forensic samples can be guaranteed by pre-screening samples with the qPCR described here.     

Feasibility and Safety of Transradial Arterial Approach for Simultaneous Right and Left Vertebral Artery Angiographic Studies and Stenting

Objectives This study investigated whether the transradial artery (TRA) approach using a 6-French (F) Kimny guiding catheter for right vertebral artery (VA) angiographic study and stenting is safe and effective for patients with significant VA stenosis. Background The TRA approach is commonly performed worldwide for both diagnostic cardiac catheterization and catheter-based coronary intervention. However, to our knowledge, the safety and feasibility of left and right VA angiographic study and stenting, in the same procedure, using the TRA approach for patients with brain ischemia have not been reported. Methods The study included 24 consecutive patients (22 male,2 female; age, 63–78 years). Indications for VA angiographic study and stenting were (1) prior stroke or symptoms related to vertebrobasilar ischemia and (2) an asymptomatic but vertebral angiographic finding of severe stenosis (>70%). A combination of the ipsilateral and retrograde-engagement technique, which involved a looping 6-F Kimny guiding catheter, was utilized for VA angiographic study. For VA stenting, an ipsilateral TRA approach with either a Kimny guiding catheter or a left internal mammary artery guiding catheter was utilized in 22 patients and retrograde-engagement technique in 2 patients. Results A technically successful procedure was achieved in all patients, including left VA stenting in 15 patients and right VA stenting in 9 patients. The mean time for stenting (from engagement to stent deployment) was 12.7 min. There were no vascular complications or mortality. However, one patient suffered from a transient ischemic attack that resolved within 3 h. Conclusion We conclude that TRA access for both VA angiographic study and VA stenting is safe and effective, and provides a simple and useful clinical tool for patients unsuited for femoral arterial access.     

Imaging of questionable and unusual pelvic masses

Ultrasonography is usually the initial diagnostic examination performed for evaluating gynaecological conditions and pelvic masses. The authors' experience with 11 "problem cases" and a review of the literature of such enigmas has led to the following recommendations in the following order: a plain radiograph or repeat ultrasound study; ultrasound study with the water enema technique; gastrointestinal examination if the answer is still not apparent, followed by computed tomography or a real-time ultrasound study during a clinical pelvic examination.     

Plague and war: political breakdown and the spread of HIV

This exploratory data analysis finds a negative relationship between some types of war and HIV prevalence (i.e. as the former increases in intensity, the latter decreases). The study uses a longer time-frame and broader range of countries than similar studies, with explicit differentiation between sub-Saharan African and other developing countries. The study uses a variety of methods for analyzing time-series-cross-section data. These methods serve as both a robustness check for the results as well as a real-world demonstration of common suggestions for TSCS data.     

腹膜后纤维化的CT、MRI表现

目的：研究腹膜后纤维化的ＣＴ、ＭＲＩ表现。方法：本组经临床病理证实病例８例,其中男５例、女３例,平均年龄４８．０岁。特发性６例,非特发性２例。８例全部进行了ＣＴ扫描,其中２例作了强化扫描,１例进行了ＭＲＩ扫描。结果：８例中病变呈弥漫性３例,肿块性５例。ＣＴ平扫可呈低密度、不均匀密度或等密度,增强扫描显示不同程度强化。ＭＲＩ、Ｔ１ＷＩ、Ｔ２ＷＩ呈低信号强度。结论：本病为一种ＣＴ扫描表现多变的少见疾病,如腹膜后出现弥漫或肿块样病变合并肾及输尿管积水时应考虑到本病诊断。     

Eating disorders and associated symptoms among adolescent Swimmers

The article reports on two studies investigating the frequency of eating disorders among swimmers. The first study was a screening based on self-report only and the second was a controlled study with a clinical interview of alle subjects. In the screening study, 28% of men and 3.5% of women had suspected eating disorder symptoms. No significant relationship was found between risk levels and competitive levels. In the controlled study, no indications of anorexia nervosa were found. Among Swimmers, 3.2% satisfied the DSM-III-R criteria for bulimia nervosa, and 9.7% had partial bulimic conditions. The results did not support the hypothesis of an increased frequency of clinical or partial eating disorders in elite athletes. The presence of symptoms was more related to being a woman rather than being a swimmer. Suggestions for further research are outlined to determine the causal relationship between sports and eating disorders.     

