mTORC1 and the regulation of skeletal muscle anabolism and mass

The mass and integrity of skeletal muscle is vital to whole-body substrate metabolism and health. Indeed, defects in muscle metabolism and functions underlie or exacerbate diseases like diabetes, rheumatoid arthritis, and cancer. Physical activity and nutrition are the 2 most important environmental factors that can affect muscle health. At the molecular level, the mammalian target of rapamycin complex 1 (mTORC1) is a critical signalling complex that regulates muscle mass. In response to nutrition and resistance exercise, increased muscle mass and activation of mTORC1 occur in parallel. In this review, we summarize recent findings on mTORC1 and its regulation in skeletal muscle in response to resistance exercise, alone or in combination with intake of protein or amino acids. Because increased activity of the complex is implicated in the development of muscle insulin resistance, obesity, and some cancers (e.g., ovarian, breast), drugs that target mTORC1 are being developed or are in clinical trials. However, various cancers are associated with extensive muscle wasting, due in part to tumour burden and malnutrition. This muscle wasting may also be a side effect of anticancer drugs. Because loss of muscle mass is associated not only with metabolic abnormalities but also dose limiting toxicity, we review the possible implications for skeletal muscle of long-term inhibition of mTORC1, especially in muscle wasting conditions.     

Analgesic effects and anti-inflammatory properties of the crude methanolic extract of Schwenckia americana Linn (Solanaceae)

Aim of the study

To evaluate analgesic effect and anti-inflammatory properties of Schwenckia americana (Solanaceae), a medicinal plant used for treating rheumatic pains and swelling in North-western Nigeria.

Materials and methods

Three doses (25 mg/kg, 50 mg/kg and 100 mg/kg) of the crude methanolic extract of Schwenkia americana were evaluated for analgesic and anti-inflammatory activities using acetic acid induced writhing test, formalin induced nociception, and formalin induced hind paw oedema in rats.

Results

All doses (25, 50, 100 mg/kg) of the extract tested were effective. The extract at the tested doses produced a percentage inhibition of the acetic acid induced abdominal constriction of (53.3, 58.0 and 86.7%), respectively. A percentage inhibition of the formalin induced nociception of 44.00, 56.04, and 56.04% (early phase) and 33.00, 36.63 and 59.71% (late phase) was also produced. The inhibition of oedema formation increased with increasing dosage from 25 to 100 mg/kg. The crude extract produced a statistically significant analgesic and anti-inflammatory activity comparable to the effect of standard drug (10 mg/kg Piroxicam).

Conclusion

This study demonstrated the potential analgesic and anti-inflammatory properties of crude methanolic extract of Schwenkia americana thus justifying its traditional usage.     

Phytochemical screening and antibacterial activities of Vernonia ambigua, Vernonia blumeoides and Vernonia oocephala (Asteraceae)

Some Vernonia species (Vernonia ambigua, Vernonia blumeoides and Vernonia oocephala) used in Northern Nigerian traditional medicine, were subjected to phytochemical screening using standard procedures. The antibacterial activity using the disc diffusion method as outlined by the NCCLS was carried out on Klebsiella pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Corynbacterium ulcerans, methicillin resistant Staphylococcus aureus (MRSA), Salmonella typhi, Pseudomonas aeruginosa, Shigella dysentriae, Proteus mirabilis and Pseudomonas fluorescence. The results of the antibacterial activity as indicated by zone of growth inhibition ranged from 14 to 27 mm for the crude ethanol extracts and chloroform fractions of the Vernonia species being studied. The activity of chloroform fraction of V. blumeoides was higher on C. ulcerans and K. pneumoniae (27 mm), while the chloroform fractions of V. oocephala and V. ambigua were more active on P. mirabilis (27 mm) and S. typhi (22 mm), respectively. It is worth of mention that the chloroform fractions of the three Vernonia species demonstrated activity (20 mm) against MRSA. The minimum inhibitory concentration (MIC) values ranged from 1.25-2.5 mg/mL for all the organisms tested. The MIC of 1.25 mg/mL exhibited by the chloroform fractions on both Gram positive and negative bacteria indicates broad spectrumactivity of the Vernonia species being studied. Phytochemical screening of the extracts/fractions revealed the presence of steroids/terpenes, saponins, flavonoids, alkaloids, tannins and glycosides. The antibacterial activity exhibited in this study may be attributed to flavonoids, saponinss or sesquiterpene lactones. The overall results indicate that the extracts/fractions are potent antibacterial preparations at least in vitro. This lends credence to the use of these plants for the treatment of various infectious diseases.     

Angiosarcoma of the small intestine

Primary gastrointestinal angiosarcomas are very rare and those of the small bowel even more rare. We report a case which is the first in the literature from this part of the world. It presented in a 25-year-old woman with multiple dissemination and rapid fatality. Diagnosis was based on histological morphology using Hematoxylin and Eosin (H and E) stains, plus reticulin special stain to outline the vascular nature.     

Disseminated Langerhan's cell histiocytosis: a case report and review of the literature

Langerhan's cell histiocytosis is characterized by the presence of large mononucleated cells associated with inflammatory cells. We describe the clinical presentation, histopathology and some immunohistochemistry findings, in an eight-year-old female patient.     

