Can cystatin C be a better marker for the early detection of renal damage in primary hypertensive patients?

In this study, we aimed to compare Cystatin C (Cys C) with other traditional glomerular filtration rate (GFR) markers and to evaluate its superiority over them in detecting early renal involvement in patients with primary hypertension. Fifty-one primary hypertensive patients and 29 healthy control subjects, who were similar in terms of age and gender, were included in the study. In all subjects serum levels of Cys C, beta-2 microglobulin, serum creatinine (SCr), uric acid, BUN, albumin; 24 h urinary levels of protein (Upro), albumin (Ualb) and creatinine were measured. The GFR was calculated according to Creatinine Clearance (CrCl), Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas. The MDRD was used as the reference method. A GFR<80 mL/min/1.73 m2 was considered as the lower cut-off limit. Mean levels of the serum parameters were found to be significantly higher in the patient group than they were in the control group (p<0.05). Mean CrCl, CG, and MDRD levels were lower in patients than they were in controls but the difference was statistically significant for CG and MDRD. The serum parameter having the best correlation with MDRD was SCr (r = -0.760) in patients and Cys C (r = -0.622) in controls. However, in ROC analysis; the area under curve (AUC) for Cys C was found to be superior (AUC = 0.900) to the other markers. The CrCl was the parameter having the worst diagnostic efficiency (AUC = 0.598). As a conclusion, compared to other traditional markers, measurement of Cys C may be a better parameter to estimate GFR, especially to detect mild reductions of GFR in primary hypertensive patients.     

Hydroxyapatite cement reconstruction in the growing craniofacial skeleton: an experimental model

Hydroxyapatite cement (HAC) has been shown to osseoconduct and may even osseoconvert. These properties render it suitable for repairing cranial defects in growing children. The objective of this pilot study was to determine if growth is restricted after HAC reconstruction in a growing, nonprimate, animal model. Frontoparietal craniotomies were performed on 10 4-week-old Yorkshire piglets. In 3 control piglets, the bone flap was resutured; in 7 experimental piglets, the defect was reconstructed with HAC. Analysis 6 months after surgery included craniometric measurements, biomechanical testing, and histological sectioning. Nine craniofacial measurements did not differ between controls and experimental animals. The mean midline-to-temporal line distance contralateral to the defect was 20% larger in the experimental group (P = 0.006), however, and experimental animals had a larger difference between right and left orbital breadths (+3% difference versus -1% difference; P = 0.003). The mean stiffness of the HAC-repaired defect was not different from the contralateral side in contrast to the resutured bone flap in controls, which was significantly less stiff than unoperated bone (162 N/mm compared with 358 N/mm; P < 0.05). Based on our animal model, HAC seems to be a sound alternative method of craniotomy reconstruction in the growing skull.     

Renal Transplant Ureteral Stenosis: Treatment by Self-Expanding Metallic Stent

We report the use of a metallic stent in a transplant ureteral stenosis. A 28-year-old man with chronic renal failure due to chronic pyelonephritis, who received a living-donor renal transplant, presented with transplant ureteral stenosis. The stenosis was unresponsive to balloon dilation and was treated by antegrade placement of a self-expanding Memotherm stent. The stented ureter stayed patent for 3 years. It may be reasonable to treat post-transplant ureteral stenosis resistant to balloon dilation with self-expanding metallic stents. However, long-term follow-up is required to evaluate the efficacy of this treatment.     

Osmitopsis asteriscoides (Asteraceae)-the antimicrobial activity and essential oil composition of a Cape-Dutch remedy

The essential oil composition and antimicrobial activity of Osmitopsis asteriscoides, a medicinal plant used in traditional herbal preparations in South Africa has been investigated. Three different antimicrobial methods (disc diffusion, minimum inhibitory concentration by micro-titer plate and time-kill studies) were comparatively evaluated against Candida albicans, Staphylococcus aureus and Pseudomonas aeruginosa. A preliminary screening was done using the disc diffusion method on nine bacterial and four fungal isolates. Minimum inhibitory concentrations showed some correlation with the disc diffusion method. However, time-kill studies appear to be a more superior method for determining antimicrobial activity of volatile compounds such as essential oils. Two moderately susceptible and one resistant organism were selected to further demonstrate the variability between the three methods. The antimicrobial activity of the essential oil, tested by means of time-kill methodology at concentrations ranging from 0.5 to 2% (v/v) indicate a strong fungicidal activity against Candida albicans and the oil was also found to be bacteriostatic against Staphylococcus aureus in a concentration-dependent manner. The essential oil rapidly reduced viable counts of Pseudomonas aeruginosa, but regrowth was noted after 240 min. The results have been generated in duplicate in separate microbiology laboratories using different time-kill methods and the results are congruent. The two major essential oil components camphor and 1,8-cineole were investigated indicating the positive antimicrobial efficacy of 1,8-cineole independently and in combination with camphor. In addition to (-)-camphor and 1,8-cineole, 40 compounds were identified by GC-MS in the hydro-distilled essential oil. The high concentration of cineole and camphor and their synergistic effect is presented as a possible explanation for the traditional use of Osmitopsis asteriscoides for treating microbe-related illnesses.     