冲和药物速渗治疗仪与正骨、针刀联合治疗腰软组织伤病研究

 目的 研究冲和药物速渗治疗仪与正骨、针刀疗法联合治疗腰软组织训练伤病的临床疗效、作用机制和不良反应.方法 将腰部软组织训练伤病患者80例随机分为冲和组和常规组.冲和组40例,采用每日1次冲和治疗,7次为一疗程;常规组40例,采用理疗、按摩等常规治疗方法;应用脊柱运动范围(Taimela test)测量腰椎活动度评估疗效.结果 经治疗2周后两组有效率:冲和组86.5%、常规组74.6%,差别虽无统计学意义,但观察随访1年,冲和组腰部损伤事件发生率明显低于常规组(P<0.01);治疗前后两组腰椎活动度相比较有统计学意义(P<0.01).结论 药械冲和疗法具有疏理肌丝,改善病理性骨骼肌细胞重构的作用,可有效地改变推拿、针刀术后肌丝修复过程中的粘连、结节和瘢痕形成等的病理过程,是正骨、针刀术后的连续性治疗方法.     

Static and mobile DXA scanner in-vivo cross-calibration study

In-vitro cross-calibration of DXA scanning equipment, with a phantom device, has been recommended for assessing agreement between devices co-located within DXA scanning services.This study evaluated in-vivo and in-vitro cross-calibration of a static and a mobile DXA scanner within the same service in their individual clinical settings.50 individuals from a volunteer group were recruited to take part in this study and had DXA measurements made on two GE Lunar Prodigy Advance (GE Lunar, Bedford, UK) scanners.Results in this study showed that the scanners agreed, with no clinically significant differences in BMD measurements made at the same site on the individual devices used in this study. The in-vivo cross-calibration of the instruments was a useful experience, which demonstrated closely calibrated systems and raised the profile of the bone densitometry service within the hospital.     

Design and analysis of research on sport performance enhancement

PURPOSE: The purpose of this study was to assess research aimed at measuring performance enhancements that affect success of individual elite athletes in competitive events. ANALYSIS: Simulations show that the smallest worthwhile enhancement of performance for an athlete in an international event is 0.7-0.4 of the typical within-athlete random variation in performance between events. Using change in performance in events as the outcome measure in a crossover study, researchers could delimit such enhancements with a sample of 16-65 athletes, or with 65-260 in a fully controlled study. Sample size for a study using a valid laboratory or field test is proportional to the square of the within-athlete variation in performance in the test relative to the event; estimates of these variations are therefore crucial and should be determined by repeated-measures analysis of data from reliability studies for the test and event. Enhancements in test and event may differ when factors that affect performance differ between test and event; overall effects of these factors can be determined with a validity study that combines reliability data for test and event. A test should be used only if it is valid, more reliable than the event, allows estimation of performance enhancement in the event, and if the subjects replicate their usual training and dietary practices for the study; otherwise the event itself provides the only dependable estimate of performance enhancement. Publication of enhancement as a percent change with confidence limits along with an analysis for individual differences will make the study more applicable to athletes. Outcomes can be generalized only to athletes with abilities and practices represented in the study. CONCLUSION: estimates of enhancement of performance in laboratory or field tests in most previous studies may not apply to elite athletes in competitive events.     

Mammography in the pre-operative assessment and post-operative surveillance of patients treated by excision and radiotherapy for primary breast cancer

To evaluate the place of mammography in the selection of patients for excision and radiotherapy for primary breast cancer a detailed analysis of pre-operative mammograms was performed in (i) a study group of 37 patients who developed local recurrence; (ii) a matched control group with a median local recurrence free survival of 57 months. There were significantly more multifocal tumours in the study group. Tumours were significantly larger (P = 0.02) and closer to the nipple (P = 0.008) in the study group compared to the control group. Regular follow-up mammograms were available in 26 of the study group. Twenty-one patients had mammographic evidence of either residual or recurrent tumour. We conclude that pre-operative mammography is essential in the selection of patients for excision and radiotherapy. Following treatment, mammography is useful in detecting residual or recurrent disease.     

