Urinary schistosomiasis-associated morbidity in schoolchildren detected with urine albumin-to-creatinine ratio (UACR) reagent strips

ObjectiveTo evaluate urine albumin-to-creatinine ratio (UACR) reagent strips for detection of urinary tract pathology (UTP) associated with urinary schistosomiasis in schoolchildren from Zanzibar.Patients and methodsSixty-six schoolchildren were examined for urinary schistosomiasis and UTP using urine reagent strips (Hemastix^®), urine microscopy and portable ultrasonography. The UACR was estimated using Microalbustix^®; univariate and logistic regression methods were used to test for statistical associations.ResultsPrevalence of egg-patent schistosomiasis was 65.2% while 77.3% had micro-haematuria and 66.1% had a least one ultrasound-identified UTP. Abnormal UACR (≥3.4 mg/mmol) was frequent (88.4%) but an unsatisfactory identifier of UTP, albeit highly sensitive: sensitivity (SS) = 100.0%, specificity (SP) = 23.8%, positive predictive value (PPV) = 71.9%, negative predictive value (NPV) = 100.0%. When only severely abnormal UACR was considered (≥33.9 mg/mmol), SS decreased while SP improved: SS = 58.5%, SP = 61.9%, PPV = 75.0%, NPV = 43.3%.ConclusionAbnormal and severely abnormal UACRs were strongly associated with egg-patent urinary schistosomiasis and UTP, although via different mechanisms: respectively, from venous blood released directly into the urine from bladder wall perforations, and from leaching sera released from chronic egg-induced lesions throughout the urinary tract. From a control perspective, Microalbustix^® reagent strips are therefore best applied in pre-screening protocols allowing selection, or rather confident exclusion, of schoolchildren with urinary schistosomiasis for more detailed investigations.     

Histomorphologic and histomorphometric evaluation of various endosseous implant healing chamber configurations at early implantation times: a study in dogs

Aim: The objective of this study was to evaluate the early healing of endosseous implants presenting various healing chamber configurations in a beagle dog mandible model. Methods: The four premolars of 12 beagle dogs were extracted and allowed to heal for a period of 8 weeks. Implants allowing six different healing chamber configurations were placed in each dog (three per side, six configurations per dog). The animals were sacrificed after 3 and 5 weeks in vivo (n=6 per time in vivo), and the implants were non‐decalcified processed to slides of ～30 μm thickness. Bone‐to‐implant contact (BIC) and bone area fraction occupied (BAFO) within the healing chamber were quantified. Statistical analysis was performed by a GLM ANOVA model at 5% significance level. Results: Osseointegration and healing with woven bone filling throughout all healing chambers was observed. Replacement of woven bone by lamellar bone showing primary osteonic structures was observed at 5 weeks. BIC was significantly affected by healing chamber configuration (P<0.001) and was not affected by time in vivo (P>0.42) at 3 and 5 weeks in vivo. BAFO was not affected by healing chamber configuration (P>0.14) however significantly increased over implantation time (P<0.001). Conclusion: Regardless of healing chamber design and dimensions considered, healing allowed the devices osseointegration. However, healing chamber configuration significantly affected osseointegration measurable parameters such as BIC. To cite this article:
Marin C, Granato R, Suzuki M, Gil JN, Janal, MN Coelho PG. Histomorhpologic and histomorphometric evaluation of various endosseous implant healing chamber configurations at early implantation times: a study in dogs.
Clin. Oral Impl. Res. 21 , 2010; 577–583.
doi: 10.1111/j.1600‐0501.2009.01853.x     

Physiological studies on endorhizospheric establishment of Azotobacter chroococcum in wheat

Ten strains of Azotobacter chroococcum were studied for their ability to invade the endorhizosphere of wheat. Strain W‐5 exhibited ability to invade endorhizosphere as shown in the microscopic observations. This strain was compared with the strain OA‐3 which did not invade the endorhizosphere zone. Strain W‐5 showed higher production of cellulase and pectinase than OA‐3. Both the strains induced defense enzymes in the host plant. However, induction of peroxidase and phenylalanine ammonia lyase activities (PAL) was higher in OA‐3 than W‐5. Quantitative differences in flavonoid like compounds obtained from root extracts and root exudates of plants inoculated with these strains were observed. (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Prosopis pubescens (Screw Bean Mesquite) Seedlings are Hyperaccumulators of Copper

Due to health reasons, toxic metals must be removed from soils contaminated by mine tailings and smelter activities. The phytoremediation potential of Prosopis pubescens (screw bean mesquite) was examined by use of inductively-coupled plasma optical emission spectroscopy. Transmission electron microscopy was used to observe ultrastructural changes of parenchymal cells of leaves in the presence of copper. Elemental analysis was used to localize copper within leaves. A 600-ppm copper sulfate exposure to seedlings for 24 days resulted in 31,000 ppm copper in roots, 17,000 ppm in stems, 11,000 in cotyledons and 20 ppm in the true leaves. For a plant to be considered a hyperaccumulator, the plant must accumulate a leaf-to-root ratio <1. Screw bean mesquite exposed to copper had a leaf-to-root ratio of 0.355 when cotyledons were included. We showed that P. pubescens grown in soil is a hyperaccumulator of copper. We recommend that this plant should be field tested.     

The influence of nursing homes in the functioning of internal medicine services

BackgroundSome hospitals attend to great number of patients who come from nursing homes whose median age, seriousness of illness and comorbidity differ of these patients from those of non-institutionalized patients. This can partly modify and thereby affect some of the parameters used to measure “assistance quality”.Materials and methodsThe data related to the demographic, clinical factors, severity criteria and mortality, were studied in patients hospitalized in two Internal Medicine Services during 2005–6 on the basis of whether they arrived from a nursing home or not. The data were obtained from the electronic databases of the two centers.ResultsDuring the study period, 13,712 patients were hospitalized (7110 in Fundación Hospital Alcorcón (FHA) and 6602 in Hospital Universitario Fuenlabrada (HUF)). A total of 789 (15.3%) patients of FHA arrived from a nursing home in comparison to 132 (2.6%) of those in HUF. Patients arriving from nursing homes were older (84.1 vs 69.8; p < 0.05), had a more serious illness (Group Related Diagnostic weight 2.1 vs 1.9; p < 0.05), more comorbidity (Charlson Index > 0; 75.5% vs 67.3%; p < 0.05) and increased mortality (16.8% vs 6.8%; p < 0.05) than the non-institutionalized patients, while length of hospital stay were shorter in the institutionalized patients (7.8 vs 8.3; p < 0.05). Intrahospital mortality was significantly associated with living in a nursing home (Odds Ratio 1.4 Confidence Interval 95% 1.1–1.8), regardless of age, gender, condition, comorbidity (Charlson Index), and the involved hospital.DiscussionThe number of nursing homes attended by a hospital determined the activity of an Internal Medicine Service. This study indicates that the patients from nursing homes were older, with increased severity and comorbidity of their illness, greater mortality and rehospitalization although, with similar length of stay.     

Clinical course of children requiring prolonged continuous renal replacement therapy

A prospective observational study was performed to analyze the clinical course of critically ill children who require continuous renal replacement therapy (CRRT). Variables associated with prolonged CRRT were analyzed. Of the 174 children treated with CRRT, 32 (18.3%) required CRRT for >14 days and 20 (11.5%) for >21 days. Prolonged CRRT was more common in patients with heart disease and those requiring mechanical ventilation, hemodiafiltration, and higher doses of heparin. The same factors were found when patients with CRRT for >14 days and 21 days were studied. Overall mortality rate was 35.6%; it was slightly higher in patients on prolonged CRRT (43.7% with CRRT > 14 days and 45% with CRRT >21 days), though the differences were not statistically significant. We conclude that there were no differences in the pre-CRRT clinical characteristics, severity of illness, and renal function in critically ill children requiring prolonged CRRT. Prolonged CRRT was more frequently required by patients with heart disease and those on mechanical ventilation. Patients with prolonged CRRT required more frequent hemodiafiltration and higher doses of heparin. Mortality was slightly higher in children with longer CRRT, though this difference did not reach statistical significance.