Data quality assessment in healthcare: a 365-day chart review of inpatients' health records at a Nigerian tertiary hospital

Background

Health records are essential for good health care. Their quality depends on accurate and prompt documentation of the care provided and regular analysis of content. This study assessed the quantitative properties of inpatient health records at the Federal Medical Centre, Bida, Nigeria.

Method

A retrospective study was carried out to assess the documentation of 780 paper-based health records of inpatients discharged in 2009.

Results

732 patient records were reviewed from the departments of obstetrics (45.90%), pediatrics (24.32%), and other specialties (29.78%). Documentation performance was very good (98.49%) for promptness recording care within the first 24 h of admission, fair (58.80%) for proper entry of patient unit number (unique identifier), and very poor (12.84%) for utilization of discharge summary forms. Overall, surgery records were nearly always (100%) prompt regarding care documentation, obstetrics records were consistent (80.65%) in entering patients'' names in notes, and the principal diagnosis was properly documented in all (100%) completed discharge summary forms in medicine. 454 (62.02%) folders were chronologically arranged, 456 (62.29%) were properly held together with file tags, and most (80.60%) discharged folders reviewed, analyzed and appropriate code numbers were assigned.

Conclusions

Inadequacies were found in clinical documentation, especially gross underutilization of discharge summary forms. However, some forms were properly documented, suggesting that hospital healthcare providers possess the necessary skills for quality clinical documentation but lack the will. There is a need to institute a clinical documentation improvement program and promote quality clinical documentation among staff.     

The Emergency campaign for smallpox eradication from Somalia (1977-1979)--revisited

The historical significance of smallpox eradication from Somalia lies in the fact that the country was the last to record the last endemic smallpox case in the world. Before 1977 the programme was mismanaged. In the mid-1970s, the programme was plagued with concealment. Confirmation of smallpox outbreak in Mogadishu in September 1976 delayed global smallpox eradication. The Government maintained that there was no ongoing smallpox transmission in the country after the Mogadishu outbreak and frustrated independent attempts to verify its claim. In February 1977 the Government allowed World Health Organization (WHO) epidemiologists to search, unhindered, for smallpox outside Mogadishu. Soon widespread smallpox transmission was detected. The Government appealed for international support. The strategy to stop the smallpox transmission was based on surveillance and containment. The WHO took the leading role of the campaign which, in spite of the Somalia/Ethiopia war of 1977/78, culminated in the eradication of smallpox from the country. Somalia was certified smallpox-free on 19 October 1979.     

Comamonas testosteroni meningitis in a patient with recurrent cholesteatoma

Comamonas testosteroni, a lesser-known member of the genus, has shown little apparent capacity for causing infections in humans. We here present a case of purulent meningitis due to C. testosteroni, which occurred in a patient who had recurrent cholesteatoma. Ceftriaxone treatment was not effective in this patient even though in vitro the bacteria were susceptible to the drug. The patient responded well to meropenem therapy.     

Can formal education and training improve the outcome of instrumental delivery?

OBJECTIVE(S): The primary objective was to examine the effect of formal education and training on instrumental delivery with respect to its success rate and associated neonatal and maternal morbidity. The secondary objective was to determine factors that could influence the success rate of instrumental delivery. STUDY DESIGN: Prospective case-control study with historical controls set in a teaching hospital in Sheffield. The prospective group included all women who had instrumental deliveries between 1 November 1999 and 29 February 2000. The control group included all women who delivered between 1 February 1997 and 1 February 1998. An educational package involving formal postgraduate training and self-directed learning were introduced in the time period between the prospective and the control groups. Medical notes were reviewed in the historical controls. For both the control and prospective groups, the following patient characteristics were recorded: maternal age, parity, whether or not onset of labour was induced, use of oxytocin in the second stage of labour, delay in the second stage, operator grade, vaginal findings at delivery and the use of epidural analgesia. RESULTS: The overall failure rate was not different in the prospective group (16%) compared with the control group (18.5%). However, the introduction of an educational package was associated with significant decrease in maternal morbidity associated with cervical, severe labial and high vaginal tears (Odds Ratio (OR) 0.29, CI 0.09-0.97) and neonatal morbidity associated with admission to SCBU (OR 0.72, CI 0.02-0.60), severe neonatal scalp injury (OR 0.14, CI 0.02-0.98) and facial injuries (OR 0.02, CI 0.01-0.04). The factors identified to affect the success of instrumental deliveries were: OP and OT positions of the baby at delivery (OR 0.28, CI 0.17-0.44) and inexperienced operators (OR 0.11, CI 0.02-0.58). CONCLUSION: In this study, formal education and training of medical staff did not influence the success rate of instrumental delivery but was associated with improved safety for both mother and baby.     

Effect of calcitonin on carrageenan foot oedema

The effect of salmon calcitonin (SCT) on acute inflammation was tested in carrageenan induced foot oedema of the rat. A considerable inhibition of the oedema was obtained with 20 MRC U/kg of SCT. The injection of SCT is followed by decrease of calcemia. A hypothesis of possible inhibition of prostaglandin (PG) synthesis and/or release, caused by decrease of calcemia, is advanced.