Sonographic detection of lymph nodes in the intussusception of infants and young children: clinical evaluation and hydrostatic reduction.

OBJECTIVE: Our aim was to assess the sonographic appearance of enlarged lymph nodes in the intussusception in infants and young children and to investigate whether the enlarged lymph nodes affect the hydrostatic reduction rate of intussusception. MATERIALS AND METHODS: This retrospective case control study included a total of 65 children with intussusception, consisting of two groups: a study group of 28 patients with lymph nodes detected in intussusception and a reference group of 37 patients of similar age without lymph nodes in intussusception. The selection criterion for the study group was the presence of a minimum of two lymph nodes, of which at least one had a long axis of 11 mm or greater. The intussusception patterns, target or doughnut-like, and the presence of trapped fluid in the intussusception were also evaluated. Clinical records were reviewed for associated disease. The reducibility of both study and reference groups was assessed and correlated with all the sonographic features mentioned. RESULTS: Twenty-two of the 28 patients in the study group and none in the reference group had a recent or a current history of gastroenteritis. The overall hydrostatic reduction rate was 46.4% in patients with enlarged lymph nodes in the intussusception and 81.1% (p < 0.005) in patients without enlarged lymph nodes in the intussusception. Larger rather than numerous lymph nodes significantly affected the reducibility rate. Most of the reference group patients had a hydrostatic reduction at first attempt, whereas a second attempt at hydrostatic reduction was required in most of the study group patients. CONCLUSION: Enlarged lymph nodes in the intussusception are mainly found in patients with a current or recent history of gastroenteritis and decrease the overall hydrostatic reduction rate.     

Effects of Buscopan on gastro-oesophageal reflux and hiatus hernia

This prospective study was undertaken to establish whether Buscopan (hyosine butyl bromide) interferes with the detection of a hiatus hernia or induces gastro-oesophageal reflux. One hundred and four consecutive patients were included in the study who came for barium meal and swallow examinations over a period of 3 months. Ten patients were excluded from the study. The examinations were performed by the author. The manoeuvres to detect gastro-oesophageal reflux and hiatus hernia were performed before and after intravenous Buscopan. It was found that Buscopan does not induce gastro-oesophageal reflux in the majority of patients, or interfere with detection of a hiatus hernia. The conclusion of this study is that Buscopan can be given early on in the barium meal examination without a significant effect on hiatal function.     

Differences in aerobic and anthropometric characteristics between peripubertal swimmers and non-swimmers

In order to judge the effect of moderate sports training on the anthropometric characteristics and aerobic capacity of boys before and during puberty, a comparative study was conducted of 140 children, 94 of whom were not undergoing any specific training and 45 of whom were spending more than 3 hours a week practising swimming. The boys were divided into three maturity groups according to pubic hair status: prepubertal, pubertal, and end of puberty. The study shows greater maximal oxygen uptake in absolute terms, body weight, lean body mass, chest circumference, arm circumference, and arm muscle area for the swimmers. The morphological differences between the swimmers and non-swimmers concern physical characteristics generally involved in swimming. The difference in aerobic capacity, however, may be in part due to the morphological changes engendered by training; a longitudal study would confirm this. It is suggested that anthropometric indicators of arm muscles may be used in the biological supervision of swimming training.     

腹腔镜微创手术与开腹手术对结直肠癌患者免疫功能、应激反应及疗效的影响

目的对比研究腹腔镜微创手术与开腹手术对结直肠癌患者免疫功能、应激反应及疗效的影响。方法选取2015年5月至2019年5月周口市中医院普外科收治的43例结直肠癌患者作为研究对象,并按照随机数表法将其随机分为研究组(22例)与对照组(21例),其中研究组患者采用腹腔镜微创手术予以治疗,对照组患者采用开腹手术予以治疗,对比观察两组患者的临床疗效以及手术前后CD3^+、CD4^+、CD8^+等免疫功能相关指标水平,白细胞介素-6(IL-6)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)等炎症因子水平与卡氏功能状态(karnofsky performance status,KPS)评分。结果研究组患者手术时间明显长于对照组(t'=4.431,P=0.000),术中出血量明显少于对照组(t'=10.323,P=0.000),肠蠕动恢复时间及住院时间明显短于对照组(t/t'=7.129、6.220,P均=0.000);术后3、7 d,两组患者CD3^+、CD4^+水平均呈先降低后升高的趋势,且研究组患者CD3^+、CD4^+水平均明显高于对照组(3 d:t/t'=2.251、4.795,P=0.031、0.000;7d:t=2.353、3.100,P=0.023、0.003),而CD8^+水平呈先升高后降低的趋势,且研究组患者CD8^+水平明显低于对照组(3d:t=2.068,P=0.045;7 d:t=2.714,P=0.010);术后3、7 d,两组患者IL-6、CRP与TNF-α水平均呈先升高后降低的趋势,且研究组患者IL-6、CRP与TNF-α水平均明显低于对照组(3 d:t/t'=3.430、2.188、3.670,P=0.002、0.034、0.001;7 d:t/t'=2.529、2.971、2.127,P=0.016、0.006、0.041);术后2周,研究组患者KPS评分明显高于对照组(t=3.361,P=0.002)。结论腹腔镜微创手术治疗结直肠癌可有效缩短患者的术后恢复时间,减轻机体应激反应,提高患者免疫功能及生存质量,疗效显著,临床应用价值较高。     

Relationship of physical activity and fitness to lipid and lipoprotein (a) in elderly subjects.

PURPOSE: To determine, both by a cross-sectional and longitudinal study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to blood lipids and lipoprotein(a) [Lp(a)] in a population of healthy and weight-stable elderly volunteers aged 66-84 yr. METHODS: In a cross-sectional study in 52 subjects (23 men and 29 women), all independent variables (age, anthropometric, VO2max, and PA indices) were used in a multiple stepwise regression analysis to select variables influencing lipid and lipoprotein parameters. In a prospective nonintervention study, 38 subjects (17 men and 21 women) were reexamined after 6 months. RESULTS: In a cross-sectional study, sports activity index contributed significantly to total cholesterol (TC), low density lipoprotein (LDL) cholesterol (LDL-C), TC/high density lipoprotein (HDL) cholesterol (HDL-C) ratio, and LDL-C/HDL-C ratio variance in men, whereas VO2max accounted for 23% variance of apolipoprotein A-I in women. In a prospective study, there was no indication that any measured variable was correlated with absolute or relative changes in PA indices in the total group or when analyzed by gender. CONCLUSIONS: These data confirm that favorable relationship between PA/fitness and blood lipid profile is visible in elderly people but spontaneous changes in habitual PA are not a sufficient stimulus to alter serum lipid and lipoprotein levels in this population. Furthermore, there is no direct association between Lp(a) levels and PA, fitness, or body composition in the elderly men and women.     

Legal and ethical obligations to conduct a clinical drug trial in Australia as an investigator initiated and sponsored study for an overseas pharmaceutical company

