Changes in the parotid salivary gland of beta-thalassemia patients due to hemosiderin deposits

2 patients afflicted with beta-thalassemia major presented with pain and swelling of the parotid salivary gland. In 1 patient, the symptoms were of long standing and particularly severe, with diminished and highly viscous salivation. In the other patient, the parotid glands had only recently become painful, while salivary output and quality remained normal. The parotid anatomy in both patients, as demonstrated by sialography, and the clearance of opaque material were normal. Tc99 scintigraphy revealed reduced uptake and rapid clearance of the isotope from the parotid serous glands into the oral cavity, in contrast to the increased uptake by the sublingual mucous glands. Iron deposits were demonstrated in the parotid secretory serous cells. It is postulated that the impaired function of the parotid is linked to iron deposits in the serous cells of this gland, as a sequella of beta-thalassemia.     

Small intestine transit time and lactose absorption during phototherapy

Diarrhea is often seen during phototherapy in jaundiced infants. Lactose malabsorption and reduced gut transit time (GTT) are some of the proposed explanations. However, the etiology of the diarrhea is still controversial. We investigated GTT and lactose absorption during phototherapy using the H2 breath test. Breath H2 was measured every 10 min for 150 min after feeding of jaundiced infants with and without phototherapy, and in controls. There were 12 newborns in each group. The time of increase of H2 excretion over 10 ppm was taken as the transit time. Lactose malabsorption was estimated by integrating the area under the excess H2 curve. No difference was found in GTT, lactose absorption, peak breath H2 and the time of the peak between phototherapy-treated infants and jaundiced and nonjaundiced infants. The results did not support the presence of lactose malabsorption during phototherapy and the decreased total GTT reported in the literature was not due to shortened small intestinal transit time.     

A link between perceptual learning, adaptation and sleep

Between-sessions gains in the texture discrimination task have been attributed to memory consolidation. A strong dependence of consolidation on sleep was suggested though not always supported by experimental results. Here we suggest that the interaction between consolidation and sleep depends on the adaptation level obtained during the training session. We find that both discrimination thresholds and learning depend on the number of trials used during training, with more trials producing higher discrimination thresholds due to suppressive processes related to adaptation. In addition, while learning benefits from increasing number of trials, a further increase in number of trials reduces learning. Consolidation may benefit from between-session sleep in the adapted states.     

Integron-mediated ESBL resistance in rare serotypes of Escherichia coli causing infections in an elderly population of Israel

OBJECTIVES: To identify and characterize the aetiology of an outbreak of extra-intestinal multidrug-resistant Escherichia coli infections in elderly patients in Israel. METHODS: Extended-spectrum beta-lactamase (ESBL)-producing clinical isolates of E. coli from extra-intestinal sources were tested for susceptibility to non-beta-lactam drugs, and their serotypes were determined. Restriction enzyme digestion, followed by PFGE of DNA purified from isolates, was used to classify the phylogenetic relationship between them. Plasmid DNA from five isolates of different serotypes was used to transform an E. coli laboratory strain. The plasmids were partially sequenced. RESULTS: E. coli isolates from 86 patients, mostly elderly, were shown to be positive for inhibitor-susceptible ESBLs, and more resistant to cefotaxime than to ceftazidime. Ninety-six per cent of ESBL producers were also resistant to gentamicin, and 100% to trimethoprim/sulfamethoxazole and ciprofloxacin. All isolates belonged to one of five serotypes. PFGE analysis of purified DNA yielded 17 profiles. Sequencing of plasmids isolated from the transformants identified sul1, aac(6')-Ib and bla(CTX-M-2). These genes were embedded in an integron, InS21. CONCLUSIONS: Extra-intestinal infections with ESBL-producing E. coli of different serotypes and probably mixed clonality showed a surprising homogeneity in resistance profiles, with 100% being co-resistant to ciprofloxacin and trimethoprim/sulfamethoxazole, and 96% to gentamicin. Plasmid DNA from three isolates from different serotypes contained integron InS21, previously demonstrated in Salmonella enterica from Argentina. This is the first molecular identification of an ESBL gene and integron in Israel or neighbouring geographical areas.     

Arthrocentesis--incentives for using this minimally invasive approach for temporomandibular disorders

TMJ arthrocentesis is a nonarthroscopic lavage performed through two needles that are introduced into the upper compartment of the joint. Complemented by joint unloading and physiotherapy, this procedure often replaces surgical intervention in the TMJ. The procedure is highly efficient for resolving TMJ disorders caused by adhering forces or friction that are eliminated by lavage, such as intermittent clicking, anchored disc phenomenon, and open lock, and releases approximately 70% of the symptomatic TMJ osteoarthritis. The outcomes are sufficiently effective to prevent further surgical intervention. Arthrocentesis is a valuable diagnostic tool and the aspirated fluid can be used efficiently for diagnosis, therapy, and research of TMJ disorders.     

Noninvasive identification and monitoring of cancer mutations by targeted deep sequencing of plasma DNA

Plasma of cancer patients contains cell-free tumor DNA that carries information on tumor mutations and tumor burden. Individual mutations have been probed using allele-specific assays, but sequencing of entire genes to detect cancer mutations in circulating DNA has not been demonstrated. We developed a method for tagged-amplicon deep sequencing (TAm-Seq) and screened 5995 genomic bases for low-frequency mutations. Using this method, we identified cancer mutations present in circulating DNA at allele frequencies as low as 2%, with sensitivity and specificity of >97%. We identified mutations throughout the tumor suppressor gene TP53 in circulating DNA from 46 plasma samples of advanced ovarian cancer patients. We demonstrated use of TAm-Seq to noninvasively identify the origin of metastatic relapse in a patient with multiple primary tumors. In another case, we identified in plasma an EGFR mutation not found in an initial ovarian biopsy. We further used TAm-Seq to monitor tumor dynamics, and tracked 10 concomitant mutations in plasma of a metastatic breast cancer patient over 16 months. This low-cost, high-throughput method could facilitate analysis of circulating DNA as a noninvasive "liquid biopsy" for personalized cancer genomics.     

Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin.

We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent.