Priority actions for the non-communicable disease crisis

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis--leadership, prevention, treatment, international cooperation, and monitoring and accountability--and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies. The priority interventions were chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility. The most urgent and immediate priority is tobacco control. We propose as a goal for 2040, a world essentially free from tobacco where less than 5% of people use tobacco. Implementation of the priority interventions, at an estimated global commitment of about US$9 billion per year, will bring enormous benefits to social and economic development and to the health sector. If widely adopted, these interventions will achieve the global goal of reducing NCD death rates by 2% per year, averting tens of millions of premature deaths in this decade.     

Low radiation dose ECG-gated chest CT angiography on a 256-slice multidetector CT scanner

Computed tomography angiography (CTA) of the thorax other than cardiac CTA, is utilized for a multitude of conditions and ranges in application from a diagnostic test, to presurgical planning and postsurgical follow-up. Helical CTA without electrocardiogram (ECG) gating has been routinely utilized for the evaluation of thoracic vasculature. However, its applicability can be limited in the evaluation of the thoracic aorta and pulmonary vasculature because of the artifacts resulting from cardiac motion. Traditional retrospective ECG-gated helical scans address this issue but at the price of a high radiation dose to the patient. In this paper we review CTA dose reduction strategies for non-coronary indications, examine field of view requirements, and discuss breath hold challenges for ECG-gated acquisitions. In addition, we present clinical examples performed using low-dose prospective gating technique for evaluation of the aorta acquired on a 256-slice multidetector computed tomography system.     

Sample Matrix Interference in Immunoassays for Organochlorine Residues in Plant-derived Foods and Some Strategies for Their Removal

Immunoassays for two groups of organochlorine insecticides, cyclodienes (endosulfan and heptachlor) and DDT were applied to the analysis of a diverse range of plant-derived foods. Water-miscible solvent extracts of high-moisture, low-fat foods such as cauliflower, cabbage, green and red blue grapes and tomato caused little or no interference with the assays, enabling methanol or acetonitrile extracts of the foods to be analysed directly by immunoassay, after dilution in assay buffer. Reasonable recoveries of spikes of these pesticides were obtained by direct analysis of extracts of spiked commodities, with reliable detection down to 0.025 mg kg^-1 heptachlor or endosulfan and 0.1 mg kg^-1 DDT in the commodities. Acetonitrile extracts of milk could also be analysed directly for DDT. In contrast, extracts of low moisture, non-fatty (rice) and fatty (cottonseed) food commodities interfered appreciably with the assays, reducing assay colour and detection sensitivity. Some simple cleanup methods were developed to remove interference and enable detection of spiked organochlorines in these foods. Extracts of coloured foods, such as tea, coffee and spinach caused similarly major interference in the assays, and a number of simple clean-up methods were ineffective in removing interference. However, use of an immunoaffinity chromatography method for cyclodienes enabled quantitative recoveries to be obtained in extracts of several of these foods when analysed by either ELISA or gas chromatography. Direct analysis was suited for screening purposes but immunoaffinity chromatography results were more quantitative. These results indicate that ELISAs can be applied under developing country conditions to a range of diverse foods, but that cleanup strategies need to be tailored to different types of foods.     

In vitro leishmanicidal activity of 3-substituted isocoumarins: synthesis and structure activity relationship

Twenty-five 3-substituted isocoumarins were synthesized using cutting edge microwave-assisted technology in high yields. The syntheses of different isocoumarins were carried out in a single step by the direct condensation of homophthalic acid with aryol and acyl chlorides under the solvent-free conditions without any solid support. The structures of all the synthesized compounds were characterized using different spectroscopic techniques including UV, IR, (1)HNMR and EIMS and purity was confirmed by CHN analysis. All the synthesized compounds were tested for in vitro leishmanicidal activity. Compounds 3a, 3b, 3g, 3l, 3m, 3r, 3t, 3w, 3x, and 3y displayed potential in vitro leishmanicidal activity with IC(50) values in the range of 0.56-84.38 microg/ml, whereas standard inhibitors amphotericine B have IC(50) = 0.24 microg/ml. The compounds 3b, 3g, 3m, 3t, 3w, 3x, and 3y having IC(50) values 27.86, 28.88, 36.49, 34.37, 28.68, 0.89 and 0.56 microg/ml, respectively, were most active among the present series while remaining others were found less active. The compound 3x and 3y can act as potential lead molecules for further development of isocoumarin-based new drugs for the treatment of leishmaniasis.     

Clarification of the Innervation of the Bladder,External Urethral Sphincter and Clitoris: A Neuronal Tracing Study in Female Mongrel Hound Dogs

Many studies examining the innervation of genitourinary structures focus on either afferent or efferent inputs, or on only one structure of the system. We aimed to clarify innervation of the bladder, external urethral sphincter (EUS) and clitoris. Retrograde dyes were injected into each end organ in female dogs. Spinal cord, mid‐bladder, and spinal, caudal mesenteric, sympathetic trunk and pelvic plexus ganglia were examined for retrograde dye‐labeled neurons. Neurons retrogradely labeled from the bladder were found primarily in L7‐S2 spinal ganglia, spinal cord lateral zona intermedia at S1‐S3 levels, caudal mesenteric ganglia, T11‐L2 and L6‐S2 sympathetic trunk ganglia, and pelvic plexus ganglia. The mid‐bladder wall contained many intramural ganglia neurons labeled anterogradely from the pelvic nerve, and intramural ganglia retrogradely labeled from dye labeling sites surrounding ureteral orifices. Neurons retrogradely labeled from the clitoris were found only in L7 and S1 spinal ganglia, L7‐S3 spinal cord lateral zona intermedia, and S1 sympathetic trunk ganglia, and caudal mesenteric ganglia. Neurons retrogradely labeled from the EUS were found in primarily at S1 and S2 spinal ganglia, spinal cord lamina IX at S1‐S3, caudal mesenteric ganglia, and S1‐S2 sympathetic trunk ganglia. Thus, direct inputs from the spinal cord to each end organ were identified, as well as multisynaptic circuits involving several ganglia, including intramural ganglia in the bladder wall. Knowledge of this complex circuitry of afferent and efferent inputs to genitourinary structures is necessary to understand and treat genitourinary dysfunction. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc.     

Aggressive pilomatrixoma

We report a case of aggressive pilomatrixoma (PMX) in a 25‐year‐old male who presented with swelling in left supraclavicular region of 2‐month duration. A diagnosis of small round cell tumor was suggested on fine‐needle aspiration cytology. He underwent wide excision of the mass. On histomorphological examination, a diagnosis of aggressive PMX was made. The swelling recurred after 3 months of complete resection and on examination had similar morphological features. The case is presented because of the potential diagnostic difficulties on cytological examination and rare occurrence of aggressive variant of PMX. Diagn. Cytopathol. 2014;42:906–911. © 2014 Wiley Periodicals, Inc.     

The N-terminal region containing the zinc finger domain of tobacco streak virus coat protein is essential for the formation of virus-like particles

Tobacco streak virus (TSV), a member of the genus Ilarvirus (family Bromoviridae), has a tripartite genome and forms quasi-isometric virions. All three viral capsids, encapsidating RNA 1, RNA 2 or RNA 3 and subgenomic RNA 4, are constituted of a single species of coat protein (CP). Formation of virus-like particles (VLPs) could be observed when the TSV CP gene was cloned and the recombinant CP (rCP) was expressed in E. coli. TSV VLPs were found to be stabilized by Zn²⁺ ions and could be disassembled in the presence of 500 mM CaCl_2. Mutational analysis corroborated previous studies that showed that an N-terminal arginine-rich motif was crucial for RNA binding; however, the results presented here demonstrate that the presence of RNA is not a prerequisite for assembly of TSV VLPs. Instead, the N-terminal region containing the zinc finger domain preceding the arginine-rich motif is essential for assembly of these VLPs.     

Diabetes mellitus in Asian Indian children and adolescents

AIM: To study the clinical and metabolic profile of type 1 and type 2 diabetes mellitus in children and adolescents in a South Asian population. RESEARCH DESIGN AND METHODS: Sixty children were recruited. They were divided into three groups: Group I--type 2 diabetes mellitus (DM2), Group II--type 1 diabetes mellitus (DM1), and Group III--healthy controls. The clinical history and biochemical parameters (HbA1c, serum insulin, C-peptide, triglycerides, total cholesterol and HDL-cholesterol) were recorded. Homeostasis model assessment for insulin resistance (HOMAIR) and quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS AND CONCLUSIONS: Children and adolescents with DM2 had a significant family history of DM and clinical features of insulin resistance, including increased body mass index, waist:hip ratio and acanthosis nigricans. They also had decreased insulin sensitivity together with dyslipidemia of metabolic syndrome, i.e. high triglyceride, high total cholesterol and low HDL-cholesterol. The presence of these predictors of cardiovascular disorders is known to contribute to morbidity and mortality. Hence, DM2 needs to be recognized early in Asian Indian children.