Most multi-centre trials are both financed and sponsored by the pharmaceutical company involved. What follows will map the path adopted for an investigator initiated and sponsored study for a new indication of an established medication. The chief investigators of a company-sponsored, investigator-initiated, multi-centre, placebo-controlled study of an established medication, Pharmaceutical Benefit Scheme (PBS) listed for treatment of one condition but trialled in the management of another condition (trial of off-label use), were approached to submit a protocol to repeat the type of study with a different compound. The new study would test a different agent, also PBS listed, for the same condition as in the initial study and with the same off-licence application. The company would finance the study, provide the medication and matched placebo but only review the investigator-initiated protocol which would be sponsored by the principal investigator. This required the investigator to implement the trial, as would normally be done by the pharmaceutical company, yet also act as its principal investigator. The principal investigator, with colleagues and a Clinical Research Organisation (CRO), developed a protocol, adapted for the new agent, and submitted it for approval. Upon acceptance a contract was negotiated with the pharmaceutical company which had to overcome jurisdictional conflicts between common law and civil law legal systems. A CRO was contracted to undertake administrative functions which dictated special contractual agreements to overcome possible conflicts of interest for a sponsor/investigator to protect patient interests. There was need to find indemnification insurance with jurisdictional problems, co-investigators, ethics committee approvals and finance management as just some of the difficulties encountered. The paper will outline how these obstacles were overcome and how ethical and legal issues were respected through compromise. The ethical and legal obligations were addressed in a fashion which allowed the conduct of a trial adopting a proven methodology but novel infrastructure such that it was a totally independent study with regards conduct and reporting of final data, irrespective of the results being either positive or negative. This may represent a more acceptable way to ensure that future clinical trials are devoid of undue influence from the pharmaceutical industry which may still fund the study.     

Simultaneous surface registration of ictal and interictal SPECT and magnetic resonance images for epilepsy studies

BACKGROUND: Subtraction of ictal and interictal single photon emission computed tomography (SPECT) images is known to be successful in localizing the seizure focus in the pre-surgical evaluation of patients with partial epilepsy. A computer-aided methods for producing subtraction ictal SPECT co-registered to the magnetic resonance image (MRI) (the SISCOM method) is commonly used. The two registrations involved in SISCOM are (1) between the ictal-interictal SPECT images, which was shown to be the more critical, and (2) between the ictal image and MRI. OBJECTIVE: To improve the accuracy of ictal-interictal registration in SISCOM by registering all three images (ictal, interictal SPECT, MRI) simultaneously. METHODS: The registration problem is formulated as the minimization of a cost function between three surfaces. Then, to achieve a global minimum of this cost function, the Powell algorithm with randomly distributed initial configurations is used. This technique is tested by a realistic simulation study, a phantom study and a patient study. RESULTS: The results of the simulation study demonstrate that, in surface-based registration, the triple-registration method results in a smaller ictal-interictal SPECT registration error than the pair-wise registration method (P<0.05) for a range of values of the cost-function parameter. However, the improved registration error is still larger than that obtained by the normalized mutual information method (P<0.001), which is a voxel-based registration algorithm. The phantom and patient studies reveal no observable difference between registration results. CONCLUSIONS: Although the improved accuracy of triple registration is slightly worse than voxel-based registration, it will soon be possible to apply the results of this study in research utilizing the triple-registration principle to improving voxel-based results of ictal-interictal registration.     

Sulindac versus ibuprofen in sprains and strains.

In a double-blind parallel group randomised study 191 patients with acute sprains and strains of ankle, hip, shoulder or knees were treated with either 400 mg sulindac or 1200 mg ibuprofen per day for 4 days; of these, 176 completed the trial. Spontaneous pain (day and night), pain on active movement, swelling and tenderness were assessed before and after the treatment period along with a physician's and patient's assessment of therapy at the end of the study. The vast majority of patients had a successful outcome whichever treatment they were taking. No patients reported any adverse effect during the study.     

A multicentre and prospective study of suspected cases of child physical abuse

In this multicentre prospective study, the authors aim to describe the social and clinical characteristics of a population of children who arrived with a suspicion of physical abuse at five Emergency Services across France and who underwent clinical and thorough radiological screening according to a common predetermined protocol. A total of 185 cases of children seen at the Emergency units of five French hospitals over a 4-year period was assessed via a specific protocol and included in this study. The results of this study show socio-cultural factors consistent with previous reports on abused populations, and in particular give interesting data concerning the type and severity of lesions present, on the whole, in 80% of the population studied. In particular this study revealed a high prevalence (30%) of bone fractures. Apart from giving a perspective on the French population, this study adds some information to the too few preexisting studies of its kind-and stresses the importance of effective identification of possible cases of child abuse and of a thorough and sensitive screening protocol.