A study on the genotoxic activities of some new benzoxazoles

The Bacillus subtilis rec assay has been specially developed to detect DNA-damaging potential in chemicals, with the rationale based on the relative difference of survival of a DNA repair combination proficient strains and its deficient strain, which is interpreted as genotoxicity. The genotoxic activities of newly (1–6) and previously (7–18) synthesized various benzoxazoles and benzimidazoles were analyzed via the B. subtilis rec assay. Newly obtained benzoxazole and benzimidazole derivatives (1–6) were synthesized in the presence of polyphosphoric acid (PPA) and 6 N HCl, respectively to detect their DNA-damaging activities. Among the tested compounds, 6-methyl-2-(o-chlorophenyl)benzoxazole (9), 5-amino-2-(p-methylbenzyl)benzoxazole (4), 5-(p-fluorobenzamido)-2-phenylbenzoxazole (13), and 2-(p-methylaminophenyl)benzoxazole (18) showed genotoxic activities having Rec₅₀ values of 1.85, 1.74, 1.60, and 1.50 or S-probit values of 0.534, 0.482, 0.460, and 0.357, respectively. On the other hand, 2-(p-bromobenzyl)-5-methylbenzimidazole (6) and 2-benzyl-5-(p-fluorophenylacetamido)-benzoxazole (15) were exhibited a reverse effect that displayed a bacterial growth in the rec ^- strains while there was no any bacterial growth in rec ⁺ strains at the same concentration.     

Evaluation of nutritional status and factors related to malnutrition in children on CAPD.

OBJECTIVE: The aim of this study was to investigate the nutritional status of children on continuous ambulatory peritoneal dialysis (CAPD) and to relate it to the dose of dialysis and serum levels of inflammatory cytokines and insulin-like growth factor-1 (IGF-1). PATIENTS: 17 CAPD patients (8 girls, 9 boys; mean age 13.1 +/- 3.5 years, median 15 years) were included in the study. Anthropometric measurements and serum albumin levels were used in the evaluation of nutritional status. Serum interleukin (IL)-1beta, IL-6, tumor necrosis factor alpha, and IGF-1 levels were determined in all CAPD patients and in a healthy control group. Weekly Kt/V and creatinine clearance (CCr) were measured to determine adequacy of dialysis. RESULTS: The mean dialysis period was 23.7 +/- 15.2 months (median 23 months). Anthropometric measurements and serum albumin level were as follows: height 130.2 +/- 15.6 cm, height standard deviation score (HtSDS) -4.2 +/- 2.4, body mass index (BMI) 16.3 +/- 1.6 kg/m2, body mass index standard deviation score (BMISDS) -0.8 +/- 0.9, triceps skinfold thickness (TST) 4.2 +/- 1.4 mm, midarm circumference (MAC) 16.21 +/- 2.3 cm, upper arm muscle area (AMA) 1799.1 +/- 535.7 mm2, upper arm fat area (AFA) 334.5 +/- 143 mm2, and serum albumin 3.1 +/- 0.7 g/dL. The BMI was above the fifth percentile in all patients; TST and MAC were below the fifth percentile in 14 patients (82.4%) and 10 patients (58.8%) respectively. The AMA was below the fifth percentile in 8 patients; however, the AFA was below the fifth percentile in all patients. Mean serum albumin level was under 3.5 g/dL in 70.5% of the children. We found significant positive correlations between BMI and Kt/V (r = 0.69, p < 0.01), CCr (r = 0.64, p < 0.05), and IL-6 (r = 0.61, p < 0.01). There was an inverse correlation between BMISDS and dialysis period (r = -0.58, p < 0.05); and between IL-6 and serum albumin (r = -0.49, p < 0.05). A significant positive correlation between BMISDS and serum IGF-1 level (r = 0.62, p < 0.01) was noted. We also found a significant positive correlation between serum IGF-1 level and both HtSDS (r = 0.57, p < 0.05) and TST (r = 0.52, p < 0.05). Significant positive correlations between AFA and CCr and IGF-1 were also noted (both r = 0.56, p < 0.05). CONCLUSION: Although many factors may be responsible for malnutrition and growth retardation, we found that prolonged period of dialysis, inadequate dialysis, and low IGF-1 levels are the most important risk factors in CAPD patients.     

Food allergy severity predictions based on cellular in vitro tests

ABSTRACT

Introduction

Food allergy is increasing in prevalence and the severity of allergic reactions is unpredictable. Identifying food-allergic patients at high risk of severe reactions would allow us to offer a personalized and improved management for these patients.     

Low Density Granulocytes and Dysregulated Neutrophils Driving Autoinflammatory Manifestations in NEMO Deficiency

Journal of Clinical Immunology - NF-κB essential modulator (NEMO, IKK-γ) deficiency is a rare combined immunodeficiency caused by mutations in the IKBKG gene. Conventionally, patients are...     

An Evaluation of Clinicopathological Factors Effective in the Development of Central and Lateral Lymph Node Metastasis in Papillary Thyroid Cancer

Introduction and Aim

Papillary thyroid cancer (PTC) constitutes more than 90% of newly emerging differentiated thyroid cancers. Lymph node metastasis is often seen in PTC. There is a high risk of central metastasis in the presence of clinicopathological factors such as extrathyroidal extension, multifocality and lymphovascular invasion. The aim of this study is to evaluate the clinicopathological features that are effective in the development of lymph node metastasis.