Aponeurotic-Cutaneous Tract Exeresis in Patients With Persistent Lymphorrhea After Kidney Transplantation: A Valid Approach in a Day Surgery Setting

BackgroundLymphatic disorders (LDs) are the most common minor complications after kidney transplantation (KT), with an incidence rate between 0.6% and 33.9%, which appears to be related to both surgical and medical factors. LDs mostly resolve spontaneously, but occasionally a surgical approach may be required.Materials and MethodsWe report our experience with 7 KT recipients who developed persistent lymphorrhea (>150 mL/24 h) between October 2017 and March 2019. All cases were treated as outpatients with parietal fistulectomy (PF). The fibrotic aponeurotic-cutaneous tract was thoroughly excised, and the residual aponeurotic defect was closed by watertight suturing. Serial abdominal ultrasounds (US) were carried out after the procedure.ResultsA small perirenal graft lymphocele of <2 cm was detected by US in all patients after 48 to 72 hours, without any evidence of either vascular or ureteral compression. During the subsequent scheduled US follow-up, lymphoceles did not increase in size, and additional interventions were not needed. Neither superficial nor deep surgical-site infections were recorded in such patients.ConclusionsPF was found to be a safe and effective minimally invasive approach for persistent lymphorrhea after KT. It could be easily performed with local anesthesia in a day surgery setting and did not require patient hospitalization.     

Dental Care Utilization of Hospitalized Persons Living with HIV and Substance Use

Journal of Community Health - People living with HIV (PLWH) who use drugs experience worse health outcomes than their non-using counterparts. Little is known about how often they seek dental care...     

Comprehensive dietary evaluation of Italian primary school children: food consumption and intake of energy,nutrients and phenolic compounds

Abstract

Information on children’s diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n?=?172, 8–10?years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children’s diet. Future research should look at the health implications of dietary choices in children.     

Second National Conference on Human Retroviruses. Good news, bad news, and no news

The second annual National Conference on Human Retroviruses and Related Infections was held in Washington, D.C., January 29-February 2, 1995. Lectures addressed such topics as viral dynamics, United States AIDS epidemiology, immunopathogenesis, antiretroviral therapy, and HIV vaccines. Symposia were held on the interactivity of sexually transmitted diseases (STDs) and AIDS, the causes leading to long-term nonprogressors, and factors causing individuals to be exposed but uninfected. Oral presentations reviewed the following: 1) a study on the efficacy of oral ganciclovir for prevention of CMV disease in CMV-seropositive, HIV-infected individuals with CD4 counts of 50 or less; 2) data supporting rifabutin prophylaxis against MAC infection once the CD4 count is below 100; 3) the safety of the screened blood supply in the United States; 4) ACTG 063, a study examining the use of AZT with and without acyclovir; 5) perinatal transmission; and 6) four independent studies examining the efficacy of 3TC (lamivudine) as part of a combination of antiretroviral drugs in HIV-infected patients who were both AZT-naive and AZT-experienced.     

Quantitative immunogold evidence that glutamate is a neurotransmitter in afferent synaptic terminals within the isthmo-optic nucleus of the pigeon centrifugal visual system

A quantitative electron microscopic analysis of glutamate (GLU) immunoreactivity using the post-embedding immunogold technique was carried out within the isthmo-optic nucleus (ION) of the pigeon centrifugal visual system (CVS). Measurements were performed in each of eight different categories of axon terminals, including those that were GABA-immunoreactive (-ir), considered representing control profiles and identified using a single or double-label immunocytochemical procedure. The results demonstrated that the glutamate immunogold particle densities for both mitochondrial and vesicular pools and for total surface area of bouton profiles were significantly higher in P1a, P1b and P2b terminals and not significantly different in P4 and P5 terminals compared to those recorded in control GABA-ir terminals (P2a, P2c, P3). Moreover, the values measured in GLU-ir positive profiles were all significantly higher than in either P4 or P5 terminals. The results suggest that tectal neurons, which provide the main input to the ION cells, are either inhibitory GABA-ir possibly associated with P2c and/or P3 terminals or excitatory GLU-ir via P1a, P1b and P2b terminals. Such differential effects of tectal afferents may be the basis for the modulation of centrifugal activity and consequently of end target retinal ganglion cell responses. The data are relevant to hypotheses implicating the avian CVS in mechanisms of selective enhancement of visual attention to either novel or meaningful stimuli within the visual field.     

Primary breast carcinoma: immunocytochemical and immunohistochemical evaluation of biological parameters

Fine needle aspiration biopsy is an effective procedure for the diagnosis and biological characterization of carcinoma of the breast. The authors compared the immunocytochemical expression of oestrogen receptor and progesterone receptor, Ki67 antigen and p53 protein, evaluated in pre-surgical fine needle aspirates, with the immunohistochemical results observed in the corresponding histological sections. Fine needle aspirates and paraffin embedded sections obtained from 37 patients with primary carcinoma of the breast were studied by immunocytochemistry and immunohistochemistry, respectively. Percentage agreement between values obtained with cytology and histology was 89.6% for oestrogen receptor, 76.9% for progesterone receptor, 91.3% for Ki67 and 77.7% for p53. The data reported here suggest that the evaluation of biological parameters by fine needle aspiration biopsy may be useful to decide the best medical and surgical treatment for primary breast carcinoma.     

Are general circulation models obsolete?

Traditional general circulation models, or GCMs—that is, three-dimensional dynamical models with unresolved terms represented in equations with tunable parameters—have been a mainstay of climate research for several decades, and some of the pioneering studies have recently been recognized by a Nobel prize in Physics. Yet, there is considerable debate around their continuing role in the future. Frequently mentioned as limitations of GCMs are the structural error and uncertainty across models with different representations of unresolved scales and the fact that the models are tuned to reproduce certain aspects of the observed Earth. We consider these shortcomings in the context of a future generation of models that may address these issues through substantially higher resolution and detail, or through the use of machine learning techniques to match them better to observations, theory, and process models. It is our contention that calibration, far from being a weakness of models, is an essential element in the simulation of complex systems, and contributes to our understanding of their inner workings. Models can be calibrated to reveal both fine-scale detail and the global response to external perturbations. New methods enable us to articulate and improve the connections between the different levels of abstract representation of climate processes, and our understanding resides in an entire hierarchy of models where GCMs will continue to play a central role for the foreseeable future.