On the Paragommus and the epidemiology of paragonimiasis in Fujian Province.

Up till now, 4 species of Paragonimus, namely P. westermani Kerbert, 1878, P,     

On the chemoprophylactic effect of pyquiton in murine schistosomiasis japonica.

Using two systems of Schistosoma japonicum C_(57)BL mouse and S. japonicum CFWmouse, the killing effect of pyquiton has been clearly demonstrated on both adult wormsand invasive schistosomula. S-T electron microscopy revealed different degrees of trauma     

Does serum procalcitonin aid in the diagnosis of bloodstream infection regardless of whether patients exhibit the systemic inflammatory response syndrome?

Background

Physicians frequently rely on the systemic inflammatory response syndrome (SIRS) criteria to detect bloodstream infections (BSIs). We evaluated the diagnostic performance of procalcitonin (PCT) in detecting BSI in patients with and without SIRS.

Methods

We tested the association between BSI, serum PCT levels, contemporaneous SIRS scores and serum lactate using logistic regression in a dataset of 4279 patients. The diagnostic performance of these variables was assessed.

Results

In multivariate regression analysis, only log(PCT) was independently associated with BSI (p < 0.05). The mean area under the curve (AUC) of PCT in detecting BSI (0.683; 95% CI 0.65–0.71) was significantly higher than serum lactate (0.615; 95% CI 0.58–0.64) and the SIRS score (0.562; 95% CI 0.53–0.58). The AUC of PCT did not differ significantly by SIRS status. PCT of less than 0.1 ng/mL had a negative predictive value (NPV) of 97.4 and NPV of 96.2% for BSI in the SIRS-negative and SIRS-positive patients, respectively. A PCT of greater than 10 ng/mL had a LR of 6.22 for BSI in SIRS-negative patients. The probability of BSI increased exponentially with rising PCT levels regardless of SIRS status.

Conclusion

The performance of PCT for the diagnosis of BSI was not affected by SIRS status. Only PCT was independently associated with BSI, while the SIRS criterion and serum lactate were not. A low PCT value may be used to identify patients at a low risk for having BSI in both settings. An elevated PCT value even in a SIRS negative patient should prompt a careful search for BSI.

     

Role of the kallikrein–kinin system in the maturation of cardiovascular phenotype

Recent studies indicate that during early phases of life the kallikrein–kinin system (KKS) plays a role in kidney development. In the rat kidney, the spatial and temporal pattern of expression of the genes encoding for kallikrein or bradykinin (BK) B₂-receptors parallels postnatal nephrogenesis and blood flow redistribution from the inner to the outer renal cortex. Animal models with genetic dysfunction of the renal KKS show alterations in the functional maturation of the kidney, and ultimately develop salt-sensitive hypertension. Kininogen-deficient Brown Norway Katholiek rats have undetectable urinary kinin levels and show an exaggerated blood pressure sensitivity to chronic excess of salt or mineralocorticoids. Another rat model with genetic reduction in urinary kallikrein excretion is characterized by an altered pressure–natriuresis relationship, with this defect being corrected by infusion of purified rat tissue kallikrein. Knockout mice lacking the BK B₂-receptor gene show elevated blood pressure and heart rate under basal conditions and enhanced blood pressure sensitivity to salt. In rats, prenatal blockade of the BK B₂-receptor by icatibant leads to a cardiovascular phenotype similar to that of animals with genetic defects of the KKS. Delayed renal maturation is observed when high salt intake is associated with icatibant. Collectively, these findings indicate a relevant role of the KKS in the physiologic maturation of renal and cardiovascular phenotypes. Genetic or environmental factors, able to potentiate the activity of the renal KKS, could protect against the development of arterial hypertension.     

Euthanasia in the Third Reich--only a problem of psychiatry? On the development of the euthanasia debate 1933-1941 in Germany

The devastating consequences of the Fascist dictatorship in Germany for the ethical thinking of the physicians are particularly clearly recognizable by the mass killings of severely damaged children and patients with chronic psychic diseases which were performed at that time. Recent investigations of the developments which began in 1938 show that by way of intensive efforts for a juridicial legalization of the "active euthanasia" an enlargement of this killing practice has been striven after. References to a motive of compassion and the free decision of the affected persons should cover the real intention for reducing welfare services. A bill presented in 1940 for a law "on euthanasia for incurable ill persons" found the unanimous consent of the renowned physicians consulted for this purpose. Though this law finally did not become legal beginning with 1941 the medical practice showed further forms of the repressive and antihumane association with ill persons who were regarded as incurable, which must be valuated as practical consequences of an unadmissible relativation of the life-preserving task of medicine.     

Detection of Hb Setif in north Iran and the question of its origin: Iranian or multiethnic?

Hb Setif is a rare type of hemoglobinopathy resulting from an aspartic acid to tyrosine substitution at codon 94 (GAC>TAC) of the α2-globin gene. In manual and automated hemoglobin (Hb) electrophoresis examination of the case, an unusual band was detected and the result of subsequent capillary electrophoresis suggested that to be Hb Setif. Carrying out polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing, a typical Hb Setif mutation (GAC>TAC) was identified. The haplotype of the α cluster was + + - M PZ + - - - -. This is the first report of such a hemoglobinopathy in North Iran. Various reports of such Hb variants in Iran and countries in the Mediterranean region and North Africa, suggest that the mutation may have occurred around 6,000 years ago, prior to colonization of Aryans on the Iranian plateau.